APPENDIX 47
Memorandum by Health First (PH 7)
1. HEALTH FIRST
IS THE
SPECIALIST HEALTH
PROMOTION UNIT
FOR LAMBETH,
SOUTHWARK AND
LEWISHAM, BASED
IN COMMUNITY
HEALTH SOUTH
LONDON NHS TRUST
2. INTER-OPERATION
OF HAZ, EAZ, HLCS,
EMPLOYMENT ACTION
ZONE, HIMP
AND COMMUNITY
PLANS
— These initiatives are not linking
particularly well at the moment because they have all come on-stream
at roughly the same time and people are trying to come to terms
with all the zones and their other job at the same time.
— People often have these intiatives
such as HAZ tagged onto their full remit and therefore, it is
difficult to develop the work when people are not given the time
to effectively participate—basically it is an add-on.
— The structures tend to develop in
parallel and do not link well into existing structures even though
that is the aim in theory.
— The pressure to have early wins by
the Government is in contrast to the long-term development of
innovation and sustainability which is supposed to be at the heart
of the HAZ.
HLCS
We welcome these community based initiatives
and the response locally has been positive. However, listed below
are various shortfalls:
— NOF did not set quotas initially
for geographic areas, eg LSL and as a result there are many bids
submitted with little chance of them all being funded.
— However, bids have been developed
over a two-year time period and a lot of good work could be lost
if bids are not funded—there is only so much work that can
be linked into existing work.
— This lack of foresight has actually
raised expectations and will create bad feelings as a result.
— This also encourages competition
rather than co-operation which seems fundamental to the success
of this process.
— The amount of work required to develop
these bids has meant again that those agencies that already have
some resources are more able to do the work that NOF requires
for the various stages of bid development—as a result the
small and undeveloped organisations again do not benefit from
the process.
2. ROLE OF
THE HEALTH
DEVELOPMENT AGENCY
The HDA will have a powerful role in setting
standards in health promotion and public health, and in suggesting
models of service delivery. Therefore they need to make sure they
are following good practice in development work and looking at
what work is already happening in the field locally. They should
encourage local pilots and trail blazers, and a diversity of delivery
mechanisms.
We recommend that the HDA work collaboratively
with specialist health promotion units (such as ourselves).
Recently there have been major difficulties
caused by reductions in printed resources. Priority areas such
as HAZs will have increased demand for resources, yet our allocations
have recently been reduced.
Clear lines of accountability, roles and responsibilities
for national campaigns and literature/resources availability are
needed.
HDA and Workplace Health Promotion
— National Standards for workplace
health are urgently needed. The HDA have indicated that they are
addressing this, but it should be stressed that there needs to
be standards developed to reflect different types of workplace,
so that employers have a better understanding of what they are
aiming for. At the moment there is a wealth of information on
health at work in the NHS, but this needs to be adapted to meet
the needs of employers outside this sector. The standards do not
necessarily need to be in the form of an award scheme (following
the ending of the Health at Work Award), but such award schemes
do improve the motivation of employers generally, and if developed
in an appropriate way, they could be extremely rigorous and sustainable.
— In general, it would be helpful if
there were resources for employers outside the NHS, to provide
a framework or audit tool for developing health at work strategies.
Whilst existing NHS-focused resources may be suitable, employers
outside this sector do not necessarily identify with them or recognise
their relevance.
— The HDA needs to continue with its
programme of work in relation to SMEs, as this factor is still
extremely hard to reach.
3. PCG/PCTS COULD
PLAY A
PIVOTAL ROLE
IN IMPROVING
THE HEALTH
OF LOCAL
POPULATIONS, HOWEVER
THEY ARE
GENERALLY TOO
CAUGHT UP
WITH MEDICAL
MODELS AND
ILL HEALTH
TO BE
IN A
POSITION TO
VIEW "HEALTH"
IN A
MORE INCLUSIVE
AND PREVENTATIVE
MODEL
Unclear how PCT boards and LA partnership boards
may work together. Potential for them to achive benefit but in
some areas there is also the potential for a duplication of the
problems seen between joint working of NHS/LA over recent years.
The PCTs could extend remit to cover all aspects
of primary access resulting in the co-operation but brave decisions
should be made about independent status of GPs, dentists, ophthalmologists,
pharmacists, etc, for such a role to truly work.
4. THE EXTENT
TO WHICH
CURRENT PUBLIC
HEALTH POLICY
IS REDUCING
HEALTH INEQUALITIES
It should be recognised that improvements will
often be long-term, and that "quick wins" may sometimes
be undrealistic.
3 July 2000
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