Preventative Budgeting Tool – Guidance

Introduction

This document provides guidance on how to use the Preventative Budgeting Tool, which has been developed by the Scottish Government Prevention Unit, in collaboration with public sector partners, to support the identification of planned preventative spend in public sector budget allocations.

What is the Preventative Budgeting Tool?

The Preventative Budgeting Tool is an excel-based tool, which supports users to analyse planned spending within their budget, how much of this spend could be tagged as preventative, how this compares to other types of spend (e.g. acute/ responsive/ treatment), and how this could impact on outcomes.^[1]

The tool walks users through a process for:

• Organising budget data into a consistent format.
• Tagging budget allocations in line with a classification of prevention, to understand whether the planned spend is preventative (or something else) and what “level” of prevention it is.
• Tagging the planned spend (both preventative spend and other spending) against a range of outcomes, linked to Scotland’s National Outcomes.

The tool draws on an established methodology first developed by the Chartered Institute for Finance and Accounting^[2], adapted to the Scottish context.

Who can use the Preventative Budgeting Tool?

The Preventative Budgeting Tool has been developed to be applicable to any budget, including Scottish Government portfolio areas, public sector organisations (e.g. health boards and local authorities), and non-public sector budgets (e.g. voluntary organisations).

Given this tool has been developed predominantly to support budget setting and future spending plans, e.g. as part of the development of the Scottish Budget each year, we have called it the “Preventative Budgeting Tool”. This language is distinct from a tool focussed on “preventative spend”, which looks backwards to track what has actually been spent. As a result, this guidance uses terms such as “budgeted spend”, “planned spend” or “budget allocations”. However, this tool can also be used to look at past spend – i.e. it can be used as a tool for analysing “preventative spend”.

Why has this tool been developed?

The Preventative Budgeting Tool has been developed by the Scottish Government Prevention Unit to support identification and classification of planned preventative spend within budgets across the public sector and beyond. In doing this, it allows for the baselining and tracking of preventative spend budget metrics, backed up by a detailed assessment of what budget lines are considered preventative vs other types of planned spend.

This Tool provides the first step in supporting national and local decision makers to identify planned preventative spend. The tool can, in conjunction with other evidence on the impact of planned spend on preventable outcomes, support action to prioritise high-impact interventions. It can support policymakers to consider how budgeted spend could be moved “upstream” to improve outcomes and reduce future public service demand for public services in Scotland.

The tool delivers directly on a commitment in Scotland’s Public Service Reform Strategy, to “re-design our approach to identifying, tracking and monitoring planned preventative spend and set out how this will be utilised in future Budget processes” ^[3]. It also supports other key strategic documents, such as the Population Health Framework^[4] and Fiscal Sustainability Delivery Plan^[5].

How will this tool support national and local decision making?

The Tool is being used at a national level to develop aggregate estimates of planned preventative spend across the whole Scottish Budget, as well as supporting local analysis of budgets:

• At national level, the Tool is being used to systematically analyse planned preventative spend across the Scottish Budget by Summer 2026, with a view to embedding this system of tracking prevention into ongoing annual budgeting by December 2026. This includes working across Scottish Government portfolios and public sector organisations to analyse what proportion of allocated budgets can be defined as preventative, with a view to developing broad aggregate estimates across the Scottish Budget. This aims to support Ministers and policy makers to identify and prioritise prevention and upstream investment in strategy, budgeting and delivery.
• At local level (e.g. within a portfolio, health board, local authority or other organisation), the tool provides detailed analysis of planned preventative spend across a budget, which can be used to support local analysis of preventative investment. The tool will also help illustrate the links between planned preventative spend across portfolios/ organisations for a particular outcome (e.g. poverty/ inequality). This could help coordinate and join up work across the public sector to more effectively tackle key outcomes.

The Prevention Unit tested the Preventative Budgeting Tool through a pilot programme involving 7 Scottish Government Portfolios and 9 Health Boards, focussing on tagging prevention against the 2025/26 Budget allocations.^[6] This covered around 40% of total Scottish Budget by value. The wider roll out of the pilot programme across the full Scottish Budget 2025/26 is planned for Autumn 2026, alongside estimates for 2026/27 and 2027/28 by the end of 2026.

The Prevention Unit are also exploring additional metrics that could be added to future versions of the tool to more fully cover the impact of planned preventative spend. This could include standard metrics such as the impact of activity, evidence or timescales, or metrics more closely reflecting elements of the Public Service Reform Strategy of interest, such as moving prevention closer to community, working across multiple partners, and co-design of services.

Principles guiding our approach

The Preventative Budgeting Tool and Guidance has been developed to provide as methodical and robust a process as possible for identifying planned preventative spend within budgets. This is balanced against practicality and proportionality so that this approach can be easy to use and applied widely without significant resource requirements.

This guidance has been developed in line with a set of principles (Figure 1). These principles run through how we have defined prevention, what we are seeking to measure, what level of budget information and resource is required, and how results from this exercise should be used.

Figure 1 – Preventative Budgeting Tool key principles

A method for preventative budgeting should be like:

Easy to use - Based on a clear definition of prevention, and a structured approach to applying these definitions to any activity quickly.

Proportionate - Built on existing budget data and reporting and use a level of aggregation that balances detail with resource available to users.

Practical - Focussed on the key types of preventative activity we want to encourage as a government.

Realistic - Clear about what the results can and can’t be used for. This project aims to produce usable analysis, but assessments are partly subjective and non-auditable.

In line with the principles set out above, this approach has been designed to provide a “top down” assessment of planned preventative spend within a budget. This type of approach involves applying a standardised set of categories to budget lines to track and monitor shifts in budget allocations over time. This allows for a tagging approach to be applied at a high level to budget lines in a proportionate way, even though much of the spend is allocated to other organisations, and not spent by Government directly. Following the “top down” approach means the tagging exercise can reach across large budgets relatively quickly. This contrasts to a “bottom up” approach, which focusses on a detailed mapping of services to classify activities and matching this to actual spend on those activities. This is more appropriate to ‘front-line’ organisations where services/activities are delivered. The original preventative investment guidance developed by CIPFA focusses on a “bottom up” approach.^[7]

The guidance also acknowledges that there is some subjectivity present with the approach, and provides strategies for making subjective assessments about planned preventative spend.

Alignment with other Tools

This work is closely aligned with similar guidance published by the Chartered Institute for Public Finance and Accounting (CIPFA)^[8]. While these tools are consistent, there are some differences between the two approaches.

In particular, the Prevention Unit guidance focusses on a “top down” approach to tagging budget allocations, working from the published Scottish Budget data, and using more detailed budget data where available. The CIPFA methodology provides a method for “bottom up” mapping of services at a local level, and tagging spend closer to front line delivery of the activity.

There are also some minor differences between the classifications used in each exercise (for example, this guidance includes a category for “acute/ responsive/ treatment” spend, whereas the CIPFA guidance includes this in a wider “not preventative” category). However, these different classifications can be easily mapped to each other.

Guidance

Overview of the Preventative Budgeting Tool

The Preventative Budgeting Tool provides a simple structured process for identifying and tracking planned preventative spend within budgets and understanding the link between this spend and outcomes.

It does this by supporting users to organise budget data in a consistent format, and then to "tag" budget allocations according to a classification of planned preventative spend and outcomes. This can be viewed as a four-step process (Figure 2).

Step 1 - Organise budget data:

Identify budget data to be used in tagging Organise this into a consistent format for tagging process

Step 2 - Preventative budget tagging:

Follow structured process for classifying each budget line by "spend category" (preventative or other) and "level of prevention"

Step 3 - Outcomes tagging:

Assess impact of activity on outcomes Score evidence underpinning outcomes tagging

Step 4 - Results:

Generate estimates for planned preventative spend Consider the implications of the results and explore interactions with "other" spend.

Step 1 (Organise budget data): the process allows users to organise their budget data into a standard format, which makes it easier to assess planned preventative spend and outcomes later in the process. This includes all budgeted spend, whether considered preventative or not.

Step 2(Preventative budget tagging): walks users through a structured process for tagging budgets in line with a “spend category” (e.g. whether the planned spend is preventative vs acute/ responsive/ treatment) and “level of prevention” (e.g. primary, secondary, tertiary prevention). This is based on an understanding of the “primary purpose” and “target population” of the budget line, which provides a guide to whether the budget line is preventative and at what level. The definitions for these concepts are provided later in this guidance.

Step 3 (Outcomes tagging): allows users to assess whether a budget line has a positive, neutral or negative impact on a set of outcomes. This supports understanding of how much planned spend is targeting a particular outcome. This is also mapped to a range of other frameworks of interest in prevention policy, such as "risk and protective" factors, "drivers of demand" for public services (as mentioned in the Public Service Reform Strategy)^[9], or "Marmot Principles" (used in Scotland's Population Health Framework)^[10]. The outcomes are also mapped more widely to Scotland’s draft National Outcomes^[11]. The tool allows users to score the evidence available on the impacts of the activity on different outcomes.

Step 4 (Results) - Once the budget has been tagged using the preventative budgeting approach, you will able to produce an overarching estimate of the proportion of the budget that is planned preventative spend vs other types of activity, and (if preventative) what level of prevention. We recommend framing results to consider key points such as: being clear on the pros and cons of the tagging approach; considering the implications of both “preventative” and other types of spend; and building in tagging of outcomes and impact beyond the simple tagging approach in the tool.

The excel workbook has been designed to focus on a particular year, however this approach can be replicated and the results combined to produce results over time.

Step 1 – Organise Budget Data

The first step in our process is to identify the budget data we are looking to classify, and organise this into a format to allow each activity to be assessed in line with our prevention classification.

The budget information used should reflect how your organisation organises and records budgeted spend, and can include as many tiers/ levels of aggregation as is useful. Following similar guidance by CIPFA^[12], we find a simple three-tier structure works well in most contexts:

• Tier 1: Department or Directorate - for example: the "Education and Skills" portfolio in Scottish Government; "Frontline Healthcare Delivery" in a Health Board, or "Culture, Leisure and Wellbeing" in a Local Authority.
• Tier 2: General service or activity area - for example "Whole Family Wellbeing Fund", "Mental Health Services", or "Culture and Sport".
• Tier 3: Specific disaggregated service - for example "Family Group Decision Making", "Improving Access to Psychological Therapies", or "Libraries".

This structure can be adapted to fit your organisation’s budget structure. In cases where users are looking to tag very detailed budget data then additional tiers could be added, or “tier 3” could be expanded to be more specific (e.g. "Libraries" could become "Libraries - community outreach").

The key point in organising the data is to ensure that each budget line is described at a level that is meaningful and allows for as clear a classification as possible later in the process.

Ideally, the budget information identified should:

• Focus on specific programmes and interventions – i.e. it should focus on policies, programmes, investments (where possible) rather than breaking down into service information (e.g. staff costs, operational costs, etc). It is generally easier to understand the objective of an activity rather than staff costs (which can address multiple activities). However, strategies for tackling items such as “staff costs” are provided in this guidance (see “apportionment”).
• Balance detail and proportionality - when selecting the budget data, it is important to consider time and resource available to the user. Tagging a budget on 1000 lines would provide granular analysis, but also require a higher level of resource. In contrast, a reasonably rounded picture may be possible in 100 lines, which are more aggregate but less time consuming to tag. In line with our principle of “proportionality”, we recommend users start with a level of aggregation that provides sufficient detail and can be completed within a defined period (e.g. 2-3 days). More detailed assessments or further analysis could then be completed subsequently to continuously improve the approach.
• Be regularly recorded - Ideally this information will be regularly recorded or collected every year. This will make it easier to update any assessments in future, particularly if spend categories remain the same year on year (assessments can be rolled over).

Step 2 – Preventative Budget Tagging

Once the budget data has been identified and organised, the next step is to tag the budget lines in line with the Preventative Budget Classification used in this guidance.

The Preventative Budgeting Tool includes a “Prevention Tagging” tab, which walks users through the structured process for classifying each budget line by “spend category” (e.g. preventative vs acute/ responsive/ treatment) and “level of prevention” (e.g. primary, secondary and tertiary prevention).

To support the consistent classification of budgeted preventative spend, users should consider two things – the target population of a policy and the primary purpose.

• Population group targeted - The target population described is the specific group of people supported by the activity. This could be a particular group defined by their age (e.g. 0-18 year olds) socio-economic status (e.g. children in poverty, adults in long term inactivity), health or care needs (adults with complex care needs) or working/living context (frontline staff, residents in temporary accommodation).
• Primary purpose of the spend - typically prevention aims to stop a problem from happening, escalating, or getting worse as its primary purpose. For example a vaccine aims to stop disease. Whereas, the main purpose of hospital care is often to respond to a health problem. We suggest an approach outlined by CIPFA, where a primary purpose statement typically follows a pattern – planned spend X supports [target population] by [specific activity] to [intended purpose].^[13]

The target population and primary purpose should support assessment of what spend category the budget line can be allocated to and, if preventative, what the level of prevention is. Note for some areas, such as environmental activities, there may not be a defined population group, given they are targeting the natural environment or a place. In these cases, we recommend focussing solely on primary purpose.

A note on the intent of an activity vs evidence of impact: Our classification is based on the intent of a policy – e.g. the intention of a vaccine is to prevent people becoming sick. Given evaluation evidence isn’t available on all activity in practice to understand the impact on outcomes (particularly for a new activity), it is not feasible to have a broad system for preventative budgeting that is evaluation-based. This makes the indicator partly subjective, but allows it to reach across the full budget and simplifies the classification. Outcomes and evidence are considered in step 3, and should highlight where further development of the evidence based underpinning spending should be pursued.

Identifying the spend category

Using the target population and primary purpose of the spend, users have four options for classifying what “spend category” the spend is (Figure 3).

We recommend tagging each spend in line with the closest applicable spend category. However, if you wish to apportion any larger spending lines, see the guidance on apportionment later in this paper.

To support the classification of different spend categories, Figure 4 provides some general guidance and examples to how the primary purpose and target population can be used to indicate what spend category the spend is. A more detailed set of examples is provided in Annex A.

Identifying the level of prevention

In addition to defining whether an budget line is “preventative” or not, the Scottish Government also defines different “levels” of prevention activity, largely corresponding to where an activity sits in the formation of a problem (Figure 5).

If a budget line was classified as “preventative” in the previous section, then this must be classified in line with our definitions of the levels. If a budget line was classified as any other category, no further action is required.

We recommend tagging each spend in line with the closest applicable level of prevention. However, if you wish to apportion any larger spending lines, see the guidance on apportionment below.

Figure 6 provides shows how these assessments of target population and main purpose are used to make an assessment of the level of prevention. A more detailed set of examples is provided in Annex A.

Note, the “levels” framework differs slightly from similar guidance developed by CIPFA, who also split “primary” out to include a “primordial category”.^[14] However, this guidance aims to keep a simpler framework by maintaining three levels rather than four. Users can separate out primordial spend from the primary category if preferred (see CIPFA guidance for definition of this category).

Apportionment

It is recommended in Step 1 that users should aim to use budget data at a level of detail which allow lines to be easily classified based on the closest relevant classification. For example, an activity that is majority secondary but could have some minor tertiary elements can be reasonably classified as secondary.

However, for some aggregate lines (particularly for lines with large values), users may wish to split lines out to account for different categories of spend. In these cases, a budget line can be apportioned into different spend categories and levels.

An example of this could be a "mental health staff" budget line that can’t be broken down. The user may estimate that this is around 50% prevention and 50% acute/ responsive/ treatment spending, while the budgeted preventative spend is mostly primary (75%), with the remainder being secondary prevention (25%).

In this case, the user should input each of these proportions under the relevant columns in the “Prevention tagging” tab. This can be done in the excel workbook as follows:

• For the budget line in question, input the proportion to be applied to the spend line for each of the relevant spend category (there is a column for each category). In the example above, this would be 50% in that preventative column and 50% in the acute/ responsive/ treatment column.
• Then, for the planned preventative spend, you should apply the relevant proportions to the columns for the levels of prevention. These proportions will only be applied to planned preventative spend. In this case, this is 75% in the “primary” column and 25% in the “secondary” column.

In line with the “proportionate” principle of the preventative budgeting approach described in this guidance, users can use indicative proportions where information isn’t easily available. For example, users may wish to apportion lines based on “proxy measures”. Taking a hypothetical example, if there is a budget line for police officers, but you want to represent the amount of planned spend on policy community outreach within that line, you could use any other data available (e.g. a breakdown of hours spent on different activities) to come up with a proxy measure for the preventative component of that line.

Any assessments of this type should be documented in the Excel sheet alongside the budget line for transparency, and further consideration should be given to how more robust measurement could be developed in future.

Staff costs and organisational functions

One example where apportionment is likely to be useful is a case in which there is a “staff costs” line. Often staff costs can’t be broken down and account for a large budget line. We suggest taking a proportionate approach to classifying staff costs by apportioning based on whether they are directly attributable to delivering preventative activities or not. For example, in apportioning a “health workforce” line, the user could pursue a rough apportionment based on a mapping of which health professions engage in preventative services (administering vaccines) vs other services (e.g. A&E doctors, finance teams).

This is also true for functions such as human resources or marketing departments. If there are specific activities that can be identified as preventative in these functions, then these could be apportioned as preventative if sufficient justification is provided. For example, a HR training programme that aims to support healthy workplace behaviours. However, it is expected that the vast majority spend in these departments will be “other” spend.

Useful tips

• Importance of step 1 - If Step 1 has been completed (organising budget data), this will make the rest of the exercise much easier. Data that is as defined as possible with a clear purpose will be easier to tag.
• Provide detail - Given there is an element of subjectivity to the prevention assessment, we recommend providing as much information as possible on target population group and main purpose of the policy, as it will help with assessing the levels.
• Seek multiple perspectives – it is useful to bring in multiple perspectives to help test the tagging approach. For example, if the budget is being tagged by a finance team, then involving service or delivery colleagues can help understand more about activities and test any initial tagging.
• Note and come back – where there are difficult examples, it may be useful to do a “quick assessment” or a rough “first pass”, note your thought process, and then come back later once you have classified the rest of the budget lines. Often going through the classification process for other activities can help thinking through, and if not, then working through with others can then be used to come up with an approach to tagging the budget line.

Step 3 – Outcomes of Spend

The “Outcomes” tab in the Preventative Budgeting Tool allows users to record whether the spend has a positive, negative or neutral impact on a range of outcomes. It then provides a structure for thinking through the level of evidence supporting the assessment of the potential impact against outcomes.

The outcomes that users can tag spend against are set out in Figure 7. These outcomes have been designed to be high level enough to be manageable for users, while also providing useful analysis across a number of domains. The level of aggregation also helps with mapping against other frameworks (see mapping section below).

Figure 7 – Key outcomes included in Preventative Budgeting Tool

Outcomes:

• Employment and job quality
• Income inequality and poverty
• Secure and safe housing
• School education
• Participation in training
• Healthy adults
• Healthy children
• Connected societies and places
• Human rights and discrimination
• Justice and security
• Climate change
• Environmental sustainability

This is a subjective exercise, however, we recommend tagging against outcomes where there is a demonstrable and tangible impact to make it useful. Users should use the notes column to capture commentary on the selections they have made for each spend line.

The Tool also allows users to tag both the "main outcome" impacted by the budget line and "secondary outcomes” impacted. It is assumed that a budget line aims to have a positive impact on the main outcome, while it may have a mix of positive or negative impacts on secondary outcomes. For example, “activity A" impacts “Healthy children” as a main outcome, has secondary impacts on “Healthy adults”, “school education” and “Justice and security”, and have a negative secondary impact on the “environmental sustainability”.

If the user is unsure of the impact, then it is recommended that this be left as “neutral” and reviewed with more information.

Evidence scores

The tool also allows users to score the evidence available on the impacts of the budget line on different outcomes. This is contained in the “Outcomes” tab in the excel Tool.

This makes it possible to distinguish between a subjective exercise to consider impacts on outcomes, and a more specific assessment based on the strength of available evidence. For example, we may assess an activity to have a positive impact on 5 outcomes, however there may be strong evidence of impact against two outcomes, with little evidence to support the impact on other three.

The evidence scores used in the tool are set out in Figure 8.

The results tabs in the Excel spreadsheet will illustrate the results from the outcomes tagging and also provide results for impact on outcomes where there is sufficient evidence only (defined as having an evidence score of > 1).

Mapping of outcomes to other frameworks

There are a number of outcome frameworks that are used in analysing prevention in Scotland and in other jurisdictions. There is interest, for example, in how spend aligns with "risk and protective" factors, different "drivers of demand" for public services (as mentioned in the Public Service Reform Strategy)^[15], or "Marmot Principles" (used in Scotland's Population Health Framework)^[16]. The outcomes framework is also mapped against Scotland’s draft National Outcomes as outlined in a letter to Parliament on the 16^th February 2026.^[17] The National Outcomes used in the tool will be revised when the National Outcomes are finalised.

To support analysis against these different frameworks, while avoiding the need to tag against all of these frameworks separately, we provide a mapping of the outcomes mapped above with a set of associated risk/protective factors, drivers of demand, Marmot Principles and National Outcomes. This mapping is provided in Figure 9.

Note these categories have been mapped at a high level, and simplifies the complex links between these different frameworks. This has been done to support high level analysis and reduce burden on users who wish to tag against multiple different frameworks. The Tool also provides flexibility for users to add their own tags, which could include, for example, more specific key risk or protective factors of interest, or a key outcome being targeted.

Interpreting results

Once the user has input the budget data (Step 1), tagged against prevention (Step 2), and against outcomes impacted by budget line (Steps 3 and 4), results will be generated in the "results" tabs.

This includes three sets of results tabs:

• "Prevention" - provides aggregate results for planned preventative spend and level of prevention targeted by spend. This sums all the spend across the different categories within the Tool to provide an overall figure for the organisation, portfolio, department under consideration. This allows users to see, for example, how much of the budgeted spend recorded in the tool is “primary” vs “secondary” prevention. A table is also provided to aggregate results by broad activity area.
• "Prevention outcomes" - provides aggregate results of the impact of planned preventative spend on key risk/protective factors, drivers of demand and Marmot Profiles. This provides results for budgeted preventative spend only (e.g. excludes other forms of activity). The results for main outcome targeted should sum to equal the total amount of budgeted preventative spend recorded in the tool. For secondary outcomes, because multiple outcomes can be selected for each spend, the figures will NOT add up to the total amount of budgeted spend.
• "National outcomes" - provides aggregate results of the impact of all budgeted spend (preventative and other spend) on wider outcomes. The results also split between the main outcome targeted by budgeted spend and secondary outcomes, to allow representation for a wider range of outcomes achieved by an activity. Results including tagging the quality of evidence are also provided.

The user should also consider come key points when presenting results and developing narratives around spending:

• Be clear on pros and cons of the tagging approach – this approach has the advantage of being able to classify and segment budgets in a structured way, but also involves some subjectivity and is only as good as the budget data available to the user.
• Consider the implications of both “preventative” and other types of spend – Typically, a lot of activity has indirect links to prevention, even if it is not in the scope of our prevention category. For example, if activity is categorised as “acute/responsive/ treatment”, the way these services are provided can have an indirect impact on prevention.
• Bring in multiple perspectives - As you go through the tagging you should bring in perspectives of those delivering policy, particularly if being led by finance or analysts.
• Building in tagging of outcomes and impact - Finally, the preventative budget tagging is the first step in developing an understanding of preventative activity. The next step is to understand the outcomes of spend and then build the evidence on what impact that spend actually has. The Prevention Unit developed the Prevention Toolkit, which contains guidance on tools for analysing impact of preventative interventions.^[18]