REQUEST FOR DIRECTOR DECISION DD537 Title: Securing and using additional external resources to support Health Inequalities Strategy delivery Executive Summary: The Greater London Authority Act 1999 requires the Mayor to lead preparation of a strategy which identifies health inequalities in Greater London, the priorities for reducing them, and the roles to be played by key partners in implementing the strategy. The Mayor s Health Inequalities Strategy and First Steps to Delivery plan were published in April 2010. This paper seeks approval to enter into a funding agreement with the Department of Health under which they will contribute 18,000.00 toward the GLA s costs of delivering expert health inequalities support to the London Health and Wellbeing Board Partnership Support Programme led jointly by London Councils and NHS London. This paper also seeks approval to use this funding and an additional 10,000 already received from the Department of Health (see MD724) to pay increased fees of GLA s contractor (UCL-Consultants) for the provision of related expert support. This will help to deliver agreed early priorities of the Mayor s Health Inequalities Strategy. Decision: Approval is sought for the: GLA to enter into a funding agreement with the Department of Health (Regional Public Health Group) under which they will contribute 18,000.00 toward the GLA s costs of delivering expert health inequalities support to the London Health and Wellbeing Board Partnership Support Programme led jointly by London Councils and NHS London; and variation of the GLA s contract with UCL-Consultants for services required to establish a Marmot Review team regional pilot on health inequalities to include expert health inequality services (with a value of up to 28,000.00) required by the GLA to deliver expert health inequalities support to the London Health and Wellbeing Board Partnership Support Programme (led jointly by London Councils) and NHS London and to the London Health Inequalities Public Health Network. AUTHORISING DIRECTOR/HEAD OF UNIT I have reviewed the request and am satisfied it is correct and consistent with the Mayor s plans and priorities. It has my approval. Name Jeff Jacobs Position Executive Director of Communities and Intelligence Signature Date 1
PART I - NON-CONFIDENTIAL FACTS AND ADVICE Decision required supporting report 1. Introduction and background 1.1 Section 309E of the Greater London Authority Act 1999 (the Act ) requires the Mayor to develop a strategy setting out proposals and policies for promoting the reduction of health inequalities between persons living in Greater London. The London Health Inequalities Strategy (HIS) was published by the Mayor in April 2010. 1.2 Preparation of the HIS was supported by an Advisory Group including the London Regional Director of Public Health who is also the Mayor s Health Advisor. Successful delivery of the HIS requires ongoing investment in London-wide partnership action, close cooperation with local partnerships, and the continued building of expertise and evidence at both regional and local levels. Delivery structures and processes include involvement from the Department of Health s London Regional Public Health Team (RPHG-L). 1.3 The initial RPHG-L contribution of 45,000 of funding towards HIS delivery was approved under DD328. Arrangements for this work were formalised through a Memorandum of Understanding between the GLA Health Team and the RPHG-L. This funding was used to meet the costs of the award of a contract to UCL-Consultants to further facilitate regional delivery of action on health inequalities, drawing on both the HIS and the evidence from the Marmot Review (award approved under DD399). 1.4 The additional RPHG-L contribution of 18,000 will be used to meet the costs of varying the GLA s contract with UCL-Consultants in order to deliver a series of health inequalities workshops for NHS, local authority and voluntary sector leaders from each borough. In addition UCL-Consultants will support London Boroughs in implementing local health inequalities strategies through workshops, master-classes and consultancy as negotiated between the Marmot Review Team and key stakeholders 1.5 The existing 10,000) funding from the Department of Health (the receipt of which income was approved by MD724) will be used to meet the costs of varying the GLA s contract with UCL- Consultants in order to deliver a practical framework for local authorities to monitor and respond to the impact of changes in housing, employment and income benefits on health and health inequalities in London. 1.6 The Health Team (Health and Communities Unit) within the Communities and Intelligence Directorate will ensure that value for money is achieved by: ensuring that the revised contract with UCL-Consultants clearly specifies how performance will be measured and monitored, including by clearly outlining the activities, deliverables, roles/responsibilities, milestones and timetables expected of UCL-Consultants; project managing all work associated with the Health Inequalities Strategy, including this contract, according to the GLA project management methodology; regularly monitoring performance of the contractor once the contract is awarded; regularly assessing activities in the light of intended outcomes, and meeting with the provider to discuss performance and budgetary issues. 1.7 Officers are satisfied that UCL-Consultants offer value for money, their rates being identified as 2
comparable to other London consultancy providers. Their ability to draw on their extensive evidence-base and directly relevant experience enables them to provide the required consultancy support without the need for time-consuming and costly preparatory and background work. The appointment of an alternative provider following a competitive procurement exercise risks losing this expertise and experience, that provider would have to undertake more work than UCL Consultants to reach the same objectives and this would be likely lead to greater project costs being incurred and the review taking significantly longer than would be the case if UCL Consultants were engaged. In any event because of their expertise and experience it is highly unlikely that any other bidder would score more highly than UCL-Consultants in any competitive exercise 1.8 Payment will be made to UCL-Consultants on receipt of an invoice following the delivery of milestones. 1.9 Accordingly, approval is sought to enter to arrangements with Department of Health (Regional Public Health Group) (funding) and UCL-Consultants (variation of current contract) to facilitate the GLA s enhanced HIS delivery. 2. Other issues for consideration These pieces of work form a small addition to the overall programme of delivery of early HIS priorities. For this reason the links to the strategic plan, impact assessments and consultation and assessment of risk are as for the overall HIS delivery plan (see below). Links to strategies and Strategic Plan 2.1 The Strategic Plan commits to finalising and publishing the HIS Delivery Plan, and coordinating delivery of early HIS priorities. The Strategic Plan Delivery Form reference number that relates to this proposal is 89SP10/11. 2.2 The HIS has significant implications for both current and planned GLA strategies and has been drafted in parallel with their development to ensure consistency. The First Steps to Delivery plan references GLA strategies and programmes of particular relevance to HIS action. In some cases the plan specifies initiatives already identified in conjunction with other GLA strategy policies. Impact assessments and Consultation 2.3 Development of the HIS was influenced by an Integrated Impact Assessment (IIA) process and the IIA report was published on the GLA website to support the consultation process. Development of the strategy also involved extensive stakeholder engagement at every stage. Within the GLA, policy and strategy leads have been consulted at key stages in the strategy s development; as have external health experts including the Regional Director of Public Health for London. 2.4 During the formal public consultation stage 95 written responses were received, many of them composite (for example, from a number of NHS or community groups, from networks of individuals, or from partnerships such as the London Health Commission). In addition, 57 responses (a mixture of individual and organisational) were made to the online questionnaire. 3
Risk 2.5 Development of the HIS and associated documents has been subject to rigorous project management procedures including risk management. This included preparing and updating risk registers, in accordance with GLA project management guidance, and regular HIS project team meetings to track progress. Risks were also identified and shared with members of the HIS Steering Group and HIS Advisory Group. The risks associated with delivery are being identified and action to reduce these will be agreed with key partners over the coming months. 3. Financial Comments 3.1 DD399 approved the award of a consultancy contract with UCL Consultants in order to establish a Marmot Review Regional Pilot on health inequalities in London and to support the implementation of priorities relating to the Health Inequalities Strategy at a contract value of up to 45,000, that was to be funded by income from the Department of Health, the receipt of which was approved by DD328. 3.2 This approval is seeking to secure and provide additional resources to support the Health Inequalities Strategy. This includes the following: the receipt of grant funding of 18,000 from the Department of Health (Regional Public Health Group) to deliver expert health inequalities support to the London Health and Wellbeing Board Partnership Support Programme led jointly by London Councils and NHS London; the variation of the GLA s contract with UCL-Consultants for services required to establish a Marmot Review team regional pilot on health inequalities to include expert health inequality services (with a value of up to 28,000.00) required by the GLA to deliver expert health inequalities support to the London Health and Wellbeing Board Partnership Support Programme (led jointly by London Councils and NHS London) and to the London Health Inequalities Public Health Network; and the use of the grant funding and additional funds of 10,000 to pay the increased fees associated with the variation of the GLA s contract with UCL-Consultants (from 45,000 to 73,000). 3.3 The increase in the proposed contract with UCL Consultants from 45,000 to 73,000 requires additional budget provision of 28,000, which will be funded from a new income stream from the Department of Health ( 18,000) for which approval is being sought above and a separate income stream from the Department of Health ( 10,000), of which the receipt of income was approved by MD724 as further support for the Health Inequalities Strategy work stream. 3.4 The receipt of the income and associated expenditure will be accounted for within the 2011-12 Health Programme budget. All appropriate budget adjustments will be made. 3.5 Any changes to this proposal, including budgetary implications will be subject to further approval via the Authority s decision-making process. 3.6 The Health Team within the Communities & Intelligence Directorate will be responsible for managing this project and contract. 4
4. Legal Comments 4.1 Under section 309E of the Greater London Authority Act 1999 (the `Act ), the Mayor must prepare and publish a Health Inequalities Strategy. The Strategy must contain the Mayor s proposals and policies for promoting the reduction of health inequalities between persons living in Greater London. 4.2 Under section 34 of the Act, the Authority, acting by the Mayor, may do anything which is calculated to facilitate, or is conducive or incidental to, the exercise of any functions of the Authority exercisable by the Mayor. 4.3 Officers have indicated that the proposed entry into a funding agreement with the Department of Health variation of the Authority s contract with UCL-Consultants is required to facilitate and which may be considered conducive to the implementation of agreed early priorities of the Health Inequalities Strategy. On this basis the proposed award of contract may be considered to fall within the Authority s section 34 powers. 4.4 The GLA s contract with UCL-Consultants provides expressly for the variation of the contract in writing by the parties. 4.5 Therefore, the director may approve officers recommendations if satisfied with the content of this report. 4.6 Officers should ensure that funding and variation agreements are put in place and executed by the Authority, Department of Health and UCL-Consultants before any reliance is placed on the funding or the additional services commence. 5. Background/supporting papers MOU between GLA and DH DD328 DD399 MD724 Agreement between GLA and NHS Lambeth to receive Spearheads funding 5
Public access to information Information in this form is subject to the Freedom of Information Act 2000 (FOI Act) and other legislation. Information on this decision will be included in the Mayor s report and decision list. The form will be available publically from then. Any facts and advice that should not be made automatically available on request should not be included in Part 1 but instead on the separate Part 2 form. Deferment is only applicable where release before that date would compromise the implementation of the decision being approved. Is the publication of this approval to be deferred? NO If yes, for what reason: Until what date: Is there a part 2 form NO ORIGINATING OFFICER DECLARATION: Legal Advice: The Commercial Law and Projects team have commented on this proposal. Tick to indicate approval () Financial Advice: The Communities and Intelligence finance team has commented on this proposal on behalf of the Assistant Director of GLA Finance. Executive Director, Resources I have been consulted about the proposal and confirm that financial and legal advice have been taken into account in the preparation of this report. Signature Date 6