Learning from 25 years of preventative interventions in Scotland

3. Benefits of Preventative Approaches

The case studies within this report begin to demonstrate the value that Scotland has derived from its investment in preventative interventions over the years. Benefits include:

• Improved health outcomes. Many of the interventions included in this report have directly led to measurable improvements in health outcomes. Examples include (amongst others): vaccination programmes such as the Covid-19 vaccines programme which have saved tens of thousands of lives; the National Naloxone Programme (NNP) which was associated with a reduction in opioid-related deaths of between one third and one half in the four weeks following release from prison; the introduction of 20 mph limits in Edinburgh; and improved road markings for motorcyclists which have resulted in large reductions in collisions and casualties.
• Improved economic outcomes. Preventative interventions have also resulted in improved economic outcomes. The latest statistics show that Fair Start Scotland (Scotland’s first fully devolved employability service) has supported over 26,000 people into employment since its introduction in 2018. The Scottish Child Payment (SCP) is projected to reduce the relative child poverty rate by four percentage points, keeping 40,000 children out of relative poverty and reducing debt amongst low income families.
• Improved longer term outcomes. A number of the case studies have begun to demonstrate progress in improving longer term outcomes. An example of this is the Family Nurse Partnership (FNP) which is starting to evidence improvements in outcomes amongst participants on the programme over time. Demonstrating longer term impact takes time but evidence from the United States (US) where FNP has been delivered and evaluated over a much longer timeframe shows evidence that the programme has resulted in improvements in mental health, fewer interactions with the justice system and reductions in use of welfare and other Government assistance.
• Reduced Inequalities. Many of the preventative interventions introduced in Scotland have been successful at reducing inequalities. Examples include; Minimum Unit Pricing of alcohol (MUP) which has had a positive impact on health outcomes, particularly for men and those living in the most deprived areas, contributing to tackling alcohol related health inequalities; and Breastfeeding Friendly North Lanarkshire, a recent local initiative that has helped to increase breastfeeding rates in the most deprived areas from 16% to 26% after 6-8 weeks, improving infant and maternal health.
• Progress in addressing complex social problems. Several of the preventative interventions included as case studies in this report have demonstrated progress in addressing complex social problems. Scotland’s HFP Programme which ran from 2019 to 2022 was successful in providing sustainable housing solutions for homeless people with complex needs. The Caledonian System effectively took a ‘whole systems’ approach to address domestic abuse, improving the safety of women and children.
• Cost savings and reduced demand on public services. Evidence from the case studies suggests that preventative interventions have resulted in cost savings and reduced demand on public services. For example, it has been estimated that smokefree legislation in Scotland will result in a net present value of £4.6bn over a 30 year timeframe. The internationally recognised Childsmile programme has led to large improvements in children’s oral health and cost benefit analysis found that by the eighth year of the toothbrushing programme the expected savings were more than two and a half times the costs of the programme implementation.