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Devolution prevention pilot CCG Governing Body February 2016 haringey.gov.uk National context Councils increasingly funded by local economies Individual devolution deals with big cities + a single county deal (Cornwall)


  1. Devolution prevention pilot CCG Governing Body February 2016 haringey.gov.uk

  2. National context • Council’s increasingly funded by local economies • Individual devolution deals with big cities + a single county deal (Cornwall) • Manchester’s deal is unique: includes £6 billion of NHS and social care budgets devolved haringey.gov.uk

  3. ‘Devolution’ in London Sub-regional planning/commissioning • Discrete (though large scale) planning and commissioning exercises rather than permanent devolution of funds and powers to sub- regions Piloting for future devolution • Building the case for future devolution of powers/funds on behalf of London, rather than achieving devolution now • Chance to use pilot status to spur internal improvement, build better partnerships and leverage in external support (public sector reform) haringey.gov.uk

  4. London Health and Care Collaboration ( ie Devolution ) Agreement • Signed by Mayor (GLA), London CCGs, London Councils, NHSE, PHE (Dec 15 th ); set up 5 pilots: – Barking & Dagenham, Havering and Redbridge - developing an Accountable Care Organisation (primary and secondary care integration) – Lewisham - integrating physical & mental health services alongside social care – Hackney – aim: full integration of health & social care budgets & joint provision of services + focus on prevention – North Central London – estates pilot ( develop a regional capital programme; devolve powers to approve NHS capital business cases; retain more of the proceeds of sales – Haringey – prevention pilot haringey.gov.uk

  5. Prevention: a priority for Haringey • Council’s corporate plan – a ‘cross - cutting’ theme • CCG (draft) operational plan: ‘a radical upgrade in prevention and public health’ • Our approach: Health in all policies haringey.gov.uk

  6. Haringey prevention pilot • To work with London and national agencies on two goals: – Healthy environments – Sustainable employment • The ‘Healthy environments’ strand is about: – Finding the most effective ways of using planning and licensing powers to create healthy environments (testing the capacity of existing powers and working through the issues and risks that enhanced powers would bring). • The ‘Sustainable employment’ strand is about: – Piloting new ways of supporting more people into sustainable employment – integrating the employment support and health systems, with a particular emphasis on supporting people with mental health issues, workplace retention and working with employers haringey.gov.uk

  7. Healthy Environments haringey.gov.uk haringey.gov.uk

  8. Case study: Healthy Environments More outlets in the east haringey.gov.uk

  9. Case Study – Healthy Environments Haringey Fast Food-Free Zone • New initiative to ban hot takeaways from opening within 400m of primary and secondary schools. It is proposed that this new policy would form part of the Council’s Planning Policy documents • This will limit the number of the shops outside of the exclusion zone and aim to encourage more pupils to eat the healthy food on offer inside their schools rather than walking to nearby takeaways • The Council has already faced legal challenge from KFC and MacDonald's in relation to the proposal haringey.gov.uk

  10. Healthy environments • Initial scoping has identified some priority areas to explore: – Alcohol: • Determining if there is a legally robust route to a Minimum Unit Pricing by-law • Health as a fifth alcohol licensing objective – Tobacco: - confirming whether the Government is seeking to pilot local Tobacco licensing – Saturation policies for gambling premises - seeking advice on our current planning policy, and establishing how we could use a Local (data) Profile • Engagement with DH, PHE, DCLG underway • We are determining the internal/local improvements that we can make, eg: gathering data to support our existing saturation policies haringey.gov.uk

  11. Sustainable Employment 11 • Northumberland Park (11) has the highest rate of out of work benefit claimants at 24%, followed by Tottenham Green (15) at 19% and Tottenham Hale (16) at 18% • The lowest rate is found in both Crouch End (4) and Muswell Hill (9) at 5% • 13 wards have a higher proportion of out of work benefit claimants than the Haringey average (11.3%) • The highest rates of out of work benefits claimants are situated in the east haringey.gov.uk

  12. Sustainable Employment 12 1, 782 ESA claimants have MSK problems 5, 920 ESA/IB claimants have mental ill health 12, 730 ESA/IB claimants 5, 600 JSA claimants 21, 770 out of work benefit claimants 45,900 economically inactive 180, 000 working age population in Haringey haringey.gov.uk

  13. Case Study – Sustainable Employment 13 • Twining Enterprise started delivery in Haringey July 2015 • 2 Employment Specialists integrated into EIS and RET teams (secondary care) • 35 are engaged, with 5 jobs created to date • IPS Evidence based model • Based on 8 Principles including client-centred, paid work focus, ongoing in work support, employer engagement haringey.gov.uk

  14. Sustainable employment • Initial internal scoping has identified the following options: – We focus on supporting people with mental ill health (49% of ESA cohort) – Expand the number of people able to access employment support via the Individual Placement Support (IPS) model – Intervening earlier by building support around primary care and the 'Fit note' conversation – Better retention support to help people stay in work – working with employers • Islington Council and CCG’s Health and Work Programme – opportunities to share learning haringey.gov.uk

  15. Timeline Agree Prevention Pilot priorities internally February Submit support ‘asks’ to March Government/external agencies Commence building evidence base with April partner support Prevention Pilot conclusions published April 2017 Devolution of powers to Haringey/all 2017-18? London? haringey.gov.uk

  16. Governance and delivery • Devolution steering group chaired by Jeanelle; membership includes: Sarah Price; senior officers across council; co-chairs of 2 delivery groups • Engagement of other partners including Local – JCP, police, BEHMHT; Regional – GLA; National – DWP, PHE, DH, DCLG • Delivery groups report into the steering group: – Healthy environments workstream – co-chairs: Marion Morris and Eubert Malcolm – Sustainable employment workstream – co-chairs: Vicki Clark and Tamara Djuretic – Looking for CCG representation on the delivery groups haringey.gov.uk

  17. Next steps • Looking for CCG involvement in the Delivery Groups • Discussion at HWB February 23 rd • Devolution steering group February 24 th • Project manager to develop project plan (after Feb 8 th ) • Workshops and conversations to explore priorities in more detail, esp with external partners • Sustainable Employment workshop 2 nd February • Aim to formally submit priorities to Government agencies at end of February and negotiate support to develop detailed business cases (secondments, funding) haringey.gov.uk

  18. Discussion • View on the focus of the two workstreams? • Consider the CCG contribution to the two Haringey pilots, especially to the sustainable employment workstream haringey.gov.uk

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