As the country begins Baroness Casey’s Big Conversation on Care, one question should be at the centre of the debate: “How many people could avoid reaching crisis point in the first place?”
Much of the national conversation about health and care understandably focuses on treatment, hospital pressures and waiting times. But if we are serious about building a sustainable system, prevention has to be treated as part of the solution, not as an optional extra.
At HILS, we see this every day. A fall, poor nutrition, increasing frailty or social isolation can often look like separate issues. In reality, they are closely connected. They are also often missed until someone reaches crisis point.
In 2025-26, HILS carried out more than 2 million interventions to help people stay well, safe and independent at home. These included hot meals and wellbeing checks through our Meals on Wheels service, nutrition support for people at risk of malnutrition, strength and balance support to help prevent falls and frailty, advocacy, and community activities to reduce isolation.
Many of these moments are simple: a meal at the door, a wellbeing check, practical advice, reassurance, or help to speak up. Individually, they may seem small. Collectively, they are opportunities to identify concerns earlier and prevent needs from escalating.
Prevention rarely makes headlines. Nobody writes a news story about the hospital admission that did not happen, the fall that was avoided, or the older person who remained independent because the right support arrived at the right time. But those outcomes matter.
As the Big Conversation on Care continues, prevention deserves a place alongside treatment, recovery, and reform. If we want a sustainable health and care system for the future, it can not remain on the sidelines.
The Casey Commission’s Big Conversation on Care is now open, inviting people across England to help shape the future of adult social care: https://lnkd.in/eCZQK3Qb
