MD2852 Mental Health Recovery Mission & Thrive LDN work programme 2021

1.1. The London Recovery Board (LRB), co-chaired by the Mayor of London, has launched the Recovery Programme, which includes a Mental Health and Wellbeing (MHWB) mission. This mission has a commitment that, by 2025, London will have a quarter of a million change agents, supporting Londoners where they live, work and play. The longer-term aim, agreed by the LRB, is for Thrive LDN to lead the work with mental health sector stakeholders to deliver the MHWB mission’s broad objectives; to ensure Londoners have the skills, tools and resources to support one another; and to protect or promote mental health and psychosocial wellbeing.

1.2. These broad objectives all, in turn, support and complement the five Healthy Minds objectives of the Mayor’s statutory Health Inequalities Strategy:

• 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
• action is taken across London to prevent suicide, and all Londoners know where to get help when they need it.

1.3. Thrive LDN is a public mental health partnership supported and funded by the Mayor of London, London’s integrated care systems, London boroughs, NHS England and Public Health England. The partnership approach is governed by the Thrive LDN Advisory Group, which reports to the London Health Board, and provides oversight for the delivery of the MHWB mission.

1.4. This MD for £600,000 is the GLA’s contribution to the delivery of the MHWB mission. This funds the GLA’s partnership contribution to Thrive LDN’s foundational work that also supports delivery of the Mission.

1.5. The table below gives a breakdown of the decisions being sought for 2021-22 expenditure for the delivery of the MHWB mission. This includes new activity directly focused on delivery of the MHWB mission, and long-standing programmes of work led by Thrive LDN that the GLA wishes to continue funding, as they directly contribute to the delivery of the mission’s objectives.

1.6. 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, including the GLA’s Contracts and Funding Code.

Mental Health Recovery mission

2.1. The Mayor wants to support public mental health recovery from the pandemic, where every Londoner has the opportunity to participate in, and feel empowered to make a difference through, their communities, workplaces and local democratic institutions. This will help to create a city in which everyone feels comfortable talking about their mental health, and to create a change in culture where Londoners are more resilient and have the capacity to cope with uncertainty and adversity.

2.2. The LRB has agreed the MHWB mission’s objective as: by 2025 London will have a quarter of a million change agents, supporting Londoners where they live, work and play.

2.3. Delivery of this objective will take a co-ordinated public health approach, made up of programmes of work set out below. These will have the overall aim to:

• reduce the impact of COVID-19 on Londoners’ mental health and wellbeing, and do this in a way that does not entrench inequalities
• decrease the vulnerability of people experiencing greater social and economic disadvantage.

Thrive LDN partnership foundation programmes

2.4. Thrive LDN’s core objectives, funded and supported by health and care partners for London as described in paragraph 1.3, include a range of activities. These activities also serve as foundations to the delivery of the MHWB mission. We are therefore seeking spending approval for these alongside specific mission deliverables to maximise their impact.

2.5. The table below gives a breakdown of deliverables for this programme, and the decisions being sought for proposed 2020-21 expenditur

2.6. Total approval being sought for the MHWB mission: £600,000

3.1. 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
• advance equality of opportunity and foster good relations between people who have a protected characteristic and those who do not.

3.2. 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 provides regular updates on their work for the equality, diversity and inclusion action plan, which feed into the Mayor’s Annual Equality Report (MAER). Publication of the MAER is a legal requirement. It outlines the arrangements put in place by the GLA over the last financial year, in order 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.

3.3. 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, and to identify issues concerning the four cross-cutting themes under the GLA Act 1999. The Impact Assessment noted that the establishment of Thrive LDN, although in early stages when the document was written, was likely to lead to positive outcomes with regards to mental health – in particular for some groups with protected characteristics (for example, people with disabilities arising from mental health conditions). The Health Inequalities Strategy was adopted in October 2018 (www.london.gov.uk/programmes-strategies/health-and-wellbeing/health-inequalitiesstrategy), and the integrated impact assessment was published at the same time (www.london.gov.uk/sites/default/files/the_mayor_of_londons_health_inequalities_strateg y_iia_report_-_final_23.08.17_0.pdf).

3.4. Thrive LDN has published insights reports in 2019-20 and 2020-21 detailing outcomes to date. Thrive LDN’s research model includes a community insights function which involves regular community engagement and participatory action research projects to ensure their work is informed by lived experience. A recent example of this being Pandemic Stories, which was published August 2021.

3.5. The mental health programme delivered through Thrive LDN has taken a proportionate universal approach (a key principle in addressing health inequalities) 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 statistics, and this is continually taken into consideration during programme development. In particular, the Right to Thrive workstream focuses on those at higher risk of unfair treatment based on their identity, beliefs or 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, for example, the protected characteristics in the Equality Act). By recognising intersectionality we are, for example, recognising that experiences of discrimination may differ for the Black LGBTQ+ community and the Asian LGBTQ+ community.

Key risks and issues

4.1. Risks 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:

4.2. In addition to the Mayor’s commitment to deliver the MHWB mission, this work directly supports delivery of the Mayor’s Health Inequalities Strategy, a statutory duty under the GLA Act 1999.

Impact assessment and consultations

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

4.4. Participation is the driving force of Thrive LDN, and the partnership regularly publishes insights from outreach and engagement work with Londoners. For example, in 2020, Thrive LDN published Thrive Together, which summarised findings from listening to over 10,000 Londoners disproportionately at risk of developing poor mental health.

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

5.1. Approval is being sought for expenditure of £600,000 on the Mental Health & Wellbeing Recovery mission and the Thrive LDN work programme for 2021-22.

5.2. The expenditure is detailed in the below table.

5.3. This expenditure will be funded from the Health Team’s Programme budget for 2021-22.

5.4. These programmes all sit within the ‘Mental Health & Wellbeing’ mission.

6.1. Sections 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
• consult with appropriate bodies.

6.2. Under section 31(3) of the Greater London Authority Act 1999 (the GLA Act), the GLA’s general powers (referred to above) cannot be used to incur expenditure in providing any health services that may be provided by any other public body. However, this prohibition does not apply to the provision of services or facilities for promoting improvements in, or protecting, public health (section 31(5A) of the GLA Act). To the extent that the decisions requested in this Mayoral Decision may involve the provision of health services, they involve the provision of services or facilities for promoting improvements in, or protecting public health that the GLA is permitted to provide using its general powers.

6.3. 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.

6.4. Any services required must be procured by TfL Commercial, who will determine the detail of the procurement strategy to be adopted in line with the GLA’s Contracts and Funding Code (‘the 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.

6.5. Officers must ensure any grant funding being provided is distributed fairly, transparently, in accordance with the GLA’s equalities, and in a manner that affords value for money and is in accordance with the 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.

7.1. 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 2021-22, alongside a timeline for each specific deliverable.

• The London Health Inequalities Strategy 2018-28:

www.london.gov.uk/programmes-strategies/health-and-wellbeing/health-inequalities-strategy

• The London Health Inequalities Strategy Implementation Plan 2018-2020:

www.london.gov.uk/sites/default/files/his_implementation_plan.pdf

• Health Inequalities Strategy Annual report 2018-19:

www.london.gov.uk/sites/default/files/his_annual_report_1819_final.pdf

• The Health Inequalities Strategy Consultation Integrated Impact Assessment: www.london.gov.uk/sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf

• Thrive Together:

https://thriveldn.co.uk/wp-content/uploads/2020/11/Thrive-Together-report.pdf

• Thrive LDN Insights report 2020-21:

https://thriveldn.co.uk/resources/insights2021/.