02 July 2019
Governance of the new Public Health Scotland body needs to model a transparent, accountable and participative
Public Health Reform must take a whole systems approach, including the wider system of support within which the voluntary sector operates.
It should therefore take into account the significance of the role of the voluntary sector in delivering against the public health priorities – including through public funding and other sources of investment.
The language used within the Public Health system must match the values and principles of people-centred service design
The Public Health Body should consider hosting a ‘wellbeing lab’ function which would support innovation, concept development, wider engagement and new ways of working.
SCVO welcomes the opportunity to respond to the Scottish Government’s Public Health Scotland consultation, which is specifically aimed at informing the proposals to form a new Public Health Body in Scotland.
A key question for our sector is whether the mechanisms and structure adopted for public health reform, particularly the new Public Health Body will deliver against the following priorities proposed by the Scottish Government and agreed by SCVO and many of our members.
- A Scotland where we live in vibrant, healthy and safe places and communities.
- A Scotland where we flourish in our early years.
- A Scotland where we have good mental wellbeing.
- A Scotland where we reduce the use of and harm from alcohol, tobacco and other drugs.
- A Scotland where we have a sustainable, inclusive economy with equality of outcomes for all.
- A Scotland where we eat well, have a healthy weight and are physically active.
This response is based on our openly developed ‘wiki’ analysis which explores a voluntary sector perspective and offers some proposals emerging from discussions to date, with the aim of supporting voluntary sector responses (including that of SCVO) to the Scottish Government.
It draws from the views provided by voluntary organisations in two roundtable events, SCVO’s engagement in meetings with the third sector public health stakeholder group plus online discussions facilitated on SCVO’s policy networks.
Analysis and recommendations
|Governance of the new Public Health Scotland body needs to model a transparent, accountable and participative approach||Voluntary organisations consulted by SCVO believe that the key indicator for public health should be ‘quality’ of life (see evidence from the third sector above). This is seen as relevant to each of the public health reform priorities and therefore offers a whole-system measure of progress. However, the key to success of the public health reform agenda, will be the trust that Scotland’s people have in the new system. This can be enhanced by securing transparency, accountability and participation in the design and delivery of the public health body and its strategy. A practical way to take this forward could be the Scottish approach to service design which has been developed through a human rights-based approach to its new social security powers.||Work with the Scottish Open Government Action Plan principles and framework to secure transparency and accountability. Engage with the Scottish approach to service design to increase participation. Voluntary organisations also have practical suggestions for the governance arrangements of the new public health body. This includes ensuring a clear and straight line of accountability through Scottish Ministers to the Scottish Parliament, an open government approach to governance, and wider participation in governance out with the Public Health Body board.|
|Ensuring Public Health Reform takes a whole systems approach, including the wider system of support within which the voluntary sector operates||
Voluntary organisations with a bearing on public health are diverse and include organisations of
different sizes working at national, regional and local level, and sometimes very local
community level. It’s important to reflect this diversity in any engagement strategies to
secure a whole system approach.
Many voluntary organisations play a key role in public health as part of the wider system, sometimes without realising it. This includes, advice, addiction services, community gardening, befriending, lunch clubs, self-help and hobby groups, community arts and sports and many others. This is the community-based preventative agenda in action, but is not always visible to the NHS system, and often brings in other sources of public and voluntary funding.
There is a need to create a space within which innovative, risky and formative ideas can be developed and tested outside the usual NHS parameters or structures that might constrain it.
Voluntary organisations consulted by SCVO believe that support to process and share their data and intelligence is of particular importance to bring them in to the public health reform conversation (see detailed evidence). This is likely based on a perception of what is valued by the NHS.
Don’t oversimplify engagement to just one channel e.g. third sector interfaces, a seat on the
board for a third sector representative, or a third sector committee, to engage the voluntary
sector. National bodies such as CHEX, Voluntary Health Scotland and others are equally
Proposal for a research and development space hosted by the new Public Health body, a ‘wellbeing lab’ (see below), could help unlock innovation and improvement in a safe space.
|Ensuring the language used within the Public Health system matches the values and principles of people-centred service design||There is a lot of NHS jargon in public health reform, including ‘whole-system’, Scottish approach to ‘service design’, IJBs, HSCPs, and Interfaces. If participation is central to public health reform, then we need to find a way to de-jargonise. One way to do this is to develop and share real life stories of what successful public health engagement looks like. We should ask people to help rethink how the concepts and language is used.||Use a people panel to de-jargonise public health reform terms and concepts. There are opportunities to learn from the design of the social security people-led policy panel set up by Inclusion Scotland and the Scottish Government’s own social security experience panels. Use storytelling techniques to ensure public health reform is more engaging, and not just seen as an NHS clinical intervention.|
In conversation between third sector public health stakeholders, we identified the need for a more systematic way for non-statutory partners to engage with public health reform, following the formation of the public health body and its functions.
We felt that a collaborative and open space which would support innovation, concept development, wider engagement and new ways of working would be a useful way to bring the best insights and input from non-state actors into public health reform. The rallying concept around which everyone could agree would be ‘wellbeing’ which is central to the Scottish National Outcomes Framework, as linked to the Sustainable Development Goals.
The concept was endorsed by all the voluntary sector members that attended the Scottish Government’s Public Health Reform third sector stakeholder group on 18th June.
The ‘Wellbeing lab’ would be a cross-departmental function hosted and resourced by the new Public Health Body.
Its aim would be to provide an open and safe space within which to engage stakeholders, beneficiaries and practitioners with the latest insights and intelligence on public health, in order to experiment, innovate and design the leading-edge approaches to supporting wellbeing in Scotland.
Its success would be measured by:
- the extent to which open, transparent and participative models of service design are mainstreamed into public health functions.
- the extent to which community-based approaches to public health are aligned with clinical approaches
- trust in the new public health system by partners across sectors, and the general public.
- It would be designed as a contained and controlled environment relative to the other functions of the public health body, able to take on a higher level of acceptable risks.
- It would provide an effective and trusted mechanism to support engagement with public health stakeholders
- It would provide the conceptual space within which to co-plan (with partners) the integration of whole-systems approaches with target-based models and the public health principles, as linked to the Scottish National Outcomes
- As a ‘wellbeing lab’ it would allow the public health function to closely align with Scotland ambitions to be a ‘wellbeing economy’.
- It would allow the new body to trial more open policy making, participation and Scottish approaches to service design, which might be riskier to advance otherwise.
- There are already precedents set and learning available for working this way within Government and across sectors, such as the Ingage function within Scottish Government, the Joint Improvement team (now iHub), and the Glasgow Centre for Population Health.
We have presented the key areas that we believe need to be expressly considered in the legislation to set up the new Public Health Body. This includes, openness and accountability, ensuring a whole-systems approach considers the whole of what the voluntary sector does at all levels of policy and practice to support people and communities, and ensuring the language and concepts used support wider engagement in the design and delivery of public health.
It’s important to note that the voluntary sector already plays a significant role in delivering against the public health priorities, through initiatives at national and local levels using a variety of public funding and other sources of investment.
We have also made a specific proposal for a ‘well-being lab’ function within the new Public Health Body, which we believe will provide a practical mechanism for realising these ambitions.
The Scottish Council for Voluntary Organisations (SCVO) is the national body representing the voluntary sector.Supporting 45000 voluntary organisations, 2000 members, 100,000+ staff, £1m volunteers. View the latest sector stats
SCVO’s policy works to ensure that the needs and concerns of the voluntary sector in Scotland are represented in the Scottish, United Kingdom and European Parliaments.
By acting as an authoritative and trusted voice for the sector, SCVO’s policy and research output is delivered through a strong evidence base and an engaged membership.
Further details about SCVO’s policy and research can be found at https://scvo.org.uk/policy-research
Head of policy
Scottish Council for Voluntary Organisations,
Mansfield Traquair Centre,
15 Mansfield Place, Edinburgh EH3 6BB
Tel: 0131 474 8000