MD2439 Health Team Work Programme 2019/20

Type of decision:

Mayoral decision

Code:

MD2439

Date signed:

12 March 2019

Decision by:

Sadiq Khan, Mayor of London

Executive summary

This MD seeks approvals necessary for the GLA’s Health Team to deliver elements of the London Health Inequalities Strategy and to support the Mayor’s leadership role in health and health inequalities, including the London health and care devolution agreement (2017). It includes: Health Team activity in 2019/20 and the GLA’s contribution to the London Health and Care Partnership between 2018/19 and 2021/22. In some areas, where further work is required to develop the delivery mechanism for a given project/initiative, the Mayor is asked to approve the spending envelope and to delegate to the Executive Director or Assistant Director approval of detailed expenditure proposals via a DD or ADD.

Decision

That the Mayor approves:

(a) For 2018/19:

(i) Receipt of £325,000 (from NHS England (£100,000), the Office of London Clinical Commissioning Groups (£100,000), Public Health England (£62,000) NHS Improvement (£50,000), Lloyds (£10,000), IOR Group £3,000));
(ii) Expenditure of £238,317 to support the work set out at section 2.80 in the London Health and Care Partnership work programme for 2018/19; and
(iii) The award of the remaining GLA and partnership funds (£379,683) to Lambeth Clinical Commissioning Group as a contribution to its costs of discharging the finance function of the Healthy London Partnership (section 2.82); and

(b) For 2019/20:

(i) Receipt of £136,000 (from Transport for London (£89,000) and the Oak and Park Royal Development Corporation (£47,000));
(ii) Expenditure of up to £2,554,000 to deliver the work set out in section 2 in the Health Team’s work programme for 2019/20, of which £457,000 will be subject to further Director/Assistant Director decisions setting out detailed expenditure plans; and

(i) Expenditure of up to £300,000 over two years for the Health and Care Devolution programme set out in section 2.86, which will be subject to a further Director decision setting out detailed expenditure plans; and

(d) In respect of b(ii) and c(i) above, delegates authority to the Executive Director (Communities and Intelligence) and Assistant Director (Health, Education and Youth).

Part 1: Non-confidential facts and advice

Introduction and background

1. The GLA Health Team has developed a programme of work to lead and implement the Mayor’s Health Inequalities Strategy for London (October 2018) with relevant partners and stakeholders; and support his leadership role as chair of the London Health Board. The aims of this approach are:

Healthy children;
Healthy minds;
Healthy places;
Healthy communities;
Healthy living; and
Supporting the Mayor’s leadership role for health.

1. The Mayor is required to produce a health inequalities strategy for London under the Greater London Authority Act 1999. Londoners experience stark health inequalities that are amongst the widest in England. This means that some Londoners are unnecessarily spending long periods of their lives in poor health or dying prematurely from potentially avoidable causes. Addressing health inequalities will ensure all Londoners benefit from good health, contribute to economic and social development, and reduce avoidable demand on the health, social care and welfare systems.

1. The Health Team is supporting the Mayor in developing a comprehensive approach to health for all Londoners which addresses the range of factors affecting health inequalities in London over the Mayoral term and beyond. Social, environmental and economic factors, known as the ‘wider determinants of health’ are a significant cause of health inequalities.

1. The wider determinants of health can be tackled by taking a Health in All Policies’ (HiAP) approach. The World Health Organisation defines HiAP as ‘an approach to public policies across sectors that systematically takes into account the health and health systems implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity.’ The Health Team does this by identifying opportunities to improve health through the work of the GLA group, supporting work on areas like transport, planning, housing, policing and the fire service.

1. There are embedded public health specialists within the GLA Planning team and Transport for London. The Health Team has supported the Mayor’s new Violence Reduction Unit (VRU) since its inception and helped define what a public health approach to violence reduction means for London. The Health Team has been heavily involved in embedding this approach within the unit and communicating it to internal and external partners. Embedded specialist public health skills and advice will help maximise the public health approach to violence reduction and connect the work of the VRU with other mayoral strategies.

1. Health and social care services also play a key role in Londoners’ health, although most studies suggest that healthcare accounts for less than half of the inequalities in people’s overall health. The Health Team is supporting the Mayor’s role in championing and challenging the health and social care system in London, ensuring it is as effective as possible in addressing health inequalities and in responding to challenges and opportunities including prevention, workforce recruitment and retention, digital innovation, maximising the contribution of health and care estates, and health and care service integration.

Previous mayoral decisions

1. MD2115 (May 2017) contained an indicative breakdown of expenditure for most of the Health Team programmes for 2019/20 and this MD builds on MD2115. The Mayor did approve 2019/20 expenditure for the following two programmes under cover of MD2115:

Up to £490,000 for the Healthy Young London Programme in 2019/20, which is now split into three separate workstreams: Healthy Early Years London, Healthy Schools London and London’s Childhood Obesity Taskforce; and
Up to £250,000 for the Healthy London Workplaces workstream in 2019/20.

1. MD2115 did not set out the details of how the budget would be spent for both programmes in 2019/20.

1. In September 2018 the Mayor approved expenditure for Health Team programmes for 2018/19 under cover of MD2323, which contains background information on these programmes. Other relevant expenditure approvals are listed under each workstream in section 2.

Summary of approvals sought within this mayoral decision

1. The table below gives a breakdown of 2018/19 budget for the London Health and Care Partnership workstream, and the decisions being sought for 2018/19 expenditure.

Workstream

Funding 2018/19

Expenditure 2018/19

London health and Care Devolution Programme

Total: £618,000

Approval of receipt of external income: £312,000
GLA’s 2018-19 Health Devolution Programme budget: £306,000

Total: £618,000

Approval to spend through this MD: £238,317 (programme delivery)
Approval to transfer remaining partnership funds to Healthy London Partnership: £379,683

1. The table below gives a breakdown of the 2019/20 proposed budget by workstream, and the decisions being sought for 2019/20 expenditure. 2018/2019 carry forwards have been included within the table for completeness. New decisions are required for carry forwards given the focus / delivery approach for some workstream strands have shifted.

Workstream	2019/20 proposed allocation	Approval to spend through this MD	Approval to spend via delegation to director or AD
Healthy Early Years London	£142,000	£142,000	N/a
Healthy Schools London	£122,000	£122,000	N/a
London’s Childhood Obesity Taskforce	£301,000	£301,000	N/a
Mental Health First Aid	£375,000	£375,000	N/a
Thrive London Mental Health Programme	£325,000	£295,000	£30,000
Healthy London Workplaces	£165,000	£165,000	N/a
Tobacco, Alcohol, Drugs, Gambling	£28,000	£28,000	N/a
Health in All Policies: Public Health Specialists	£250,000	£250,000	N/a
Legacy funding from the London Health Improvement Board	£75,000	£0	£75,000
Health Inequalities Strategy Implementation budget (breakdown below):
Health Inequalities Strategy mobilisation	£140,000	£140,000	N/a
Healthy Minds for Children	£47,000	£0	£47,000
HIV Fast Track Cities	£15,000	£15,000	N/a
Social prescribing	£160,000	£25,000	£135,000
Dementia Friendly London	£10,000	£10,000	N/a
Inclusion health	£43,000	£23,000	£20,000
London Health and Care Partnership:
NHS Liaison	£135,000	£135,000	N/a
London Health Board	£71,000	£71,000	N/a
Health and Care Devolution	£150,000	£0	£150,000
Total	£2,554,000	£2,097,000	£457,000

1. Expenditure will take the form of grant awards or payment for services procured depending on the nature of the work concerned and in line with relevant GLA procedures.

1. The table below gives a breakdown for proposed budget 2020/21 and 2021/22 for the Health and Care Devolution programme.

Workstream	2020/21 proposed allocation	2021/22 proposed allocation	Approval to spend through this MD	Approval to spend via delegation to director
Health and Care Devolution	£150,000	£150,000	£0	£300,000

Objectives and expected outcomes

Healthy Early Years London (Healthy children)

1. Purpose: The Healthy Early Years London (HEYL) programme aims to support London’s 13,000 early years childcare settings to boost the health, wellbeing and development of under-fives as they grow, play and learn, targeting those serving the most vulnerable communities.

1. Ambition by 2020:

A minimum of 10% of London’s early years registered settings will be signed up to Healthy Early Years London (with a potential increase to 15% pending the evaluation); and
All 17 “priority” boroughs (identified as having the worst outcomes in London on a range of measures) will be providing local support for Healthy Early Years London.

1. HEYL is new programme which launched in October 2018 following a period of development and piloting. It involves: engagement of boroughs, recruitment of early years settings to achieve HEYL award status; leadership and support of network and strategic advisory groups; hosting an annual celebration event and embedding HEYL in wider policy work across the GLA and with partners.

1. The 2019/20 work programme includes: implementing a moderation process; finalising and implementing Bloomberg Partnership for Healthy Cities evaluation recommendations; maintaining and developing an interactive website; investigating HEYL as a toolkit for best practice; commissioning a HEYL video; and further development of promotional materials.

1. Expenditure approvals already in place: (approved under cover of DD2158 (Oct 2017)) for receipt and spend of £60,000 from Bloomberg Philanthropies cities programme to commission a process and impact evaluation of the first year of the Healthy Early Years London programme. This programme is not included in the table below as no further decisions are required for this work. See section 1.7 regarding detail on expenditure approvals under cover of MD2115.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Fixed term staff expenditure within GLA Health Team (G9 0.6 FTE, G5 1.0 FTE)	Approval to spend £78,000
Commissioning a HEYL video and promotional materials	Approval to spend £7,000
Network and Strategic Advisory Group meetings; celebration event	Approval to spend £8,000
Maintenance of website and digital platform: to rectify ongoing bugs and implement website modifications/development to improve website access and functionality for childcare providers/users	Approval to spend £19,000
To sustain high quality local training and support to increase engagement in the HEYL programme and to trial and evaluate a proposed HEYL moderation process. Building capacity for boroughs and settings to: Increase engagement in HEYL Accelerate achievement of HEYL Bronze & Silver awards Implement effective quality assurance and moderation Meet the voluntary food and drink guidelines for England	Approval to spend £30,000 (carry forward from 2018/19, but new decision required)

1. Total expenditure approval requested under this section: £142,000.

Healthy Schools London (Healthy children)

1. Purpose: The Healthy Schools London (HSL) programme aims to ensure that school age children continue to develop in healthy environments. Each HSL school has committed to prioritising: healthy eating; physical activity; personal, social, health and economic education (PSHE); and emotional health and wellbeing.

1. Ambition: Recruit 2150 schools (80%) to the HSL programme by 2020, with 60% of recruited schools achieving an HSL award. The Mayor will encourage those already signed up to progress through the scheme to achieve Bronze, Silver and Gold awards.

1. Delivery of HSL: this is an established programme that involves: engagement of boroughs; recruitment of schools to achieve HSL award status; leadership and support of a network; hosting an annual celebration event, promoting action on childhood obesity and mental health; supporting roll-out of The Daily Mile; and embedding HSL in wider policy.

1. The 2019/20 work programme includes: commissioning a review of Silver and Gold Awards and various promotional materials. The team will also investigate potential development of school health data profiles.

1. Expenditure approval already in place: see section 1.7 regarding detail on expenditure approvals under cover of MD2115.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Fixed term staff expenditure within GLA Health Team (G9 0.6 FTE)	Approval to spend £38,000
Commissioning HSL promotional materials and resources	Approval to spend £6,000
Network and Strategic Advisory Group meetings; celebration event	Approval to spend £8,000
Maintenance of website and development of a digital platform: to implement updates and modifications, including links to resources and improved functionality for schools/users.	Approval to spend £20,000
Development of template policies for schools to adapt as part of their work towards achieving HSL awards and improving outcomes, e.g. child obesity and violence reduction. Setting up password protected section on the HSL website to host policies and award application forms so schools and borough leads can easily access them. Build capacity with local delivery partners and schools to support them to do the following: Example data sets/profiles relevant to HSL activities Surveys and monitoring tools for specific HSL activities Example measurable outcomes separated into themes Examples of effective HSL activities and their impact	Approval to spend £30,000 (carry forward from 2018/19, but new decision required)
Development of quality assurance process for HSL, including plans for moderation and its implementation	Approval to spend £20,000 (carry forward from 2018/19, but new decision required)

1. Total expenditure approval requested under this section: £122,000.

London’s Childhood Obesity Taskforce (Healthy children)

1. Purpose: London’s Childhood Obesity Taskforce champions action across London to help children achieve and maintain a healthy weight. The Taskforce seeks to create environments that support children’s health, changing how London’s families approach diet and activity, and in doing so reduce the risks of poor health in adulthood through overweight and obesity.

1. Ambition: The Taskforce wants to see obesity rates among London’s primary school children halved by 2030; with an ambition that this will happen even sooner.

1. Expenditure approvals already in place: (approved under cover of MD2222 (January 2018)) for spend of £270,000 on London’s Childhood Obesity Taskforce over 2018/19 and 2019/20. This expenditure comprises £180,000 in GLA expenditure and receipt of £90,000 from Guy's and St Thomas' Charity. Detail on how the programme budget would be spent in 2019/20 was not specified in MD2222. MD2222 supersedes MD2115 (see section 1.7) regarding expenditure approvals for London’s Childhood Obesity Taskforce.

1. £18,000 was spent during 2018/19 from Guy's and St Thomas' Charity funds, with a remaining £72,000 to be spent in 2019/20.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Fixed term staff expenditure within GLA Health Team (G9 1.0 FTE, G7 1.0 FTE)	Approval to spend £116,000
Contribution to joint International Conference on Childhood Obesity with Guy’s and St Thomas’ Charity. The event will aim to reach and influence national/international policy and strategy to ultimately impact on improving child obesity outcomes in London.	Approval to spend £50,000
In May 2019 the Taskforce will set out an action plan, building on their statement of intent. Funding is required to support delivery of these actions to ensure that the Taskforce has sufficient impact and influence to achieve the Mayor’s ambition of halving levels of child obesity by 2030. While these actions are still in development, we anticipate they will include bespoke analysis and intelligence to explore new policy initiatives and engage stakeholders in the work of the Taskforce through at least four engagement exercises and associated reports.	Approval to spend £60,000
Commissioning of topic expertise and evaluation to support development of the Taskforce action plan. This is required due to the delay in launching the Taskforce, which has led to compressed timelines with a requirement for additional resource in 2019/20.	Approval to spend £40,000 (carry forward from 2018/19, but new decision required)
Funding to support the Programme Development Group in development and delivery of the Taskforce action plan, including convening London leadership, sharing learning and peer review exchanges with other cities (specifically developing a relationship with Amsterdam).	Approval to spend £35,000 (carry forward from 2018/19, but new decision required)

1. Total expenditure approval requested under this section: £301,000.

Mental Health First Aid (Healthy minds)

1. Purpose: Fund the training of Youth Mental Health First Aid (YMHFA) instructors in every London borough and fund the delivery of Youth MHFA in state schools and further education colleges.

1. Ambition: To ensure that every state-funded school and further education college in London has access to a Youth Mental Health First Aider by 2021.

1. Expenditure approval already in place: (approved under cover of MD2265 (March 2018)) for spend of £375,000 in 2019/20 and £375,000 in 2020/21 for YMHFA. YMHFA is funded by the Young Londoners’ Fund. Detail on how the budget would be spent in 2019/20 was not specified.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Fund year 2 of the YMHFA programme. Year 2 deliverables are: 1) train ten YMHFA Instructors and 2) for instructors to deliver YMHFA training in 2,000 schools. The training will be commissioned out through a competitive public procurement tender.	Approval to spend £300,000
Funding for project management of the delivery of the programme. A Project Officer post will be based within Healthy London Partnership (HLP) with a grant agreement between GLA and HLP to ensure delivery of programme objectives and specify the funds to transfer.	Approval to spend £50,000
Fund year 2 of programme evaluation. The agreed research questions are: 1) Did YMHFA improve knowledge and awareness of mental health conditions? 2) Did YMHFA increase the skills and confidence of school staff to spot the signs of poor mental health in young people? 3) Did YMHFA increase signposting of young people to mental health support and services? 4) What impact, if any, did YMHFA have on wider school-based mental health strategies? 5) What impact did YMHFA have on the mental health and wellbeing of young Londoners? There is a grant agreement in place between the GLA and HLP for the funds to transfer. Note: the evaluation is jointly funded from Thrive London Mental Health Programme budget and this budget (YMHFA).	Approval to spend £25,000

1. Total expenditure approval requested under this section: £375,000.

Thrive London Mental Health Programme (Healthy minds)

1. Purpose: Thrive LDN is a citywide movement to improve the mental health and wellbeing of all Londoners, supported by the Mayor of London and London Health Board partners. Thrive LDN aims to reduce the number of Londoners affected by poor mental health.

1. Ambition:

Mental health becomes everybody’s business. Londoners act to maintain their mental wellbeing, and support their families, communities and colleagues to do the same;
Londoners’ mental health and physical health are equally valued and supported;
No Londoners experience stigma linked to mental ill health, with awareness and understanding of mental health increasing city-wide;
London’s workplaces support good mental health; and
Action is taken across London to prevent suicide attempts, and all Londoners know where to get help when they need it .

1. Expenditure approval already in place: (approved under cover of MD2171 (September 2017)) for expenditure of £100,000 in 2019/20 for Young London Inspired programme. This is to fund year 2 of the programme. Young London Inspired is a grants scheme for voluntary sector organisations to create social action opportunities for young Londoners at greater risk of poor mental health. The programme is delivered in partnership with Team London and this would be a cross-charge to them. The Young London Inspired programme is not included in the table below as no further decisions are required for this work.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Commission evaluation to establish the collective impact of Thrive LDN. Thrive LDN’s Theory of Change and evaluation framework is currently being independently reviewed. As part of the review, an improved monitoring and evaluation framework will be developed and implemented to enable Thrive LDN to better demonstrate impact to funders and partners. £25,000 will fund delivery of the evaluation. The evaluation will be commissioned out through a competitive public procurement tender.	Approval to spend £25,000
Fund year 2 of programme evaluation. The agreed research questions are: 1) Did YMHFA improve knowledge and awareness of mental health conditions? 2) Did YMHFA increase the skills and confidence of school staff to spot the signs of poor mental health in young people? 3) Did YMHFA increase signposting of young people to mental health support and services? 4) What impact, if any, did YMHFA have on wider school-based mental health strategies? 5) What impact did YMHFA have on the mental health and wellbeing of young Londoners? There is a grant agreement in place between GLA and HLP for the funds to transfer. Note: the evaluation is jointly funded from YMHFA budget (approved under MD2265) and this budget (Thrive London Mental Health Programme).	Approval to spend £25,000
Participation & Thrive LDN Champions: fund an extension of the Thrive LDN Champions’ network and leadership development programme. The network is open access to all Londoners and the leadership development programme will be for 50 Londoners. This will be commissioned out and run from October 2019 to March 2020 (the existing programme is funded until September 2019).	Allocation of £30,000 to this area of activity A delegation to the AD to approve detailed expenditure proposals for this work via an ADD
Fund Thrive LDN campaigning activity for 2019/20 including: ‘This is Me’ campaign during Mental Health Awareness Week, which reaches approximately one million London employees to reduce stigma and discrimination in the workplace. ‘This is Me’ campaign is part of a multi-year grant agreement with the Lord Mayor’s Appeal. ‘Are we OK London?’ campaign that will run from July to October 2019 and reaches approximately five million Londoners to raise awareness of inequality and mental health. The ‘Are we OK London?’ campaign will be commissioned out through public procurement tender.	Approval to spend £60,000
Thrive LDN Culture programme: fund 20-30 cultural activities and events as part of the ‘Are we OK London?’ campaign, including World Mental Health Day (WMHD) 2019 programme. This will be a combination of 20-30 small commissions and a budget virement to the Peer Outreach Team to deliver one event for young Londoners at City Hall on WMHD. Collectively the events will reach approximately 5,000 Londoners.	Approval to spend £25,000
Right to Thrive: fund 16-30 projects and activities to improve the mental health and wellbeing of Londoners from communities facing multiple disadvantage. This will be a small grants scheme that will launch in July. The grants scheme will be commissioned out to a specialist provider through public procurement tender.	Approval to spend £150,000 (£75,000 of which is carry forward from 2018/19, but new decision required)
Programme costs: flexible budget to cover miscellaneous programme costs throughout the year, such as staff expenses and venue hire.	Approval to spend £10,000

1. Total expenditure approval requested under this section: £295,000. Total approval which will be sought under a forthcoming ADD: £30,000.

Healthy London Workplaces (Healthy places)

1. Purpose: The London Healthy Workplace Charter, an accreditation scheme, helps London’s employers to create healthier workplaces.

1. Ambition: Continue to promote and deliver the London Healthy Workplace Charter (LHWC) – aiming to achieve 1,000 employer sign-ups and 750,000 employees benefiting by 2020.

1. Expenditure approval already in place: (approved under cover of MD2115 (May 2017)) for expenditure of £165,000 in 2019/20 for Healthy London Workplaces. Detail on how the budget would be spent in 2019/20 was not specified.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Contractor – Affinity: this is a one-year extension to the current provider’s contract to deliver the assessment and verification of the programme. This option to extend is included in Affinity’s current contract which expires at the end of March 2019. A new tender will be raised at the end of Q3 19/20.	Approval to spend £37,000
Contractor – Low Paid Sector (LPS) engagement: this is a one-year contract which will undertake focused work on engaging priority areas in LPS such as retail, hospitality, catering and social care. Activity will include presentations, workshops, network meetings, mentoring sector champions and events. The contractor will be asked to sign up 20 organisations, recruit 5 sector champions, organise 3 events, present at 3 external events, and produce a final report.	Approval to spend £40,000
Process evaluation: this is a proposed extensive process evaluation project for the newly revised London Healthy Workplace Award due to launch April 2020. The tender will be issued in Q2 19/20. Outcomes will aim to refine the new programme.	Approval to spend £35,000
Comms/creative support: Advertising campaigns to target business sectors on the priority list; Telemarketing campaign; Co-promotional activity with the Good Work Standard; Health Inequalities Strategy related promotional activity – poverty, working conditions; and Small and medium-sized enterprises support for mentally healthy workplaces: events/engagement (Thrive LDN).	Approval to spend £26,000
Awards ceremony	Approval to spend £5,000
General catering/events	Approval to spend £4,000
Digital/technical (e.g. CRM)	Approval to spend £5,000
Sponsorship used for promotional and outward facing activity for the programme	Receipt of external income from Lloyds (£10,000) and IOR Group (£3,000) in 2018/19. To be carried forward into 2019/20.

1. Approval to receive external income from Lloyds (£10,000) and IOR Group (£3,000) in 2018/19. Total expenditure approval requested under this section: £165,000.

Tobacco, Alcohol, Drugs, Gambling (Healthy living)

1. Purpose: That steps are taken to reduce the use of tobacco and illicit drugs, the misuse of alcohol, and problem gambling.

1. Ambition: To share learning and best practice, support partnership work, and use the leadership of the Mayor to highlight these issues.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Convene an event to showcase best practice approaches to reducing alcohol-related harms especially amongst the most vulnerable Londoners (Health Inequalities Strategy commitment). Stakeholders include local authorities (public health, trading standards, Association of Directors of Public Health, London Councils), Public Health England, London Joint Working Group on hepatitis C, NHS England, voluntary, community and social enterprise (VCSE) sector.	Approval to spend £6,500
Contribute to a 2019 Christmas alcohol harm reduction campaign (informed by the evaluation of the 2018 campaign). This will contribute to the Health Inequalities Strategy aim to reduce harms caused by alcohol.	Approval to spend £15,000
Use the Mayor’s convening power to highlight the importance of understanding how drug services meet the needs of the most vulnerable groups including those within the criminal justice system and rough sleepers, looking at how they can deliver better outcomes for individuals and communities, and reduce blood-borne viruses and tuberculosis. This will be delivered through an appropriate event and supporting materials.	Approval to spend £5,000
Hepatitis C Roundtable Event. This will take place in the autumn and will bring partners together across the system to develop leadership and more joined-up working to improve hepatitis C diagnosis and treatment.	Approval to spend £1,500

1. Total expenditure approval requested under this section: £28,000.

Health in All Policies: Public Health Specialists (Leadership for health)

1. Purpose: Specialist public health skills and advice are available to support a) the Mayor’s Transport Strategy and transport policies and b) the London Plan and planning policies.

1. Ambition: All the work of the GLA contributes towards improving the health of Londoners and reducing health inequalities.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for 2019/20 spend.

Deliverable

Decision being sought for 2019/20 spend

Fixed term staff expenditure within GLA Health Team.

GLA investment of up to £114,000 to continue to fund specialist public health expertise. There are currently two public health specialists embedded within the organisation (GLA Planning team & Transport for London). This funding will ensure these teams continue to maximise the contribution of transport, planning and other strategies to health improvement and tackling health inequalities.

GLA net expenditure of £114,000
Receipt of up to £89,000 (from Transport for London) and up to £47,000 (from the Oak and Park Royal Development Corporation)

Approval to spend £250,000

1. Approval to receive external income from Transport for London (up to £89,000) and Oak and Park Royal Development Corporation (up to £47,000). Total expenditure approval requested under this section: £250,000.

Legacy funding from London Health Improvement Board (Leadership for health)

1. The London Health Improvement Board pre-dates the London Health Commission. It was established with a budget of £2 million, received from the NHS, in the financial year 2012/2013. The board’s priorities were tackling the following areas by taking a pan-London, strategic view:

Early diagnosis and prevention of cancer;
Reducing childhood obesity; and
Reducing alcohol abuse.

1. £75,000 remains from the original £2 million budget.

1. Decision being sought for 2019/20 spend: allocation of £75,000 to priorities within the areas of activity bulleted above, to be agreed in consultation with the London Health and Care Partnership. A delegation to the director to approve detailed expenditure proposals for this work via a DD.

Health Inequalities Strategy Implementation

1. This budget includes the following programme funding:

Health Inequalities Strategy mobilisation;
Healthy Minds for Children;
HIV Fast Track Cities;
Social prescribing;
Dementia Friendly London;
Inclusion health;
NHS Liaison (integrated into a later section on the London Health and Care Partnership); and
London Health Board (integrated into a later section on the London Health and Care Partnership).

Health Inequalities Strategy mobilisation

1. Purpose: To mobilise and support partners and stakeholders across London to engage with and work with us on addressing health inequalities, through the London Health Inequalities Strategy.

1. Ambition: To narrow the gap in healthy life expectancy between deprived and more affluent areas, between men and women and between different population groups.

1. Expenditure approval already in place: (approved under cover of MD2406 (February 2019)) for receipt and expenditure of £314,000 (£157,000 in 2018/19, £126,000 in 2019/20 and £31,000 in 2020/21) from the Health Foundation on a project to accelerate learning on addressing health inequalities and the wider determinants of health at a city level. This project is not included in the table below as no further decisions are required for this work.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Fixed term staff expenditure within GLA Health Team (Health Inequalities Strategy delivery) G8 0.6 FTE	Approval to spend £25,000
Programme costs: flexible budget to cover miscellaneous programme costs throughout the year, such as venue hire, document design and printing, and travel. All costs will relate to work on the Health Inequalities Strategy Implementation Plan and partnership work. Specific projects requiring flexible support include: - Facilitation of the London local authority scrutiny Health Inequalities Strategy working group and development of a tool for use by local scrutiny; and - Mapping the Health Inequalities Strategy against the NHS Long Term Plan to influence insertion into local sustainability and transformation partnership (STP) plans.	Approval to spend £12,000
Annual partnership event to bring together city-wide partners to reflect on and drive further progress on the London Health Inequalities Strategy, and the work of the London Health Board. The event will be jointly developed and funded with the London Health Board. Funding will support organisation of the event, catering, printing, planning, and development of advance materials (e.g. video, resources).	Approval to spend £10,000
Health Inequalities prospectus to promote opportunities for partnership working, collaboration and funding on Health Inequalities priorities – the development of this resource will be commissioned externally.	Approval to spend £15,000
Commission the Town and Country Planning Association (TCPA) to support the GLA to develop the School Superzones Model and to design a brochure to disseminate the School Superzones Model to London boroughs. The School Superzones Model is intended to provide local authorities with a framework to create healthy environments within 400 metres walking distance from schools.	Approval to spend £8,000
Develop a resource or an approach, working with public health and other key colleagues in the GLA Group, to support a sustainable approach to ‘health in all policies’ in the GLA. The approach will be developed to support ‘health in all policies’ across the five aims of the Health Inequalities Strategy.	Approval to spend £20,000
Series of five workshops (e.g. deep dives) bringing together leaders from across London (e.g. from across healthcare, public health, local authorities/boroughs, voluntary and community sector), to explore together, understand the complexities, and drive progress on some of London’s most difficult health inequalities challenges. The workshop topics will link to the Health Inequalities Strategy, and topics will be selected in discussion with partners. The funds will be used for: external contractor time to organise and plan the event, room bookings, catering, facilitation costs, printing etc.	Approval to spend £35,000 (carry forward from 2018/19, but new decision required)
Resource/approach to support Health and Wellbeing Boards to implement the Health Inequalities Strategy. This will be developed in consultation with partners, including Directors of Public Health and Health and Wellbeing Boards.	Approval to spend £15,000 (carry forward from 2018/19, but new decision required)

1. Total expenditure approval requested under this section: £140,000.

Healthy Minds for Children (Healthy children)

1. Purpose: To ensure that children’s mental health is supported and protected; to help all of London’s children and young people have the support they need to grow into healthy, resilient adults.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable

Decision being sought for 2019/20 spend

Work programme on children and young people’s mental health and emotional wellbeing. This workstream will be developed working in partnership with colleagues across the GLA group and with partners to establish the priority area where we can have the greatest impact, including violence prevention and strengthening support in schools.

Allocation of £47,000 to this area of activity.

A delegation to the AD to approve detailed expenditure proposals for this work via an ADD.

1. Total approval which will be sought under a forthcoming ADD: £47,000.

HIV Fast Track Cities (Healthy communities)

1. Purpose: People and communities are supported to tackle HIV, tuberculosis and other infectious diseases and address the stigma around them.

1. Ambition: Zero stigma and discrimination, zero new HIV infections and zero new deaths from AIDS by 2030 (from HIV Fast Track Cities partnership’s action plan).

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable

Decision being sought for 2019/20 spend

The GLA’s contribution to the HIV Fast Track Cities programme supports delivery of the HIV Fast Track Cities partnership’s action plan, also supported by London Councils, Public Health England, and NHS England. The action plan includes tackling stigma and discrimination, barriers to testing, and supporting treatment adherence.

Tackling HIV is one of the Mayor’s manifesto commitments, and a priority in the Health Inequalities Strategy. The latter includes a commitment to supporting people and communities to tackle HIV and the stigma surrounding it.

Approval to spend £15,000

1. Total expenditure approval requested under this section: £15,000.

Social Prescribing (Healthy communities)

1. Purpose: The Mayor has committed to supporting the roll out of social prescribing, ensuring it becomes a routine part of community support across London. Five key workstreams will enable this: workforce development (including supporting volunteers), provision of social welfare legal advice, digital solutions, evaluation and support for the voluntary sector.

1. Ambition: Social prescribing will be available for the most vulnerable Londoners by 2028.

1. Development of projects to support these workstreams are included below. GLA projects will focus on developing evaluation tools and measures, access to social welfare legal advice, supporting volunteers and supporting the voluntary, community and social enterprise (VCSE) sector. The NHS will focus on other areas such as NHS workforce development (including developing link-worker roles in London) and digital solutions.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Launch and delivery of the final social prescribing vision for London – draft published in December 2018. This partnership document outlines the Mayor’s and key stakeholders’ approach to accelerating social prescribing across London, particularly within the most deprived communities by 2028. Funding will also be spent on delivering a social prescribing cross-sectoral “deep dive” event in May 2019.	Approval to spend £15,000 (£10,000 of which is carry forward from 2018/19, but new decision required).
Project to deliver an effective evaluation tool and outcome measures, and good practice guides relevant to mainstreaming social prescribing. This project will be commissioned externally.	Allocation of £50,000 to this area of activity. A delegation to the AD to approve detailed expenditure proposals for this work via an ADD.
Support the VCSE sector and local authorities to deliver the social prescribing vision for London. This would be through engagement activities and funding projects to support mainstreaming of social prescribing focusing on support for the VCSE sector. Scoping is currently taking place with the VCSE sector on the best way deliver these projects.	Allocation of £45,000 to this area of activity. A delegation to the AD to approve detailed expenditure proposals for this work via an ADD.
Sponsor the 2^nd international conference on social prescribing, hosted by the University of Westminster on behalf of the London Social Prescribing Network, occurring in July 2019	Approval to spend £5,000
Establish a London-wide network for social prescribing commissioners.	Approval to spend £5,000
Undertake further work to map and grow the provision of social welfare legal advice in health settings. A report will set out recommendations on how to increase access to social welfare legal services in health settings and beyond in London. This will be linked to the Communities and Social Policy team’s project to evaluate social welfare advice provision in London. Any carry-over funding not required to grow social welfare legal advice will be used towards support for the VCSE sector and local authorities to deliver the social prescribing vision for London.	Allocation of £40,000 to this area of activity (carry forward from 2018/19, but new decision required). A delegation to the AD to approve detailed expenditure proposals for this work via an ADD.

1. Total expenditure approval requested under this section: £25,000. Total approval which will be sought under forthcoming ADDs: £135,000.

Dementia Friendly London (Healthy communities)

1. Purpose: For London to be a dementia friendly city so that there are more chances for all Londoners to take part in community life.

1. Ambition: Helping all those living with dementia in London to be empowered and supported to live well. For London to be a dementia friendly city by 2022.

1. Expenditure approval already in place: (approved under cover of DD2264 (September 2018)) for spend of £50,000 in 2019/20, and £25,000 between April and September 2020, for Museum of London Dementia Project. This project is not included in the table below as no further decisions are required for this work.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
Appoint GLA Group Dementia Champion Support GLA Group Dementia Champion and Alzheimer’s Society to deliver Dementia Friendly London Dementia Friendly City Hall (building audit and action plan) Dementia awareness including Dementia Friends training for GLA staff Support for Transport for London, Met Police and Fire Brigade	Approval to spend £10,000

1. Total expenditure approval requested under this section: £10,000.

Inclusion Health (Healthy communities)

1. Purpose and ambition: To engage with and empower some of London’s most vulnerable and excluded populations, and to understand, promote and share what works in developing healthy and resilient communities. To promote effective community-led approaches to tackle health inequalities in London.

1. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

Deliverable	Decision being sought for 2019/20 spend
The Health Inequalities Strategy includes a commitment to engage London’s most vulnerable and excluded populations. Specific project deliverables to be confirmed. Objectives will be a better understanding of the health needs of the most marginalised groups of people and where we might add value to the work in this area. E.g. connect this work with other mayoral strategies, e.g. housing, police and crime.	Allocation of £20,000 to this area of activity. A delegation to the AD to approve detailed expenditure proposals for this work via an ADD.
One citizen-led engagement project targeted at young offenders under 25 including women. Linked Health Inequalities Strategy action: A piece of peer research undertaken with young offenders on an area of health they identify as important.	Approval to spend £6,000
Workshop and action learning sets delivered in each of the five London Health and Care Partnership regions to share learning and best practice on what works at the local community level to build healthy and resilient communities. Training and resource materials developed; evaluation of process and impact including a workbook that captures the learning and can be shared more widely; pan London learning event.	Approval to spend £17,000

1. Total expenditure approval requested under this section: £23,000. Total approval which will be sought under a forthcoming ADD: £20,000.

London Health and Care Partnership (Leadership for health)

1. Purpose: The GLA participates in work with the NHS, Local Government and other health and care partners to progress the health and care vision for London, and the London health and care devolution agreement. In addition, the GLA supports the Mayor to champion and challenge the NHS and wider health and care system on behalf of Londoners.

1. Ambition: The London Health and Care Partnership works together to make London the healthiest global city in the world.

1. Better Health for London established ten aspirations to make London the World’s Healthiest City. The London Health and Care Devolution Memorandum of Understanding (MOU) was signed by the Mayor and partners in November 2017 and cemented the London health and care partnership commitment to work together on estates, digital innovation, optimising estates, prevention, and health and care integration. Partnership funding and priorities for these workstreams are overseen each year through the Partnership Steering Group, with due diligence through the Partnership Delivery Group.

1. Healthy London Partnership (HLP) has been established by health and care partners in London as the delivery vehicle for London-wide health and care transformation activity. HLP supports the London Health and Care Strategic Partnership Board and the sub-boards that were established to provide strategic and operational leadership and oversight for London level activities within the devolution MOU. Political oversight and strategic direction are provided by the London Health Board. Since 2016/17 HLP has held some partnership resource overseen by the Partnership Steering Group, but not all of it. From 2019/20 it is intended that HLP holds all the pooled partnership resource.

1. Previous approvals: Staffing: The Mayor approved under cover of MD2323 the establishment of the NHS Liaison programme and approved expenditure of up to £100,000 in 2018/19 towards funding for a Senior Policy Officer (NHS Liaison) and a Senior Health and Care Policy and Partnership Manager. £51,000 of GLA expenditure towards funding of the London Health Board Secretariat Manager post in 2018/19 was also approved by the Mayor under cover of MD2323.

1. Income in 2018/19:

Income in 2018/19

Decision being sought for 2018/19

Receipt of partnership income to support delivery of the London Health and Care Devolution programme

Receipt of income in advance from London Health Board partners of £212,000 (NHS England £100,000, Office of London Clinical Commissioning Groups £100,000, Public Health England £12,000).

Receipt of income 2018/19 of £100,000 (£50,000 NHS Improvement, £50,000 Public Health England).

Total

£312,000

1. Approval is being requested in this section to receive external income of £312,000 in 2018/19.

1. Expenditure of GLA Devolution Programme funds to support the London Heath Board and London Health and Care Devolution programme in 2018/19 as follows:

Deliverable 2018/19	Decision being sought for 2018/19 spend
GLA contribution to G10 (FTE 1.0) London Health Board Secretariat Manager (approved under MD2323).	£51,000 (approved under cover of MD2323)
Partnership contribution towards London Health Board Secretariat Manager (total cost of post £71,000).	Approval to spend £20,000
London Health Board conference and Manchester devolution masterclass.	Approval to spend £9,067
NHS Estates Programme: Development of London Health and Care Estates Strategy; Development of London Capital Pipeline; and The progression of London Estates Board’s progression to phase 3 ‘shadow decision making’ in line with the devolution MOU. Specific items of expenditure listed below.
London Estates Delivery Unit (LEDU) Programme Director post	Approval to spend £109,250
LEDU Contractor	Approval to spend £46,000
NHS estates strategy support services (Deloitte) (approved under cover of ADD2211)	Approval to spend £4,000
Software to support the NHS Estates Strategy	Approval to spend £50,000

1. Total expenditure approval requested under this section: £238,317.

1. Transfer of funds 2018/19:

Approval to transfer GLA devolution programme contribution to Lambeth Clinical Commissioning Group (which provides the finance function for the Healthy London Partnership)	£67,683
Approval to transfer the balance of partnership funds to Lambeth Clinical Commissioning Group (which provides the finance function for the Healthy London Partnership) (2018/19), carrying forward the balance into 2019/20 if necessary and subject to approval from partners	£312,000
Total	£379,683

1. Approval is being requested to transfer remaining GLA and partnership funds of £379,683 to Lambeth Clinical Commissioning Group on behalf of Healthy London Partnership.

1. Proposed budget 2019/20:

Deliverable 2019/20	Decision being sought for 2019/20 spend
NHS Liaison Team programme fixed term staff expenditure (G12 0.8 FTE, G9 1.0 FTE)	Approval to spend £135,000
London Health Board programme fixed term staff expenditure (G10 1.0 FTE)	Approval to spend £71,000
The London Health and Care Devolution Programme is a partnership working together to develop devolved delivery arrangements following the MOU with Government to devolve responsibilities. The GLA’s contribution of £150,000 per year will be pooled with contributions from London Councils, NHS England, London Clinical Commissioning Groups and Public Health England, as part of a wider collaborative funding for pan-London health and care. Further aligned expenditure includes: London Health Board Secretariat manager post (included in fixed-term staff expenditure above) GLA contribution to the London Estates Delivery Unit (based in the Housing and Land team and funded from Housing and Land budgets from 2019/20 onwards)	Allocation of £150,000 to this area of activity A delegation to the director to approve detailed expenditure proposals for this work via a DD

1. Total expenditure approval requested under this section: £206,000. Total approval which will be sought under a forthcoming DD: £150,000.

1. Proposed budget 2020/21 and 2021/22:

Deliverable 2020/21 and 2021/22

Decision being sought for 2020/21 and 2021/22 spend

The London Health and Care Devolution Programme is a partnership working together to develop devolved delivery arrangements following the MOU with Government to devolve responsibilities. The GLA’s contribution of £150,000 per year will be pooled with contributions from London Councils, NHS England, London Clinical Commissioning Groups and Public Health England, as part of a wider collaborative funding for pan-London health and care.

Allocation of £150,000 in 2020/21 and 2021/22 (total £300,000) to this area of activity

A delegation to the director to approve detailed expenditure proposals for this work via a DD

1. Total approval which will be sought under a forthcoming DD: £300,000.

Equality comments

1. An Integrated Impact Assessment, which included an Equalities Impact Assessment within its scope, was conducted as part of the development of the Health Inequalities Strategy. This identified major positive and negative impacts of the programme for groups protected under the Equality Act 2010 and proposed ways to strengthen benefits and mitigate negative impacts, as well as identify issues concerning the four cross-cutting themes under the GLA Act 1999. The Health Inequalities Strategy was adopted in October 2018 (https://www.london.gov.uk/what-we-do/health/health-inequalities-strategy), and the integrated impact assessment was published at the same time (https://www.london.gov.uk/sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf).

1. The focus on inclusion health, and tackling stigma, will impact positively on health of those with protected characteristics.

1. At a London level, the health and care devolution agreement signed with national and London partners references reducing health inequalities as one of the central aims. This is being overseen by the London Health Board. A focus on reducing health inequalities will benefit people with protected characteristics, for example disabled people and minority ethnic communities, who often experience poorer access and outcomes from health and care services.

1. Detailed impact assessments were undertaken of the new models of care developed through the devolution pilot areas, and local governance arrangements will be put in place to ensure fairness in delivery.

1. The London Health Board will have political oversight of the health and care devolution programme and will ensure that health inequalities are considered in the wider roll out of devolution, based on the learning from the pilots.

1. Impact assessments have also been carried out on the other main elements of the health inequalities work programme.

1. The Healthy Young London programme is a universal offer but also aims to target those areas of London with high levels of child poverty and ingrained health inequalities. The prospective health and health inequalities impact assessment of the early years elements of the programme suggest that it should have a positive effect on health inequalities. However, careful consideration needs to be given to the support available to settings and childminders who participate in the early years programme. Take up of the programme will need to be monitored to ensure it is being taken up equitably across London, particularly in areas with a higher level of deprivation or where more of the population is from an ethnic minority group.

1. Evaluation of Healthy Schools London (September 2016) has shown that schools in areas with low socio-economic status (SES) are more likely to be enrolled in the programme than schools in high SES areas.

1. A Health Inequalities Impact Assessment was carried out on the Healthy Workplace Charter programme in 2013. This looked at the likely potential impacts on those with protected characteristics and concluded that the programme has beneficial impacts. A focus on low paid sectors will also help to support those with protected characteristics.

1. Partners are still developing the Thrive LDN programme, so a full equalities impact assessment has not yet been conducted, but is based on a principle of proportionate universalism, meaning that it will seek to improve the mental health of the whole population, while recognising that some people have greater needs and need proportionately greater support. Development of the programme has included extensive engagement with a wide range of organisations representing groups with protected characteristics and people who have experienced mental health problems.

Other considerations

Major risks and issues

1. Risk assessments have been conducted for each element of the programme. The biggest cross- cutting risks identified are as follows.

Risk	Mitigation
Changes in partnership funding and collaboration arrangements affect ability to deliver projects	Clarification of partner funding contributions, improved governance and active participation in partnership forums
Inability to recruit high-calibre candidates with relevant skills and expertise to vacant roles in the team	Recruitment strategy, on-going team development, and focus on team delivery and reputation
Delay in the publication of the adult social care green paper, prevention green paper and future local government funding arrangements	Focus on developing an effective London Health Board to champion and challenge the health and care system, and the needs of Londoners
National policy developments cut across the aims of the health inequalities strategy	Close partnership working, and staying abreast of policy development

Links to Mayoral strategies and priorities

1. The health team work programme has been designed to fulfil the Mayor’s manifesto commitments to be a champion for health in the city, to improve public health, and to meet statutory duties to develop a health inequalities strategy.

1. The GLA health programme is directly related to delivery of the Mayor’s Health Inequalities Strategy, a statutory duty under the GLA Act 1999.

1. It is also directly linked to the delivery of the Mayor’s manifesto commitments to:

Champion and challenge London’s NHS;
Get to grips with health inequality in London;
Promote active lifestyles, support those who want to shake off lifestyle risks and tackle childhood obesity;
Renewed focus on HIV prevention; and
Break down the stigma of mental illness and coordinate efforts to reduce the number of people who take their own lives.

1. In addition, elements of the health programme will support delivery of other statutory and non-statutory strategies and programmes, including: the London Plan, Transport, Economic Development, Environment, Housing, Culture, Sport, Social Integration, and Food.

Impact assessment and consultations

1. Impact Assessments have been conducted on the key elements of the programme, as detailed

above. Consultation with Londoners and stakeholders on the Health Inequalities Strategy took place in 2017, and a comprehensive report to the Mayor has been compiled here: https://www.london.gov.uk/sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf.

Financial comments

1. This decision seeks approval for the following:

1. Expenditure of £618,000 towards the delivery of the 2018-19 London Health Board and London Health and Care Devolution Programme (£239k); and transfer of funds to the ‘Healthy London Partnership’ (£380k) for devolution work. Of the total amount, £306,000 will be funded from the GLA’s 2018-19 Health Devolution Programme budget, the balance of £312,000 will be funded from grant income (£212,000 was received as income in advance in financial year 2017-18, and the balance of £100,000 in 2018-19). Details of NHS contributors is detailed in section 2.73 to 2.87 of this report.

1. Receipt in advance, and expenditure of £13,000 from Lloyds (£10k), and IOR Group (£3k) as sponsorship income towards the 2019-20 Healthy London Workplaces Programme.

1. Receipt and expenditure of £136,000 from Transport for London (£89k), and Oak and Park Royal Development Corporation (£47k) toward the 2019-20 Public Health Specialists Programme.

1. Expenditure of up to £2,554,000 on the Health Team’s Work Programme for 2019-20 as detailed by the table below.

Workstream	Expenditure (£)	Expenditure subject to further DD/ADD setting out detail		Income	Net cost to GLA
Workstream	Proposals being approved through this MD	Expenditure subject to further DD/ADD setting out detail	Total Expenditure	Income	Net cost to GLA
Healthy Early Years London	£142,000		£142,000		£142,000
Healthy Schools London	£122,000		£122,000		£122,000
London’s Childhood Obesity Taskforce	£301,000		£301,000	£72,000	£229,000
Mental Health First Aid	£375,000		£375,000		£375,000
Thrive London Mental Health Programme	£295,000	£30,000	£325,000		£325,000
Healthy London Workplaces	£165,000		£165,000	£13,000	£152,000
Tobacco, Alcohol, Drugs, Gambling	£28,000		£28,000		£28,000
Health in All Policies: Public Health Specialists	£250,000		£250,000	£136,000	£114,000
Legacy funding from London Health Improvement Board		£75,000	£75,000		£75,000
Health Inequalities Strategy Implementation:
Health Inequalities Strategy mobilisation	£140,000		£140,000		£140,000
Healthy Minds for Children		£47,000	£47,000		£47,000
HIV Fast Track Cities	£15,000		£15,000		£15,000
Social prescribing	£25,000	£135,000	£160,000		£160,000
Dementia Friendly London	£10,000		£10,000		£10,000
Inclusion health	£23,000	£20,000	£43,000		£43,000
NHS Liaison	£35,000		£35,000		£35,000
London Health Board	£20,000		£20,000		£20,000
London Health and Care Partnership:
NHS Liaison	£100,000		£100,000		£100,000
London Health Board	£51,000		£51,000		£51,000
Health and Care Devolution		£150,000	£150,000		£150,000
Total	£2,097,000	£457,000	£2,554,000	£221,000	£2,333,000

1. The total cost for the 2019-20 work programme is £2,554,000 Of this amount, £1,958,000 will be funded from the Health Team’s budget for 2019-20; £375,000 (for Mental Health First Aid), will be funded from the Mayor’s Young Londoner’s Fund (as approved by MD2265), and the balance of £221,000 will be funded from external income as follows: £72,000 for the London’s Childhood Obesity Taskforce, will be funded from grant funding to be received from Guy’s St Thomas Charity (as approved by MD2222); £13,000 is sponsorship income from Lloyds (£10k), and IOR Group (£3k) towards the Healthy London Workplaces Programme (approval requested above); and £136,000 is income from Transport for London (£89k), and Oak and Park Royal Development Corporation (£47k) toward the Public Health Specialists Programme (approval requested above).

1. Approval is also sought for expenditure of up to £300,000 towards the delivery of the Health and Care Devolution Programme, with costs to be incurred over two financial years in 2020-21 (£150k), and 2021-22 (£150k).

1. Future years’ budgets are indicative and still subject to the GLA’s annual budget setting process.

Legal comments

The foregoing sections of this report indicate that the activity in respect of which approval is sought may be considered to be facilitative of and conducive to enabling the exercise of the GLA’s general powers in a manner which takes account of the need to promote the improvement of health of persons, health inequalities between persons and have complied with the GLA’s related statutory duties to:

(a) Pay due regard to the principle that there should be equality of opportunity for all people;

(b) Consider how those 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; and

1. Sections 120 and 121 (respectively) of the Greater London Authority Act 1999 provide that a functional body, such as TfL and OPDC may, with the consent of the Mayor, pay a grant towards meeting capital or revenue (respectively) expenditure incurred or to be incurred by the GLA for the purposes of, or in connection with, the discharge of its functions. Please note that funding provided by way of capital grant cannot be used for revenue expenditure and vice versa.

1. To the extent that expenditure proposed:

Amounts to the provision of grant funding as a contribution to related third party

project costs and not a payment for services to be provided, officers must ensure that the proposed funding is disbursed in a fair and transparent manner in accordance with the GLA’s Contracts and Funding Code and a funding agreement is put in place between and executed by the GLA and any proposed recipient(s) before any commitment to provide the funding is made; and

Is to be incurred on the procurement of works, services or supplies, officers must ensure that the works, services or supplies are procured in accordance with the GLA’s Contracts and Funding Code and that appropriate contract documentation is put in place and executed by the successful bidder(s) and the GLA before the commencement of any works, services or supplies.

6.4 In any event, officers must ensure that:

No reliance is placed upon any external third-party funding until legally binding arrangements are in place with the funder(s) in question and they are content that the GLA can comply with any conditions applicable to the provision of such funding;

The terms of any related proposed funding agreements and contracts for works, services or supplies do not have the effect of fettering the discretion of any successor administration, considering in particular the London elections taking place in May 2020 and accordingly the GLA must retain the right to terminate for convenience and milestones for events should be structured so as to mitigate risks of abortive costs being incurred; and
They comply fully with all applicable GLA HR/Head of Paid Service protocols in respect of any staffing proposals, in particular the need to gain all necessary approvals for the creation of new posts.

6.5 The Mayor may, under section 38 of the Greater London Authority Act 1999, delegate the exercise of the GLA’S functions to the Executive Director (Communities and Intelligence) and Assistant Director (Health, Education and Youth) as proposed should he so wish.

6.6 In taking the decisions requested, the Mayor 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 and foster good relations between persons who share a relevant protected characteristic (race, disability, gender, age, sexual orientation, religion or belief, pregnancy and maternity and gender reassignment) and persons who do not share it (section 149 of the Equality Act 2010). To this end, the Mayor should have particular regard to section 3 (above) of this report.

Planned delivery approach and next steps

1. A detailed business plan for the work of the Health Team has been developed, setting out the full range of programme, policy and advocacy work the team plans to undertake in 2019/20. Highlights linked to the decisions in this MD are summarised below.

Activity	Timeline
Production of a video and other promotional material for the HEYL programme	Q3
Annual HEYL and HSL celebration events	Q2
Trial and evaluate a new moderation process for HEYL	Q3
Develop template policies for schools to support implementation of HSL	Q2
Development of initial school profiles and data sets to support HSL	Q3
Review of HSL quality assurance process and moderation	Q3
International conference on childhood obesity	Q4
Public London’s Childhood Obesity Taskforce action plan	Q1
Undertake a peer review exchange with another city	Q2
Train ten Youth Mental Health First Aid (YMHFA) instructors	Q1
Deliver YMHFA training in 2,000 schools	Q4
Undertake an evaluation of YMHFA	Q3
Undertake an evaluation of Thrive London	Q3
Establish a Thrive London champions’ network	Q2
Run the ‘This is Me’ anti-stigma campaign	Q2
Convene ‘Are we OK London?’ cultural activities	Q3
Right to Thrive	Q3
Receive a report on engagement of the low paid sector in the healthy workplaces award	Q4
Undertake a process evaluation of the Healthy Workplace Award (HWA)	Q4
Hold an annual awards ceremony for the HWA	Q3
Convene a best practice event on reducing alcohol harms	Q3
Run a Christmas alcohol harm reduction campaign	Q3/4
Convene an event on drug services and inclusion health	Q2
Convene a roundtable of preventing and treating hepatitis C	Q2
Develop Health Inequalities Strategy implementation tools for local authority health scrutiny committees, and health and wellbeing boards	Q3
Convene an annual Health Inequalities Strategy event to celebrate progress and address barriers to implementation	Q3
Develop a Health Inequalities prospectus	Q2
Publish the findings of initial work to develop Superzones around schools in London	Q2
Hold five deep dive meetings to progress key priorities in the Health Inequalities Strategy	Q1-4
Contribute to the Fast Track Cities international conference	Q3
Launch the social prescribing vision	Q1
Publish resources to support evaluation and outcome measures from social prescribing	Q3
Sponsor the 2^nd international conference on social prescribing	Q2
Establish a network of local social prescribing commissioners and champions	Q3
Take forward the City Hall and GLA group dementia friendly plan	Q2
Convene sub-regional workshops to support inclusion health and community approaches in emerging health and care integration plans	Q2
Convene the annual London Health Board conference	Q3

MD2439 Health Team Work Programme 2019/20

Executive summary

Decision

Part 1: Non-confidential facts and advice

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