Health and Wellbeing

What can we do differently to deliver better outcomes and save

money?

Castle Vale Neighbourhood Community Budget

Pilot

Ruth Miller 6th September 2012

Castle Vale Neighbourhood Partnership Board

• Responsible for the strategic overview of the neighbourhood

• Brings together the key stakeholders from education, health, housing, BCC and WM Police with TRA and 6 elected residents

• Responsible for the production of the neighbourhood plan

Community Safety Forum

Jobs, Education and Training

Housing and Environment

Resident Scrutiny Role 2005 Group

Endowment Trust Fund

Community Aspiration and Leadership

Ward / Constituency/ City Strategic Partnerships (1)

Sub-Groups

Diagram one

Health Improvement Forum

(1) Restructuring in Birmingham City Council means that at the time of writing there is a lack of clarity regarding how these strategic structures will operate.

Neighbourhood Partnership

Board

Youth Council

Informal Networks

Neighbourhood Community Budget Pilot: Castle Vale [Population: c10,000]

Aspirations…•A fit and active community.•More responsive and local services with increased take up and better outcomes•Community control of leisure services

Challenges…• Time commitment required by health

partners to disaggregate budgets and establish new ways of working.

• Encouraging and supporting local residents to take advantage of opportunities to co-design.

… will be achieved by…• Better co-ordination between GPs and

community-based Health providers to develop a package of tailored services, managed by…

• a Castle Vale Health and Well-being Board that will manage pooled budgets and commission local health services. This activity would be complemented by:

• the possible transfer of a swimming pool, football stadium and playing fields, and a nature conservation area to community ownership

Key achievements over the past three years

Health &Well-being

Health Improvement Forum

Effective partnerships

Neighbourhood baseddata driving local health initiatives

Resident Involvement CVCRS

community health programme delivering a range of interventions

10 year neighbourhood plan

Key reasons for successes and failures

Failures:• Inevitable limited

resource• Greater links across all

services required• Need to get GP’s

involved- missing link to inter-agency work

• HAT very successful but in some ways led to people thinking everything is done for them

• Need to get people involved in green space more

• Change takes time!!

Successes:• Effective relationships

and communication• Common goals and

agendas• Getting best value out

of resources in place • Fantastic community

infrastructure• Lots of groups in

Castle Vale

Developing the local needs analysis

• Secondary data – from BEN PCT and Birmingham Public Health Information Team

• Primary data – from a community health survey of 600 residents

• Resident consultations at events and groups

• Partner consultations• Trends and new baselines

Future challenges and prioritiesSmoking prevalence, especially mid-age men

Growing obesity, poor diet, low physical activity

Alcohol consumption especially young people

Mental wellbeing Isolation in mid-years

Low, declining self-rated health status generally Whole person / whole family approach (work, skills, money, lifestyle, positive aspiration, quality of life, civic engagement)

Need to integrate GP and community based actions better

Neighbourhood Community Budget Pilot

• Opportunity to explore new ways of resourcing local services that respond to local priorities in a more effective, efficient and economic way

• Opportunity to take our aspirations for local health management to a ‘new’ level, looking at devolution of budgets, not just influence

• Opportunity to test out the gov proposals for local health reform, see if it works in practice

• Back up of CLG to obtain support and commitment from key partners- high profile pilot that agencies and individuals will want to be part of

-Needs significant buy-in from public sector partners-Statutory commissioners and finance officers need to be involved early-Partner engagement, particularly GPs- previous history / difficulties with engaging-Having said that, GPs are very interested in the new approach-Community politics!- working with key reps to agree to progress items as a collective

-Access to information- difficult and time consuming

-Too many priorities (health)- agreeing with the steering group to focus on 2-3 target areas as part of the pilot project

-Need to be outcome focussed

-Processes within the City CAT process eg swimming pool procurement systems/ EU requirements

Neighbourhood Community Budget- challenges

– Castle Vale NCB Project Plan

Key milestones

Establish a health steering group

Feb 2012

Develop newly constituted CV health and wellbeing Board

July 2012

Establish CV HealthVoice Mar 2012

Develop new CHAT network

April 2012

Establish baseline audit/ spend mapping

July 2012

Develop Evaluation Framework

July 2012

Workshop to confirm budgets and agree what we will do differently via NCB

July 2012

Develop draft community budget

September 2012

Neighbourhood Partnership

Board

Castle Vale Health and

Wellbeing Board

HealthVoice

Community Health Action Talks

(CHAT)

Birmingham Health and

Wellbeing Board

Neighbourhood Partnership BoardHealth and Wellbeing Relationship

chart

Community commissioning

body

Strong leadership and partnership working

Locally set priorities and outcomes

Aligning or pooling resources

Robust governance and accountability

.

Community commissioning overviewCommunity commissioning is an ambitious form of co-production – where power and responsibility for local public service commissioning is shared by local partners. It will vary from place to place depending on what makes sense locally but key elements have been evidenced as: devolving or sharing

commissioning power and responsibility with communities; building community capacity to commission; strong local leadership and partnership working; locally set service priorities and outcomes; aligning or pooling resources; establishing robust governance and accountability.

Service users and community members have a central role in local public service

commissioning using mainstream spendSenior

partners buy into the new commissionin

g model

Community is supported and

trained to take

commissioning

responsibility

Existing commissioners devolve or share power

with community

Resources are mapped / aligned /

pooled and accountability

is managed

A local leader(s) believes a

new approach is needed to local public

service commissionin

g and instigates

change

A Members will vary but will

include service users and

residents plus others e.g.:

• Community organisations

• Service providers and employees

• Existing commissioners e.g. Local Councillors

• Business partners

Local partners can identify their service needs and priorities -

whatever is important to them e.g.

unemployment ; health; traffic calming; street

lightingLocal partners can

review service delivery against

outcomes, and based on

results contracts can be renewed

or decommissio

ned

Local partners can procure services to

meet their priorities, design specifications,

and desired outcomes. This may require de-

commissioning

Local partners can

design services to meet local priorities – resulting in

more effective, integrated

and personalised

services

Leader could be from anywhere

in the community e.g.

voluntary organisation; community group; local

authority

Community commissioning body can take a variety of forms e.g. advisory body; mutual; social

enterprise; CIC

A community commissioning

body is formed to influence

commissioning of local services

Local partners can have one or more roles across the commissioning

cycle