Issue - decisions

1.

Title of Item/Report

Public Health Grant Spend

2.

Record of the Decision

Consideration was given to a report Public Health Grant Spend.

Through an outcome-based review, £1m of the public health grant had been identified to realign to other areas of the Council. The work builds on existing joint working between Public Health and other services across the Council. Working with Finance, the proposed Council areas to receive realigned funding had been identified. Further work was commencing on specific public health indicators to be achieved through discussion with the relevant service areas. To satisfy Department of Health and Social Care (DHSC) assurance requirements, service level agreements would articulate joint working in each Council area, use of funding and indicators which must demonstrate specific public health added value.

DHSC had implemented a new strengthened national assurance process, regarding spend of the Public Health grant (Appendix 1 of the report).  To satisfy the assurance process, written evidence in the form of service level agreements (SLAs) was required to demonstrate specific added value through use of the Public Health grant in achieving Public Health outcomes.  National guidance stipulated areas / activity the grant cannot be used for, including other areas of Council statutory activity.  Through this process, DHSC also sought to determine there was an appropriate balance between funding Public Health core services, and wider Council activity supporting Public Health.  All areas across Tees Valley and the North East were putting or had put SLAs in place.  Comparison across Councils on wider use of the grant had limited value due to: nationally recognised variation in spend captured in budget reported outturn (RO) categories; and significant variation in set-up, scope and ways of working of wider Council services.

Public Health already worked closely with a wide range of Council areas and public health funding was used across these services.  In 2025/26 a total of £4.2m expenditure across other Council services and central overheads was forecast to be funded via public health, with £3.5m being funded through the public health grant and £0.7m funded through public health reserves (Appendix 2 of the report).

The Council areas receiving public health funding had been reviewed through joint working with Finance, to ensure that they were in line with the DHSC assurance requirements and to make sure that the funding could continue through public health grant funding as the public health reserve was drawn down.  Some of the existing public health contributions would be reduced and others would increase.  The exact amounts of funding for each service would be determined once public health indicators had been specified, to ensure the funding reflected joint working and public health added value but would include:

•         Trading standards, enforcement

•         Employment & training, inclusive growth, economic and place development

•         Parks and green space, active travel

•         Homelessness (complex lives) and communities, engagement & consultation

•         Workplace health

The public health outcomes linked to these areas were detailed at Appendix 3 of the report.

Some areas funded by Public Health had historically been funded through reserves; these were now being covered through core Public Health grant.  The total contribution would increase from £4.2m to £4.5m and this would be funded in full from the Public Health grant in future years.  Therefore, the Public Health grant contribution would increase from £3.5m in 2025/26 to £4.5m from 2026/27 (Appendix 4). If £1m of the Public Health grant was not used in this way to fund other services providing public health outcomes then this would create a budget pressure the Council would have to meet from elsewhere.

Discussions would now take place with relevant Directors / Assistant Directors to maximise joint working through the proposed spend, to deliver specific public health indicators.  Service Level Agreements (SLAs) would be required for all the spend across areas of the Council beyond Public Health, including both existing areas of spend and proposed new areas.

Discussions were ongoing with neighbouring Local Authorities to share good practice regarding SLAs, to inform our local approach.  The SLA would be tested in one or two service areas, in conversation with the Assistant Director / service lead. It was proposed Public Health indicators in the SLA would mirror and complement existing indicators wherever possible and that they would be built in to reporting mechanisms working with the corporate performance team.

RESOLVED that:-

1. The update on delivering the Public Health grant outcomes-based review be noted.

2. The wider Council areas where public health funding is planned to be realigned, to achieve public health outcomes be noted.

3. The mechanism for evidencing outcomes and spend to satisfy national assurance requirements be noted.

3.

Reasons for the Decision

Public health funding supports activity across a range of Council areas, to support a cross-Council approach to delivering health and wellbeing outcomes.  It is important that this process is undertaken in-line with national parameters for grant spend and national assurance mechanisms, while maximising the opportunity to improve local outcomes. 

The work is undertaken as part of Council-wide outcomes-based review activity, aiming to maximise efficiency and address the Council’s financial position.  Areas receiving public health funding will in turn release the equivalent amount from their budgets to contribute to Council-wide efficiencies.

4.

Alternative Options Considered and Rejected

None

5.

Declared (Cabinet Member) Conflicts of Interest

None

6.

Details of any Dispensations

None

7.

Date and Time by which Call In must be executed

Not applicable. Report for noting only.