Report of the Deputy Director of Public Health

This report provides an overview of progress made from October 2022 to October 2023 on the Making Manchester Fairer Action Plan.

The Committee considered the report of the Deputy Director of Public Health that provided an overview of progress made from October 2022 to October 2023 on the Making Manchester Fairer Action Plan.

Key points and themes in the report included:

·         Providing an introduction and background, noting that Making Manchester Fairer (MMF) is Manchester City Council’s five-year action plan to address health inequalities in the city focussing on the social determinants of health;

·         Information on the MMF Programme Workstreams;

·         Information on the structure and purpose of the MMF Governance and Programme Board;

·         The approach to general communications and engagement;

·         An update on workforce development;

·         Consideration of resident and community engagement and involvement;

·         Information on Kickstarters and the Investment Fund;

·         The approach to engaging with anchor institutions, recognising that Manchester institutions and businesses had a key role in addressing health inequalities and it was recognised what impact their collective actions could have on health outcomes by changing their operations, investments and services;

·         Describing the approach to monitoring and evaluation with a summary of progress across all the MMF workstreams;

·         A deep dive on the theme of Homes and Housing, noting thatthere were six themes within this workstream of the Making Manchester Fairer programme which would be delivered through the Council’s Housing Strategy 2022-2032; and

·         Next Steps for MMF Action Plan.

The Committee heard from members of the Making Manchester Fairer Programme Board. Abi Brown stated that she wished to bring her lived and professional experience as a young black female working in Public Health to the conversation and to advocate for positive change. Adil Mohammed Javed described that he had a background in the arts and culture sector and had joined the Board to provide insight and to articulate the voice of local communities with the ambition to empower and educate to tackle heath inequalities. Sinead O’Connor described her lived experience of accessing services and reiterated the importance of hearing and acknowledging the unique voice of lived experience, as this would inform the solutions to address inequalities.   

The Deputy Leader and Making Manchester Fairer Programme Board Co-Chair paid tribute to the three Board Members for attending the meeting and articulating their experience. She stated that the breadth of knowledge and experience that the members brought to the discussion stimulated positive and important conversations to drive the work of the Board and provide the appropriate governance.

The Committee heard from Professor Sir Michael Marmot who spoke of the need for both national and local actions to address health inequalities. He stated that Manchester had demonstrated positive progress in this area of activity and that other authorities across Greater Manchester could learn a lot from the Manchester model and experience. He further paid tribute to Manchester for taking the initiative in developing and adopting an Anti-Poverty Strategy. He said that all Marmot recommendations were important to address health inequalities, however it was important that local people and decision makers determined which ones they prioritised to reflect local need, and this should be informed by people with lived experience, recognising that Manchester had done this. He discussed national government policy and mindful of a potential election he commented that health equity should be at the heart of all national government policy decision making, adding that the positive outcomes of this approach was evidenced based. He stated that the experience in Manchester was a positive example of what could be achieved, and he called for the country to become a Marmot country. He further made reference to the Health Equity Network and commented that there was a tangible buzz and excitement generated through this network and it offered a forum for support and learning across all partners to progress this work. In response to the Member’s discussion regarding health prevention initiatives he reiterated that whilst these were important it was the social determinants that had the biggest impact on health outcomes. He commented upon the importance of addressing poverty to achieve the establishment of a fairer society.

Some of the key points that arose from the Committee’s discussions were:

·         Noting the detrimental impact austerity had had on public services across Manchester and supporting the call for a Marmot country;

·         Recognising the significant amount and range of work that had been undertaken in the previous year to deliver the MMF programme;

·         Discussion of how the impact of this work would be evaluated, commenting that residents in wards were largely unaware of this work;

·         Calling for additional resources to support the work force development that was described;

·         Was there a correlation between the reduction of Sure Start Centres and the increased number of SEND children (Special educational needs and disabilities);

·         What provision was available for young people who were not in education or training;

·         Recognising that residents often had complex health and social needs;

·         Calling for further regulation of the tobacco and alcohol industry, noting the proliferation of online 24/7 access to home delivery services;

·         Welcoming the approach to addressing mould and damp in properties, noting that Social Landlords were more responsive to residents on this issue, however challenges for tenants within the Private Rented Sector remained;

·         Calling for all existing powers to be used to improve housing conditions within the Private Rented Sector;

·         Welcoming the reduction in the number of families housed in temporary accommodation, adding that families with children needed to be accommodated close to the school they were attending wherever possible;

·         All Council departments should work together to coordinate activities and policies to promote and deliver MMF; and

·         Recognising the good practice described at Haveley Hey Community School and stating that good practice needed to be shared across all schools.

The Deputy Director of Public Health discussed the methodology of evaluation of MMF and stated that this would be undertaken and reported at the appropriate time. She stated that MMF was a five-year plan and the success would be demonstrated by improving health outcomes and narrowing the gaps across the city. She commented that the evaluation of the Kickstarter programmes would be undertaken next year. She informed the Committee that a bid for additional grant funding to support this evaluation work had been submitted. She stated that areas of greatest need would require greater attention and this approach was recognised and understood. In response to the discussion regarding alcohol and tobacco she stated that whilst the Making Manchester Fairer correctly focused on the social determinants of health, Public Health also commissioned alcohol and tobacco services. The Director of Public Health supported the call from the Committee for increased regulation of the tobacco and alcohol industry.

A Member recommended that a briefing note be circulated following the meeting that described the methodology used to identify those areas with the highest need. Further, that officers provide a briefing note that details the location of temporary accommodation across the city and how that related to the MMF methodology to identify those areas with the highest need.

The Strategic Lead for Making Manchester Fairer addressed the issue raised by the Member in relation to complex needs and made reference to the work of the Changing Future Programme. The Changing Futures programme was led by the Greater Manchester Combined Authority (GMCA) and was working in partnership with the ten GM authorities, and other organisations across the VCSE and statutory sector, to improve the way that local systems and services worked for adults experiencing multiple?disadvantages, including homelessness, drug and alcohol problems, mental ill health, domestic abuse and contact with the criminal justice system.

The Director of Housing Services informed the Committee that Manchester’s existing homelessness strategy covered the period 2018-2023 and expired at the end of December 2023. He described that there was a consultation exercise currently underway, and this had been reported to the Communities and Equalities Scrutiny Committee at their meeting of 10 October 2023. He commented that the discussions regarding families and children were fully acknowledged and would be reflected in the refreshed strategy.

The Head of Strategic Housing stated that social landlords were very responsive to the issue of damp and mould following the tragic death of Awaab Ishak, adding that there was a great deal of national scrutiny on social landlords surrounding this issue. In terms of the Private Rented Sector, he advised that they worked with landlords to improve conditions using all available levers, however if required enforcement action could be taken. He commented that there were commissioned advice services that private tenants could access for a range of tenancy advice, including in relation to disrepair.

The Deputy Leader paid tribute to all of the staff working within the Homeless Service, recognising that they worked in a very challenging environment.

The Executive Member for Early Years, Children and Young People stated that the importance of MMF was recognised and understood within Children’s Services. He stated that Covid had significantly contributed to the increased number of SEND children, more so than the reduction of Sure Start Centres. He commented that the national response to children and the pandemic had been very lacking, however Manchester had taken the initiative to implement strategies to improve the outcomes for young people.

The Committee then heard from Sue Spiteri, Executive Headteacher, Haveley Hey Community School and Claire Buxton, Deputy Head, Haveley Hey Community School. The Executive Headteacher described the context and levels of social deprivation in which the school operated. She further commented that she had worked closely with local Members and ward coordination to support the Kickstart programme at the school. She suggested that all Ward Plans should be framed and structured using the key themes of MMF.

The Deputy Head described the initiatives that had been implemented at the school to support pupils. She described that the school had been an early adopter of the Kickstarter programme and an Intensive Support Teaching Assistant had been employed, supported by an Education Psychologist and Speech and Language Therapist. This had resulted in a programme of bespoke activities and initiatives that had been developed and delivered.  She described that the benefits of this approach would be formally assessed and reported however positive outcomes were already being realised, in terms of reading, writing, maths and pupil attendance.

In response to specific questions the Assistant Director for Education, Schools QA and SEND stated that Manchester had a comprehensive offer in relation to education and training, and the number of young people not in education and training was relatively low when compared to other core cities. She reiterated the previous comments regarding the impact that Covid had on young people, particularly in regard to social and language skills and that work was underway to address this. In addition, she made reference to the Family Hubs that had been established. She described that the three hubs in Longsight, Cheetham and Wythenshawe would provide a range of advice and services, all targeted at parents, children, and young adults. The Hubs supported MMF as they would provide access to a wide range of services to help families, from health issues such as infant feeding, mental health support, stopping smoking, to building better relationships, accessing school and education support, as well as providing advice on jobs, skills training, and next steps post-18.

The Executive Member for Healthy Manchester and Adult Social Care reiterated the commitment to ensure that addressing health inequalities was central to all Council decision making. He commented that it was the intention to mainstream the Kickstarter programmes. He stated that he was very proud of the work that had been delivered over the previous year, noting that there had been a significant cultural change in the approach and discussions that were now undertaken around the issue of health in Manchester as a result of the adoption of the Making Manchester Fairer approach and principles. He informed the Committee that he would provide all Members with a regular update on the progress of MMF.

The Chair commented that there were a number of strategies and polices across the Council and reflected on the earlier discussion on resident awareness of MMF. She recommended that all strategies and policies be framed and prominently articulated with the Marmot Themes and MMF.

Decisions

The Committee recommend;

1. All Council strategies and policies are to be framed and prominently articulated with the Marmot Themes and Making Manchester Fairer.

2. All Ward Plans should be framed and structured using the key themes of Making Manchester Fairer.

3. That officers provide a briefing note that described the methodology used to identify those areas with the highest need.

4.  That officers provide a briefing note that details the location of temporary accommodation across the city and how that relates to the MMF methodology set out in (3) above.