Agenda item

The Board received a report which gave an update to the Board on the Sustainable Employment strand of the Devolution Prevention Pilot. The report was introduced by Tamara Djuretic, AD Public Health and was included in the agenda pack at page 155-161 and a copy of the presentation slides were attached to the report, at pages 163-167 of the agenda pack. The AD Public Health introduced Vicky Clark, Head of Economic Growth and Development to the Board, who assisted in presenting this item to the Board.

The Board were advised that the pilot scheme would focus

on the cohort of people with mental ill health as there was a clear need

and a good evidence base that their health and employment outcomes

could be improved. The main objective of the pilot was to support

people who were living with/recovering from a mental health problem

to have sustainable employment – an outcome evidenced by reduced

numbers of people with a mental health condition claiming

Employment Support Allowance (ESA) and reduced demand for health

services, specifically primary care. Early intervention was at the heart

of the proposed model - preventing people from becoming

unemployed in the first place.

The following comments were noted in relation to piloting the

proposed early intervention model:

·         Evidence suggested that length of absence from work, and employer status (Public/Private sector, large company vs. small and medium businesses) were the way to segment the cohort and this was reflected in our proposed model.

·         The current intention was to conduct a small pilot of this model to test whether this is the best way to segment the cohort, and whether we can identify any additional criteria that may be more relevant (e.g. factors based on social functioning, behaviour and attitudes).

·         Initial conversations with Maximus – the provider of the national Fit for Work service (remote occupational health advice) – suggest that they may be interested in working with Haringey to test the impact of a more locally tailored service, which introduced face-to-face support. Maximus would potentially be the source of the additional capacity required to run a small pilot.

·         It was anticipated that the evidence gathered through a small pilot would enable the development of a business case for a scaled-up invest-to-save model that we would put forward to the Government as devolution ‘ask’. The Sustainability and Transformation Plan (STP) process or the Innovation Fund of the (joint DWP/DH) Work and Health Unit, were two possible vehicles for the business case.

·         This would be a large ‘at scale’ transformation, starting with the introduction of genuinely new ways of working on the ground through a pilot.

The Chair Healthwatch Haringey commented that she had concerns about the application of the Fit for Work programme and particularly in light of some of the mistakes made by ASOS. The Chair Healthwatch Haringey requested that the Board be kept up to date with the progress of this work and an evaluation of its implementation. The AD Public Health commented that there would be a robust evaluation process and agreed to bring this item back to a future meeting of the Board. (Action: Tamara Djuretic).  Ms Clark advised that the Fit for Work programme was unrelated to the previous Work Capability Assessment.

The Director of Public Health advised that she recently spoke at a GLA meeting on the devolution piece, commenting that the prevention pilot demonstrated that Haringey was a borough committed to prevention and early help and that devolution was a mechanism to deliver these outcomes at a local level.

The Lay Member Haringey CCG welcomed the devolution pilot. The Lay Member Haringey CCG commented that she was not surprised to see that people in deprived areas were less well, as poverty was a real factor in determining health outcomes. The Lay Member Haringey CCG suggested that there could be scope to bring together cohorts of older people in more deprived areas with younger people, particular in regards to those with lower employment outcomes in a wider intergenerational piece of work that would have the potential to be transformational. 

The Cabinet Member commented that he was struck by the extent to which environmental factors played a key role in physical health outcomes, such as physical health and feeling safe in your community. Cllr Arthur sought clarification on how the data might be used to prioritise these aspects and to do something differently in those areas.

RESOLVED:

I). To take note of the current proposed early intervention model and rationale, its potential scale and inherent risks.

II). To take note of the potential to collaborate with the Joint Work and Health Unit and Maximus.

III). To provide strategic support across the partnership to implement the pilot as part of the Health and Wellbeing Strategy.

III). To champion the pilot as part of the Health and Wellbeing Strategy and ensure that all partners are actively engaged in planning and delivery.