Measuring Prevention and Demand Avoidance in NHS-Commissioned Services
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Prevention sits at the heart of NHS policy. From reducing hospital admissions to stabilising people in the community, commissioners increasingly expect providers to demonstrate how services prevent escalation rather than simply respond to crisis.
However, prevention is often harder to measure than activity. The absence of an event — an admission that didn’t happen, a crisis that was avoided — can feel intangible unless providers use the right approach.
This topic links closely with prevention and early intervention and continuous improvement.
Why prevention outcomes matter to commissioners
Commissioners view prevention as a value-for-money issue. Effective preventative services:
- Reduce pressure on acute settings
- Support system sustainability
- Improve long-term outcomes for people
Providers that can evidence this position themselves as strategic partners.
The challenge of measuring what didn’t happen
Demand avoidance is difficult because it relies on counterfactuals. Commissioners therefore expect providers to:
- Use proxy indicators
- Compare trends over time
- Triangulate data sources
Credibility comes from transparency, not certainty.
Common prevention outcome measures
Depending on service type, measures may include:
- Reduced emergency admissions
- Fewer crisis referrals
- Stabilised risk profiles
- Improved self-management
These should be linked clearly to service interventions.
Using baseline and comparator data
Strong providers establish:
- Baseline demand levels
- Expected escalation pathways
- Post-intervention trends
This allows commissioners to see change over time.
Qualitative evidence and case examples
Prevention outcomes are strengthened by:
- Case studies showing avoided escalation
- Professional judgement narratives
- Service user feedback
This adds context to numerical data.
What commissioners look for
Commissioners value prevention evidence that is:
- Plausible and proportionate
- Linked to system pressures
- Used to inform service design
Over-claiming undermines trust.
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