Agenda item

            The Committee considered the following report:

 

“1.0      Purpose of Report or Summary of main Issues

 

1.1       The purpose of this report is to update members on progress to date since the last report was presented to People & Communities Committee in November 2021.  It outlines the context, reminds members of the findings and recommendations of the VfM Review, sets out the proposed arrangements for governance and oversight, and outlines the agreed priorities and emerging actions in support of Phase VII and community planning under health inequalities.  It also seeks approval from members to provide Belfast Healthy Cities with a longer-term commitment (in terms of contract and finance) to end of March 2026.

 

2.0       Recommendations

 

2.1       Given the recent positive conclusions of the Value for Money Review completed in 2021, alongside the recent redesignation of Healthy Cities status for Belfast from 2021 to 2026, and the role that BHC will play in addressing identified health inequalities priorities and actions agreed under the Belfast Agenda Refresh (22-26 new community plan) it is recommended that Committee:

 

·        In addition to the funding already secured for 22/23 - agree to commit to fund Belfast Healthy Cities at the same level (£81,294 per annum) for a further 3-year period to align with the Phase VII and Community Plan timeframes – to 31 March 2026. 

·        Note a report will be brought to Living Here Board on 13th June requesting that the Board recommend to the Belfast Community Planning Partnership that the Health Inequalities Strategic Reference Group (HISRG) be established, and recognised, as the oversight body for allocating resources to, and agreeing and reviewing action(s) undertaken in support of, health inequalities work in the city under community planning.  It is proposed that Belfast Healthy Cities will have representation on this group.

 

3.0       Main report

 

3.1       Background/Context

 

            Belfast’s membership to the WHO European Healthy Cities Network is facilitated by Belfast Healthy Cities (BHC), an independent partnership organisation, recognised as having charitable status by The Charity Commission for Northern Ireland. Belfast Healthy Cities is governed by a Board of Directors, elected annually and representing the public, university, voluntary and community sectors.

 

            Council are one of four core funders to Belfast Healthy Cities, along with the Public Health Agency (PHA), Belfast Health and Social Care Trust (BHSCT) and Northern Ireland Housing Executive (NIHE).  Annual funding amounts to over 300k of which BCC contributes £81,294.

 

            Phase VI of the WHO European Healthy Cities Network was in operation from 2014 and came to an end in 2019.  The application process for Phase VII commenced in 2019, with the outcome originally expected to be known by April 2020. This was significantly delayed by the onset of the Covid-19 pandemic and as such the existing contract with BHC was extended during 19/20, 21/22 and for the first quarter of 22/23.

 

            On 21st May 2021 Belfast Healthy Cities confirmed that the City of Belfast had been successful in its application (previously approved by Council), and had been designated in Phase VII, and thereby extended as a WHO European Healthy City to April 2026.

 

3.2       Copius Consulting Value for Money Review Conclusions

 

            On behalf of the four funders, BCC led on a quotation exercise and as a result Copius Advisory Services/Consulting were appointed to undertake a ‘value for money’ review based on the Challenge, Compare and Consult components of the 4 C’s of Best Value.  The findings of the review were presented to P&C Committee in November 2021.

 

            Ultimately the review concluded that the funding provided to BHC by each of the partner organisations represented good value for money based on return for investment.  As part of the recommendations several work areas were identified for the funding bodies to consider and progress, namely:

 

1.      Ensuring BHC investment is strategically aligned to policy drivers including the Programme for Government, Making Life Better and the Belfast Agenda.

2.      Moving performance analysis to an outcomes focused / based approach (away from output measures).

3.      Establishing a clearly defined role for Belfast Healthy Cities with consistency of service across Belfast.

4.      The removal of duplication in planning and reporting between Belfast Healthy Cities and the various funders involved in this process.

 

            The funders agreed to continue to work with Community Planning leads, and with Belfast Healthy Cities, and Belfast Health Development Unit, to ensure better alignment of existing resources and streamlining of oversight and accountability processes to include addressing the governance concerns and duplication issues identified that had been identified within the review.

 

 

3.3       Nov 21 P&C Committee Report

 

            The report to members of P&C committee in November 2021 sought approval for officers to continue to work with partners to:

 

•        undertake a series of facilitated discussions between Nov 21-Mar 2022 namely with BHDU staff, BHC staff and Board alongside key health and community planning leads to develop and agree health priorities for Belfast to be progressed as part of the Belfast Agenda Refresh, Belfast’s Phase VII plan and the emerging ICP structure and planning process for Belfast; and

•        agree the governance structure and resources anticipated/required to progress the priority actions.

 

3.4       November 2021 to May 22 Progress Update

 

            Facilitated Workshops

 

            Irene Hewitt was appointed by the Public Health Agency to facilitate three workshops on behalf of the funding partners.  The first was held on 9^th December and focussed on governance and specifically the proposal to establish a Health Inequalities Strategic Reference Group – it was attended by representatives from BCC, BHSCT, HSCB, NIHE and PHA.  The second was held on 14th December 2021 and brought together BHC and BHDU staff alongside thematic leads from across the health family specifically those responsible for drugs and alcohol, mental health, physical activity and nutrition to review existing community planning priorities and actions and agree how these should be amended and/or further developed in support of the ‘health inequalities’ priority under the Belfast Agenda refresh.  A third focussed workshop was facilitated by Irene on 7th March and involved the BHC CEO and several Board members working alongside the funding partner leads to consider the Phase VII priorities alongside the proposed refreshed community planning priorities identifying opportunities for alignment.

 

3.5       Governance and Oversight

 

            The VfM review recommended that funding partners considered their position as Board members of Belfast Healthy Cities and whether this could be considered as a conflict of interest – this applied to Belfast City Council, Belfast HSC Trust and NIHE – PHA do not currently sit on the Board.  As a result of this recommendation, each agency has had follow up meetings with their internal legal departments and all three have been advised to withdraw from the Board.  This has been communicated verbally to Belfast Healthy Cities and formal responses are currently being drafted. 

 

            It has been agreed from 22/23 onwards that:

 

•        Regular contract monitoring will continue to be undertaken by each funding body – using the same (PHA and BCC-quarterly) or similar (BHSCT-bi-monthly) progress monitoring template.

•        A more strategic level review will occur biannually between the funders and BHC.

•        BHC will also join the HISRG once established which will then incorporate the wider view and work being undertaken across the city to tackle health inequalities.

 

3.6       Agreed Priorities, Actions & Outcomes Based Accountability (OBA) Approach

 

·        The funders and BHC will meet collectively to set and review progress against targets twice a year (as noted above).

·        The 22/23 Progress Monitoring Return PMR) will be transitional taking account of the fact that the refreshed community plan won’t be finalised until towards the end of 2022/23.  The PMR will have more of a focus on outputs and outcomes and the funders have agreed to support BHC to develop an OBA approach to a number of in-year actions.

·        The contract with BHC will specify that the PMR will be reviewed and adjusted (where/when necessary) on annual basis – to take account of developments and emerging issues.

 

Phase VII Priority Areas	Action Areas
Promoting Healthy Transport	-Supporting good active travel infrastructure to increase physical and mental wellbeing -Generating the Evidence to Support Reduction in Car Dependency -Improving Air Quality and Public Health
Greening the City	-Intersectoral Partnership for Healthy Places -Child Friendly Places -Age Friendly Cities
Community Prosperity	-Caring Places that Enhance Health and Well-being and Reduce Health Inequalities
Increasing Knowledge & Capacity	- Inequalities Training: Building Public Health Capacity at the Local Level -Health Literacy: Fostering Greater Participation for Health and Well-being through Increasing Health Literacy - Seminar Series on People; Place; Participation; Prosperity; Peace; Planet
Maximising Learning & Knowledge Exchange	- Promote Belfast within global and European networks and to maximise knowledge and learning from WHO, international and other networks among elected representatives; stakeholders in the public, voluntary, community and private sectors

 

3.8       It is clear from the priority and action areas outlined above, and the initial mapping work already undertaken that there will be significant alignment with the proposed refreshed Belfast community plan priorities actions across all of the themes, namely:

 

Climate, Resilience & Sustainability	Connectivity, Sustainable & Active Travel	Housing-led Regeneration	Health Inequalities	Future City Centre
Educational Inequalities	Employability & Skills	Sustainable & Inclusive Economic Growth	Community & Neighbourhood Regeneration	City Regeneration & Investment
Cross Cutting themes:	Inclusive Growth	Children and Young People	Good Relations & Shared Future	Older People

 

            As outlined previously, it will be considered and agreed via the Health Inequalities Strategic Reference Group (HISRG) who is best placed (from Belfast Healthy Cities, from Belfast Health Development Unit or via thematic or service leads within the Partner Organisations – or indeed a combination of some or all) to provide support to take forward timebound specific pieces of work in support of key actions.  We will also be able to draw on Belfast Healthy Cities relationships and networks with peers and colleagues in the UK, Ireland and Europe to avail of, and share, learning and expertise.

 

3.9       Financial and Resource Implications

 

            The total in-year financial allocation from Belfast City Council to Belfast Healthy Cities is £81,294 which has been included in the planned budget for 2022/23 and previously approved by P&C Committee in November 2021 – ratified by Council in December 2021.

 

            Officers are seeking approval to enter into a contract with Belfast Healthy Cities from 22/23 to 25/26 to align with the both the timeframe for Phase VII (21-26) along with the refreshed Belfast Community Plan (22-26).  This would involve a contract being in place from 1st July 2022 to 31st March 2026 and Council commitment to continue funding BHC to the same level (£81,294) for 23/24, 24/25 and 25/26.  Members will be aware that the level of funding will be subject to annual approval by committee through the estimates setting process.

 

            It is worth noting that Council has previously approved continuous funding (approval was given on the 5th September 2012 by the then Health & Environmental Services Committee that funding to BHC be maintained for three years from April 2013 to March 2016).  This level of commitment allows for stability within the organisation in relation to recruitment and retention, and in the building and maintaining of relationships, as well as for consistency in developing and delivering on agreed actions in support of Phase VII and Community Planning. 

 

            It should also be noted that Belfast was first designated to the WHO European Healthy Cities Network in 1988 and that the city has been a key member since that time, supported by Belfast Healthy Cities, with the recent VfM review in 2021 having concluded that this arrangement represented a good return on investment for Council (and the other funding partners) in relation tackling health inequalities in the city and raising the profile of Belfast within the European Healthy Cities Network.

 

3.10      Equality or Good Relations Implications/

            Rural Needs Assessment

 

            None identified at this stage but kept under continuous review.  It should be noted that much of the work undertaken by BHC is to address, or promote awareness of, health inequalities and best practice whole population or targeted approaches to mitigate or prevent these.”

           

            The Committee adopted the recommendations.