Local Government Services > Health Improvement
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| Food Trainers working in Caerphilly County Borough schools to improve health and nutrition. |
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There’s more to health than waiting times and prescriptions - the factors that determine people’s and communities’ health are extensive, and are summarised in the universally accepted graphic below. Health is clearly everybody’s business, so improved health status cannot be delivered, owned or promoted by a single sector, agency, or individual.
In between the global ecosystem and individual factors affecting health are a range of other influences – many of which local councils play a leading role in shaping, and have done since the parishes, shires and urban boroughs of the 19th Century dealt with poverty relief and the provision of common amenities.
Every service provided by local authorities impacts on the health and wellbeing of communities and individuals. Recognition of the scale and potential of councils’ roles in improving well-being is growing, and increasingly local authorities are being seen as health improvement agencies in their own right.
In Wales, local government has been galvanising its approach to health improvement through action around Health, Social Care and Well-being Strategies, developed and implemented through local partnerships and in-part in response to Health Challenge Wales.
All 22 local authorities are signed up to the following principles to maximise their health improvement potential:
- Utilising their community leadership role
- Protecting health through fulfilling their statutory obligations
- Providing high quality direct care and support to vulnerable groups
- Developing strong local strategic partnerships to deliver sustainable improvements in life circumstances
- Investing in their workforces
- Building evidence based policy by collecting robust information
- Increasingly reflecting the principles of the World Health Organisation Ottawa Charter for Health Promotion
Local health boards (LHBs) are the bodies responsible for commissioning primary care services and hospital and community health services to provide for locally identified needs. Their prime function is to implement strategies to improve the health of their population by engaging in partnerships. They share common boundaries with councils and are the key statutory partners in developing and implementing the HSCWB strategies mentioned above. Each Board has a Ministerial appointed Chair and LHBs are accountable to the National Assembly for Wales. The 14 NHS Trusts in Wales provide secondary and tertiary care services as well as community health services, and include the Welsh Ambulance Trust.
In Wales, we are pursing a unique approach to improving health through partnerships between LHBs and councils and with other local agencies to encourage cross-sectoral working.
In light of the Beecham Report – Beyond Boundaries (July 2006) and the subsequent Welsh Assembly Government response Making the Connections: Delivering Beyond Boundaries (November 2006) this approach to strategic collaboration is encouraged and actively developed. The primary framework for all activity to secure health improvement for communities is the local HSCWB strategy – this remains one of the small number of local plans legally required, and is built from a comprehensive assessment of the needs of the local population.
- Resources for health improvement
Longer-term investment is needed to ensure that a collective response to Wales’ health improvement challenges is further developed. There is a need to strengthen capacity and local relationships, building on the work of local health, social care and well-being partnerships. Local needs often require local solutions matched to local accountability for changes.
- Embedding health improvement
Local government’s community leadership role needs to be fully utilised, councils need to continue to build the local vision and direction for health improvement and health inequality reduction through their activity in advocating for and empowering local communities, for example around health care service reconfiguration.
- Healthier local policy development
The collection, sharing and use of relevant information and increased use of tools such as Health Impact Assessment will continue to help improve the health impact of local policy and action, which are increasingly being implemented by partnerships between organisations to ensure that services are orientated towards delivering health improvement.
- Reducing health inequalities
A better shared understanding of need is required to inform investment through joined-up community needs assessments and more robust local resource mapping. Health improvement and the reduction of health inequalities are being discussed by emergent Local Service Boards and should feature in Local Service Agreements. Action to address needs should be monitored through shared and outcome focused indicators with investment in only the most effective interventions to ensure tangible change for communities.
- Joined up action
Partners across health-care and social services recognise their shared responsibility in addressing pressures in delivering continuing care and reducing delayed transfers of care. Innovative joint working is widespread and needs to be consolidated and promoted. Further constructive use of local scrutiny processes for health, building on experience from elsewhere, could assist in this development.
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Beecham: Beyond Boundaries
Making the Connections: Delivering Beyond Boundaries (Welsh Assembly Government)
Making the Connections: Delivering Better Services for Wales (Welsh Assembly Government)
Making the Connections: Local Service Boards in Wales: A prospectus for the first Phase 2007-2008
Guidance for Health, Social Care and Well-being Strategies, Welsh Assembly Government
Fulfilled Lives Supportive Communities
Raising the Standard - The Revised National Service Framework for adult mental health services in Wales and an action plan for Wales, 2005
Adult Mental Health Services for Wales: Equity, Empowerment, Effectiveness, Efficiency
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