Shaping healthy places with district councils

Source: PSE April/May 2019

District councils are achieving excellent outcomes by shifting health solutions from clinical settings to community ones. They have a significant role to play in public health and are improving people’s physical and mental wellbeing. Cllr Isobel Darby, DCN lead for enhancing the quality of life, reports.

Evidence shows that how well and long we live is much more dependent on the social and built environment around us than the medical care we receive. Districts provide key services which have a direct impact on the social determinants of health, such as housing, planning, leisure, recreation, and environmental health, and they play a huge role in creating a healthy environment for our residents.

Their key role ranges from developing affordable housing, undertaking home adaptations and reducing homelessness, to providing cycle lanes and imposing restrictions on unhealthy food outlets. Districts are not only making healthier places to live, but are reducing the burden on other parts of the public sector.

‘Shaping healthy places: exploring the district role in health,’ recently published by the DCN in collaboration with the LGA, details innovative prevention initiatives by district councils to improve people’s lives and save long-term costs to the public purse. Numerous effective initiatives by districts can be seen across the country, ranging from painting blue lines on pavements in Bicester to create 5km circular walking and jogging routes; using the planning and design process to create ‘playable landscapes’ in South Cambridgeshire; to providing rehabilitation and exercise classes in village halls and social housing common rooms in the Forest of Dean to improve their accessibility.

The positive impact of social prescribing is also helping to keep people fit and well and out of hospital, with the effective contribution of district councils recognised by the NHS. This includes Wealden District Council which has a jointly-funded NHS and council health coaching service, with local GPs prescribing community activities from the council’s not-for-profit leisure operator, including coffee mornings, singing workshops, and walking groups. Not only has the scheme improved participants’ mental and physical health and reduced their medication requirements, it also cut regular GP visits by them by 61%.

Similarly, Wycombe District Council’s ‘Healthy Homes on Prescription’ allows medical or social care practitioners to refer patients for fast-tracked housing solutions to support independent living at home, such as a stairlift or central heating. People with a long-term chronic health condition can apply for up to £5,000 without means testing to help support their home needs, preventing hospital admission and GP attendances.

Elsewhere, South Norfolk Council has done more than 1,600 cases of social prescribing so far this year, of which 44% were identified as needing support from a ‘core’ district service (housing, benefits, adaptations) and 78% could be referred to support offered through the council’s Help Hub. Month by month, the council is solving 60% of these cases at point of first contact, either through effective navigation or information sharing.

Social prescribing by local authorities has been praised by England’s top doctor, Professor Keith Willett, who recognised how councils had helped cut delayed transfers of care to their lowest level in three years. It was therefore disappointing that the recent NHS announcement on new social prescribers did not suggest that these would be local authority-led, which ignores the plethora of innovative activity in councils across the country. 

Another area saving the NHS thousands is the provision of good-quality housing. Every £1 spent on handyman services saves £7.50 for the NHS. Similarly, every £1 spent on home adaptations saves the health service £108 in prevented falls over 10 years.

This is why district councils need to be better rewarded for their essential and effective role in public health. The DCN is calling for district councils to be allowed to levy a 3% “prevention precept” on council tax, which could raise £42m a year in 2019-20 and deliver significant long-term savings many times that amount for the NHS and social care authorities.

With further support for their cost-effective prevention work, districts, which are on the frontline of our communities, can achieve even more to deliver better lives and stronger economies.


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