Councils predict healthier future, Localis report finds
Author: Localis |
Local government think-tank Localis today launches a major new report, ‘In Sickness and in Health’, which assesses the recent move to a more localist health system and uncovers a real spirit of optimism in local government, with 96% believing that their council will improve the health of their residents.
The report finds the transition has gone well so far but also highlights barriers to further progress, proposing recommendations to both national and local government.
Click here to read a copy of the report.
April 2013 saw local government assume a major new role in health services, with 2.7 billion of public health funding switching from NHS control into the hands of local authorities, and the creation of new Health and Wellbeing Boards which enhance the role of councils in the planning and oversight of all local health services. And the report raises the possibility that the future could see an even closer marriage of health and local government with councils assuming greater ? even complete ? responsibility for health commissioning.
Informed by a survey of over 80 senior local government leaders, ‘In Sickness and In Health’ finds (formerly NHS) public health teams successfully working alongside their new local government colleagues to focus not just on the traditional big public health issues such as sexual health, obesity, smoking cessation but to explore new and innovative ways to tackle the wider social, cultural and environmental determinants of health.
The report’s principle recommendations are:
Firstly, local authorities cited confusion over data sharing procedures as a significant barrier to integration. To enable effective collaboration between local authorities and health colleagues, the report therefore recommends that the Government should move to a presumption in favour of data sharing between all local partners.
Secondly, the report suggests the Government should consider making the Minister for Public Health a joint Department of Health/Cabinet Office position, in order to aid integration across departmental silos and make a statement that it is embedding public health at the heart of all its policies.
Thirdly, the report finds some councillors fear that they will not have the necessary levers to adequately affect decisions about local health services. To address this perception, the report recommends that the Government review the operation of the new health system in 2015 to ensure that Health and Wellbeing Boards have real influence, and, if their democratic voice is not heard, look at expanding councils’ powers over health commissioning.
The report has attracted support from within the health sector and across the political spectrum (see full quotes below).
- Professor Sir Michael Marmot, who chaired the Government-commissioned review ‘Fair Society Healthy Lives’ (2010) – a key driver behind the reforms – said that the report ‘provides advice that will give local authorities across England valuable direction and guidance.’
- Norman Lamb MP, Minister of State for Care and Support, said ‘This report is a welcome addition to the ongoing discussion and work on integration. It shows how the health reforms, introduced in April, were designed to put integration at the heart of the health and care system. The reforms have presented a great opportunity for local commissioners to join up services so that they put the needs and preferences of local people first.’
- Rt Hon Stephen Dorrell MP, Chair of the Health Select Committee and former Secretary of State for Health, ‘welcomes this timely study of the implications of greater engagement between local government and the full range of health and care services.’
- Clive Betts MP, Chairman of the Communities and Local Government Select Committee, asserts that the report ‘offers useful recommendations on collaboration between health and wellbeing boards and clinical commissioning groups, on holding GPs and NHS England to account and on how councils can embed public health in all local services.’
Launching the report, Localis Chief Executive Alex Thomson said:
‘Local government has a long and proud history of improving the health of the nation so these reforms represent a real homecoming. It’s heartening that there is such a sense of optimism about the opportunity to once again help local people live longer, happier lives. Things are looking good so far, but only time will tell if additional powers are needed.’
A further press release, including quotes from the Minister’s speeches, will be issued later on Tuesday.
‘In Sickness and in Health’ will be launched on Tuesday 3rd September at 9.15am at Localis’ offices in Westminster. Speaking at the launch will be Minister of State for Care and Support, Norman Lamb MP.
ENDS
NOTES TO EDITORS:
1. 96% response rate explained ? all of the leaders and chief executives of English local authorities were surveyed, with 80 responses. Of those who responded to the question: ‘Do you believe that your local authority will be able to positively influence the public health of your residents?’ 96.3% (or 77 respondents) answered either ‘yes, immediately’ or ‘yes, eventually’.
2. The key recommendations made in the report are as follows:
- The Government should review the new health system in 2015 to ensure that Health and Wellbeing Boards have real influence over commissioning, and, if their democratic voice is not being heard, consider granting local government greater ? even complete ? responsibility for health commissioning.
- The Government should consider making the Minister for Public Health a joint DH/Cabinet Office position, in order to aid integration across departmental silos and make a statement that it is embedding public health at the heart of all its policies.
- To enable effective collaboration between local authorities and local partners, the Government should move to a presumption in favour of data sharing for local health bodies.
- It is crucial that local authorities maintain public confidence in the reforms by only spending public health funds on things that are demonstrably related to improving health outcomes for local people.
- Local authorities must seek to broaden local understanding in a clear and user-friendly format of what their JSNA is (explaining the data about the area in which they live), what its conclusions are (the health priorities that flow from that data), and what that means for local services.
- A representative body for HWBs ? perhaps divided into regional sub-groups ? should be created to assure two-way accountability between NHS England and HWBs.
- Local Healthwatch should be given a free role to offer their support or criticism for policies and or their implementation without regulatory or political interference.
- To help foster GP engagement in the new system, we recommend that practices send additional GPs to CCG board meetings when feasible, and that GPs are invited to play a more prominent role in the development of key documents such as JSNAs.
- The Government should maintain its position that strategic commissioning must be ‘provider neutral’, focusing on local need and the best pathways to deliver services to meet that need.
3. Supportive quotes in full:
Norman Lamb MP, Minister of State for Care and Support, said:
“This report is a welcome addition to the ongoing discussion and work on integration. It shows how the health reforms, introduced in April, were designed to put integration at the heart of the health and care system. The reforms have presented a great opportunity for local commissioners to join up services so that they put the needs and preferences of local people first.
I recently announced a call for local areas to become integration ‘pioneers’. I want to make integration the norm in the next five years, and to bring an end to disjointed care – one of the biggest frustrations for people who use health and care services. Better coordinated health and care has the potential to really improve peoples’ experiences and outcomes. It will also make the health and care system more efficient so that it can meet the needs of the 21st century. Health and Wellbeing Boards will be central to achieving this aim as they bring together local commissioners, along with patient and service user representatives, to plan services around local needs.”
Rt Hon Stephen Dorrell MP, Chair of the Health Select Committee and former Secretary of State for Health, said:
‘I warmly welcome this timely study of the implications of greater engagement between local government and the full range of health and care services. The progressive divorce between locally determined care services and nationally directed public health and acute health services was always a policy dead-end. Gwilym Tudor Jones encourages both national and local government to think about the implications of putting this great historical error into reverse.’
Clive Betts MP, Chair of the Communities and Local Government Select Committee, said:
‘The return of public health to local government is a welcome development that offers the potential for significant benefits. To secure improvements, however, local councils will have to work hard to engage not only with their local NHS, but with other areas such as employment, housing and transport. To that end this report offers useful recommendations on collaboration between health and wellbeing boards and clinical commissioning groups, on holding GPs and NHS England to account and on how councils can embed public health in all local services. These are the first steps in tackling the causes of the causes of poor health.’
Cllr Sir Merrick Cockell, Chairman of the Local Government Association, said:
‘The biggest single challenge facing the public sector at the moment is coping with the demands of the UK’s ageing population. Drawing together services at a local level to promote healthy lifestyles and collaborate in a way which enables people to stay independent longer and reduces the need for acute treatments is fundamental to meeting that challenge. The shift toward greater local control of health commissioning and provision through the leadership of health and wellbeing boards points the way to a better way of working, but this type of approach has to be embraced right across the public sector. The LGA is working with national partners and local authorities to support all areas to develop strong and integrated plans that address local health challenges and make the most of local assets. Localis has yet again provided a considered and thought-provoking analysis which will no doubt help the sector to work to place greater control over services into the hands of local communities.’
4. About Localis
Localis is an independent think-tank dedicated to issues related to local government and localism. We carry out innovative research, hold a calendar of events and facilitate an ever growing network of members to stimulate and challenge the current orthodoxy of the governance of the UK. Please visit www.localis.org.uk for more information