7.0 WORKING IN PARTNERSHIP ON ENVIRONMENT AND HEALTH
It is recognised that many of the complex interactive determinants of health and wellbeing appear at the level of community and solutions involve input from a spectrum of agencies and institutions. Key players include health boards, local authorities, broader community planning partnerships, third sector organisations, community based organisations and communities themselves. The success of Good Places, Better Health therefore relies on a level of co-operation and shared sense of purpose.
The Concordat between Scottish Government and local government marked a new relationship where the direction of policy and overarching outcomes are set by central government but local authorities and their partners, through a reduction in ring-fenced funds and associated monitoring, have been given greater autonomy to deliver their services to meet the varying local needs and circumstances across Scotland.
Single Outcome Agreements ( SOAs) have been forged between Scottish Government and each local authority. For 2008/09 these cover all local government services in each area as well as a significant range of responsibilities of Community Planning Partnerships ( CPP). From 2009/10, all SOAs will cover the range of CPP responsibilities.
Good Places, Better Health will support development of SOAs and will be a tool to enable effective working by a number of partnership organisations to deliver on shared outcomes as identified nationally and in SOAs. We therefore envisage a win-win situation for central and local government as Good Places, Better Health provides a toolkit for multi-agency delivery.
We will support and develop a number of geographic field prototypes for Good Places, Better Health which will provide toolkits and support to enable local partnerships to engage with key stakeholders to identify and implement new and improved actions at a local level based on shared outcomes. We will also look to identify existing good practice in the area of environment and health at a local level and gather and disseminate that good practice throughout Scotland.
The field prototypes will bring partners together to explore the locally available intelligence, transfer knowledge from the national scale and encourage and facilitate a more strategic approach to environment and health at a local level. We will provide knowledge on tools and techniques to map out and analyse the problems and identify and implement solutions which can enable communities, organisations and the public sector at a local level to effectively create physical environments which are safe and nurturing of health.
An outline of how we envisage Good Places, Better Health will influence partnership working around health outcomes is presented in Annex 2.
We anticipate a number of community planning partners being involved in Good Places, Better Health throughout its course, bringing each partner a number of benefits. Outlined below is a practical example to illustrate what this prototype may deliver for one group of professional partners.
What does Good Places, Better Health mean for partners engaged in community regeneration?
How does health feature in community regeneration pre Good Places, Better Health?
Those engaged in community regeneration have been working in an outcome focused context for a number of years. This has recently gathered pace in the context of the Concordat with Local Government, development of SOAs, and the introduction of the Fairer Scotland Fund. There are a limited number of tools, techniques and practical advice on how to plan for delivery of health outcomes levered by community regeneration.
This has meant that despite an underlying assumption that actions to improve housing and undertake community regeneration would in turn improve the health of communities, health is not always viewed as a primary objective or driving force of regeneration activity, and is not easy to evaluate as a tangible outcome of regeneration. 3 This may limit the potential for regeneration to maximise positive and directly attributable health outcomes.
How might health feature in community regeneration with Good Places, Better Health?
Good Places, Better Health will help regeneration professionals to examine their role and the role of others by working back from an outcomes-focused approach. It will enable them to view their actions through the prism of health by offering an analytical approach which recognises that better health and reduced health inequalities are central to sustainable economic growth and that the physical environment has a key role to play in achieving health outcomes that align with regeneration outcomes.
Good Places Better Health will seek to provide those engaged in community regeneration with improved knowledge, understanding, practical actions and tools and techniques to contribute far more meaningfully to a "healthier" Scotland, through:
- provision of clear mapped evidence on how physical environment impacts on health.
- making closer links with other existing sources of relevant research, evidence, learning and capacity building activity such as the ongoing work with GoWell and the suite of Learning Networks being supported by the Scottish Centre for Regeneration.
- provision of toolkits and support through field prototypes on how to use the modified DPSEEA model to map the local physical environment issues and link them to health outcomes.
- provision of toolkits on how to use the modified DPSEEA model to identify where to focus actions to achieve improved health outcomes locally.
- the field prototypes which will provide tools and support to enable engagement and partnership approach at a local level between public sector, third sector and communities on physical environment and its impact on health.
- provision of toolkits to demonstrate clearly how regeneration work delivers on the "healthier" national strategic objective.
For example, in relation to mental health and wellbeing, managers will be better equipped to ensure regeneration projects can create positive environments in terms of noise, litter, access to greenspace, access to culture, safe streets, opportunities for play, increased opportunities for active travel, reduced isolation, improved community cohesion, and to demonstrate the impact they are having through evidence-based actions. Annex 2 further highlights some of the physical environmental factors that have an important impact in relation to mental health and wellbeing.