Published: 28/07/2005, Volume II5, No. 5966 Page 22 23
This week, HSJ and sister title Local Government Chronicle launch the Sustainable Communities Awards 2006. Here, Ann McGauran looks at how the health sector and local authorities are teaming up to improve lives, while opposite Emma Parsons explains why you should enter the awards
It is hard to come up with the perfect blend of ingredients that creates the kind of place in which people want to live and work. But you can't beat the sense of satisfaction earned by those who successfully play their part in that process.
Making sure communities are sustainable calls for an all-round approach, though the elements required differ nationally. The South East needs homes, while the North West is looking for ways to attract workers and residents and create jobs.
Building new communities is not just about bricks and mortar; it is also about providing health and education services, transport links, open spaces and food sources. What connects all this is partnership-working, and to do this well councils must work closely with other local authorities, health and the private and voluntary sectors.
The government is serious about the agenda and it is being pushed heavily across departments. If everyone makes this work it is the answer to many problems around crime and antisocial behaviour, health inequalities, education and environmental issues.
But no one single authority can do this in isolation. Pit closures left a legacy of deprivation in the area of West Yorkshire covered by Eastern Wakefield primary care trust. Earlier this year a covert police operation to target drugs in a deprived area succeeded in arresting 64 drug dealers and closing five drug dens. Months before, the PCT's director of public health, Val Barker, met the divisional crime manager to make sure treatment and support systems were in place for the drug users as their illegal supplies ran out.
Within hours, a temporary treatment facility and a community support centre were up and running. Ms Barker says local people were immediately appreciative: 'When we closed down the crack houses people applauded.' The operation relied on excellent inter-agency cooperation that included integrated service provider Turning Point.
New ways of working and new approaches to funding mean the prospects for creative and flexible partnerships have never been better. Local strategic partnerships will play a key role in creating sustainable communities. They were set up to bring together all the major players - public, private, voluntary and community - to adopt an integrated 'holistic' approach to that area's needs, with a focus on strategy.
The full potential of LSPs has not yet been realised. In many areas there has been difficulty translating them from talking shops to effective forums for driving ideas forwards. The real prospect of a tipping point came in July 2004 with the launch of pilot local area agreements (LAAs) in 20 areas. LAAs simplified the number of additional funding streams from central government going into an area, with agreements struck between the government, the local authority and its major delivery partners working through the LSP.
The second round of LAAs - confirmed last month in 66 areas, pooling some£800m of funding from over 100 funding streams - indicates a genuine enthusiasm for more streamlined working. The agreements concentrate on a core set of outcomes, and in average areas are reporting on 64 targets instead of hundreds. The negotiation of local public service plans will be integrated with LAAs, providing rewards in return for greater performance in locally agreed areas.
Milton Keynes - one of four growth areas in the South East identified in the Office of the Deputy Prime Minister's communities plan - is expected to absorb an extra 71,000 houses over the next 25-30 years. The city's director of public health, Dr Nicholas Hicks, is jointly appointed by Milton Keynes council and Milton Keynes PCT, which are coterminous. He sits on the management teams and reports to the chief executives of both. In his area, the importance of the LSP can't be overstated.
One of the biggest challenges is how to design a city that is conducive to health at the same time as tackling poor life expectancy in the worst wards. The LSP's first major task was to develop the community strategy for 2004-34, setting out a whole set of principles for the future.
'The things that make it work are shared boundaries and the shared common agenda and a real willingness to make it work, ' says Dr Hicks.
'It is new; the streets are laid out in grids and there is an attitude that we can make things happen.' What is crucial is that the government must ensure that PCTs are coterminous wherever possible with the upper tier of local authorities - either unitary or county - and wherever possible have a ratio of one to one. People like Dr Hicks cannot sit on any more than two management teams.
Steve Maddox is chief executive of Wirral Metropolitan borough council and co-chair of Cheshire and Merseyside public health network.
He says work on the ground has to be supported by 'champions' at a higher level, and LSPs give an over-arching framework in which this can work.
'There is a fantastic amount of collaborative working between staff at the front line to address health inequalities and health promotion, but that needs to be supported by leaders of organisations seeing health as a key strategic issue, ' says Mr Maddox. 'If You have got leaders signed up to the agenda, the public health white paper Choosing Health has got to be better delivered.' What appears to be missing currently is enough real leadership and champions for sustainability at every level and in every government department, private industry and the voluntary sector.
Zenna Atkins is chair of Portsmouth City teaching PCT. She says some areas are 'fabulous', while some are 'really struggling with how to ensure the community is sustainable for everybody'. For people with complex needs, she asks: 'How do you ensure they can live in an ordinary place and have those services wrapped around their needs?' In Portsmouth, there have been years of excellent working between the coterminous local authority and NHS. 'Relationships are well established and they are less hung up on the bureaucracy of delivery. It becomes very much more difficult if you do not have the same populations. If you are creating a shared vision for the same folk It is much easier.' Brian Stapleton, Croydon council's divisional director for partnerships, business and community, says partnership has become a way of life and the link between the local authority and the PCT is 'extremely strong and supportive'.
The government has a genuine will. It wants to practise sustainability in all forms and has tried to make sure the issues are reflected in LAAs. It is trying to create mechanisms for it all to come together, and aligning these will maximise potential benefits. But, confusingly, the public health white paper sees LAAs sitting alongside the NHS local delivery planning process rather than as a framework for integrated planning.
Good local partnership-working is fundamental to sustainable communities, but local targets and incentives will not deliver this agenda in isolation. Local players work with the national regulations they are given and they respond to the economic incentives. Much work remains to be done on those national drivers.
SEEKING SUSTAINABILITY STARS
ABOUT THE AWARDS
The Sustainable Communities Awards are launched by HSJ and LGC, in association with the Department for Environment, Food and Rural Affairs, to highlight and reward the work that is going into creating neighbourhoods in which people want to live and work, both now and for future generations.
These awards are aimed at partnerships between service providers which are instrumental in delivering this key government agenda.
Truly sustainable communities cannot be delivered until traditional geographical and service barriers are broken down, and all public service providers find ways to work successfully together and with the private and voluntary sectors.
DEFRA's sustainable development strategy Securing the Future, published in March, outlines the government's long-term vision for delivering better quality of life through sustainable development.
For communities to be sustainable they must provide jobs, hospitals, schools and transport links, clean, safe and green public spaces and respect the environment.
The goal is to create places where people can lead healthy and prosperous lives, without fear of crime.
This is a crossgovernmental agenda and everyone involved in the delivery of public services has a part to play if the government's vision is to be realised.
In launching these awards, HSJ and LGC want to seek out the best and reward the groundbreaking work already being done in this increasingly important area.
See advertisement on pages 24-25 for details of how to enter, or go to www. sustainable communities2006. com
The ingredients for sustainable communities vary.
Local area agreements are concentrating on a core set of outcomes, which have been streamlined.
PCTs should ideally be coterminous with the upper tier of local author ities.