Taking forward the role of council regulators
The following sections aim to facilitate a greater contribution by local authority regulatory services (LARS) to the health of the communities they serve. You will find practical advice through a number of case studies based on the views and experience of LARS staff. These illustrate the breadth and depth of the role they can play in improving health and addressing the causes of poor health or inequalities.
The gathering of these examples has been a joint project between the IDeA's Healthy Communities programme and LACORS (Local Authorities Coordinators of Regulatory Services). This is the body responsible for overseeing local authority regulatory and related services in the UK.
Use the links below to navigate through the various sections of this article:
- The wellbeing power
- Hampton compliant, LAA and national indicator objectives
- Smokefree England work
- Case study examples
- Process for carrying out case studies
- Effective partnership between local authority regulatory services and the NHS
- Sources of further information
Seven years ago the Health Development Agency (HDA) and the Chartered Institute of Environmental Health published a joint report, 'Environmental Health 2012'. Taking its lead from the NHS strategy developed in the wake of the Health White Paper 'Saving Lives', this report argued that the major determinants of health lie outside the remit of the NHS.
It supported a greater role for local authority environmental health departments - working in partnership with other agencies - in tackling these issues. At the same time it expressed the view that "the mainstream practice of environmental health has become fixed on the delivery of a narrow agenda".
The report warned that:
"…the necessity for local authorities to focus on the statutory enforcement duties placed on councils by government, and on complying with performance management and best value regimes, has resulted in environmental health officers having to take on predominantly technical and enforcement roles […] at the expense of effective practice of the wider principles of environmental health protection."
The provision under Section 2 of the Local Government Act 2000 of the ‘wellbeing power' and the creation of local strategic partnerships (LSPs) offered an opportunity to challenge the trend. The ‘wellbeing power' allows local authorities in England and Wales to do whatever they consider likely to promote the economic, social and environmental wellbeing of their area - unless prohibited elsewhere in legislation.
The wellbeing power
Research by Communities and Local Government into take-up of the ‘wellbeing power' has demonstrated that local authorities have interpreted it as covering health issues. However, there is plenty of scope for more use to be made of it. Moreover, partner organisations are often unaware of the ‘wellbeing power' and what councils can do with it. Meanwhile, national regulators and LARS have not always found it easy to influence the strategic thinking of LSPs.
The Department of Health (DH) recognised the crucial lead role local authorities could play in tackling health inequalities and improving the health of the communities they serve. This led to the setting up of the Healthy Communities programme, funded by the DH and managed by the Improvement and Development Agency (IDeA). It builds on the IDeA's established areas of expertise and its support of local government improvement. The programme aims to build the capacity of local authorities to:
- tackle local health inequalities
- provide leadership to promote wellbeing
- foster a joined-up approach to health improvement throughout local government and through partnership working with local health organisations, the voluntary and community sector (VCS), the private sector and other local partners
- improve the impact of LSPs and local area agreements (LAAs) on the health and wellbeing of the local community.
Hampton compliant, LAA and national indicator objectives
At the same time there has been an ever growing emphasis on the need for regulatory services to be 'Hampton compliant'. This means consistent, accountable, transparent, targeted and proportionate. Additionally, the advent of LAAs has moved the emphasis of performance management away from a rigid approach to inspection. It now rewards targeting activity on those areas which make an impact on the priorities identified in the LAA.
LACORS' work on how regulatory services can contribute to LAAs, has demonstrated the wide range of LARS contribution to national indicator (NI) objectives. Many of these relate to population health. However, this is not an automatic process. If policy makers are to take advantage of the opportunity offered by the more flexible performance framework that now exists, then strong and sustainable partnerships need to be built between LARS and other agencies.
What LARS can bring to these partnerships is a voice and presence in local businesses, detailed knowledge of communities and technical expertise in a wide variety of population health issues. It can act as a conduit for information, educators and, where appropriate, an enforcement agency.
Smokefree England work
The impact of LARS' work on Smokefree England demonstrates that, where a strong national partnership can be established, LARS can play a vital part in achieving truly significant health outcomes. The work of local authority environmental health services in promoting the introduction of the new laws in England has been acknowledged by DH as vital in achieving high levels of compliance. LARS represented the public face of a national partnership overseeing the introduction of a major change in behaviour.
This resource is one element of local government's efforts to build on this success and demonstrate ways in which similarly effective partnerships can be developed. This will allow LARS to continue to maximise their contribution to improving wellbeing and reducing health inequalities. To this end it provides a series of case studies illustrating best practice. These focus not only on what has been done but, in particular, on how the relationship between LARS and health partners has been built and maintained.
Case study examples
1: Luton Borough Council - looks at the background to setting up a new post of a health and wellbeing coordinator at the council, jointly funded by the primary care trust (PCT) and the council. And it examines how the post has contributed to a corporate approach to health.
2: Rochdale Metropolitan Borough Council - discusses the development of a more holistic and preventative approach to health by regulatory services. It explores the development of an integrated impact assessment. This builds on the methodology of health impact assessments and the setting up of a health ‘peer challenge' system throughout council services.
3: East Dorset District Council - looks at the way in which the NHS National Service Frameworks have been used within the council. This approach has developed a health improvement statement and joint training on health and wellbeing.
4: Norfolk County Council - discusses the work of the council's health improvement management group and, more specifically, the work of the trading standards department, linking their enforcement activity with healthy eating and smoking cessation.
5: London Borough of Newham - which has set up a non-profit social enterprise company to extend the council's regulatory services beyond enforcement. It includes health advice and promotion, and acts as the national lead on shisha (hookah) smoking.
6: East Riding of Yorkshire Council - considers the work of the council's licensing and food standards staff in screening for sexually transmitted diseases. It also promotes healthy eating in food outlets, including takeaway food based on multi-ethnic cooking.
Process for carrying out case studies
The case studies are based on interviews with local authority staff. They were also asked about lessons they had learned and advice they would give to colleagues in local government and the NHS who want to improve partnership working. This advice forms the basis of the ‘top tips' sections. There is one for local authority regulatory staff, another for NHS colleagues and, finally, a checklist of questions for councillors to ask themselves.
This last list is potentially useful for a wide range of councillors, including those with responsibility for planning and oversight of LAAs, those with cabinet or scrutiny responsibilities for regulatory services or health and those who have been nominated as ‘health champions'. And finally, any councillors who are also non-executive directors of PCTs or NHS trusts, or governors of NHS foundation trusts.
Effective partnership between local authority regulatory services and the NHS
Sources of further information
Alternatively a downloadable PDF version is available:
Taking Forward the Role of Council Regulators (PDF, 28 pages, 1.45MB large file)
17 July 2015