MD2631 Thrive LDN work programme 2020/21

The GLA Health Team has developed a programme of work to lead and implement the Mayor’s ten-year London Health Inequalities Strategy (HIS) 2018-28 (October 2018) with relevant partners and stakeholders, and to support his leadership role as chair of the London Health Board. The vision and aims of this approach are:

• healthy children - every London child has a healthy start in life;
• healthy minds - all Londoners share in a city with the best mental health in the world;
• healthy places - all Londoners benefit from an environment and economy that promotes good mental and physical health;
• healthy communities- all of London’s diverse communities are healthy and thriving;
• healthy living - the healthy choice is the easy choice for all Londoners; and
• supporting the Mayor’s leadership role for health.

The Healthy Minds chapter of the London Health Inequalities Strategy has the following five objectives:

• 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, and all Londoners know where to get help when they need it.

Thrive LDN is a public mental health partnership supported and funded by the Mayor of London, London’s Sustainability and Transformation Partnerships, London Councils and London local authorities, NHS England and Public Health England. This MD for £725,000 is the GLA’s contribution to Thrive LDN, with other partners identified above contributing funding in addition to this. Thrive LDN has financial hosting arrangements in place with both the Greater London Authority and Healthy London Partnership, with other partner contributions being received by Healthy London Partnership. The majority of the team are based at Healthy London Partnership, however, there is one member of staff at the Greater London Authority working on Thrive LDN. The partnership approach is governed by the Thrive LDN Advisory Group and reports to the London Health Board. Thrive LDN formally launched in December 2016. For 2017/18 a one-year business case was agreed with partners. Following this, a three-year business case (2018-21) was agreed with partners.

The table below gives a breakdown of the decisions being sought for 2020/21 expenditure for Thrive LDN as part of the Healthy Minds workstream.

1. Expenditure will take the form of grant awards or contracts for services which will be procured depending on the nature of the work / services concerned and in line with relevant GLA procedures including the GLA’s Contracts and Funding Code.

Healthy minds: all Londoners share in a city with the best mental health in the world

The Mayor wants all Londoners to feel comfortable talking about their mental health, and to see an end to the stigma people face due to mental health problems. He also wants people and organisations across the city to work together to reduce suicide rates. The Mayor’s key ambition is for more Londoners to be trained in mental health first aid informed approaches, starting with young Londoners.

This aim is articulated across a range of programmes including:

• Mental Health First Aid; and
• Thrive LDN Mental Health Programme.

Mental Health First Aid

Purpose: Fund the training of Youth Mental Health First Aid (YMHFA) instructors, covering all London boroughs, and fund the delivery of Youth MHFA training in all state schools and further education colleges

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.

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.
• MD2510 (August 2019) approved extra spend of £375,000 from the Young Londoners Fund unallocated scale-up funding to provide Mental Health First Aid training to the youth sector including youth clubs, universities, faith communities and other settings.

The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2020/21 expenditure.

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

Thrive LDN Mental Health Programme

Purpose: Thrive LDN is a citywide movement to ensure all Londoners have an equal opportunity for good mental health, supported by the Mayor of London and London Health Board partners.

In addition, Thrive LDN has been asked by partners, including the Mayor’s Office and the Greater London Authority, to coordinate the public mental health response to COVID-19 in London on behalf of the Public Health England Office for London, to support the mental health and resilience of Londoners during and after the pandemic.

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.

The overall aims of a coordinated public mental health response to COVID-19 are to:

• buffer the effects of COVID-19 on Londoners’ mental health and wellbeing and do this in a way which does not entrench inequalities; and
• decrease the vulnerability of people experiencing greater social and economic disadvantage.

The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2020/21 expenditure.

Total expenditure approval requested under this section: £350,000.

Total approval being sought for the Healthy Minds aim: £725,000:

Under Section 149 of the Equality Act 2010, as a public authority, the GLA must have ‘due regard’ of the need to:

• eliminate unlawful discrimination, harassment and victimisation; and
• advance equality of opportunity and foster good relations between people who have a protected characteristic and those who do not.

The Mayor’s Equality, Diversity and Inclusion strategy sets out how the Mayor will help address the inequalities, barriers and discrimination experienced by groups protected by the Equality Act 2010. This strategy includes objectives relating to mental health which are reflected in our mental health work programme. The GLA Health Team provide regular updates on their work for the Equality, Diversity and Inclusion action plan, and feed into the Mayor’s Annual Equality Report (MAER). Publication of the MAER is a legal requirement and outlines the arrangements put in place by the GLA over the last financial year to demonstrate that due regard has been paid to the principle that there is equality of opportunity for all people in the exercise of the Mayor’s general powers.

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).

The mental health programme delivered through Thrive LDN has taken a proportionate universalism (a key principle in addressing health inequalities) approach to all activity, by addressing the whole population while providing bespoke support for individuals, communities and groups who need it. Thrive LDN is committed to widening participation and reach across London to give everyone the equal opportunity to good mental health and wellbeing. Thrive LDN recognises that certain cohorts are over-represented in mental ill-health stats and this will be taken into consideration in future programme development. In particular, the Right to Thrive workstream focuses on those at higher risk of unfair treatment based on their identity, beliefs or their social class. The aim is to improve opportunities across London for marginalised and intersectional communities in London (intersectionality is the interconnected nature of social categorisations, e.g. the protected characteristics in the Equality Act). By recognising intersectionality we are, for example, recognising that experiences of discrimination may differ for Black LGBTQ+ community and Asian LGBTQ+ community.

Major risks and issues

Risk are assessed and managed on a programme basis. Cross-cutting and major risks are reported quarterly through the GLA’s corporate performance management process. At the time of writing, the major risks are as follows:

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

Impact assessment and consultations

Impact assessments have been conducted on the key elements of the programme, as detailed above.

Participation is the driving force of Thrive LDN and the partnership regularly publish insights from outreach and engagement work with Londoners. For example, in 2017/18 Thrive LDN facilitated 18 community conversations in half of London boroughs attended by over 1,000 Londoners. A meta-analysis from the community conversations was published here. In 2020, this was followed up in the Londoners Did report, which outlined how this work developed and how those conversations made a difference locally.

In 2019/20, more than 1,500 people from the Black LGBTQ+, Asian LGBTQ+, Latino, Gypsy, Roma and Traveller, and transgender communities, as well as people seeking refuge in London, co-produced and participated in a series of activities and events to celebrate and protect their diversity and explore and improve mental health and wellbeing in a safe space. The primary outcome of this work has been over 1,500 people from London’s most disadvantaged communities are better placed to make decisions about their own health and care, reducing the gap of inequality and improving outcomes on an individual and community level. Following this, Thrive LDN launched the Right to Thrive grants scheme to support mental health projects with and for intersectional and marginalised communities in London. Grants totalling £200,000 have been awarded so far.

There are no known conflicts of interest to note for any of those involved in the drafting or clearance of this decision.

Approval is being sought for expenditure of up to £725,000 on the Health Team’s “Healthy Minds” Work Programme for 2020-21. This expenditure is for Thrive LDN to deliver the work relating to Londoners’ mental health and wellbeing (the Healthy Minds chapter of the London Health Inequalities Strategy).

Of this amount, £375,000 for Mental Health First Aid will be funded by the Mayor’s Young Londoner’s Fund (as approved via MD2265); the remaining £350,000 will be funded by the 2020-21 Healthy Minds programme budget held within the Health Unit.

Paragraphs 1 to 2 of this report indicate that the decisions requested of the Mayor concern the exercise of the GLA’s general powers, falling within the GLA’s statutory powers to do such things considered to further or which are facilitative of, conductive or incidental to the promotion of economic development and wealth creation, social development or the promotion of the improvement of the environment in Greater London; and in formulating the proposals in respect of which a decision is sought officers have complied with the GLA’s related statutory duties to:

• pay due regard to the principle that there should be equality of opportunity for all people;
• consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom; and
• consult with appropriate bodies.

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

Any services required must be procured by Transport for London Commercial who will determine the detail of the procurement strategy to be adopted in line with the GLA’s Contracts and Funding Code. Officers must ensure that appropriate contract documentation is put in place and executed by the successful bidder(s) and the GLA before the commencement of the services.

Officers have indicated in paragraph 2.12 of this report that the framework under which it is proposed the Right to Thrive Grant administration services required are to be “call-off” and have been procured fully in accordance with the requirements of that framework. Officers must ensure that appropriate “call-off” documentation is put in place and executed by Groundwork and the GLA before the commencement of the services.

Officers must ensure any grant funding being provided to third parties as set out in Section 2 is distributed fairly, transparently, in accordance with the GLA’s equalities and in a manner which affords value for money and in accordance with the Contracts and Funding Code. Officers must ensure that an appropriate funding agreement is put in place between and executed by the GLA and the recipient before any commitment to fund is made.

Officers must ensure that 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.

A detailed business plan for the work of the Health Team will be developed, setting out the full range of programmes, policy and advocacy work the team plans to undertake in 2020/21 alongside a timeline for each specific deliverable.