BUCK David, DUNN Phoebe
A contribution to the understanding, assessment and development of the role of district councils in improving the health of their citizens and communities. The report sets out what determines health, why district councils have an important role to play in shaping it, and the public health system and policy context in which district councils operate. It describes the key areas in which district council functions contribute to public health and provides a quick guide to the high level economics of public health for district councils. In addition, the report presents key evidence, including the impact on health, effectiveness and, where available, cost-effectiveness and return on investment, for each of the core functions of housing, green space and leisure, and environmental health services, arguing that district councils’ wider enabling role, in economic development, planning and engaging with their communities has benefits for health. A number of short case studies of innovation in service delivery in relation to health and wellbeing are also included. In the final section the report outlines a set of high-level recommendations for district councils and other stakeholders to ensure that they take advantage of the opportunities on offer.
ERNST AND YOUNG
In this report, commissioned by the Local Government Association, a journey towards better health and care for individuals is set out; driven by local system leaders and supported by a more empowering and enabling system. The report has been developed through: a review of existing literature published by partners, charities and research organisations; four workshops with the LGA and partners to define the vision, understand the system barriers from a range of perspectives and describe the required changes; and further discussion with regional contacts and the Health Transformation Task Group to sense check that barriers and key considerations are locally relevant and reflect the experience in local areas. Section 1 sets out a vision for better care and support, arguing that a reformed system needs to deliver: better health and wellbeing more equally enjoyed; better choice and control for all; better quality care, tailored for each person; and better outcomes for each pound spent. Section 2 focuses on key barriers preventing the achievement of a reformed system. These include: creating dependency through the way treatment is provided; chronic underfunding of the system and a lack of capacity to transform; fragmented commissioning incentivising treatment over demand management; and national regulations that disempower local areas. Section 3 sets out four steps to better care, which are: put people in control; fund services adequately and in an aligned way; devolve power to join up care, support and wellbeing; and free the system from national constraints. The report concludes that collectively these steps will enable localities to address challenges, deliver a better system and ultimately drive better outcomes and greater sustainability for all.