- Dr Matt Pearce took up the Director of Public Health reins at two councils – Reading and West Berkshire
- The LGA support with several different exercises has helped establish him in his role and support the wider health and care system to focus on prevention
- Challenges and opportunities have been identified - and strong foundations been put in place
Dr Matt Pearce became Director of Public Health for Reading and West Berkshire councils in July 2024. “Being a joint appointment across two councils and with several leadership changes preceding my arrival, there was a clear need for external support and expertise to enable system-wide changes. This included reshaping two teams, influencing two councils and supporting a review of two health and wellbeing boards.
“People naturally expect change when someone new arrives but delivering that across two organisations - each with its own pressures and expectations - was never going to be simple. That’s why I decided to bring in the LGA. I’d worked with Kay and her team before and knew they were independent, respected and could provide some additional capacity. They could ask the difficult questions, support the reset and help us embed public health across both councils and bring partners together to make a difference to our communities.”
Embedding health in all policies
Several exercises were undertaken with the LGA to establish a clear foundation for the public health arrangements across Reading and West Berkshire. The first involved using the LGA’s and Association of Directors Public Health’s public health self assessment tool to provide an honest, structured view of where each service stood. The subsequent report enabled the two teams to reflect on their strengths, weakness and opportunities. These findings directly informed a significant reconfiguration of both teams with the aim of supporting each council becoming a “public health organisation”.
The second exercise involved workshops on health in all policies hosted by the LGA and attended by both councils’ leadership teams and members. “The workshops have been a real catalyst for how we’ve restructured the public health teams,” said Matt. “One of my ambitions from the moment I came into post was to move beyond a commissioning model and make public health something that genuinely shapes how the whole organisation thinks and works.
“A key outcome from the workshops was the alignment of a new public operating model to each council directorate. Like a business partner model adopted in other council departments, the aim was for public health to be more visible and provide specialist public health skills to influence the building blocks of life, such saplanning, transport, economic development, housing, parks and leisure. This included each directorate having a lead public officer working closely with their senior leadership teams.
“I wanted all council staff to feel confident applying a public health lens to their decisions and using the levers within local government to tackle inequalities. Ultimately, my ambition is that everyone thinks like a public health officer. That’s when we’ll know the culture shift has really taken hold.”
Each council established a funding pot to initiate a series of test-and-learn projects to put health in all policies into practice across the two councils. “Health in all policies is often seen as a theoretical and nebulous concept, but we wanted to bring it to life and showcase the value which public health can bring to each organisation and the difference councils could make to our communities by modifying some of the things they already did” said Matt.
One such project was seconding planning officers to work in each public health team for two days a week, strengthening the link between planning and health outcomes. Alongside this, other projects included targeted work focusing on damp and mould in housing and using llibraries to lend health-related items, such as anti-fall equipment and heart and blood pressure monitors.
Reshaping the Health and Wellbeing boards
These early pieces of work were followed by a third intervention - bringing in LGA experts to support a review of the two health and wellbeing boards. Matt said: “What became clear very quickly was that the two boards were facing different challenges. Structures, relationships and expectations had evolved in different ways.
“That’s why it was so valuable having the LGA carry out a series of indepth interviews with board members across both places. One of the reviewers was an experienced local government officer and the other came from the NHS - having those two distinct perspectives really helped people open up and gave us a clear view of what needed to change.
“The feedback was honest, but constructive and it’s already shaping the reset. We’re now making a number of changes, including agreeing a clear, small set of priorities - so everyone is focused on the things that will genuinely make a difference.”
The LGA experts recommended that the boards should “go on the road”, holding meetings in community venues rather than council offices. This was intended to make the boards more visible, strengthen local engagement and reconnect them with the places they serve.
“For years the board meetings had been held in the council chamber - formal, traditional and, for some of our voluntary sector partners, quite intimidating,” said Matt. “Taking the board out into the community has already started in Reading with the aim to make the meetings more visible and accessible to local communities.
“We’ve been meeting in community halls and centres and each time we spend part of the agenda talking about what’s happening in that specific local area, so that we can understand better the communities we serve. We are working more as a strategic partnership and having honest conversation on how we can make a difference.
“The support from the LGA has been fantastic - and has helped us to do all this at pace. We’ve identified the weaknesses and now have strong foundations to move forward. This next year is about delivery and we are grateful for the support which the LGA has provided.”