Public Health in the Community
- Published on Wednesday, 13 October 2010 01:00
- Written by Liam Hughes
Following the success of the Healthy Communities Conference, in an exclusive article for Govtoday, Liam Hughes, National Adviser to the Healthy Communities Programme at Local Government Improvement and Development describes the challenges ahead for local government and their ‘new’ role in Public Health
Public health is coming home to local government, and this has put the spotlight on the role of local councils in promoting health and wellbeing.
The Healthy Communities Programme at Local Government Improvement and Development was established to help build local government capacity for health improvement (with a strong focus on reducing health inequalities). Local Government Improvement and Development (previously called the IDeA) is part of the Local Government Group, and its aim is to help councils perform well for their local population.
The approach is through sector-led improvement. The agency provides a wide range of help, especially peer support. It makes use of both member and officer peers who come from local government and can provide trusted insights and experience to help their colleagues. There are also health peers drawn from the public health world.
There is a small group of national advisers at LGID who take a lead on particular themes, including children, adult support and care, active ageing, culture, leisure and sport, and the community and voluntary sector LGID also supports ‘place-based budgeting’ and work on efficiency and productivity. My primary role as national adviser for health is to assist the joint heads of the Healthy Communities Programme (HCP), Sue Johnson and Susan Biddle, and all the members of the team, to make a difference for local councils and their partners. I also provide wider support to the LGA Group on matters of health and wellbeing.
The aim of the Healthy Communities Programme is to help local authorities to build up their confidence, skills and knowledge for health improvement, and share innovation and best practice. Making this work well requires building close working relationships between local government and the public health community. This means staying in touch with key organisations, such as the Faculty for Public Health, the Royal Society for Public Health, the UKPHA, NICE, the NHS Institute, the Chartered Institute of Environmental Health, the Public Health Observatories and the Association of Directors of Public Health. It also means building productive relationships across the DH, NHS and other parts of government, at national and local level, to make sure that the potential of local councils for health improvement is properly understood and supported.
An important part of my role has been to act as an interpreter between the different cultures and languages in use across the public sector. Many people in local government are doing health improvement without knowing that they already speak the language of public health. I also act as a relationship manager with the public health community, working very closely with the leading lights of the key organisations to explain what local government is doing and to plan joint activities.
There are major changes on their way. Local councils are to be given the leadership role for health improvement and the reduction of health inequalities in their communities. Their track record for health improvement work has been recognised in the recent health white paper, and local government has welcomed this news. As we move upstream from medical diagnosis and treatment, to look at the ‘causes of the causes’ of poor health, we are entering local government’s natural territory.
There are many things still to be finalised in the second white paper on Public Health, which is due later in the year. It is encouraging that it will constitute the government`s response to the Marmot Report on Health Inequalities. Sir Michael’s work recognised the central place of local government in shaping the building block for good health at a local level – through family support and the early years, education, spatial planning, regulation, housing and the environment, community mental health and active ageing. The report reinforced the potential of local councils to develop places that support good health and wellbeing.
Local Government Improvement and Development is helping local councils and their partners to improve their efficiency and productivity through community budgeting – pooling local public sector resources to cut out waste and use resources more effectively.
Investment in health improvement is likely to produce local dividends for the public sector. Promoting workforce health will reduce the cost of running council services and lighten the load on the NHS and benefits system. Encouraging active ageing will mean that people will need less treatment from the health services and less help from adult social care services. There are many more examples. There are exciting opportunities, even in the midst of fiscal retrenchment, to base public health interventions on the evidence of what works and to build a strong business case for prevention.
What will success look like? Councils that do health improvement well are likely to look like councils that do most things well.
They share some common features:
- strong political and managerial leadership for improvement, driven locally, rather than reacting to demands from the centre;
- partnerships focused on outcomes, which also value efficiency in the use of public resources;
- real local engagement, and recognition of the strengths of local people, as well as their problems;
- telling the local story of health improvement and building skills for turning information into insights;
- energy, creativity and innovation, trying out new approaches;
- systematically implementing proven prototypes so they become the norm;
- reflection on what has been achieved and what can be done better.
The working hypothesis is that councils that have these features are more likely to be successful at helping people to improve their health.
The Healthy Communities Team is helping councillors prepare for change, for example, by setting up health and wellbeing boards at an early stage, and developing more appropriate Joint Strategic Needs Assessments to tell the local health improvement story.
The team’s work on community assets fits in well with the ideas of the ‘Big Society’ and the empowerment of people to influence local developments. In the background, there is the fundamental issue of local resilience in the face of economic retrenchment and social change. Public health may be coming home to local government, but at a time of extreme challenge – the signs are that local councils are up for it!
Govtoday and Local Government Improvement and Development are holding an online Forum ‘Health and the Big Society’ for those interested in this agenda, with speakers from our recent Healthy Communities Conference available to answer your questions - for more information and to register please go to: www.communities.idea.gov.uk/comm/landing-home.do?id=980146