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Leading better together – working with local government Martin Seymour Principal Consultant, Healthy Communities Programme

Dec 29, 2015




  • Leading better together working with local governmentMartin Seymour

    Principal Consultant, Healthy Communities Programme

  • About the Healthy Communities ProgrammeHelping local government to tackle health inequalities and improve the health of their communities

  • Healthy Communities ProgrammePeer support and peer reviewsHealthy Communities benchmarkThe leadership academyKnowledge websiteCommunities of PracticeValuing Health the business caseCommunity engagement and community asset mappingJSNAPartnershipsTotal Place and healthThematic and topical work, eg, coastal and rural health, childhood obesityThe Communities for Health regional networksStrategic planning

  • Social Determinants of HealthDeveloping a broader understanding of the impact that local authorities and their partners can have on heath inequalities

  • Strategic Review of Health Inequalities in England post 2010 Key themesReducing health inequalities is a matter of fairness and social justice inequality is avoidable.Action is needed to tackle the social gradient in health Proportionate universalismAction on health inequalities requires action across all the social determinants of healthReducing health inequalities is vital for the economy cost of inactionA move beyond economic growth to well-being of society: sustainability and the fair distribution of health

  • Marmot review - deliveryTaking a whole system approach nationally, regionally and locally.Empowering people: securing local solutions.Creating the conditions in which people and communities take controlRegional working - NW and London

  • "Public Health is delivered by a workforce most of whom do not have 'health' in their job title."

    Securing Good health for the Whole Population Wanless Feb 2004

  • A history lesson: local councils and health

    C19th building the protective infrastructure and systems of regulation C20th provision of hospitals, health and social care services to meet need C21st helping people to change their behaviours and strengthening the social determinants for good health

  • The context for local governmentPolicy documentsAcheson reportTackling health inequalities: programme for actionChoosing HealthFair Society, Healthy LivesHealth service reviewsWanlessDarziLocal government reviewsLG Act 2000 - Powers of well-beingLG and public involvement in health act 2007Lyons Report 2007 - Place shaping

  • Local performance frameworkLocal Strategic PartnershipsSustainable Community StrategiesLocal Area AgreementsComprehensive Area AssessmentsJoint Strategic Needs Assessments

  • Partnerships for health improvement

  • Evaluating partnershipsProcess issuesEngagement of Senior managers in partnershipReorganisation impactLack of financial and human resourcesInformation sharing and best practiceCoterminosityNeed for quick winsOutcomesHealth outcomesMonitoring and evaluation problemsPerkins et al (2009) What counts is what works? New Labour and partnership in public health. Policy Press

  • Seymour M (2009) Do LSPs provide collaborative advantage for Health Improvement

  • No shared visionDominant partnerTop downProject focussedQuick winsFunding constraintsGrant givingInternal focusIndividual ownershipHealth an NHS issueMedical ModelConfidence in partnersShared identityShared visionJoint ownershipAlignmentJoint postsCitizen engagementAccountabilityHolisticHealth everyone's business.Addressing SDH

    Seymour M (2009) Do LSPs provide collaborative advantage for Health Improvement.

  • Significant challenges to deliveryTraditionally not seen as core business how can Fair Society, Healthy Lives reinforce the view that this is the core business of local government?

    How will Marmot be interpreted?

    Reduced resources impact on public health budgets

    Accountability who is responsible?

    Partnerships dependent on personalities rather than embedded in culture

  • and opportunitiesFinancial constraint never let a good crisis.Total Place - and parallel placesLocalismGeneral power of competence for councils Big Society - put more power and opportunity into peoples hands.

  • Martin Seymour Healthy Communities Programme

    Leading better together working with local government.

    Look at the role of local government at breadth or services they provide or commission and their potential to impact on health and Look at their role as leaders of local partnerships, particularly at the role of LSPs and the opportunities for improving health and wellbeing And to look at some of the challenges and opportunities emerging in these changing times

    Bit of background first Sue has told you about the agency and the programme.The IDeAThe Improvement and Development Agency for Local Government is part of the Local Government Associations family of improvement support for local councils.The LGA is the membership organisation that speaks for the whole local government sector, and it is a politically led organisation, in proportion to electoral strength at council level. The LGA philosophy is one of sector-led improvement and greater self-determination at local level.

    The IDeA is an improvement agency that has developed a range of tried and tested methods for raising standards, including the use of peers, peer reviews and leadership academies. Web 1.0 technologies are used to provide information, guidance and illustrations of good practice, through the "Knowledge" website. Web 2.0 technologies are used to promote discussion and debate in "communities of practice".

    The agency covers a wide range of topics, including community engagement and community cohesion, third sector commissioning, culture, sport and leisure, childrens services and adult social care, planning and housing and the new performance management system of the CAA and LAA. Two important new developments have concerned economic and social resilience, and "Total Place".

    The Healthy Communities Programme (HCP)This in short is what we aim to do.

    The healthy communities programme is commissioned by the DH to build capacity, capability and confidence in local government to improve health of local populations and address health inequalities.

    The programme was designed to make use of the experience of the IDeA and to respond directly to the needs of local councils for support in their health improvement role.

    Deliver through a broad programme of work with Local authorities and their partners.Some of the primary work strands are listed here

    Flag Benchmark self assessment toolJSNA - business case valuing health

    Taken as a whole the programme acts as a bridge between local councils and the public health community in its widest form.

    SDH Programmeraise awareness amongst local government elected members and officers of the social determinants of health and of the role of local government and its key partners in addressing these

    Emphasis on embedding action on health inequalities throughout all aspects of local government work to pinch the phrase from Greenwich to make health everyone's business.The SDH work delivered alongside the work of the Marmot review team, raising awareness of the implications.

    This slide is just to remind ourselves of some of what Mike said this morning on the key themes of the Marmot review and consider the role that local government plays in the delivery against these themes.

    Local government plays a crucial role in the lives of citizens and in shaping the place in which they live. Councils are directly responsible for a broad range of services either through direct delivery, commissioning or contracting. They are large employers, directly and indirectly, and contribute to the economic, social and environmental wellbeing of the area.

    They therefore have a key role to play in improving health through action on the social determinants. Yet for various reasons, and with some notable exceptions Local Authorities have not seen their health enhancing role as uppermost in their thinking or central to their core business. Our programme evaluation, including repeated IPSOS/MORI surveys of leaders and chief executives of Councils shows that this is changing and that there is a growing awareness of the health improvement agenda and understanding of the councils role.

    The role of Local government is recognised in the chapter on delivery (chapter 5) where there are some prominent messages:

    Locally and for local government Taking a whole-system approach means Developing, commissioning and improving good-quality, integrated local services - creating opportunities for individuals and communities to set the agenda for change to define local problems and search out local solutions- Ensuring Appropriate links between organisations to create partnerships to address health inequalities and to shift in power and resources towards local communities.

    There is particular relevance to local government and local strategic partnerships in the regional working the review team has established with the NW and London regions.Local Councils and Health not new - Wanless reminded us of the value of the wider public health workforce.

    Look back at history of LG ands public healthLocal Councils and Health not new - the history lesson Local authorities were reformed in the 19th Century to handle the risks associated with rapid urbanization, and they had an important public health role.

    Local government today not just through the work with adult social care and children's services but also through their influence on spatial planning, transportation, housing, urban regeneration and economic development, they can act on the social determ