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Liverpool City Council: public health transformation six years on

This case study shows the excellent work that public health in local government is doing to commission for quality and best value across all areas.


Overview

Liverpool is a city in the North West of England with a population of around 491,000. It is governed by the directly elected Mayor of Liverpool with Liverpool City Council and is one of six local authorities that make up Liverpool City Region (LCR). LCR is a combined authority in which six Merseyside councils share strategic decision making for areas such as economic development, transport, employment, skills, tourism, culture, housing and physical infrastructure.

The health of people in Liverpool is generally worse than the England average. It is one of the 20 per cent most deprived council areas in England and some areas of the city are among the most deprived, and have the greatest health inequalities, in the country.

Liverpool has a young population and a rich maritime and cultural history. Since being European Capital of Culture in 2008, global tourism has grown significantly, and the city provides a unique destination with a diverse range of leisure and cultural activities.

Organisation and partnerships

Liverpool Public Health is a department in the directorate of Adult Services and Health and works closely with partners at several levels.

  • With health colleagues in Liverpool CCG and local NHS providers – many of the initiatives in this case study involve the CCG and NHS partners.
  • With public health colleagues across Cheshire and Merseyside in the Champs Collaborative which supports joint work on health and wellbeing issues best tackled at scale, such as suicide prevention. Champs coordinate the public health input into Cheshire and Merseyside Health Care Partnership.
  • Collaboration with other public health teams and partners across LCR.

Priorities

The city council has embraced health and wellbeing across all its functions and services and works on major themed interventions to improve health. It seeks to be at the forefront of public health advances both in the UK and internationally.

A big push to tackle deprivation and reduce health inequalities is taking place through the Mayor’s Inclusive Growth Plan which has a vision for Liverpool as ‘a strong and growing city, built on fairness’. The Plan embraces a health in all policies (HIAP) approach but goes further with the concept of ‘health in all policies and places’ – HIAPP. The joint strategic needs assessment is being revised to provide the road map to inclusive growth.

Challenges and impact of budget reductions

Because health outcomes from public health interventions can often be long-term, it can be difficult to secure funding for prevention at a time of financial cut backs. Since budget reductions started in 2015, through national in-year and year-on cuts to the budget, Liverpool Public Health has lost a number of posts, but has managed to continue to deliver its responsibilities through combining roles across the team. It has also looked at opportunities to generate income through the potential to license campaign materials and will continue to do so where this can support future developments.

Public health achieves a lot through partnership working, but funding cuts to the wider council are having an impact on achieving health outcomes. Public health would like to do much more work with communities on tackling the social determinants of health, and without additional funding will look for innovative ways in which this can be achieved.