DD2653 Developing knowledge and skills on Health in All Policies across the GLA Group

The GLA Group Public Health Unit (GLAG PHU) was set up under the auspices of the GLA Collaboration Board as outlined in Mayoral Decision (MD2940). The ambition is to strengthen the GLA Group’s capacity on public health; and to support work to tackle health inequalities delivering on the commitment to embed HiAP.  In order to deliver on this ambition, a system-led and systematic approach is required to build confidence and skills to execute health in all policies and achieve change.   
1.2     Initial scoping activity was approved via ADD2613 Identifying and addressing knowledge and skills gaps with respect to Health in All Policies across the GLA Group workforce |. Work to establish the systematic approach for delivering health is all policies was approved via MD2688 Health Team Work Programme 2020/21 | London City Hall. 
1.3     In 2021, via MD2688, the GLA commissioned an external provider to perform a rapid literature review, internal and external stakeholder interviews, and workshops to prepare a report on best practice in embedding a health in all policies (HiAP) approach across organisations, illustrating this through a theory-of-change model. One strand of this multi-modal approach is knowledge and skills development across GLA Group organisations.
1.4      Understanding more about skill and knowledge gaps was advanced in 2022-23 via ADD2613. We commissioned a knowledge and skills needs assessment with senior representatives across the GLA Group. The aim of this work was to;
•    Identify knowledge and skill gaps across the organisation with regards to HiAP
•    Make recommendations for a syllabus of learning to support HiAP practice 
•    Make recommendations for the content of an introductory resource aimed at those new to the organisation(s) or new to HiAP.
1.5   The key findings of the skills and knowledge needs assessment informs this next phase of the project. The report specifically noted that existing HiAP resources and toolkits were not appropriate for the GLA Group, as the GLA Group already have an advanced understanding and knowledge of HiAP.  
1.6    It specifically recommended developing resources that support a shared language across the GLA Group with regards to HiAP and supports members to progress ideas into implementation through:
•    the development of a set of resources that are bespoke to the GLA Group, suitable for varying levels of experience and knowledge
•    resources that are available on demand and integrated into existing learning and development processes
•    a series of case studies that showcase best practice and demonstrate the application of theory into practice
•    a culture of learning and peer to peer support through annual masterclass events and regular peer to peer workshops. 
1.7    The skills and knowledge needs assessment recommended three strands of activity: (i) an introductory HiAP module; (ii) bite-size training set out as a syllabus with information in various formats covering drivers to health in London and the tools to develop HiAP strategies and programmes; (iii) interactive sessions, preferably face to face, to build a network.
1.8     Recommendations (i) and (iii) will be implemented in 2023, starting off with a HiAP in-person masterclass in autumn 2023 and the development and publication of the introduction to HiAP as an online resource.  This initial training and resource activity is undertaken via the ADD2613 approval. 
1.9     This DD sets out proposals for developing the substantive HiAP syllabus training and resources (recommendation ii) in 2023-24 and some supporting activity in 2024-25. 
 

The overarching objective of this work programme is to embed HiAP activity in a systematic way across the GLA Group, by enhancing individual knowledge and learning, alongside events and a peer to peer support network. The development of the HiAP resources are aimed at new staff and existing staff taking on new roles across the GLA Group. The implementation of this approach is supported by the GLA Group Public Health Forum and the Public Health Collaborative Professional Community who will further support roll-out to their respective organisations. Feedback and evaluation will be built into the training and network activity. 
HiAP training resources and collaboration network
2.2   The PHAST report recommends a HiAP syllabus to support practice across the GLA Group. This includes theoretical content and London specific content that will provide members with a strong background understanding of the drivers of health of Londoners, theories of behaviour change, implementation and evaluation. All items of the syllabus are important in developing a staff cohort that have varied levels of knowledge and experience.   
2.3      The GLAG PHU mapped the syllabus against some existing internal and external resources, and identified resources that would need to be developed as London specific versus those items that are more generic (such as content covering behaviour change theory). Further consultation with GLA Group members also highlighted the value of case studies in bringing theoretical content to life and demonstrating how to apply the learning to practice. 
2.4      Therefore, the commission will only focus on developing resources and case studies that do not already exist internally or externally, or where a London specific context is required. The resources will be evaluated, and any amendments will be undertaken as part of the planned refresh in 2024-25.
 2.5      The development of the HiAP training programme aligns with both GLA policy professional development programme and the GLA Group collaboration practice networks. The GLA PHU has been working closely with colleagues in these teams to ensure the approach aligns and integrates with existing processes. Development and testing of the resources will be undertaken with end- users i.e. members from across the GLA Group. The planning and delivery of the HiAP training and resources will be programmed into the wider GLA policy development activity. 
Expected outcomes 
2.6      The HiAP resources, masterclass and online workshops will directly support the ambition to process the application of HiAP from opportunistic to systematic by building skills, knowledge and capacity across the GLA Group. Alongside the resources we will establish a method to monitor delivery and impact.

2.7     The work will raise the profile of the GLA Group and further build its reputation as a world class leader of HiAP. The resources developed and the approach taken by the GLA Group will be of interest to cities and regions nationally and internationally. The development of the case studies and context specific material and tools fill a knowledge gap and will enable London to share our learning. 

2.8     In addition this activity will also support and align with the GLA Group Public Health Collaborative Professional Community and aspirations to enable deeper collaboration across the GLA Group.
 
Budget allocation 
2.9     The total cost of this activity is £70,000.

HiAP is a collaborative approach to policy development that encourages all sectors to consider the health impacts of their policies, and work together to provide integrated and joined-up responses to complex health challenges and health inequalities. HiAP covers a wide range of activities and seeks to “embed considerations of health, equity and sustainability as a standard part of decision-making processes”.

3.2     Embedding a Health in all Policies approach across the GLA Group is the goal of this commission This approach requires all sector to work towards minimising social inequalities that give rise to health inequalities (avoidable, unfair and systematic differences in health between different groups of people). Health inequalities are most often experienced by those belonging to these four groups: deprived groups, those with protected characteristics e.g., sex, ethnicity, inclusion health (socially vulnerable groups e.g., asylum seekers, homeless) and geographical areas.

3.3     As such, this programme of work – which seeks to advance knowledge and skills across the GLA Group of how to embed a HiAP approach in their work, will ultimately aim to support non-health sectors to consider health more systematically in their work and strive to improve equality and reduce inequalities across such population groups. This underpins the GLA Health team’s work, and complements the goals set out in the Mayor’s London Health Inequalities Strategy.
 

This project contributes to the Mayor’s commitment for a HiAP approach to policies and programmes that aim to reduce health inequalities.

4.2     The GLA Group Public Health Unit is funded as a shared service through agreements with TfL, MOPAC and VRU, LFC, and OPDC. It has a small programme budget, which will be used in part to fund this work with the beneficiaries of the project being the signatories to the shared-service agreement.

4.3     This proposal to progress the HiAP cross GLA Group work programme was discussed and agreed at the GLA Group Public Health Forum meeting on 9 November 2022. The Phase 1 PHAST report was presented to the Public Health Forum 26 May 2023 with recommendations for next steps as set out in this report.  

4.4     Following the conclusion of a competitive tender process and contract award to the appropriate supplier risks and issues will be assessed and managed at each phase of the work prior to commencement.

4.5     There are no conflicts of interest to note for any of the officers involved in the drafting or clearance of this decision form.
 

This decision seeks approval from the Executive Director for Skills and Communities for the expenditure of £70,000 to fund commissioning of bespoke training material to support the delivery of HiAP across the GLA group including London specific case studies to begin to address these gaps across the GLA Group organisations. 
5.2     Based on the planned delivery timeline in section 7, is it expected that the delivery phase for the resources will take place in 2023-24 and 2024-25. In 2023/24, £60,000 is available in the programme budget. Provision is also made for £10,000 expenditure on 2024-25. 
5.3     The approval includes provision for £10,000 activity in 2024-25 will be subject to the annual budget setting process and is subject to change. The expenditure of £10,000 in the financial year 2024-25 is assumed to be affordable within the provisional budget and can only be confirmed when the budget allocation is formally approved in March 2024.
5.4     Any contracts that commit the GLA in future years are subject to appropriate break clauses.
 

6.1.    The foregoing sections of this report indicate that the decisions requested of the director concern the exercise of the GLA’s general powers; falling within the GLA’s statutory powers to do such things considered to further or which are facilitative of, conducive or incidental to the promotion of economic development and wealth creation and social development in Greater London; and in formulating the proposals in respect of which a decision is sought officers have complied with the GLA’s related statutory duties to:
•    pay due regard to the principle that there should be equality of opportunity for all people
•    consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom
•    consult with appropriate bodies.       
6.2.    In taking the decisions requested, the director must have due regard to the Public Sector Equality Duty; namely the need to eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010, and to advance equality of opportunity between persons who share a relevant protected characteristic (age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; sexual orientation) and persons who do not share it and foster good relations between persons who share a relevant protected characteristic and persons who do not share it (section 149 of the Equality Act 2010). To this end, the director should have particular regard to section 3 (above) of this report.  
6.3.    All procurements of works, services and supplies required for the project must be procured in accordance with the GLA’s Contracts and Funding Code (the “Code”) and, where the value exceeds £150,000, in accordance with the Public Contracts Regulations 2015 (the “Regulations”).  Furthermore, the officers must liaise with Transport for London’s procurement and commercial team, which will determine the detail of the procurement strategy to be adopted in accordance with the Code and the Regulations. Officers must ensure that appropriate contractual documentation be put in place and executed by chosen service provider/supplier and the GLA before the commencement of the attendant services.
 

Following the conclusion of a competitive tender process and contract award to the appropriate supplier the project will be undertaken to March 2024 with the expectation that all the materials will be completed and launched ahead of the second HiAP masterclass in June 2024. Provision is made for light-touch update and refresh of materials in 2024/25. Further details are set out in the table below.