STUDDERT Jessica, STOPFORTH Sarah
This position paper sets out some of the challenges in achieving a fundamental structural shift in the health system, citing new evidence from health and local government professionals. The paper sets out the potential of reimagining health as place-based, taking an asset-based approach and focusing on shaping demands in the longer term and ultimately producing better health and wellbeing outcomes. Underpinning this approach is the recognition of the wider determinants of health, where fewer health outcomes result from clinical treatment and the majority are determined by wider factors such as lifestyle choices, the physical environment and family and social networks. Place-based health would mean reconceptualising ‘health’ from something that happens primarily within institutions, to involve all local assets and stakeholders in a shift towards something that all parts of the community, and individuals themselves, recognise and feel part of. This would mean the individual would move from being a recipient of interventions from separate institutions to being at the heart of place-based health. The paper intends to lay out the challenge for the Place-Based Health Commission, which will report in March 2016 and recommend practical steps for professionals in health and care to overcome organisational barriers – real and perceived – and make a fundamental shift towards an integrated system that puts people at the heart of it.
This paper looks at what resilience means for local authorities and offers guidance for councils in their thinking about the subject. Resilience in this context is defined as the capacity of local areas to respond to immediate crises, to build their resources and adapt to changing circumstances in the future. The paper is based on an in-depth workshop with participants from local government across England, interviews with council officers with responsibility for resilience issues, and case studies that demonstrate some of the innovative approaches that could be taken to enable resilience. The paper begins by summarising existing understandings and definitions of resilience; discusses the issues and concerns that local authorities have with resilience; then looks at some of the ways they are seeking to develop it in their areas. Case examples include a project to develop community resilience in Hounslow and Family Group Conference programme in Camden which contributes to family resilience. The second section outlines a definition and typology of resilience and then applies the typology to the example of climate change. It then proposes a checklist that authorities could follow when developing resilience strategies and interventions. The paper stresses the importance of local authorities working with communities and individuals in partnership to make places more resilient, helping communities use their assets effectively and bringing about holistic change in the way communities function.
LOCAL GOVERNMENT ASSOCIATION
This publication is a call to action to local commissioners, Government and national bodies to support health and wellbeing boards in bringing about a radical transformation in the health of local communities. It has been prepared by the Local Government Association (LGA) and NHS Clinical Commissioners (NHSCC) working jointly in consultation with members of health and wellbeing boards (HWBs) across the country. Among the essential characteristics of effective place-based boards this document highlights: shared leadership; a strategic approach; engaging with communities; and collaborative ways of working. It proposes: a national five-year funding settlement across health and care; freedom for HWBs to determine local priorities; development of a new payment system; enhanced information governance and data sharing; commitment to the principle of subsidiarity in commissioning decisions; a single national outcomes framework for health, public health and social care; and a national strategy for coordinated workforce planning and integrated workforce development across health, public health and social care.