Decision Maker: Executive
Decision status: Recommendations Approved
Is Key decision?: Yes
Is subject to call in?: Yes
To agree the new arrangements for the delivery of the Public Health Service in East Berkshire.
i. The Executive agree the new East Berkshire arrangements for Public
Health delivery; and
ii. The current Berkshire-wide Public Health arrangements are dissolved, and the new system put in place, including the appointment of a Joint Director of
Public Health for East Berkshire and Frimley ICS.
1. Since 2013 the Berkshire Public Health System has operated on a hub and spoke model with Public Health teams within in each of the six unitary authorities supported by a Shared Strategic Director of Public Health and a Shared Team hosted by Bracknell Forest Council.
2. The overall aim of the Berkshire Public Health System is to deliver the core public health duty for local authorities which is to take steps to improve the health of residents and decrease health inequalities. To meet the needs of our residents, this will require action, not only from the Council but also across our system of public services, on the wider determinants of health, health improvement, health protection and the design of health and care services.
3. National policy supports the importance of prevention of ill health – through the green paper for prevention and the NHS Long Term Plan. Locally the Joint Health & Wellbeing Strategies support increased activity to promote good health and prevent ill health. Action to prevent and manage risks for ill health have become more urgent with the recognition that risks for heart disease and stroke increase the likelihood of harm from Covid.
4. Upper tier Local Authorities receive a per capita ring-fenced grant for public health of circa £38m across Berkshire. In the three authorities in the East of the county, this totals around 17m, around half to Slough and smaller grants to RBWM and Bracknell Forest. Each authority spends different proportions of its allocation on staffing local public health teams with varying contract values and investments in broader services and programmes for public health.
5. Berkshire Chief Executives collectively oversee the functioning of the public health system through the Public Health System Board. Increasingly, they have been concerned about the ability of the public health set up to deliver what they needed, to lead across organisations to improve health, prevent illness and decrease demand for health and care services.
6. In 2019 Berkshire Chief Executives requested a review. They considered the
effectiveness of the current model, the changing context and opportunities for public health, current costs, and alternate models. They recommended dissolving the current arrangement and moving to two hub and spoke arrangements across East and West Berkshire aligning with the health arrangements in these two distinct areas.
7. As the recommendation was made the Covid-19 pandemic arrived and halted much of the progress in shifting to a new model. With increasing responsibility at a local level and the current Director of Public Health planning to move on early in the New Year, there is an urgency in progressing the new arrangements and appointing a Director of Public Health for the three Local Authorities in the East of Berkshire.
Current Public Health arrangements could be retained with a single Director of Public
Health working across the whole of Berkshire. However this is not considered to
align with the health arrangements across the geography and the ICS, which covers
Eastern Berkshire. The Pandemic has also demonstrated the need for more
focussed resources in the locality to deal with the ongoing outbreak management
and future health needs that may arise as a result of the pandemic.
Reason Key: Affects more than 1 ward;
Wards Affected: (All Wards);
Financial Impact: The Impact of these proposed changes will be covered by the Public Health Grant awarded to the authority.
Subject to Urgent Proceedings: No
Making Representations: In writing to the Director: Place, Planning and Regeneration.
Other reasons / organisations consulted
Contact: Andrew Hunter, Executive Director: Place, Planning & Regeneration Email: firstname.lastname@example.org Tel: 01344 351907.
Report author: Andrew Hunter
Publication date: 20/10/2020
Date of decision: 20/10/2020
Decided at meeting: 20/10/2020 - Executive
Effective from: 28/10/2020