This presentation summarises the discussions, and the actions to be taken forward, from our five workshops (1 on physical activity and 4 on health themes) with the third sector

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Think Intelligence, Think Intelligently
Third Sector Public
Health Workshops
Feedback and next steps
24th March 2014
Jim McManus, Director of Public Health

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Background
• Voluntary groups make an important contribution to
improving and protecting the health of the population –
from targeted work with vulnerable people to self-
management and direct interventions. Public Health skills
and capacity, joined with the voluntary sector’s
connections and “can do” mindset could produce a major
improvement in the health of Hertfordshire and also help
integrate care for people across all sectors.
• The workshops will be an excellent opportunity for the
voluntary sector to contribute to policy development, build
relationships, and discuss new commissioning
arrangements.

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What we did
• Five workshops were held, one with the Sports and
Physical Activity Partnership and Stakeholders and the
other four on specific topics, arising from the Joint
Strategic Needs Assessment, where the third sector and
public health could explore working together
• Each workshop had a presentation on the theme (these
are all on slideshare) followed by discussion and
feedback
• Commissioners from NHS and County Council, along
with Public Health, participated in the workshops with
third sector colleagues
• This presentation has the feedback and next steps from
this work

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About the Sports and Physical Activity
Partnership Workshop
• Around 60 stakeholders, brought together by
the Sports and Physical Activity Partnership,
came together to identify some ways of
collaborating on shared public health and
physical activity priorities
• The sports and physical activity partnership
convened and organised this workshop
• 15th
February 2014, Hertfordshire Sports Village

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About the third sector themed
workshops
• four workshops to explore the role the voluntary
sector can play influencing the development of
public health policy and delivering services.
• These workshops were organised jointly
between Public Health and Watford and Three
Rivers Trust, acting on behalf of all the CVSs in
Hertfordshire
– Wednesday, 26 February, 14:00 – 16:30: Public Health and Younger
People
– Thursday, 6 March, 09:30 – 12:00: Public Health and Older People
– Tuesday, 11 March, 14:00 – 16:30: Public Health and Long Term
Conditions
– Tuesday, 18 March, 09:30 – 12:00: Public Health and Mental Health

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Workshop Questions
• Each workshop considered four questions:
– What is the scope of public health, and what contribution can
the voluntary sector make to service delivery, policy
development, campaigning and tackling health inequalities?
– How can the voluntary sector help improve resilience, self-
management and secondary prevention, and so help reduce
unnecessary hospital admissions?
– How can the voluntary sector be better commissioned to
deliver public health interventions? How can relationships
between the voluntary sector and commissioners (DH, local
public health commissioners, GPs, and others) be improved?
– What scope is there to apply commissioning innovations such
as payment by results or a Total Place approach to public
health commissioning?

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Feedback – Young People 1
• Organise vol sector PH conference in
partnership with vol sector please
• Vol sector Speed dating – one part of vcs
finding out what another one does…maybe
sport talking to young people. Maybe link this to
commissioning opportunities – couple of hours.
– CVSs could do it would need a little money
• Also speed funding

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Feedback -Young People 2
• Try to make the processes as clear as possible – be
clear about what you want to commission. Some smaller
contracts e.g. “we want to nail obesity in area y” makes
it easy. Be clearer about what commissioning is trying to
achieve
– Enabling the citizen cross-cutting workstream needs
to take this on board please
– Break down big bids into smaller chunks
• Need more clarity between pan herts projects and local
district needs (latter are where vol sectors come into
their own)
• Revisit how useful the compact is please.

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Feedback -Young People 3
• Commissioners need to understand better how contracts enable vol sector
tendering and provision (e.g. biffa waste in derbyshire)
• Use simple clear language please and remove jargon
• Knowing what opportunities are available and knowing what vol sectors can
deliver on – share granular information on health topics and districts -
HRBQ is broken down by district level.
• District funding – remind districts they need to work with vol sector
• Connect scheme – club for business which want to show how community
friendly they are W3T connect – what promises can people make. Get
employers and members to adopt some protocols on promoting good public
health and good public health practices. An initiative which could be built
up. Could be copied elsewhere or built in
• Make health profiles at county and district level available, district flavour
really helpful
• Facilitate vol sector input into the JSNA please

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Feedback -Young People 4
• Would a vol sector alliance on public health be useful?
Or on another topic? A strand on obesity a strand on
MH – use this as opportunity for CPD
– Could we use email lists?
• Good to have a resource that documented what the
other groups did in themes. The database of Herts
community solutions may be a solution for this but
needs to be better accessible and used. Problem is the
minute its up to date its out of date
• Better communication in general – need to think this one
through. This is a big issue – ability to communicate
electronically.

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Feedback -Young People 5
• Use twitter and social media
• Work with cvs
• Funding to district councils needs to be
transparent in terms of what PH are expecting
• Review and revise the compact at Herts level
• Districts need to do their and lobby locally
• Try and find out who is the member responsible
for the health portfolio

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Contributions on Mental Health 1
Third sector
contributions
Working together PH, NHS, LA
contributions
•Activities which improve
self esteem and self worth,
key skills – recovery,
prevention and resilience
agenda
•Cohort of people needing
most support (complex
needs)
•Improving public
awareness
•Do more to encourage and
enable volunteering –
commissioning of services
but no funding for volunteer
centres. Cost of volunteer
centres needs to be
considered if volunteering
is a proper strategy. Echo
this for any frontline org
with minimum staffing. Cost
of keeping volunteer
centres going versus return
it brings – if volunteering is
an outcome, the
infrastructure to support it
(vol mgt) needs supporting
•Training front line workers
to understand and signpost
better
•Evidence for funding
(support vcs on getting
funding)

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Contributions on Mental Health 2
Third sector
contributions
Working together PH, NHS, LA
contributions
•CAB transition services
are a really good example
of third sector working
together
•CAB transitions service
looking at how we do a
referral process and have
an activity plan. Sharing
data on a small scale.
•Easy to connect with and
access especially where
there is a fear of accessing
services
•Reducing isolation
(flexible), trust in the sector,
local knowledge, - third
sector could promote itself
more
•People expect too much
from services – people
need to be more resilience
generally. Services need to
promote resilience and
taking responsibility for
oneself
•Making every contact
count is good
•Dealing with alcohol use
for self medication –
investment has happened
but could do more
•Lifestyle prescriptions
•Clearer pathways and
being able to move from
formal statutory into third
sector and less red tape
•Education – get into young
people
•A piece of work to support
the vol sector demontrate
return on investment for
their work.
•Commissioners to explain
clearly and consistently
what they are looking for in
return on investment and
how vcs reports ROI
•Feed this into terry please
•Training offered
•Services are reactive, not
flexible enough – need to
look at preventive agenda
more widely
•Targets having a negative
impact on service being
delivered (time limited
services) not person
centred….need to be more
user journey focused

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Contributions on Mental Health 3
Third sector
contributions
Working together PH, NHS, LA
contributions
•Innovation, new ideas and a place
where we can try new things
•Checks and balances – lobbies,
challenges and in a sense almost
holds stat sector to account (critical
friend)
•Addresses gaps in provision
•Offers value for money – outcome
focused high level of professional
•Approachable
•Good at inreach
•Easly intervention
•Undertakes research
•Culture changes – awareness into
local business etc
•Support people to access physical
activity more to improve resilience
•Dementia friendly communities
•Provide messages
•Demand on formal services – need
for navigators or signposters.
Signposting is a big issue
•Shift to much more openness to
enable people to say when they are
struggling – change social norms
•Find a friend
•Co production to harness resilience
agenda
•Get people engaged from beginning
•A process of co-production – stat
sector brings info, use vol sectors
links with ctyy to get in there and
understand, and feedback – work
together to get targeting and design
right – so working in service design
and commissioning together
•Make jsna etc data and tools
available to third sector, GIS
mapping to help third sector to focus
their attentions
•Create an environment which allows
third sector to challenge without
taking away funding
•Work to ensure third sector can flag
up changing issues and feed it back
up the line (so how do we harness
this in JSNA and JSAA processes…)
•The challenge by third sector needs
to be seen as positive
•Provide info and data and back up
for bids
•Parity of physical and mental health
•(underline this)
•We miss a lot of preventive work
because we are not breaking MH
down into component parts well
enough – how do we conceptualise
this
•Visit the space centres.

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Long Term Conditions Feedback
What can 3rd
sector do?
What can we do
together?
What can PH do,
What can CCGs,
HCS?
Integration
between health
and social care
Home from
hospital
Community
interventions
Self management
Resilience and
coping
Work with
commissioners on
integration and
also on
Invest in skills for
self-management
and resilience
Invest in home
from hospital

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Feedback – Long Term Conditions and
Older People (feedback which
overlapped) 1
1.Big issues – mental health/resilience, physical
health, cardiovascular health, prevention
2.The scheme on brief interventions on physical
activity in older people – e.g. doctor talking about
can you walk and get the paper?
3.Some tools which ordinary people and clinicians
can use on older peoples health – quick
assessments?
4.Diverse range of opportunities for people
5.Wish list for healthy older people in Herts
6.Volunteering, befriending
7.Range of activities
8.Anti-poverty strategy

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Feedback – Long Term Conditions and
Older People (feedback which
overlapped) 2
1. Re look at the policy on weight please
2. Integrated care – need to make one of the roles of the care co-
ordinator to have links into health improvement
3. Working together on projects
4. Circulate tartan rug of health indicators
5. Herts Sports Partnership can offer a range of things
6. Third sector public health conference – continuing the
conversation
7. Culture – older people are an asset not a problem
8. Build volunteering opportunities for older people
9. Five ways to wellbeing – send this round please

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Feedback – Older People
What 3rd
Sector
can do (bear in mind huge
diversity)
What we can do
together
What can
PH/HCS/CCGs
do?
•How do we engage all third
sector
•“coaching for health”
•Provide coaching
•Quality of what they provide
•Third sector think through their
offer and quality standard on
physical activity
•“low level” interventions and
training for them
•Identify gaps in services
•“Coaching for health”
•How to engage old older people
with five ways to wellbeing
•Conference or summit or piece
of work on five ways to wellbeing
and old older people
•Come back together in three
months time
•How do we have this at a
district level - or CCG footprint?
•Barriers of cost to individuals –
e.g. free physical activity
•Brief interventions for older
people in Primary Care
•Care navigators in West and
their health improvement role
•Coaching for health course for
third sector (day)
•Buddy people on the course up
with each other
•Lifestyle pathway from GPs to
services
•Health coaching
•How do we get exercise and
health walks on prescription and
then also follow them up with
appointments and text
messages

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Next Steps – Physical Activity
1. We agreed we would revitalise the Physical Activity
Alliance and feed this work into a strand of the
Lifestyle and Legacy Partnership, which will replace
the Olympic Legacy Partnership
2. We will develop a Physical Activity Strategy to improve
uptake of and access to physical activity
3. Herts Sports and Physical Activity Partnership will co-
ordinate
4. The role of the District Councils and leisure providers
will be crucial
5. Work together with NHS and Public Health on
behaviour change and lifestyle pathways for primary
care

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Next steps - Themes
1. Write up and circulate the feedback to all participants
2. Share email addresses so we can communicate with each other
3. 5 projects have already been kicked off between participants at the day
4. Co-produce a public health conference for the third sector
5. Bob Jones and Jim McManus to meet and plan next steps on behalf of
the groups and then take back to the CVSs group
6. Send report to LSPs too
7. Feed outcomes of this into the County Council corprorate voluntary
sector workstreams,
1. We would like to see the revision of the compact hopefully
2. There was a volunteering strategy produced two years ago, the
partners should revisit this, not strart again from scratch
3. We need to join up HCC when it talks to the third sector
4. Join up HCC to tlk to third sector – CB
8. Public Health to write up a “third sector offer”
9. Circulate the five ways to wellbeing (see next slide)
10. Circulate the tartan rug of health indicators (see next slide)

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Items for circulation
Tartan Rug of health
indicators for
hertfordshire
The latest version can be obtained from
joel.bonnet@hertfordshire.gov.uk
Double click on the icon to open
Five Ways to Wellbeing http://neweconomics.org/projects/five-ways-well-being
Health Challenges for
Hertfordshire
The latest version can be obtained from
joel.bonnet@hertfordshire.gov.uk
Double click on the icon to open
Herts Public Health
Strategy
http://www.hertspublichealth.co.uk/files/Healthier%20Herts
Microsoft Word
Document
Microsoft Excel
Worksheet