In an Exclusive interview with GovToday, Sir Howard Bernstein, Chief Executive of Manchester City Council , talks to Editor , Scott Buckler, about enabling effective delivery of health and wellbeing services to both communities and the public
Q, You point to four behavioural risk factors within the report; tobacco use, physical inactivity, excess alcohol consumption and poor diet, how do you believe these factors have been addressed on a community level, for instance in Manchester?
“We have a range of programmes in place to address all these issues at Community level some of which are targeted at one factor and others which are integrated within the action plans for all four factors. The most important programmes are those which are delivered in partnership between the local authority and other agencies which have multi faceted problems which require complex and comprehensive solutions, this can only happen when we are working across territorial boundaries.
A good example would be Tobacco Control, in Manchester we are currently taking a smaller community focused approach which involves campaigning and focusing on areas where smoking prevalence is high which has support from local NHS services, Trading Standards and also we engage with local environmental health officers who work with local pubs to ensure that they are supporting moves to stop smoking.”
Q, The recent Change 4 Life Campaign was seen to raise awareness on all four risk factors you address in the report, however recent announcements have put the campaign in jeopardy, how can the coalition government and local authorities raise awareness without major financial campaigns?
“It is not just about awareness, obviously raising awareness is important, however we need to ensure people have the motivation, skills and the opportunities to change their behaviours. Therefore we need to create the environment which promotes behavioural change. I think we need both local and central Government to help make a difference, obviously Central Government can provide the regulatory control on such areas as Tobacco and Alcohol. Local Authorities must work on service provision and the environment across Cities, Towns and Villages which will help people make better choices on their lifestyle.”
Q, How do you believe social and economic issues affect the behavioural risk factors of most people in the UK?
“People’s behaviour is massively influenced by the social and economic circumstances, the Marmot review set out the evidence of this in a very compelling way. Because of that it is crucial public health policy retains a focus on those determinants of health and ensures an alignment between economic development and public health outcomes. “
Q,In the report you call for stronger and more innovative mechanisms in which to improve health and wellbeing, can you tell use more about these mechanisms and the need for more working groups outside of the NHS?
“In Manchester we are doing a programme called points for life which takes the learning from many established private sector reward schemes and apply it to how you motivate people to change their health behaviour particularly around food and physical activity. This is an initiative between the council, the NHS and the Private Sector and if successful will become self financing, thanks to the initial investment from the private sector.”
Q, What are your thoughts on local commissioning models for health and wellbeing and how can these models be achieved?
“How we actually commission services to support adults, families and children are not just a preference to the NHS it is how we create integrated public services to support the needs of customers. What we have to do is move towards a multi agency commissioning model and that is something that the NHS and partners, including the council are moving towards creating.”
Q, With the recent announcement that all local authorities must began to find savings within their budgets, do you believe this will affect health and wellbeing services, the recent shelving of free school meals is one example?
“Every Authority will be concerned, it is a challenging environment, but equally there is an opportunity here to actually start changing the landscape within which the public sector operates. It is not just about efficiency, it should be about improvement and how we focus more on residents from deprived areas.”
Q,Is the NHS more geared to be a service for the sick rather than one which promotes health? If so what needs to change in order for the DH to deliver a more productive health service?
“I think the NHS has a positive role to play in shaping places in which people live and work, this contribution needs to be maximised. If we are to move to a position where communities are become self- independent and less reliant on public funding and support, then clearly the role of the NHS is to articulate the importance of positive health. We are very fortunate in Manchester as many of our NHS Institutions understand this; one of Manchester’s Central Hospitals actually sponsors one of our Academy Schools, thus recognising their important role in the community. At one level the NHS is fundamentally assisting the public to become healthier, however it needs to recognise its wider role in raising awareness of health inequalities throughout neighbourhoods and communities.”
For further details and information on Healthy Communities why not visit:http://www.hscreformseries.co.uk/