This report builds on its predecessor Revenue, capital, prevention: a new public spending framework for the future which called for the creation of a new classification of public expenditure, Preventative Departmental Expenditure Limits (PDEL). 

PDEL would sit alongside the existing classifications of expenditure, Capital Departmental Expenditure Limits (CDEL) and Revenue Departmental Expenditure Limits (RDEL). The aim would be to identify expenditure on prevention and ‘ring-fence’ that spending to encourage the ‘shift to prevention’ which many have called for within public spending.

This paper analyses the current constitutional and operational framework for public expenditure and finds that it is possible to integrate PDEL within it. It considers three expenditure areas – health, homelessness and children’s social care – and finds varying levels of maturity in developing taxonomies for prevention. It outlines how implementation of PDEL could work within the inconsistencies and varying levels of maturity within prevention and expand to cover all aspects of prevention over time. 

By differentiating between everyday spending, and preventative spending, the government could measure what really matters.

Key findings

• In health, prevention spending is already measured in the system of health accounts.
• A series of ‘pathfinding’ departments should work with HM Treasury to undertake Preventative Expenditure Audits and pilot the approach.
• PDEL should focus on primary and secondary prevention to reduce the risk of gaming whereby services to meet acute need could be reclassified as prevention.
• PDEL should focus on expenditure that has a principal goal of prevention.
• Each of the cross-government Mission Control Boards should meet together as part of a Preventative Investment Taskforce to coordinate government policy towards prevention.