Commissioning for Public Health Outcomes

Locality Based Commissioning

Background

Staffordshire County Council has identified three priority outcomes to benefit the people of Staffordshire; these are able to access more good jobs and feel the benefits of economic growth, be healthier and more independent, feel safer, happier and more supported in and by their community. The priorities will be delivered through a number of key work streams including. In addition there are a number of cross cutting themes that will enable this work to happen such as the use of innovation, supporting personal responsibility through behaviour change and by working through localities.

Achieving strategic outcomes through locality based delivery was approved at the Health and Wellbeing Board in July. In addition SCC Informal cabinet has endorsed the approach for PH resources to be used to support locality commissioning.

Key principles

  • Delivering defined outcomes – as the funding had been identified through a redistribution of resources it is important that the outcomes associated with the resource are achieved.
  • Added value – it is anticipated that partner’s outcomes can be achieved through the same activity. Localities will be able to align budgets and will be expected to report on all commissioned activities that achieve SCC defined outcomes. These are likely to be more valuable than the SCC investment.
  • Funding allocations based in need
  • Flexibility – a degree of flexibility around these outcomes should be permitted to ensure that existing locality assets are utilised effectively.
  • Transparent decision making- This should be supported by a prioritisation and evaluation tool.
  • Governance – the partnership needs to take accountability, owning success and failures. This will be supported by the work of HWB task group.
  • Reducing the demand on Services
  • Sharing of information on programmes commissioned both centrally and locally

Achieving Public Health Outcomes

There is a history of achieving public health outcomes through locality based delivery. This has involved strong partnership working and devolving of resources both personnel and financial. The overall outcome identified by the Health and Wellbeing Board is that children, adults and older people are healthier and more independent. Following a transformation programme of key commissioning areas such Alcohol and Drugs and Healthier Lifestyle programmes there has been a redistribution of the resource reducing the emphasis on centralised commissioning and services to localities. The Public health outcomes indicators developed for each locality have been drawn from the Health and Wellbeing Board, and Public Health Outcomes Framework. These can be broken down into a number of key indicators that can be commissioned at a locality level see table below.

The Locality Public Health grant has been identified following the re-design of a number of behaviour change services. As such this grant should be used to :

  • Prevent the demand for individuals to use behaviour change services such as Lifestyle and alcohol misuse services
  • Provide on going activity and support to those individuals that have utilised Lifestyle Services and in particular the provision of physical activity and community food initiatives (CFIs) . CFIs are projects that improve the availability, affordability and accessibility of healthy food.

Starting Well/ Growing Well

Outcomes / Children and parents are healthier and more independent / Children and parents feel safer, happier and more supported in and by their community
  • Healthy Weight (4-5 years and 10-11 years)
  • Physical Activity –
  • Under 5s –
Increase in frequency / intensity of physical activity of the child to meet 180mins per day target
Decrease in sedentary behaviour
Increase use of green spaces for activities related to physical activity and health.
  • 5-18yrs –
Increase in frequency / intensity of physical activity of the participant to meet 60 minutes of moderate to vigorous intensity physical activity per day.
Decrease in sedentary behaviour
Increase use of green spaces for activities related to physical activity and health.
Local Measures
  • Improved motor skills
  • Improved fitness levels in target group
  • Change in the determinants of physical activity behaviours, e.g. increased knowledge, improved self-efficacy towards activity.
  • Other lifestyle changes / outcomes as a result of participation in programme? (Qualitative data)
  • Improved healthy dietary behaviours
  • Improved knowledge of a healthy, balanced and varied diet
  • Improved skills and confidence of how to prepare and cook healthy and nutritious meals / snacks
  • Improved skills and confidence of how to menu plan and budget for healthy and nutritious meals
/
  • Alcohol related admission rates for under 18s
  • Reduced child protection cases where drugs/alcohol are a risk factor
  • Reductions in the number of people drinking above recommended levels
  • Improved resilience to long term drinking problems, particularly for young people
Target audience
People (particularly young people) not using drugs/alcohol problematically

Living Well

Outcomes / Working age people are healthier and more independent / Working age people feel safer, happier and more supported in and by their community
  • Diet
  • Proportion of physically active adults
  • Increase in frequency / intensity of physical activity to meet 150mins per week target (optional - 12 weeks, 6 months, 1 year)
  • Decrease in sedentary behaviour (moving sedentary people into 30mins of activity)
  • Increase use of green spaces for activities related to physical activity and health.
  • Excess weight in adults
  • Alcohol related hospital admissions
Local Measures
  • Change in the determinants of physical activity behaviours, e.g. increased knowledge, improved self-efficacy towards activity.
  • Other lifestyle changes / outcomes as a result of participation in programme? (Qualitative data)
  • Improved healthy dietary behaviours
  • Improved health, wellbeing and independence
  • Improved knowledge of a healthy, balanced and varied diet
  • Improved skills and confidence of how to prepare and cook healthy and nutritious meals / snacks
  • Improved skills and confidence of how to menu plan and budget for healthy and nutritious meals
  • Reduced Social Isolation
/
  • Reduced levels of drug/alcohol use
  • Reduced violence in the night time economy/ anti-social behaviour
  • Reduced domestic violence
  • Reduced drink driving
  • Reduced A&E attendances/admissions (not least acute intoxications)
Target audience
People with low level drug/alcohol problems (‘binge’/harmful drinkers/’recreational’ drugs users’)

Ageing Well

Outcomes / Working age people are healthier and more independent / Working age people feel safer, happier and more supported in and by their community
  • Diet
  • Proportion of physically active adults
  • Increase in frequency / intensity of physical activity to meet 150mins per week target (optional - 12 weeks, 6 months, 1 year)
  • Decrease in sedentary behaviour (moving sedentary people into 30mins of activity)
  • Increase use of green spaces for activities related to physical activity and health.
  • Excess weight in adults
  • Reduction in Injuries due to falls
Local Measures
  • Change in the determinants of physical activity behaviours, e.g. increased knowledge, and improved self-efficacy towards activity.
  • Other lifestyle changes/ outcomes as a result of participation in programme? (Qualitative data)
  • In creased muscular strength and endurance
  • Improved balance
/
  • Reduced drug/ alcohol use
  • Improved health (physical/mental health)
  • Happier families
  • Safer communities
  • Improved resourcefulness (jobs, accommodation etc.)
Target audience
Dependent drug users/ drinkers