Hertfordshire: the benefits of providing a public health pot for districts

Hertfordshire County Council has set up a public health funding pot to help district councils get projects off the ground. Over the past five years over £2 million has been transferred, creating a wide-range of schemes aimed at improving the health of residents. This case study shows how district councils have improved the health of their local areas.

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Hertfordshire is a large and diverse county. It is home to more than 1.1 million people. Although perceived to be affluent, there are pockets of deprivation.

Life expectancy is 7.2 years lower for men and 5.4 years lower for women in the most deprived areas of Hertfordshire than in the least deprived areas.

Across the county there are two clinical commissioning groups and 10 district and borough councils. Hertfordshire Public Health Director Jim McManus said: “We know we can’t deliver everything on our own. We need to build strong partnerships, trusting our colleagues so that together we can strengthen local capacity and develop sustainable solutions to some very complex problems.”

To help aid that partnership working, the District Partnership was established in 2013. It has seen the county council set aside a proportion of its public health budget for districts to use.

Highlights of progress

Over the past five years £2.3 million has been devolved down to the districts. In the first year £1 million was set aside, but that has since been reduced to £300,000 a year because of the squeeze on public health funds.

Over the course of the partnership the money has helped pay for over 160 local projects. Some of the most successful have been expanded to be run in more than one district.

For example, East Hertfordshire, with colleagues from North Herts District Council, launched a Meet and Eat scheme which ran in community venues. It allowed local elderly residents to get together and cook and socialise, addressing both social isolation and nutrition at the same time. It is now being in run three districts.

Shape Up has been run in collaboration with Watford Football Club. It’s aimed at overweight men, who get the chance to play football at Vicarage Road facilities and receive dietary advice and support. The programme is now open to the residents of three districts.

Meanwhile, Wellies in Woods – a fun activity aimed at getting families from deprived areas active in the natural environment – has expanded from Hertsmere where it started, while St Albans’ arts-on-prescription scheme has been picked up elsewhere too.

The close working relationship that has developed has also aided the development of county-wide initiatives outside of the partnership.

ParksHerts, a mobile-friendly website showcasing Hertfordshire’s parks and open spaces, has been launched to get people active outdoors. The project was lead by Hertsmere Borough Council on behalf of all the partners.

Hertfordshire Warmer Homes offers people at risk of fuel poverty free or discounted home energy improvements to help them stay warm in their homes and reduce their energy bills.

Mr McManus said: “We have seen some really good examples of partnership working. Providing a little bit of funding and bringing the districts and county together in this way has had a big impact."

The future

Funding has been secured for another two years – with £300,000 being set aside by the county in both 2019/20 and 2020/21. As well as developing new projects, one of the aims is to create a network of health hubs across the districts.

Stevenage Borough Council in partnership with Stevenage Leisure has already launched one. This is being run by a leisure provider and allows residents to gain access to all the healthy lifestyle projects and social prescription services at one site.

A range of services are on offer, such as support with mental health, referral into physical activity schemes and smoking cessation, to name just a few. A health and wellbeing consultant works from the hub to carry out triage, provide advice and make referrals to partner organisations.

A series of workshops is now being planned for early 2019 to start planning out how the hub approach can be rolled out.

Partnership Lead Ciceley Scarborough said: “We have so much going on now that we think having a network of healthy hubs to bring it all together is really important. It is working well in Stevenage – so we have set that ambition for the other districts.

They don’t have to follow the same model exactly, models will vary according to geography and the needs of the local population”.

Joe Capon, Health and Sport Strategy Manager at Stevenage Borough Council, is full of praise for the approach taken. He said there had been a “significant shift in partnership working” which was creating a “holistic approach to public health”.

Lessons and key messages

The partnership has evolved over time. Initially 100 projects were set up, but that has gradually been consolidated to the 36 that are currently going.

Mrs Scarborough said: “Some projects were short-term, but some did not work out. You have to expect that – and that’s where proper evaluation is crucial. But as we have moved on to different phases of the partnership we have altered the way we do things.

“We provide project management support as well as public health knowledge, monitoring and evaluation expertise. I meet with each of the districts quarterly to discuss what is happening.”

She said “the aim is to make all the projects self-sustaining, either by getting the community to run them, getting other partners engaged, or charging for services.”

As part of that process, districts have also been seeking to get some match funding either through grants or contributions from partners. In the last year nearly £200,000 of extra funding was added to the £300,000 provided from the public health budget.

“We know funding is tight and you have to make it stretch as far as you can, particularly in austere times” added Mrs Scarborough.

Contact

Cicely Scarborough

District Partnership Programme Lead

Hertfordshire County Council

[email protected]