Agenda item

Report of Liz Gaulton, Director of Public Health and Wellbeing

The Board considered a report of Liz Gaulton, Director of Public Health and Wellbeing, which detailed a stock-take of progress against the 2016 Joint Health and Wellbeing Strategy; summarised the outcomes of a senior partner workshop held in March on the new strategy; and outlined the plan for the development of the new Joint Health and Wellbeing Strategy including the Consultation Plan. Copies of the stocktake of progress at March 2019 and the Consultation Plan were set out at appendices to the report.

The report indicated that the current Health and Wellbeing Strategy covered the period 2016-19 and work was underway to produce a revised Strategy for approval and publication in autumn 2019.

The existing Health and Wellbeing Strategy 2016-19 identified three priorities:

(i) Working together as a Marmot City: reducing health and wellbeing inequalities

(ii) Improving the health and wellbeing of individuals with multiple complex needs

(iii) Developing an integrated health and care system that provides the right help and support to enable people to live their lives well

Both the Marmot and Multiple Complex Needs programmes were being evaluated formally and comprehensively. However, both the impact and learning were required to inform the refreshed Health and Wellbeing Strategy and so a light touch stocktake of key outcomes and learning from the current Strategy had been undertaken, the details of which were set out in an appendix to the report. The report referred to the successful work undertaken by both the Marmot Steering Group and the Multiple Complex Needs (MCN) Board. Reference was also made to the integration of health and care which had continued to evolve at pace in a context of a policy shift towards even closer collaboration through Integrated Care Systems.

Key learning from the current Strategy to inform the refresh included:

i) Inclusion of priorities had raised their profile and galvanised commitment around addressing health inequalities and supporting individuals with multiple complex needs

ii) Partnerships had been brought together to address the priorities and the benefits of stronger partnership working had been realised

iii) There remained a need for more active engagement of wider partners, and this was needed at an early stage in Strategy development

iv) A lack of dedicated resource to support the Strategy priorities had restricted impact in some areas

v) Opportunities had been lost as a result of the three priorities being implemented and monitored separately, so that links and synergies had not been identified and exploited

vi) There was no overarching performance framework to monitor progress of the Strategy and there was a need to find more tangible ways of measuring and demonstrating impact.

The report referred to a workshop for senior leaders from across the system held on 6 March, facilitated by the King’s Fund, which provided an early opportunity to engage senior partners in shaping the new Health and Wellbeing Strategy. The purpose was to test the King’s Fund’s population health model as a framework for reviewing current activity and developing the Strategy, and to hear from senior leaders about their ideas for future health and wellbeing priorities.

Key themes and messages arising from the workshop were:

·  There were already strong partnerships to build on in the city

·  The new Strategy should form part of the Year of Wellbeing legacy and reflect the opportunities arising from the UK City of Culture 2021 programme, which falls within the timeframe of the new Strategy

·  The system needed to facilitate community leadership – through investment in communities and having a flexible offer that empowers and enables community leadership, but also by engaging in more meaningful dialogue with communities 

·  Outcomes and impact – an evidence base was needed, especially around stronger communities and wider determinants, and to develop capacity to research, evaluate, demonstrate and grow good practice and draw on learning from elsewhere

·  Communication – the power of personal stories in demonstrating impact and building trust in services, and the need for more effective messaging about self-care, and potential digital opportunities around signposting

·  Interconnectedness (“job, house, friend”) – wider determinants and where I live / my community impact on lifestyle choices / healthy behaviours. We need to recognise the contribution of all services and consider the health and wellbeing impact of all policies

·  Concern about gaps in services – and people falling through gaps – and a need to be more joined up and strategic

·  Facilities – issues around access to services and availability of facilities locally; opportunities to bring community assets (eg. schools) into use

·  Focus on prevention – need to take bold decisions to move resources upstream.

There was a strong view that as a system there needed to be a clear focus on two or three priorities where we could make a difference by channelling resource and energy over the next few years, and a number of potential priorities were proposed. At the same time there was recognition that there were some key enablers (such as empowering community leaders or building stronger partnerships around wider determinants) where investment and change was also needed.

The Board noted the intention to bring a final draft of the Strategy in June/July for consideration and endorsement, with approval and publication taking place in the autumn.

The Board discussed the public health approach to issues including knife crime and suicide prevention along with the importance of the inclusion of tackling inequalities within the strategy. The importance of engagement with young people and their families and communities to understand their concerns was highlighted.

Discussion also centred on how the locality data obtained for the Joint Strategic Needs Assessment would be used to inform a city-wide strategy, rather than a number of different strategies for different communities. It was acknowledged that a better impact was achieved by having just one strategy.

Members questioned whether the two face to face public consultation sessions held in one location were sufficient to obtain feedback from a variety of communities. All of the groups and organisations involved in the JSNA would be invited to contribute to the consultation. 

RESOLVED that, having considered the outcomes and learning from the current Health and Wellbeing Strategy to inform the Strategy refresh:

(1) The outcomes of the Health and Wellbeing Strategy workshop held on 6^th March 2019 be noted.

(2) The proposed approach to the Health and Wellbeing Strategy refresh, including the Consultation Plan and timeline, be endorsed.