Agenda item

RESOLVED: That Cabinet;

a)    Agreed that the blueprint would be amended from 31st March 2022 to include a separate Director of Public Health for North and West Northamptonshire Councils.

b)    Noted that the Director of Public Health for West Northamptonshire Council will be funded by the Public Health Grant in accordance with s73A (2) National Health Service Act 2006.

c)    Noted that the Senior Appointments Employment Committee and the Chief Executive to take all necessary actions to complete the recruitment process and appoint a Director of Public Health for West Northamptonshire Council in conjunction with the Office for Health Improvements and Disparities at DHSC and the Faculty of Public Health.

d)    Noted that the salary of the post would be in line with the Pay Policy agreed by Council in February 2021.

REASONS RESOLVED:

The reason for the recommendation was to secure the specialist capacity and capability of a dedicated Director of Public Health to meet the statutory duties of the Council in relation to the health and wellbeing of West Northants residents, and ensure we maximise the opportunity of public health working more closely with our other unitary services to improve the wellbeing of

our residents.

ALTERNATIVE OPTIONS:

As part of the discussions and review we had considered three alternatives:

      i.        Maintaining the single shared DPH

    ii.        Putting two new Assistant Directors in place as dedicated North/West Senior leads reporting to a single DPH, and

   iii.        Creating dedicated DPH roles in each Council

Maintaining the single shared DPH.

·         The focus on the ICS and the shared role approach, with the emerging levelling up agenda means that North and West Northamptonshire Councils need to review the benefits of the shared arrangement.

·         There were clear opportunities to link up a range of community, wellbeing and people services to deliver better outcomes for residents and to make the most of the responsibility now sat with the unitary councils for all elements of local government.

·         Each unitary now delivered adults social care, public health, economic development, education, housing, leisure and community services and this enabled each council to positively influence the key determinants of wellbeing, such as jobs, housing and access to green spaces; and links services in a way that was more challenging in the past.

·         Both Councils want to develop strategies that focus on local prevention and early interventions, and both have signed up to the ICS principles of population health management and outcomes measures with targeted local delivery designed to reduce local health inequalities and address local health issues, these vary across place, and this is reflected in the plan for the ICS and council services to operate at locality level.

·         There would also be a need to join up the people and place commissioning services in each Unitary with the DPH, Adults, Children’s and property commissioners all working together to inform place shaping and address specific local health inequalities in the two new areas.

·         The new ICS design recognised the benefits of a single population health strategy for the county underpinned by an outcomes framework that all partners work within to reduce inequalities and into which the DPH would feed.

·         However, it was also recognised that there would be two “places” (set on the unitary boundaries) that would have their own health and wellbeing strategies and boards which understand and focus on the characteristics of North and West Northamptonshire’ residents and specifically tackle the health inequalities, long term conditions and poor health at a local level to make sure services reflected that local need.

·         It was a statutory duty of each Council to meet the needs of residents and it was important in the emerging Council strategies that there was a focus on local need and how resources and assets were deployed to ensure that people of all ages had the best life chances. It is the view of the Executive that these aims would be better supported by having a dedicated North and West DPH.

·         While sharing a DPH provided joined up thinking and alignment across the county and with health partners working at county footprint levels, there was a risk that there would be less focus on unique characteristics and needs of each unitary boundary and the specific wider determinants of health that affect them.

·         It would be important that the DPH work closely with other Council officers responsible for People and Place. Whilst these relationships had been progressed by the current postholder, working across organisations reduced the DPH’s capacity to achieve even greater integration and the best possible use of assets and resources to improve outcomes.

·         This was not therefore considered the best option for the Council.

Establishing three new Assistant Directors as dedicated North/West/CCG

Senior leads reporting to a single Director of Public Health

·         The above option (which was part of the original Blueprint) had been considered and was the recommendation of the existing DPH, this option was not however recommended as the statutory responsibility for North and West Northamptonshire Council remained in a shared post and created the potential for conflicting priorities and focus between a shared DPH and dedicated Assistant Directors.

Creating dedicated Director of Public Health roles in each Council

·         Creating dedicated DPH roles in each Council was the preferred option of the Executive The considerations above regarding the reasons why a shared DPH was not considered to be the best option highlight that a single DPH would ensure the best accountability and focus on resident outcomes. It should however be noted that an additional cost will result from this option.

·         There would be an increasing need for the Council and members, who were responsible for their populations, to evidence local focus and address the levelling up agenda for the two council areas, request local interventions and make budget investments that match local priorities; these would not always be aligned between the Councils and a single DPH has been recommended so sole focus and decisions could be based on a single council area.

·         Having a single DPH in each Council addressed the needs outlined within the report and created clear accountability for residents in West Northamptonshire. It would also provide a clear line of sight for members and a clearer alignment of roles, budget, services and focus.

·         When health leaders and chairs were advised of the proposal to move to a single DPH, they raised that the split could undermine the work done to date and the agreed principle of the ICS having a single population health management strategy and capability and a single cross cutting county health and wellbeing strategy.

·         To mitigate these concerns, the Chief Executives and Leaders of both North and West Northamptonshire Councils’ entered into discussions to agree and reinforce the authority’s continued commitment to their principles.

·         The Councils also agreed that a key component of the new DPH duties and job descriptions would be the requirement to collaborate with the CCG/ICS and other Council DPH counterpart in the creation of joint strategies whilst recognising that below this each of the two “Places” (unitary council footprints) in the county would each need to have their health and wellbeing strategies that were overseen by the Health and Wellbeing Boards in each.

·         In addition, it was also agreed that the Councils would continue to support a shared intelligence and decision-making unit by providing analysts capacity to make sure that the unit could support system wide evidence and intelligence to inform policy. The detail of this arrangement would be developed further with the ICS.

·         This option had been subject to consultation with the current post holder, Office for Health Improvement and Disparities (OHID) and with health colleagues. OHID and the Faculty of Public Health had confirmed this change could be executed, assisted with the development of a new Job Description and would be part of the planned recruitment processes as this would be a jointly appointed role between OHID, a Faculty Assessor and the Council.

·         The current postholder had been consulted throughout the process. Employment policies and procedures would be followed with regard to the current postholder.

At the Chair’s invitation Councillor Matt Golby presented the report, copies of which had been previously circulated.

Councillor Golby said that he wished to recognise the work that had been undertaken by the current Director of Public Health, Lucy Wightman, specifically with the response to the Covid-19 pandemic. The committee was informed that the blueprint would now allow WNC to have a designated Director of Public Health separate from North Northants Council.

Recommendations were put to Cabinet.