West of England Partnership Joint Transport Executive Committee 4 March Agenda item 10 Memorandum of Understanding (MoU) with the Health Sector: Action Plan /12 Purpose of Report 1. To outline the draft Health and Transport Action Plan /12, associated with the Memorandum of Understanding signed on 17 September 2010 and seek views. Background 2. The development work on the Joint Local Transport Plan 3 (JLTP3) and the Sustainable Community Strategies of the Local Strategic Partnerships have highlighted how walking and cycling can increase physical activity and have large health benefits. The JLTP3 strategy includes a focus on improving health and well being by increasing levels of physical activity through more walking and cycling in line with the national Active Travel Strategy (Department for Transport/Dept of Health February 2010). Measures to improve health are linked with those aimed at reducing carbon emissions, reducing congestion, supporting economic growth, improving air quality and quality of life, increasing accessibility and reducing risk of injury. 3. Cooperation through the preparatory work on the JLTP3 has led to the development of the Memorandum of Understanding (MoU) with the Health Sector. The MOU between the local authorities and NHS Bristol, NHS North Somerset, NHS South Gloucestershire and NHS Bath and North East Somerset was signed on 17 September 2010. The MoU (Appendix 1) is aimed at capturing the health benefits of active travel and building closer relationships between the health sector and the local authorities. Health and Transport Action Plan /12 4. The purpose of the draft Health and Transport Action Plan /12 (see Appendix 2) is to promote effective collaboration and develop a set of outcomes where the parties consider there is scope for improved communication, greater cooperation and coordination of activities. The draft Health and Transport Action Plan lists key actions during including the Joint Local Transport Plan 3 refresh in autumn, opportunities for collaborative funding bids (for example Local Sustainable Transport Fund bids) and proposals for improved communication. It is proposed that progress in delivering the Action Plan is reviewed in July and March 2012. 5. To assist the delivery of the draft Health and Transport Action Plan, it is proposed that an officer Transport and Health Forum is established to progress the Action Plan and the draft terms of reference for the Forum are attached in Appendix 3. It is proposed that the Forum will meet four times during on 11 March, 10 June, 9 September and 9 December. The Forum will deliberate how transport planning considers health impacts and correspondingly how health planning considers 1
transport impacts. Issues include consideration of how the transport impacts of service delivery are embedded into health service planning processes and the effects of transport initiatives on the health and well-being of the population are understood. Appendix 4 outlines the proposed changes to the organisation of the NHS and Public Health and clarifies the transition arrangements in the authorities and implications for the MOU and Action Plan. Environmental Impact Assessment 6. Measures to improve health are linked with those aimed at reducing carbon emissions, reducing congestion, supporting economic growth, improving air quality and quality of life, increasing accessibility and reducing risk of injury. Risk 7. There are no specific implications arising from the recommendations in this report Resources (financial and economical) 8. The draft Health and Transport Action Plan (Appendix 2) proposes that funding stream opportunities are identified to augment the resources available to implement measures to increase walking, cycling and public transport use. Equalities implications 9. The Transport and Health Forum, as specified in the Memorandum of Understanding and Appendix 3, is to ensure effective joint collaboration in order to promote and protect good health and reduce health inequalities, now and in the future. Views of Joint Scrutiny Committee 10. The Joint Scrutiny Committee of 1 October 2010 noted the signing of the Memorandum of Understanding with the Health Sector on 17 September and progress on the development of the associated action plan. Recommendation That members give their views and authorise the Health and Transport Action Plan /12. Appendices Appendix 1: Memorandum of Understanding (MoU) with NHS Bristol, NHS South Gloucestershire, NHS North Somerset and NHS Bath and North East Somerset Appendix 2: Draft Health and Transport Action Plan /12 Appendix 3: Draft Terms of Reference of Health and Transport Forum Appendix 4: NHS and Public Health changes; the implications for the Memorandum of Understanding on Health and Transport. Author Barbara Davies, West of England Partnership Office, Tel. 0117 922 4923; barbara.davies@westofengland.org 2
Appendix Two Health and Transport Action Plan /12 (relating to the Memorandum of Understanding: West of England Partnership and Health Sector through DPHs) Theme Joint Local Transport Plan 3 Key actions during Provision of evidence, expertise (see Appendix 1) and advice. Open communication about timescales and processes Specific deadlines Publication by March. Refresh autumn and 3 year delivery plan Outcomes JLTP3 that will contribute to improved health and reduction of health inequalities. Lead Officer (s) (Working through Health + Transport Forum) James White (WEPO) Davis (Health) July March 2012 Specific strategy development Development of walking and cycling strategies across the WoE authorities, as appropriate. Input from PCTs to assist development and updating Embedding sustainable transport principles into NHS health care delivery Autumn to link with approval of JLTP3 supplementary documents Autumn Coherent strategies for walking and cycling which dove-tail with wider transport, public health and community safety strategies Programme of travel plans and other initiatives for NHS facilities James White (WEPO)/ Appropriate Head of Transport Davis (Health)
Theme Making collaborative funding bids Project implementation Key actions during Preparation of public health intelligence and evidence case to augment transport planning in identification of funding streams and contribution to the drafting of bids eg Local Sustainable Transport Fund, National Institute for Health Research Assisting the local authorities on the detail of implementation and advocacy for projects and schemes (e.g. 20 mph, GBBN, Rapid Transit) including adding resources e.g. through Knowledge Transfer Partnership Specific deadlines There will be two bidding rounds for the Local Sustainable Transport Fund bids, the first closing in April and the second at an unspecified later date National Institute for Health Research Bids in response to national call for research bids Focus on three year Delivery Plan for Autumn Outcomes Augmenting funding resource available to accelerate implementation of measures to increase walking, cycling and public transport use. Smooth implementation that meets transport and health goals, and achieves good public buy-in. Lead Officer (s) (Working through Health + Transport Forum) Pete Davis (WEPO)/ Heads of Transport Davis (Health) Pete Davis (WEPO) Appropriate Head of Transport Davis (Health) July March 2012
Theme Transforming Health Service travel Underpinning communication and advocacy strategies Key actions during Establish baseline information about current travel and scope for improvements. Support and facilitate changes relating to travel for staff, patients, visitors and goods. underpin with evidence, including assessment of the transport impact of any major changes to the delivery of health services Range of combined communications and advocacy strategies between PCT/ Councils and other partners e.g. 20mph residential street limits (BCC only), and public transport promotion Specific deadlines Baseline information by June, and progress with extending the Avon Wiltshire Partnership green travel model throughout. 20 mph communications campaign (BCC only), and active travel throughout Outcomes To reduce the impact of travel to NHS facilities by encouragement of Travel Plans and other interventions Shift in attitudes and social norms/values which facilitate increased active travel Lead Officer (s) (Working through Health + Transport Forum) Davis (Health) Bill Davies (WEPO) Appropriate Head of Transport Julia Dean (WEPO)/UA press officers NHS Communication team July March 2012
Appendix 3 Terms of Reference for Health and Transport Forum Bath and North East Somerset, Bristol, North Somerset, South Gloucestershire Aim The aim of the Forum is as specified in the Memorandum of Understanding. It is to promote effective joint collaboration between Heads of Transport and Directors of Public Health in order to promote and protect good health and reduce health inequalities, now and in the future. Objectives/Responsibilities The key objective of the Forum is to seek to ensure that the transport system for the sub-region now and in the future is designed in such a way that it enhances health, wellbeing and prosperity for all residents, and contributes to reducing health inequalities. It will achieve this by; Bringing together relevant expertise and representation from Transport and Health sectors Building strong and constructive working relationships between the Health Sector and the Transport sector Using best available evidence to inform planning and decision-making Ensuring the assessment of transport impacts of service delivery are embedded into health service planning processes Ensuring the assessment of health impacts inform transport planning at the earliest stages of option development Supporting joint work aimed at improving the carbon footprint and wider health impacts of NHS travel (i.e. travel by staff, patients, visitors and goods). Producing and monitoring an annual Action Plan Membership The Group membership will include representatives from the following departments, organisations or teams; Each of the Transport Departments for the four Local Authorities Each of the Directors of Public Health for the four Local Authority areas Each of the major NHS provider organisations e.g. Avon and Wiltshire Partnership Trust, Great Western Ambulance Trust, North Bristol Trust, Royal United Hospitals Bath, University Hospitals Bristol Trust, Weston Area Health Trust. A representative for the Local Authority Air Quality and Noise teams Additional members will be included as necessary. If subgroups are established then all chairs of subgroups will be members of the Transport and Health Forum. Ways of working The Group will meet four times a year. The Group will be chaired by a nominee from the Directors of Public Health. The Agenda will be distributed one week in advance. Notes and agreed actions will be circulated within two weeks following the meeting. Administrative support will be provided by the Health Sector. The key principles are of openness, explanation and discussion together with shared responsibility and ownership of problems and solutions. The Group will report to the Joint Transport Executive Committee. Supporting Documents Memorandum of Understanding, signed 17 September 2010, between the Four Local Authorities of the West of England Partnership and the Four Directors of Public Health.
Appendix 4 NHS and Public Health changes; the implications for the Memorandum of Understanding on Health and Transport. Background A Memorandum of Understanding was signed on 17 September 2010 between the four Heads of Transport, and the four Directors of Public Health. The MOU initiates closer working between transport planning and the health sector, and commits to the establishment of a Health and Transport Forum for the West of England area. The policy of the Coalition government is to restructure the Health Sector. At the time of drawing up the MOU, the broad policy direction for the changes to the NHS and to public health were known. Since then there has been; Publication on 30 November of the Public Health White Paper Healthy lives, healthy people; our strategy for public health in England. The consultation period lasts until 31 March. Publication in December 2010 of the Public Health Outcomes Framework First reading in the House of Commons on 19 January of the Health and Social Care Bill. The Bill will transfer local health improvement functions to local authorities and establish Health and Wellbeing Boards. Establishment locally of the beginnings of processes for managing a smooth transition of health duties and functions, from the existing arrangements to the proposed new arrangements (see below). Local arrangements for transition Within each local authority area within the West of England, arrangements are being made to prepare for the changes outlined above. Bath and North East Somerset; the process is being managed through the Council Change Programme Board, chaired by the Council Chief Executive. A Healthy Conversation event is taking place on 9 February for the Health and Wellbeing Board, a Public Health Transition Group is being set up which will meet monthly with membership consisting of senior managers, an Elected Member, and a representative from the GP consortium. A job description for appointment of a substantive Joint Director of Public Health is currently being finalised. A programme of briefings and discussions with key partners is being developed; this will include Elected Members, Voluntary Sector, General Practices, and the general public. Bristol; a Transition Board has been established, chaired by the Joint Director of Public Health and comprising senior officers from the local authority. There are subgroups for Business and Governance, Programmes and Functions, Strategic Communications, and Workforce. Briefing and discussion events for the Health and Wellbeing Board and for Health Scrutiny have taken place or are planned. No formal transfer of staff, of formal integration of functions, will take place until there has been national confirmation of budget and HR arrangements. North Somerset; a Joint Health Development Steering Group has been established, chaired by the local authority Chief Executive. Beneath this sits a Public Health Transition Board chaired by the Director of Public Health, with subgroups relating to accommodation, the public health offer, education and training, provider services, support to GP consortia etc. The public health team will move in June to be physically located with local authority staff in Castlewood. The Health and Wellbeing Board has devoted a full meeting to the Public Health White Paper, and the local authority chief Executive and HR director will be attending a half-day event for the public health team.
South Gloucestershire; a Transition Group has been established co-chaired by the chief executive of the local authority and the chief executive of the Primary Care Trust. This will oversee the establishment of the new Health and Wellbeing Board, the transfer of public health responsibilities, and the development of joint commissioning. Public health staff from the primary care trust are relocating to the local authority offices in March. Joint Working; there is a strong tradition of shared working across the public health teams locally and regionally, in order to ensure that scarce specialist skills and capacity are used efficiently and to best effect, and in order to support a robust training and education programme, and a strong public health intelligence and analysis function. A substantial and important part of the public health function is concerned with Health Care Public Health, and the Public Health White Paper and there is concern in some quarters that the NHS Bill has not fully recognised this. It is essential that the developing arrangements ensure that all aspects of the public health role are fully safeguarded for the benefit of the public. Implications for the Health and Transport Forum The proposal to establish the Health and Transport Forum was developed in full knowledge of the Government proposals for health sector reorganisation. The Forum will assist the four local authorities in preparing for, and fulfilling one aspect of their expanded responsibilities for public health, as set out in the Health and Social Care Bill. The Forum will make efficient and effective use of scarce public health capacity, by making public health advice and support available to local authority colleagues and to NHS acute trusts (providers of hospital services). The Forum will help to avoid the need for duplication of effort, and will provide a stable mechanism for pursuing joint work during a time of considerable upheaval. Dr Angela E Raffle, Consultant in Public Health, NHS Bristol