Prevention toolkit

Tool 5 – Preventable Outcomes Budgeting Tool

The Tool

• The Preventable Outcomes Budgeting Tool builds on the Preventative Budgeting Tool (Tool 4) and provides an approach for organising budget information and tagging against outcomes related to prevention.

Use this to

• Tag an organisational budget against a set of key outcomes
• Mapped spend to associated prevention frameworks, such as drivers of demand and risk/ protective factors

You end up with

• An aggregate estimate showing the total amount of planned preventative spending which has a direct or indirect impact on a set of key outcomes.
• A detailed budget dataset with activities linked to key outcomes.

Who can use this?

• The Preventative Budgeting Tool (which includes outcomes tagging) has been developed to be applicable to any budget, including Scottish Government portfolio areas, public sector organisations, and non-public sector budgets.

How does this tool support prevention thinking?

• Outcomes tagging moves the preventative budget tagging from inputs (“the spend”) to understanding the outcomes that the budget line intends to impact.
• In conjunction with evidence of the impact, it can provide a tool for prioritising spend on key outcomes of interest and support the shifting of activity upstream.

Using the Tool

As set out in Tool 4, the Preventative Budgeting Tool walks users through a process of breaking down their spending data, organising this in a clear format and then tagging this in line with a clear definition of preventative spend.

Within the preventative spend tool, there is also an outcomes tagging tab, which can be used to link spend to outcomes. This is shown in Step 3 in Figure 10. Note you will have to do Step 1 and 2 (organising the data and the preventative budget tagging) as part of this approach, which was covered in the previous Tool (Tool 4). If you are looking solely at outcomes (not prevention), you could also use the framework for “outcomes based” budgeting and bypass step 2.

More details on outcomes mapping through the Preventative Budgeting Tool can be found here.

Figure 10 – Preventative Budgeting Process

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 aggregate estimates for planned preventative spend interrogate results and interactions with "other" spend.

Step 1 and 2 – Organise budget data and prevention tagging

The first two steps in our process are to organise the budget data available to support the tagging process, and then to use the prevention classifications to tag the planned spend as preventative or not.

This process is the same whether you are doing this for prevention-based analysis or broader outcomes-based analysis. However, if you are doing a solely outcomes-based budget (not prevention focussed) then you can skip step 2.

For more information on these steps see Tool 4 above.

Step 3 – Tag outcomes

The Preventative Budgeting Tool allows users to tag planned spend against a range of high level outcomes, that are linked to Scotland’s National Outcomes. The outcomes that users can tag spend against are set out in Figure 11.

These outcomes have been designed to be high level enough to be manageable for users, while also allowing analysis across a number of domains. The level of aggregation also helps with mapping against other prevention frameworks, such as drivers of demand, risk and protective factors, and Marmot principles (some background on these frameworks is set out in Tool 2 on Driver Mapping).

Figure 11 – 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

The Tool allows users can also tag both the "main outcome" targeted by the budgeted spend and any "secondary outcomes” impacted. It is assumed that an activity 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 X may impact “Healthy children” as a main outcome, have a positive impact on “Healthy adults” as a secondary outcome, and a negative impact on “environmental sustainability” as a secondary outcome.

If the user is unsure of the impact, then this should be left as “neutral” and explored further as the analysis is developed.

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 Tool. The evidence scale used is set out in Figure 12.

Figure 12 - Outcome Evidence Scores in Preventative Budgeting Tool

Evidence score: 0 - No evidence

Definition:

No documented evidence of effectiveness or outcomes

Examples:

• No logic model or theory of change
• No monitoring of outputs or outcomes beyond spend

Evidence score: 1 - Descriptive/ monitoring evidence

Definition: Evidence shows what is delivered, not what difference it makes

Examples:

• Logic model
• Activity and output data (e.g. number of people served, sessions delivered)
• Qualitative feedback without structure (e.g. anecdotal information)

Evidence score: 2 - Outcome evidence

Definition: Clear outcomes are measured but causality is not established

Examples:

• Time series analysis
• Key performance indicators and outcome measures linked to a logic model
• Benchmarking

Evidence score: 3 - Robust evaluation/ appraisal

Definition: Evidence demonstrates attribution and value for money

Examples:

• Economic appraisal (cost benefit analysis, cost effectiveness analysis)
• Robust/ quality evaluation evidence
• Statistical methods to establish causal links, e.g. randomised control trials

Step 4 – Results and Narrative

Once the tagging has been completed, you will able to produce an overarching estimate of the proportion of the budget that is tagged as impacting a main outcome and any secondary outcomes. Two sets of results are generated:

• "Prevention outcomes" - provides aggregate results showing the amount of budgeted spend tagged against key prevention frameworks (e.g. risk/protective factors, drivers of demand and Marmot Profiles). This provides results for spend tagged as preventative only (e.g. excludes other types of activity such as acute/ responsive/ treatment activity).
• "Broader outcomes" - provides aggregate results showing the outcomes tagged against all budgeted spend (preventative and other spend) on wider outcomes. This can be used for example to explore broader analysis of “outcomes-based” budgets.

Some key considerations when presenting results and developing narratives around spending

• Be clear on pros and cons of the tagging approach – Like preventative spend tagging, it is important to be clear that this is a budget tagging approach, which has the advantage of being able to classify and segment budgets around outcomes 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 – if you are using the outcomes-tagging approach for preventative spending, you should consider both preventative and non-preventative activity that may be focussed on a particular outcome. For example, “healthy children” as an outcome involves a range of preventative, acute and other spend that contribute to the broad outcome.
• Bring in multiple perspectives - As you go through the tagging, you should bring in perspectives of those involved in policy and delivery, particularly if the tagging is being led by finance or analysts who may have limited knowledge of the activities being tagged.
• Build in plans to tag impact against outcomes - Finally, the tagging of planned preventative spending and outcomes is the first step in developing an understanding of preventative activity. The next step is to understand the impact of that spend (what impact that spend actually has on outcomes). The Preventative Budgeting Tool will be expanded to consider impact measures in future. Furthermore, Tool 6 and Tool 7 in this Toolkit outline how you can quantify the benefits of prevention (Tools 6 and 7) to support assessment of impact.

Where to find more information/ support

More information is provided in the Prevention Unit Preventative Budgeting Tool and Guidance.

The Prevention Unit have also published a Preventative Budgeting Pilot report which applied the tool to a range of Scottish Government portfolios covering around 40% of the Scottish 2025/26 Budget. Further work is planned to develop a Budget-wide estimate of spend to be reported annually.

Other Resources

• Public Service Reform Strategy - The Public Service Reform Strategy sets out Scottish Government commitments on “developing a system of preventative spend”.
• For further information on the outcomes frameworks referenced in the Preventative Budgeting Tool:
  • National Performance Framework - For the latest information on Scotland’s National Performance Framework, including draft proposed National Outcomes (still in development), see the letter to Parliament provided by the Scottish Government on 16 February 2026.
  • Marmot Principles – The Marmot Principles are often used to consider the underlying drivers of health and wellbeing. An example of this is the Marmot Principles used in health.
  • Drivers of demand – this is the language used in the Public Service Reform Strategy to describe a set of drivers of public service demand and outcomes.

Quantifying the Return on Investment of Preventative Activity

One of the most common challenges with implementing prevention is that the benefits of intervention can be diffuse, and difficult to quantify.

To address this, there are a number of tools available for quantifying the costs and benefits of prevention for public services and for wider economy and society.

We term these tools as “return on investment” tools, which encompass general tools for understanding costs and benefits, but applied to preventative interventions.