Executive Member for Communities and Public Health

MIDDLESBROUGH COUNCIL

Report Title: Health and Wellbeing Hub

Executive Member for Communities and Public Health:

Councillor M Thompson

Date:24thSeptember 2015

PURPOSE OF THE REPORT

This reportoutlines proposals for developing a Health and Wellbeing Hub in the town centre based in Dundas House.

SUMMARY OF RECOMMENDATIONS

For the Executive to approve the proposals for developing a Health and Wellbeing Hub in the town centre, based in Dundas House, funded by capital grants received from Public health England and the Big Lottery Fund.

IF THIS IS A KEY DECISION WHICH KEY DECISION TEST APPLIES?

It is over the financial threshold (£150,000) / x
It has a significant impact on 2 or more wards
Non Key

DECISION IMPLEMENTATION DEADLINE

For the purposes of the scrutiny call in procedure this report is

Non-urgent
Urgent report / x

If urgent please give full reasons:

The PHE capital funding must be spent within the 2015/16 financial year;
The Big Lottery funding must be spent within the 2015/16 financial year;
Lifeline must vacate their Town Hall premises in order to allow the Council’s refurbishment scheme to commence;

BACKGROUND AND EXTERNAL CONSULTATION

In March 2015, PHE announced that Middlesbrough Council’s Public Health team (PH) successfully secured £300,000 capital funding from Public Health England (PHE) to develop a Health and Wellbeing Hub to support local drug and alcohol recovery services. Prior to this, Lifeline, had secured £300,000 funding from the Big Lottery to develop a community gym to be delivered over three years with the funding commencing from April 2015. This capital funding presents an opportunity to co-locate a number of existing substance misuse recovery services, public health services and other well-being services into a centrally located Health and Wellbeing Hub. This will improve and enhance the health and well-being offer for local residents, improve service coordination, and achieve financial efficiencies.

Current arrangements for drugs and alcohol services in Middlesbrough

The Middlesbrough Recovering Together (MRT) drugs and alcohol service brings together the commissioned drugs and alcohol services and programmes. The services are delivered by the following providers: Fulcrum Medical Practice, Lifeline, Thirteen Care & Support and Hope North East. The MRT services are currently delivered in a number of sites across the town. These include the Fulcrum Medical practice, Hope North East premises and community hubs, Lifeline premises on Park Road North, Forbes Buildings for the community gym and the Town hall. This poses the following challenges:

The use of different locations for service delivery results in fragmented service delivery and support for substance misuse clients. This often results in clients either failing to attend appointments or not engaging with the full range of interventions and support available.
Substance misuse clients often have a range of other health and wellbeing needs. Currently, these issues are identified by MRT staff upon assessment, signposting and referrals are then made to relevant services. Due to most of these services being delivered from other locations across the town, substance misuse clients are reported as not attending appointments and maximising on this additional support.
The use of multiple buildings costs more in accommodation and operational costs, therefore, bringing the services into one location will reduce these costs. As part of this proposal, The Fulcrum and Hope NE buildings will be retained (due to separate contractual commitments).
The planned renovation of the Town Hall requires an alternative site to be identified for Lifeline substance misuse services by December 2015. It is proposed for some of the substance misuse recovery programmes to be delivered from the Health and Wellbeing Hub. The medical support and needle exchange programmes which is currently being delivered from the Town Hall will be delivered from the Fulcrum Medical Practice and a community pharmacies.

Health and well-being hub proposal

It is proposed for the development of a Health and Wellbeing Hub in Middlesbrough operated from a town centre location and funded from the PHE and Big Lottery capital funding. The hub will combine the following services:

a.Middlesbrough Recovering Together recovery and treatment support services for alcohol and drug misuse clients.

b.a community gym to replace the current arrangement operating from the Forbes Building;

c.a wide range of public health preventative services, with emphasis on supporting local people address lifestyle risk factors such as weight management and nutrition, physical activity, smoking cessation, mental health and sexual health services;

d.broader well-being support services from housing providers, Job Centre Plus, Citizen’s Advice Bureau and voluntary/community groups all providing in-reach support and advice to ensure that the holistic and ‘one-stop-shop’ provision;

e.The Council’s public health team is working with a number of teams, departments and agencies both internal and external to the council, to maximise the well-being provision from the hub, reduce duplication and ensure coordinated development of this initiative. These include the following:

Development of a social prescribing service in Middlesbrough to ensure a coordinated approach to the provision of non-medical well-being and social interventions to address a range of health, social care and well-being needs for the local population. The emerging model will require a central co-ordination location which could be delivered from the health and well-being hub;
Ensuring close working with the recently opened Independent Living Centre (ILC) on the ground floor of Vancouver House in the town centre. The public health team is working closely with adult social care to ensure clients, carers and their families can easily access services at both the hub and the ILC.
NHS South Tees Clinical Commissioning Group (CCG) to explore opportunities for health awareness and services being delivered from the hub as part of their commissioning intentions for the future.

In order to identify suitable accommodation (size, location and rent) for the Health and Wellbeing Hub a number of options have been considered by the Council’s Valuation and Estates team. This involved a detailed review of the existing council portfolio and the external market to identify potential buildings. Once these had been identified detailed options appraisals were carried out to identify and recommend the suitable accommodation for the health and well-being hub.

Following the options appraisal it is recommended for the health and well-being hub to be located in Dundas House. The hub will utilise the ground floor retail unit as a reception area, the first floor as a training/meeting room, the second floor for the community gym and other lifestyle services, the third floor for clinical interview and intervention rooms (for one to one and group sessions), and the fourth floor for staff and office accommodation. The proposed agreement for this building is rent of £76,000 per annum for a five year lease. This includes the reception area and first floor training/meeting room would being provided rent-free, 30 secure car parking spaces.

IMPACT ASSESSMENT (IA)

An equality impact assessment for the health and well-being hub was carried out and no significant issues were identified. .

OPTION APPRAISAL/RISK ASSESSMENT

In order to identify suitable accommodation (size, location and rent) for the Health and Wellbeing Hub a number of options have been considered. Following review by the Council’s Valuation and Estates team, and having assessed the existing council portfolio along with the external market, an appraisal of ‘Reasonable Alternative’ options has been explored and thoroughly considered and recommended Dundas House for the location of the hub.

FINANCIAL, LEGAL AND WARD IMPLICATIONS

Financial –the health and well-being hub will be funded from the PHE and Big Lottery capital grants. Both grants have a requirement for the funding to be spent in the 2015/16 financial year. The running costs for the hub will be funded from the Council’s public health ring fenced grant. The hub will enable savings to be realised due to the reduction in accommodation costs.

Ward Implications – None as the hub will be for the whole population of Middlesbrough. No Member consultation has been undertaken.

Legal Implications – there are no known legal implications at this stage. The public health team will work very closely with the Council’s valuation and Estates, Legal and finance teams in finalising the agreement for Dundas House and ensure robust lease agreements are in place.

RECOMMENDATIONS

It is recommended for the Executive to approve the option of developing the Health and Wellbeing Hub at Dundas House utilising the PHE capital fund, plus the Lifeline Big Lottery Funding for a community gym.

REASONS

Thelocation of the hub in Dundas House has been recommended for the following reasons:

a)High profile and high footfall area provides an opportunity to market the service and engage with the broader public on public health issues;

b)Provides appropriate accommodation and demonstrated value for money compared to the other options considered. The other buildings that were considered had neither the space nor the facilities appropriate for the HW Hub and, especially, suitability for the community gym provision;

c)The property is immediately available and allows the Council to progress with development of the hub in line with the timescales for the Public Health England and Big Lottery Funding;

d)The hub brings into activity one of the town’s long-term vacant properties.

BACKGROUND PAPERS

No background papers were used in preparing this report.

AUTHOR:

Jonathan Bowden,

Advanced Public Health Practitioner (Team leader),

Public Health

TEL NO: 01642728756