Health and community planning the role of LSPs

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Health and community planning - the role of LSPs

• Nick Doyle
• Health Development Agency

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The new planning regime - rationale and
expectations

• Government aim
• avoid new planning requirements
• integrate any new requirements into existing
  plans
• Use other performance improvement tools
• A minimum statutory requirement
• Additional plans at local discretion

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The minimum requirement

• Community strategy - the overarching LSP plan
• Best Value performance plan
• Local delivery plan
• Crime, disorder and drugs reduction plan
• Education plan
• Children and young peoples strategy
• Housing, transport and development plans

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Barriers to joint strategic planning

• Priorities and targets
• Funding streams and flexible resources
• Planning requirements and timetables
• Boundary issues and partnership development
• Local capacity and skills
• Regional coordination

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Priorities and targets

• Different agency priorities and targets
• Inflexible local interpretation of targets
• Different performance management systems
• Targets are for agencies, not partnerships
• National targets dont relate to local priorities
• Different approaches to data collection and use

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Funding streams and flexible resources

• Different funding regimes for agencies
• Difficulties in combining initiative funding
• Specific grant funds and related audit burden
• Deadlines for spending specific grants, and the
  one-year cycle
• Lack of resources for crosscutting work in less
  deprived areas

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Requirements and timetables

• Different timetables and cycles
• Central guidance comes in silos
• Tight deadlines on initiatives increase risks
• Too much central command and control
• Unrealistic expectations about the pace of local
  partnership and planning development
• NHS focus service not joint health plans
• Difficulty of introducing local priorities

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Boundary issues

• Lack of co-terminosity among partners
• Tensions about priorities across tiers
• Topic partnerships in LSPs at different stages of
  development
• Few models for commissioning across services
• Issues of power and control of resources
• Cultural differences

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Local capacity and skills

• Lack of capacity for joint strategic planning
• Turnover of personnel and membership of planning
  groups and partnerships
• Too much pressure on a few individuals
• Uncertainty about when it is appropriate to work
  in partnership and when alone
• Hierarchy of joint planning topics

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Regional coordination

• Lack of cross-sectoral working at regional level
  can hamper local strategic planning
• Regional infrastructure of some local agencies
  e.g. NHS and police can complicate local
  strategic planning arrangements and accountability

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The challenge for regions to help LSPs on ten
practice standards

• A shared vision and common priorities
• A coherent strategic planning framework
• Agreement on partnership structure and
  accountabilities
• Champions and leaders
• Coordinated needs assessment and community
  involvement

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Reaching good practice goals - continued

• Crosscutting commissioning arrangements
• Flexible use of resources staff, money, time
  and facilities
• Coordinated approach to mainstreaming initiatives
• Common local targets and indicators
• A programme of partnership learning and staff
  development

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What is evident, if as yet poorly recognised by
central government, is that partnerships take
time to bed down for a host of structural,
procedural and cultural reasons. If there is
one lesson for systems governance and a move
towards more effective partnership working, it is
that ten years is the most appropriate (indeed
the minimum) time within which one can expect
results. Professor Murray Stewart, 2002
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Further information

• From www.hda.nhs.uk
• Hamer L, 2003. Planning with a purpose, LGA, HDA,
  NHS Confederation
• Hamer L and Smithies J, 2002. Planning across the
  local strategic partnership (LSP). Case studies
  of integrating community strategies and health
  improvement, HDA
• Hamer L and Easton N, 2002. Community planning
  and health improvement a review of policy and
  practice, HDA
• Hamer L, forthcoming. Pooling resources across
  sectors a report for local strategic
  partnerships, HDA