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Everyone agrees prevention matters. But few know what they’re actually spending on it.
Across the UK, public services are under pressure. Councils, and many other public bodies, face rising demand, widening inequalities and a funding model skewed towards short-term fixes. There is consensus that without a shift toward prevention, the public services on which we all rely will become increasingly unsustainable.
The real question isn’t whether prevention is important, but whether we’re prepared to risk the consequences of not making that shift.
Two reports from Wales provide both insight and warning. The Future Generations Report 2025 by the Future Generations Commissioner, and Audit Wales’s No Time to Lose, evaluate a decade of progress under the Well-being of Future Generations Act. Their message is unequivocal: while the principles of long-term, joined-up thinking have been widely embraced, these principles have not been structurally embedded in how public services are planned, delivered or financed.
The Commissioner describes current funding practices as a form of “collective self-sabotage”, highlighting cuts to preventative services as reactive demand continues to rise. He calls for long-term funding arrangements, greater protection for prevention budgets and better integration of the Act into core public service functions including financial planning.
Audit Wales echoes these concerns. Its review finds public bodies often lack the tools, capacity and data to map and measure preventative activity. It warns that without a more systematic shift toward prevention, budgets will be exhausted and outcomes will deteriorate.
The Audit Wales report also offers a way forward. One of its national recommendations calls on the Welsh Government to explore options for incentivising and protecting preventative spend. Importantly, it highlights the need to “strengthen the understanding of the levels of investment in prevention”, recommending that the government learn from others beyond Wales, “taking account of work that CIPFA is undertaking on understanding preventative spend”.
That work is already underway. At CIPFA, we are developing a framework for mapping and measuring preventative investment. In partnership with the Health Foundation and a group of local authorities across England, and one in Wales, we’re testing the hypothesis: can preventative spend be identified, classified and tracked in a meaningful and consistent way?
The project looks to build a shared language and method for identifying preventative activity – one that supports local authorities to better understand what they’re already doing, how it’s resourced and how that information can be used in sustainable service planning, budgeting and scrutiny.
By making prevention visible in financial terms, we can begin to shift the conversation from vague aspiration to operational practice. The goal is to equip councils with practical tools to articulate and prioritise their preventative investments in a way that works for their local context.
This work is especially timely as we approach the next UK Spending Review. National policy ambitions around prevention, early intervention, health creation and inequality reduction are well-rehearsed. But they will remain rhetorical unless backed by changes to funding structures and decision-making processes.
The UK government should take the opportunity presented by the Spending Review to begin embedding prevention on a cross-government basis, invest in national and local analytic and finance capacity and support the development of data infrastructure that allows preventative spend to be identified and tracked over time.
Wales offers both inspiration and a reality check. The Well-being of Future Generations Act reframed the conversation, but without the financial knowledge and systems to match, delivery has fallen short. If the government is serious about building a more preventative public sector, it must act now to close the gap between ambition and infrastructure.
Prevention isn’t a promise. It’s a choice. And like all choices in government, it starts with how we spend public money.
To learn more about CIPFA’s work on investing in prevention, contact Zachary Scott (policy researcher, prevention) at [email protected].
This project is part of the Health Foundation’s Healthy Lives programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.
