There is a growing emphasis on prevention to reconcile demographic pressures, resource scarcity and expectations of better quality care and support. The Care Act 2014 placed a statutory duty on English local authorities to prevent and delay the development of needs for care and support. However, evidence suggests that the prevention approach has secured less impact than intended. Given that existing approaches have achieved such limited results, new ways of addressing this apparently intractable challenge should be considered. We argue here that theory-based models that support the understanding of, and responses to, implementation barriers and facilitators can provide tools to support the development of more successful implementation. Drawing on in-depth interviews (n = 20) in selected English councils and analyses of their policy documents, we explore the ‘Ready, Willing and Able’ (RWA) model, which posits that those three preconditions must be satisfied before new practices can be implemented sustainably. We argue that RWA can provide a straightforward and parsimonious framework for identifying implementation barriers and facilitators. Using the model to identify potential bottlenecks prior to the implementation can help local actors clarify baseline barriers to progress. RWA could help to inform opportunities to target identified problems, by reinforcing facilitators and moderating barriers.

中文翻译：

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准备好、愿意并且有能力了吗？英国当地对在社会关怀中实施预防的看法

人们越来越重视预防，以协调人口压力、资源稀缺和对更高质量护理和支持的期望。 2014 年《护理法》赋予英国地方当局预防和延缓护理和支持需求发展的法定责任。然而，有证据表明，预防方法所产生的影响低于预期。鉴于现有方法取得的成果如此有限，应考虑解决这一显然棘手的挑战的新方法。我们在此认为，支持理解和应对实施障碍和促进因素的基于理论的模型可以提供工具来支持更成功实施的发展。根据对选定的英国议会的深入访谈（n = 20）以及对其政策文件的分析，我们探索了“准备好、愿意和能够”（RWA）模型，该模型假设在新实践可以实施之前必须满足这三个先决条件可持续地实施。我们认为，RWA 可以提供一个简单且简约的框架来识别实施障碍和促进因素。在实施之前使用该模型来识别潜在的瓶颈可以帮助当地参与者明确进展的基线障碍。 RWA 可以通过加强促进因素和缓和障碍，帮助为解决已发现的问题提供机会。