MD2439 Health Team Work Programme 2019/20

1. 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. 2. 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. 3. 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. 4. 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. 5. 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. 6. 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. 7. 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. 8. MD2115 did not set out the details of how the budget would be spent for both programmes in 2019/20.

1. 9. 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. 10. 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.

1. 11. 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.

1. 12. 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. 13. The table below gives a breakdown for proposed budget 2020/21 and 2021/22 for the Health and Care Devolution programme.

Healthy Early Years London (Healthy children)

1. 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. 2. 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. 3. 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. 4. 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. 5. 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. 6. The table below gives a breakdown of deliverables for this programme and the decisions being sought for 2019/20 expenditure.

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

Healthy Schools London (Healthy children)

1. 8. 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. 9. 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. 10. 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. 11. 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. 12. Expenditure approval already in place: see section 1.7 regarding detail on expenditure approvals under cover of MD2115.

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

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

London’s Childhood Obesity Taskforce (Healthy children)

1. 15. 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. 16. 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. 17. 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. £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. 19. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

Mental Health First Aid (Healthy minds)

1. 21. 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. 22. 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. 23. 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. 24. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

Thrive London Mental Health Programme (Healthy minds)

1. 26. 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. 27. 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. 28. 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. 29. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

1. 30. 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. 31. Purpose: The London Healthy Workplace Charter, an accreditation scheme, helps London’s employers to create healthier workplaces.

1. 32. 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. 33. 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. 34. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

1. 35. 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. 36. Purpose: That steps are taken to reduce the use of tobacco and illicit drugs, the misuse of alcohol, and problem gambling.

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

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

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

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

1. 40. 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. 41. Ambition: All the work of the GLA contributes towards improving the health of Londoners and reducing health inequalities.

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

1. 43. 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. 44. 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. 45. £75,000 remains from the original £2 million budget.

1. 46. 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. 47. 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. 48. 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. 49. 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. 50. 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. 51. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

Healthy Minds for Children (Healthy children)

1. 53. 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. 54. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

HIV Fast Track Cities (Healthy communities)

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

1. 57. 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. 58. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

Social Prescribing (Healthy communities)

1. 60. 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. 61. Ambition: Social prescribing will be available for the most vulnerable Londoners by 2028.

1. 62. 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. 63. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

1. 64. 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. 65. 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. 66. 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. 67. 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. 68. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

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

Inclusion Health (Healthy communities)

1. 70. 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. 71. The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2019/20 expenditure.

1. 72. 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. 73. 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. 74. Ambition: The London Health and Care Partnership works together to make London the healthiest global city in the world.

1. 75. 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. 76. 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. 77. 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. 78. Income in 2018/19:

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

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

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

1. 82. Transfer of funds 2018/19:

1. 83. 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. 84. Proposed budget 2019/20:

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

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

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

1. 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 (/programmes-strategies/health-and-wellbeing/health-inequalities-strategy), and the integrated impact assessment was published at the same time (/sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf).

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

1. 3. 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. 4. 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. 5. 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. 6. Impact assessments have also been carried out on the other main elements of the health inequalities work programme.

1. 7. 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. 8. 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. 9. 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. 10. 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.

Major risks and issues

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

Links to Mayoral strategies and priorities

1. 2. 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. 3. 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. 4. 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. 5. 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. 6. 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: /sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf.

1. 1. This decision seeks approval for the following:

1. 2. 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. 3. 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. 4. 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. 5. Expenditure of up to £2,554,000 on the Health Team’s Work Programme for 2019-20 as detailed by the table below.

1. 6. 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. 7. 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. 8. Future years’ budgets are indicative and still subject to the GLA’s annual budget setting process.

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

(c) Consult with appropriate bodies.

1. 2. 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. 3. To the extent that expenditure proposed:

1. 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

2. 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:

1. 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;

2. 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
3. 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.

1. 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.