An interview with Dr Arif Rajpura, Director of Public Health, Blackpool council.
Blackpool ranks as one of the most deprived areas in the UK. Many people were already in poverty, and the cost of living pressures are having the biggest impact on this group, who need to spend a greater proportion of their incomes on household essentials. It is also affecting people on low and middle incomes, often surviving by having several jobs, who are being pushed into poverty. More people are turning to services for support, and as the winter progresses this is a serious concern.
Planning and coordination
The experience of the pandemic had shown the importance of collaboration during a crisis. All council departments are involved in Blackpool’s response, with the Director of Public Health leading the partnership approach, supporting coordination across all sectors including the NHS and voluntary and community sector.
A cost of living partnership event was held in September with the following aims:
- share intelligence about what support is available
- discuss limitations and challenges
- pledge resources and support
- create an action plan.
The event provided analysis of how inflation could affect different groups and localities in the town, the different types of support needed, and what was already available. It considered the framework of Blackpool’s Financial Inclusion Strategy which involves ongoing work on topics such as improving access to financial support, digital skills and financial skills. A multiagency cost of living group was set up to coordinate action identified at the event and to monitor and respond to future need.
Cost of living support
A key part of the cost of living group’s work is to ensure a coordinated, accessible approach to cost of living information and advice. This includes Blackpool Council’s online cost of living information plus information through paper and other media, and advice in community settings.
Another priority is to maximise the potential of voluntary and community sector organisations. The third sector has close links with local communities, is flexible and can make the best use of resources. The government’s Household Support Fund was augmented with funding from the NHS and the council to extend the pot available for Blackpool’s cost of living – third sector and community grants programme.
A grants application group meets weekly to consider and authorise applications for grants, which are administered through the council’s corporate delivery unit. Grants have ranged from £800 to £70,000 and cover a range of topics, some of which are detailed below:
- Food banks were operating in the most deprived areas and have been extended more widely.
- Access to free hot meals has been widened.
- Warm spaces and clubs have been established providing a range of support services such as work to tackle social isolation and increase physical activity.
- Provision of emergency fuel vouchers.
- Providing 1:1 support related to energy and income maximisation.
The group is also looking at emerging initiatives that may increase support such as issuing warm packs (eg hot water bottles, blankets, draft excluders) and providing laundry facilities.
Just like in the pandemic, there have been lots of offers of support and help: ‘Blackpool people want to get on and do.’ A follow-up event took place on 7 December to consider how things are going and what more needed to be done in the new year. The event was well attended and outlined the vast range of activities going on across Blackpool. For example, one organisation had organised a coat rack scheme, with 300 donated coats given out over 10 days. A laundry facility was being used by many families and was seen as something that could be replicated by other organisations.
The event was seen as a very useful session to share good practice and to find out what is going on across the town. Unused community facilities were identified which could be occupied for additional activities. The voluntary, community and faith sector were keen that this sort of event took place regularly.
Impact on future plans
As well as working on cost of living, public health is carrying out its work programme and undertaking COVID-19 recovery work, reviewing and updating key strategies like sexual health. Its work is strongly focused in tackling the wider determinants. For example, it has funded free breakfasts at primary schools, feeding 11,000 children, since 2013. It will continue to work closely across the council and with partners on better housing, education and health. It is a key partner in Blackpool’s Financial Inclusion Strategy promoting employment, training and prosperity. The impact of the cost of living pressures on health and health inequalities means that this work is even more essential, but more challenging.
Following the pause in the national levelling up agenda over the summer, Blackpool has been allocated Levelling Up Funding for major infrastructure developments in the town centre and to improve housing. Blackpool has a major problem with poor quality accommodation becoming houses in multiple occupation (HMOs), with associated neighbourhood problems like drug and alcohol use. The opportunity to build decent homes is a “game changer” for the town and will have a big impact on health and wellbeing.
Despite the good work taking place, this is a “worrying and frustrating” time for public health. The crises of COVID-19 and cost of living are driving health inequalities and worsening poverty and deprivation. The NHS is very fragile, and chronic health problems are on the rise. There is a concern that “our best might not be good enough”.
National changes that could make a difference
- A national approach to long-term funding and policy which fully recognises that some people are facing social, economic and health inequalities and that more resources are needed to improve their life chances. This would include addressing local government funding – although a highly deprived area, Blackpool’s funding has been disproportionately cut.
- Greater lobbying and advocacy by public health on national issues.
- Powers for councils to enforce building regulations to decent homes standards.
- Reducing the number of HMOs and building family homes to lower the level of transience and create stable communities.
- Making health a criterion for considerations under the Licensing Act 2003.
- Introducing minimum unit pricing for alcohol.
- Local powers for safe injection sites to allow further progress to reduce drug deaths.
Partnerships in Blackpool are even stronger since the pandemic. The council has a communication engagement framework to ensure that across the council our residents’ voices are heard. As part of our digital inclusion strategy, we are working to ensure the residents of Blackpool have access to the internet and the skills to use it, whilst also making sure we communicate effectively with those who don’t wish to.
Although it’s an extremely challenging time, the NHS and council are working together along with the voluntary sector to help tackle the cost of living crisis for all.
Our financial inclusion work is aimed at helping people to improve their resilience to help when a future crisis point is reached.
There are some positives despite the current situation, including levelling up funding and Blackpool having Health Determinants Research Collaboration status to undertake research into the wider determinants including housing and mental health.
My wish is that over time Blackpool will no longer be in the top-ten areas for deprivation and health inequalities.
Councillor Jo Farrell, Cabinet Member for Adult Social Care and Health and Wellbeing