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ITEM NO: 13
Report To: JOINT MEETING OF EXECUTIVE CABINET AND OVERVIEW (AUDIT) PANEL
Date: 4 February 2015
Executive Member /Reporting Officer:
Councillor Lynn Travis – Executive Member – Neighbourhoods and Health
Councillor Jim Fitzpatrick – First Deputy (Performance and Finance)
Angela Hardman - Director of Public Health.
Subject: ACTIVE TAMESIDE
Report Summary: The funding agreement between the Council and Active Tameside ends on the 31 March 2015. The existing partnership model with Active Tameside needs to be developed. This report sets out the case for continued investment in sport and physical activity, Active Tameside’s service development proposals, the Council’s commissioning intentions and how the partnership model with Active Tameside may be developed in the future.
Recommendations: It is recommended that:
1. a 1 year funding agreement, as set out in this report, be approved from the 1 April 2015 with a management fee of £1.465m, a public Health grant of £0.100 (recurrent) and a Public Health Grant of £0.300m (non-recurrent).
2. a Public Health Grant of £0.100m to be paid to Active Tameside in 2014/15.
3. a strategic review be undertaken to determine opportunities for the development of a sustained operating model for Active Tameside based on a Medium Term Financial Strategy and 5 year business plan from 2016/17.
4. other options available to the Council for the operation of sport and leisure facilities be explored as part of the strategic review.
Links to Community Strategy:
Active Tameside positively contributes to the following themes of the Community Strategy:
Healthy Tameside – Increasing the number of people participating
in sport and physical activity and encouraging lifelong participation. The partnership with Active Tameside supports aims of the Tameside Health and Wellbeing Strategy, 2013-16.
Safe Tameside - Provide a welcoming and safe environment for
people to participate in sport and physical activity.
Supporting Tameside – Supporting the work of voluntary clubs and
volunteers.
Attractive Tameside - High quality sport and leisure facilities.
Learning Tameside - Coach education and sports specific
development programmes.
Prosperity – Attracting inward investment.
Policy Implications:
It is essential that any partnership with Active Tameside demonstrates value for money and makes a clear contribution to Council priorities.
Financial Implications:
(Authorised by the Borough Treasurer)
The report recommends a one year funding agreement for 2015/2016 whilst a delivery model option appraisal process is facilitated. Table 2 within section 4.6 of the report provides an indicative medium term financial strategy (MTFS) summary. No additional efficiency savings beyond 2016/2017 have been assumed with the summary MTFS. The outcome of the option appraisal process will require a Council decision later in the year. The associated financial implications for the Council relating to the outcome of this process will be given due consideration and reported accordingly.
Legal Implications:
(Authorised by the Borough Solicitor)
It is important that the Council can demonstrate that it achieves value for money for its investment in sports facilities and that the investments is justified by the beneficial outcomes. That said it needs to be recognised that in seeking Active Tameside to deliver improved health outcomes and address inequalities there has to be a sustainable infrastructure in place. The approach set out in the report allows for an appropriate review to take place to understand the most expedient way forward.
Risk Management: The risks associated with the existing partnership with Active Tameside are significant. The risks are set out in section 9 of this report.
Access to Information: The background papers relating to this report can be inspected by contacting the report writer, Angela Hardman – Director of Public Health by:
Telephone: 0161 342 2908
E-mail: [email protected]
1. REPORT SUMMARY
1.1 Exercise is the miracle cure we’ve always had, but for too long we’ve neglected to take our recommended dose. Our health is now suffering as a consequence. Whatever your age, there's strong scientific evidence that being physically active can help you lead a healthier and even happier life.
1.2 People who do regular activity have a lower risk of many chronic diseases, such as heart
disease, type 2 diabetes, stroke and some cancers. Research shows that physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer’s disease.
1.3 If exercise were a pill, it would be one of the most cost-effective drugs ever invented.1 1.4 Despite operating in financially challenging times, where the nature of competition in the
leisure industry is changing, Active Tameside continues to develop its offer to increase participation, generate additional income, reduce costs and to improve the service offer to people across Tameside. Over the recent past, Active Tameside has consistently delivered on agreed targets and making an important contribution towards improving the wellbeing of our community. Highlights include the use of new digital technology, training and gym refurbishment, new hub sites and sensory areas for people with disabilities, further development of core programmes for Gymnastics, Swimming, community activities and volunteering. A full list of key achievements can be seen at section 4.14 in the report.
1.5 Acknowledging the important contribution that physical activity and sport can make to health
improvement, and with new public health investment from the Council, the opportunity to further develop the current operating model of Active Tameside is to be seized. The proposal is to use the investment to affect transformational change to focus on getting the least active residents in Tameside more active, more often. A 1-year funding agreement, delaying the planned management subsidy reduction until 16/17, will give the Council and Active Tameside time to uundertake a comprehensive strategic review to determine opportunities for the development of a sustained operating model based on a Medium Term Financial Strategy and 5 year business plan. The review will include an appraisal of the other options available to the Council for the operation of the Council’s stock of sports and leisure facilities.
1.6 The strategic review will look also at current capabilities and the position of Active Tameside
while developing and identifying opportunities for new future collaborations and partnerships. This will inform and support future service developments such as the proposed new Aquatics Centre.
1.7 The direction of travel for the new business model for Active Tameside will be underpinned
by the Borough’s Sport and Physical Activity Strategy, which will be refreshed this year. The vision of the current strategy clearly outlines the need to increase participation in Sport and Physical Activity by the vast majority of the population in Tameside, primarily for health but also to reduce cost of inactivity to the Tameside economy - transformational and preventative approaches are needed. To achieve this vision the strategy will include interventions to ensure that all groups have the opportunity to start, stay and succeed to achieve the necessary population shift in participation.
1.8 The Council continues to be supportive of the long standing strategic relationship with Active
Tameside and the development of high quality facilities and sport and exercise opportunities for all Tameside residents.
1 http://www.nhs.uk/livewell/fitness/pages/whybeactive.aspx
2.0 INTRODUCTION
2.1 The existing funding agreement between the Council and Active Tameside ends on the 31
March 2015. Whilst the Council have no statutory duty to provide sports and leisure centres, there is a duty to improve the public’s health and address health inequalities. To this end, the Council continues to offer high quality leisure centres, which are affordable and accessible to those who will benefit most from regular participation in sport and healthy physical activity. That said, the provision of the services must be sustainable within challenging financial constraints.
2.2 This report outlines the case for continued support and investment in sport and physical
activity, Active Tameside’s service development proposals, the Council’s commissioning intentions and how the partnership model with Active Tameside may be developed in the future. Approval is sought to:
Award a 1 year management agreement to Active Tameside from the 1 April 2015 with a management fee of £1.465m, a public Health grant of £0.100 (recurrent) and a Public Health Grant of £0.300m (non-recurrent).
Award a Public Health Grant of £0.100m to be paid in 2014/15 and defer the planned reduction in the management fee of £0.175m in 2015/16 until 2016/17.
Undertake a strategic review to determine opportunities for the development of a sustained operating model for Active Tameside based on a Medium Term Financial Strategy and 5 year business plan. The review, to be completed by the summer of 2015, will include an appraisal of the other options available to the Council for the operation of the Council’s stock of sports and leisure facilities. .
2.3 The Council continues to be supportive of the long standing strategic relationship with Active
Tameside and this is recognised in the proposal to award a 1 year contract from the 1 April 2015 and a commitment to work with Active Tameside to develop a sustainable operating model. Although the development of a sustainable operating model with Active Tameside is currently the preferred approach it is not the only facility and business management option available to the Council. With this in mind, and to assure the Council of all available options, it is proposed that further work be undertaken during 2015/16 to examine these alternative options should a sustainable model for Active Tameside not be achieved.
3. ACTIVE TAMESIDE - BACKGROUND
3.1 Active Tameside manages a portfolio of facilities on behalf of the Council and receives a management fee for making a positive and tangible contribution to the outcomes articulated in the Community Strategy, Corporate Plan and Sport and Physical Activity Strategy. Active Tameside has aligned its Articles of Association, Business Plan, and service objectives to those of the Council whilst maintaining independence and delivering an efficient business model, although it remains reliant on the Council for financial support.
3.2 Active Tameside currently operates 9 sport and leisure facilities on behalf of the Council. The facilities are;
Ashton Pool, Water Street, Ashton-u-Lyne, Tameside, OL6 7AN.
The Copley Centre, Huddersfield Road, Stalybridge, Tameside, SK15 3ET.
Denton Pool, Victoria Street, Denton, Tameside, M34 3GU.
Dukinfield Pool, Birch Lane, Dukinfield, Tameside, SK16 5AP
Etherow Bowling and Activity Centre, Mottram Road, Broadbottom, Tameside, SK14
6AX.
Hyde Leisure Pool, Walker Lane, Hyde, Tameside, SK14 5PL.
Ken Ward Sports Centre, Hattersley Road East, Hattersley, Hyde, Cheshire, SK14 3NL.
Medlock Leisure Centres, Garden Fold Way, Droylsden, Tameside, M43 7XU.
Oxford Park Community Sports Centre, Pottinger St, Ashton-Under-Lyne, OL7 0PW.
3.3 The Council’s Sports Development service was successfully transferred Active Tameside on
the 1 April 2013. 3.4 Active Tameside is a Company Limited by Guarantee with Charitable Registration
incorporated in 1999. The company operates at arms-length from the Council with an independent Board of Trustees. The partnership with the Council is currently governed by 4 documents:
Management Fee Agreement. Active Tameside operates 9 leisure facilities on behalf of
the Council and contributes to the delivery of Council priorities. In exchange, the Council provides Active Tameside with an annual management fee. The current agreement expires on 31 March 2015.
Facility Improvement Funding Agreement. A Facility Improvement Funding Agreement
was made between the Council and Active Tameside on 29 January 2008. The refurbishment scheme was developed on the understanding that additional income would be generated to repay the related borrowing and ensure the financial stability of the organisation in the longer term. The refurbishment programme was completed in October 2009 with the reopening of Hyde Leisure Pool.
Twenty five-year lease in respect of the leisure facilities. The current lease between
the Council and Active Tameside expires on 31 March 2024, this leaves an unexpired term of 10 years.
3.5 In order to ensure that Active Tameside makes a positive contribution to Council priorities in
return for the annual management fee a shared vision for the partnership has been developed and will be included in the proposed funding agreement from 1 April 2015. The shared vision of the partnership is: To provide sustainable neighbourhood based services, that are accessible and meet the needs of the whole community, that improve people’s health and wellbeing. To achieve the shared vision Active Tameside and the Council agree to work together to deliver the following objectives:
To achieve the outcomes identified in the Sport and Physical Activity Strategy 2010-2020.
To support the third sector to contribute to the delivery of the Sport and Physical Activity Strategy.
To develop a strategy to reduce the management fee and provide a sustainable business model.
To exploit external funding and commissioning opportunities to develop services.
To share customer insight and performance data to ensure the service offer reflects the needs of neighbourhoods.
To exploit joint marketing and promotional opportunities to optimise demand for services. 4. ACTIVE TAMESIDE - ORGANISATIONAL HEALTH & PERFORMANCE
4.1 Active Tameside has a successful track record of delivering ‘more for less’ achieving
significant subsidy reductions since 2012. Efficiency levels are commensurate with the highest performing single contract Leisure Trusts. Active Tameside’s income levels have risen significantly during the last two-three years but trends now indicate that a plateau has been reached.
4.2 As non-statutory services, subsidy levels required for the operation of leisure facilities and
sport and physical activity services are becoming increasingly vulnerable to local government funding cuts and contract changes. Table 1 provides details of the management fee
reduction over a nine year period from 08/09. Table 1
08-09 09-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17
£m £m £m £m £m £m £m £m £m
Fee 1.925 1.825 1.630 1.529 1.439 1.289 1.125 1.125 0.775
Ken Ward 0.185 0.185 0.125 0.125 0.125 0.125 0.125
Sports Development
0.255 0.215 0.215 0.215
Public Health - Recurrent
0.100 0.100 0.100
Public Health – Non Recurrent
0.300 0.250
Total 1.925 1.825 1.815 1.714 1.564 1.669 1.565 1.865 1.465
4.3 To date Active Tameside has successfully achieved annual subsidy reductions and
continued to adhere to an annually renewed contract arrangement with the Council. Active Tameside continues to introduce measures to increase income and reduce expenditure which will help to minimise the impact on existing cash reserves. Measures to reduce subsidy without reducing services are being continually evaluated and are referenced in Active Tameside’s Corporate Risk Management Plan. The following is a summary of measures to reduce subsidy without reducing services:
Review of enhanced overtime payments to reduce employee costs.
Senior Management Team review to realign responsibilities to deliver business development opportunities.
Gym equipment investments and membership fee and charge review to stimulate demand and increase net income.
Activity Coach review to simultaneously reduce cost and provide the capacity and expertise to deliver a new range of health and wellbeing services.
4.4 Active Tameside’s medium term financial position is continually monitored and reviewed to
ensure sustainability. 4.5 It is proposed that the planned subsidy reduction of £0.175m for 2015/16 be deferred until
2016/17 to allow an appropriate period of time to review the existing business model. 4.6 Table 2 provides a contextual summary of the estimated medium term financial (cash)
position of Active Tameside.
Table 2
Financial Year Estimated In Year Cash
Outturn (Deficit) £’000
Cumulative Cash Outturn (Deficit)
£’000
2014/2015 201 201
2015/2016 (59) 142
2016/2017 173 315
2017/2018 67 382
2018/2019 93 475
4.7 The following investment proposals are being developed/progressed by Active Tameside to support longer term sustainability ;
4.8 Medlock PlayZone Scheme - A development at Medlock is estimated to achieve a net
income of circa £0.200m per year. An Executive Decision will be required in advance of 1 April 2015 to approve the scheme. The Executive Decision report will be informed by consultation with elected members for Droylsden and Longdendale and consultation with clubs affected by the development at Medlock.
4.9 Aquatics Centre - Work to identify the optimum location for Tameside’s new Aquatics
Centre continues. A working group has been set up and will report progress on a regular basis. The scheme needs to be progressed as a priority due to the poor condition of both Denton and Dukinfield Pool and the need to support Active Tameside’s medium term financial strategy.
4.10 Buy Out - Active Tameside have a joint agreement known as the Investment and Services
Agreement or ISA with a fitness equipment provider which dates back to 2005. Within the agreement there is the opportunity for Active Tameside to opt out linked to a compensation payment based on the remaining monthly basic fee and a profit calculation. Discussions have taken place to clarify the buyout figures. The detail within table 3 may require further
review if the option is to be given further consideration. Table 3
2015/2016
£’000 2016/2017
£’000 2017/2018
£’000 2018/2019
£’000
Buy out (Estimated) (550) Commission Saving 453 453 453 453
Sports Trust operational costs
(176) (176) (176) (176)
Net Surplus (Deficit) (273) 277 277 277
Cumulative pay back (Deficit) (273) 4 281 558
4.11 Investment in Green Technologies – Active Tameside is exploring opportunities to invest in
green technologies that will reduce its carbon footprint and deliver financial efficiencies enabling investment “pay-back”. Active Tameside may need the support of the Council in terms of a direct capital contribution or funding through prudential borrowing.
4.12 Active Tameside is required to review its medium term financial strategy (MTFS) on a continual basis. The Council is working with Active Tameside to develop a sustained operating model that will support a new public health commissioning relationship into the future whilst simultaneously consolidating new business opportunities and addressing a reduction in the management fee.
4.13 Active Tameside continues to perform well based on the KPI set in the current funding agreement. Year-end performance will be considered by the Director of Public Health towards the end of March 2015. However there are currently no areas of concern. Active Tameside continues to develop its offer to increase participation, generate additional income, reduce costs and to improve the service. Highlights for 2014 include;
In house facility ‘Brand Standards’ quality assurance scheme developed and introduced to improve customer experience. The scheme ensures that a high standard of service is maintained at each facility with a scoring system to evidence continuous improvement.
Copley cycle studio & ‘Myride’ virtual reality and ‘Myzone’ workout intensity monitoring introduced. This development introduces the latest industry technology to evidence member progression, attract new members and reduce attrition rates.
Copley ‘Synergy’ functional training area and gym refurbishment completed. The offer is being updated to meet the needs of the existing and future customer base.
Oxford Park ‘Synergy’ functional training area and gym extension completed.
Reception area remodelling at Copley, Medlock and Oxford Park undertaken to improve customer experience. The new reception areas are now more welcoming and encourage a positive interaction between customers and staff.
Medlock ‘Life Skills’ area (kitchen & classroom) introduced in partnership with Adult Services. Medlock Leisure Centre is recognised as a hub site for disability.
Medlock ‘Sensory Area’ for adults and children with sensory impairment.
Medlock & Hyde functional training area completed.
Medlock plan & finance in place to convert the sports hall to an ‘Adventure Play Zone’.
‘Multimedia CV Equipment’ replacement at Hyde, Copley and Ashton installed. Equipment replacement is an immediate priority for Active Tameside in order to maintain gym exercise participation (reduce attrition) and to deliver further growth
Copley sports hall floor replaced. The existing floor was in a poor condition and was in need of updating.
Gymnastics transferred to Ken Ward Sports Centre and British Gymnastics badge scheme introduction. Ken Ward Sports Centre is now operating with a zero subsidy.
‘Little Ducks’ badge scheme introduction for the development of under 5’s swimmers.
‘Les Mills Grit & Bodypump’ class introduction. Introducing the latest innovation in the fitness class programme.
Medlock ‘Community Hub’ with a new service offer for specialist groups.
‘Passport to Sport’ scheme for Coaches in Schools. The scheme will encourage primary school children to participate in main-stream activities.
‘Active Volunteers’ programme developed. The development will increase the number of volunteers working in the sport and leisure sector.
‘My Active Tameside’ staff benefits scheme launched. The scheme will contribute to staff satisfaction and retention.
Paperless invoicing system adopted.
High tech more efficient & effective ‘Telecoms System’
Whole staff ‘Team Meet’ session at the Village Ashton. The scheme will contribute to staff satisfaction and retention.
Revised ‘Business Strategy’ and Active Tameside vision and values.
Tameside Sports Trust rebrand to ‘Active Tameside’.
Public Health grant to develop a new range of ‘Health and Wellbeing Services’.
High profile ‘Tameside Sports Awards’ and awards evening. 5.0 MAKING THE CASE FOR CONTINUED INVESTMENT IN SPORT AND PHYSICAL
ACTIVITY/ INACTIVITY IN TAMESIDE/ LOCAL CONTEXT
5.1 Recent evidence shows that physical inactivity is a significant, independent risk factor for a
range of long term health conditions affecting society today. It is estimated that more and more of us will be affected by these as we age:
Major non-communicable disease, including coronary heart disease (CHD), hypertension, diabetes, chronic kidney disease and some cancers;
Stroke, peripheral vascular disease and cardiovascular disease risk factors such as high blood pressure;
Cancer of the colon, breast and endometrium (womb);
Musculoskeletal health conditions, including osteoporosis, back pain and osteoarthritis;
Depression, stress and anxiety;
Being overweight and obese.
5.2 By contrast, an active lifestyle shows clear benefits in the treatment, management or prevention of all these. In addition to reducing premature death and the incidence of disease, participating in physical activity also has benefits for mental health, quality of life and wellbeing and maintaining independent living in older age. It can also play a key role in reducing health and social inequalities2. As a result of this wide-reaching impact, physical activity has been described as the ‘best buy in public health’3.
5.3 On average, an inactive person spends 38% more days in hospital than an active person, and has 5.5% more GP visits, 13% more specialist services and 12% more nurse visits than an active individual. Recent research has shown overwhelming evidence that increasing physical activity gives health benefits that have the biggest return on investment. Just thirty minutes of moderate intensity exercise (walking) has been shown to reduce arthritic pain in arthritis sufferers by 47%, reduce the progression to dementia and Alzheimer’s by 50%, reduce the risk of hip fracture in post-menopausal women by 41% and reduce anxiety by 48%. The greatest health benefits will be experienced by those residents who move from doing no physical activity to just a little. All the current research points to the fact that low fitness levels has now been shown to be the strongest predictor of early death – even when compared to smoking, high blood pressure and obesity.
5.4 In Tameside evidence shows that by continuing to increase participation in sport and
physical activity we can reduce health inequalities, spur economic growth, and energise community engagement. The cost of inactivity to the Tameside economy is not sustainable - transformational and preventative approaches are needed. Increasing levels of physical activity will deliver on the Council’s vision to maximise wellbeing through supporting economic growth and opportunity and increasing self-sufficiency and resilience of individuals and families.
6.0 COMMISSIONING FOR IMPROVED OUTCOMES
6.1 The Council is committed to utilising its public health grant towards achieving sustainable
reductions in health inequalities through investment in the health, social and economic wellbeing of the community, as outlined in the Health and Wellbeing Strategy Making a Difference together in Tameside. The public health grant is provided to enable local authorities to discharge their duty to improve the public’s health
6.2 It is proposed that the Council will invest public health grant monies to deliver an added value
physical activity offer to the Tameside community. This will mean more activity in local areas, more local people on the street and at local facilities benefiting from being more active more often. An important emphasis will be to get more people in our community active again. The proposals support the Council’s ’15 for 15’ pledges to support our local residents with additional opportunities to get more active more often.
6.3 The future focus is not necessarily on providing lots of new activity, but ensuring the
promotion and co-ordination of existing activity across the borough, building both structured and unstructured physical activity opportunities. In commissioning Active Tameside, the primary focus would therefore be getting people started and refreshing our current sport and physical activity strategy through providing programmes in facilities, neighbourhood, work and home settings. Examples below are some of our local programmes were Active Tameside will take a lead role:
Active Travel – walking and cycling – at least some of the way to the shops, school or work
2 Marmont M. Social determinants of health inequalities. The Lancet. 2005;365(9464):1099-1104.
3 Morris JN. Exercise in the prevention of coronary heart disease: Today’s best buy in public health. Med Sci Sports Exerc.
1994;26(7):807-14.
Active Play – Early Years programme, family friendly activities, free range activity in parks, streets, playgrounds, green spaces
Active Ageing - chair based exercise, aquamobility and home exercise
Active Recreation – dance, gardening, DIY, rambling, health walks, free swim events for under 16s
Fitness Activity – joining fitness classes, power walking, jogging, cycling for fitness, swimming, Stamford ParkRun
Competitive and Adventurous Activity – team and individual sports, outdoor pursuits, triathlons
Occupational Activity – keeping active at work, taking the stairs, walking to meetings 6.4 The transformational opportunity is to increase the number of people opting into an active
lifestyle through a well-coordinated and innovative delivery system that has a robust social marketing approach that supports local delivery, tailoring messages to specific communities.
6.5 It is proposed that alongside core funding the Council will invest additional public health grant
monies in Active Tameside to add value to the existing work programme. This funding will commission Active Tameside to deliver a stronger community programme and outreach provision. The specification and outcomes for this investment will form part of the new management contract from 15/16.
6.6 Specifically, the public health grant investment will commission the delivery of three work
streams within the new transformed business model: early years, supporting people with long term conditions and older people. There is a strong evidence base to support these three priorities and the investment will work towards the following priorities in the Health and Wellbeing Strategy: Table 4
Starting Well Ensuring children are ready for school
Developing Well Tackling obesity, smoking and physical inactivity
Living Well Supporting people to choose healthier lifestyles Ensuring people with long term conditions including heart and lung
disease have access to appropriate care pathway and lifestyle support services.
Ageing Well Preventative interventions that reduce demand for costly interventions
Improving outcomes for people with long term conditions in particular the frail elderly, falls and dementia.
6.7 Strategic, intermediate and service level outcome indicators will be developed as part of the
new management agreement. This will include a core offer schedule of buildings, minimum hours and service specification. The Council already has established key performance indicators relating to the objectives of the partnership. Targets will be challenging and based on best practice and past service performance. An additional outcomes framework will be developed alongside this to ensure maximum impact of the additional public health grant and enhanced offer for Tameside residents. These will link into priorities of the Council and CCG’s Care Together Integration Programme including reducing demand for costly public sector services in particular delaying the need for health and social care support, reducing health inequalities by making the active choice the easier choice and increasing opportunities for families to be active together.
6.8 The proposal is that Active Tameside will move to a partnership investment model based on:
Successful targeting and alignment to the transformational work for health and social care integration
Proven evidence based interventions which meet the needs of Tameside residents
early intervention utilising all our assets in Tameside to support residents to become more active
Seizing opportunities for collaborative integrated delivery in communities
Promotion of personal responsibility and active engagement with residents
Innovation - finding ways to invest in new technology 6.9 The aim is that through support and investment from the Council, Active Tameside further
develops into a highly effective public health improvement delivery vehicle: 6.10 Now - Active Tameside and Public Health carried out a strategic visioning session on 5
November to agree a collective vision, strategic goals and opportunities for future development. These will be focused to align with local need and reductions in health inequalities. The outcomes agreed during this session to be embedded in Active Tameside’s refreshed Business Strategy are to:
Become a sustainable organisation - building capacity align health priorities and available resources
Raise the profile, visibility, reputation of Active Tameside – building, developing and promoting a refreshed brand and marketing strategy that can compete in a growing marketplace focusing on retaining current and attracting new members
Embrace technology
Engage with residents - creating more opportunities for Tameside residents to become more active and raising skills through training, volunteering and employment
Become a resource for engaging local people in health improvement activities
Enhance and improve the service offer for priority groups
Define Active Tameside as a lead provider in Greater Manchester
Investigate collaborative delivery and commissioning
Promote best practice and share expertise and knowledge 6.11 Active Tameside aims to build on the success of the existing health improvement services it
delivers and to increase capacity to deliver a programme of community outreach through; realigning its organisational structure, and educating and empowering its workforce in other key areas such as behavior change and motivational interviewing. Through the development of volunteers Active Tameside will support local residents to learn and develop new skills, take a more active part in their communities and boost career options.
6.12 Short Term - Active Tameside will develop and launch priority health programmes in early
2015: early years, supporting people with long-term conditions and older people. These programmes will focus on Tameside residents who are not regular exercisers and will be developed to provide easy access to high quality, affordable and engaging information, advice and activity. Each programme will embrace the use of technology and will promote independence to ensure that long-term activity habits are formed. Active Tameside will have a coordinating role and work in collaboration with a number of key partner organisations including; New Charter Housing Trust, Age UK Tameside, TMBC Children’s Centres, General Practitioners and wider primary care to raise awareness of public health priorities and to increase community engagement. Active Tameside will review existing activity opportunities within Active centres and in community settings for Tameside residents. Additional low cost or no cost opportunities will be created to meet demand as outlined in section 3.3 The review will also include the transfer of membership services to Active Tameside from Pulse, allowing for a launch of new, affordable membership packages and the introduction of a more customer-centred approach to working with members, focused on outcomes and health improvement. Effective social marketing and engagement with residents, in particular those that are inactive, will be key. Active Tameside will creatively and actively explore opportunities to widen delivery of health and social care services from those sites as part of the wider health and social care integration service redesign.
6.13 Medium Term - Sustainable partnership model - Active Tameside will need to transform
services to demonstrate improve delivery against the agreed health outcomes framework, priorities and available resources.
6.14 The Council will need to ensure sustainable and evidence based public health
commissioning arrangements and financing for Active Tameside to provide efficient, effective and responsive services.
6.15 In 2015/16 the proposed 1 year management agreement will allow Active Tameside to
develop a physical activity offer that is integrated, with maximum health gain, and have sufficient funding for long-term planning.
6.16 With a longer term agreement must come assurances to effectively manage and mitigate
risks. Therefore the management agreement will be based on the current contractual terms and conditions and will include the majority of the standard clauses, safeguarding, data protection, freedom of information, equality and non-discrimination, and termination clauses (fault and a three month no-fault termination clause agreements).
6.17 To support Active Tameside in the delivery of sustained health outcomes the Council has
identified the following enablers which will need to be in place:
Support of knowledge and skills, through public health and resource management
Transparency and accountability through a robust performance framework against identified outcomes
Sustainable resources identified through a 5 year investment model
Infrastructure and technology to enable innovation
Effective systems and processes
Effective and developing relationships with partners and stakeholders, both commissioners and other providers to exploit future funding opportunities
Effective governance, collaborative leadership and management 6.18 Table 5 illustrates the Council’s commissioning intensions over the next 3 years. It should
be noted that proposed funding agreement only relates to support for 2015/16. Commissioning in future years will be confirmed post a strategic review.
Table 5
Financial Year
Public Health Grant (Dependant on
continuation of the grant via Central
Government)
Management Fee
Comments
2014/15
£0.100m (Recurrent) £1.465m The funding will be used to: Identify inactive residents and support on a 1:1 basis £56k
Launch and market three new health improvement programmes £20k
Provide an activity subsidy to residents across the three programmes £10k
Train and develop the Active Tameside workforce (including volunteers) £10k
Deliver outreach activities in community settings £4k
2015/16 £0.100m (Recurrent) £1.465m The payment of the total £0.800m non
£0.300m (Non Recurrent)
recurrent Public Health Grant has been profiled over the 3 year period to minimise the risk to the Council.
2016/17 £0.100m (Recurrent) £0.250m (Non
Recurrent)
£1.115m Planned Management Fee reduction of £0.350m.
2017/18 £0.100m (Recurrent) £0.250m (Non
Recurrent)
£1.115m Further management fee reductions may be required by the Council from 2017/18.
7.0 PROPOSED FUNDING AGREEMENT 7.1 The proposed management fee for 2015/16 is set out in table 6.
Table 6
Element Funding
Management Fee £1.465m
Public Health Grant (Recurrent) £0.100m
Public Health Grant (Non Recurrent) £0.300m
Total Management Fee for 2015/16 £1.865m
7.2 The following proposals have been included in the draft funding agreement;
Shared vision of the partnership: To provide sustainable neighbourhood based services, that are accessible and meet the needs of the whole community, that improve people’s health and wellbeing. To achieve the shared vision the Trust and the Council agree to work together to deliver the following objectives;
o To achieve the outcomes identified in the Sport and Physical Activity Strategy 2010-2020.
o To support the third sector to contribute to the delivery of the Sport and Physical Activity Strategy.
o To develop a strategy to reduce the management fee and provide a sustainable business model.
o To exploit external funding and commissioning opportunities to develop services. o To share customer insight and performance data to ensure the service offer
reflects the needs of neighbourhoods. o To exploit joint marketing and promotional opportunities to optimise demand for
services.
1 year agreement – 1 April 2015 to 31 March 2016. The term of the agreement is
limited to 1 year in order to allow for a strategic review be undertaken during 2015/16.
Service Specification - The specification includes a schedule of buildings, minimum
hours, and service specification. The schedule of buildings includes has been reduced with the merger of the Tameside Gymnastics Centre with Ken Ward Sports Centre. Active Tameside will work with the public health lead commissioner to develop and agree an annual service delivery plan which is measured against agreed objectives outlined in the service specification. A quarterly report will be expected reporting on progress against this delivery plan. It is anticipated during the life of the contract that the reporting requirements on the service will change and Active Tameside will need to be flexible in meeting these requirements. In addition to these minimum requirements Active Tameside will have flexibility to report on any additional outputs that reflect the effectiveness of the programme. Senior staff within Active Tameside will be expected to contribute to and support any evaluation of the physical activity provision by attending regular meetings and providing data as requested, and agreeing service developments and improvements as highlighted through any evaluation.
Performance monitoring - The monitoring of the agreement will be based upon the
shared strategic objectives, key performance indicators and associated targets contained in the agreement. Active Tameside will be required to allow an authorised representative of the Council or other agency appointed by the Council to inspect the facilities at any time and the inspection may take place with or without notice. The performance of Active Tameside will be assessed on an on-going basis by the Council. In assessing performance, the following elements will be taken into account:
o Delivery of any Improvement Plan(s); o Achievement of Key Performance Indicators and associated targets; o Audit; Each building will be audited by Active Tameside and a representative of
the Council four times per year. The audit/self-assessment results will be used by Active Tameside as a management tool to improve the facilities offer.
Performance indicators – P.I’s have been established and relate specifically to the
shared objectives of the partnership. They have been designed to demonstrate performance in relation to participation, value for money, health impact, environmental impact, quality, Health and Safety and Corporate performance. Targets are challenging and based on industry best practice and performance this year and in previous years. The performance indicators measure service outcomes linked directly to Health improvement.
Management Fee Payment - The partnership agreement states that the Council will pay
funding to the Trust in 4 equal quarterly instalments payable on the first day of each quarter. It is proposed that the Trust continues to repay the annual prudential borrowing sum in March of each year. In addition, Active Tameside may seek payment re-profiling to assist with cash flow during the year. Any request for re-profiling, in year or across financial years requires approval by the Borough Treasurer in consultation with the Director of Public Health.
8.0 ACTIVE TAMESIDE – PARTNERSHIP MODEL
8.1 It is intended that the proposed 1 year management agreement will sustain the partnership
and allow time for a strategic review, which will examine the following 3 options:
Remodel the Existing Partnership - Work with and support Active Tameside to
transform the business model and create a commissioner/provider relationship.
“Buy” the service in from a commercial provider – This would involve advertising the
contract through a tendering and procurement exercise
Active Tameside to partner with other local provider - This would involve Active
Tameside merging with another larger entity with the same or similar social values. 8.2 The advantages and disadvantages of the 3 options are set out in table 7;
Table 7
Potential Option
Advantages Disadvantages
“Buy” the service in from a commercial provider.
May result in reduced costs for the Council.
Brings economies of scale.
New ideas, creativity and experience.
Vehicle for capital investment.
Lack of control.
May require a longer term contract and longer term security of tenure.
Profits taken out of Tameside and not reinvested.
Lack of local knowledge and appreciation of local issues.
The costs of terminating the contract with Active
Tameside are likely to be significant for the Council.
The procurement process may be protracted which may adversely effect health improvement outcomes.
Active Tameside to partner with other local providers with the same or similar social values.
Reduction in overheads (central costs and purchasing)
Provide the capability to raise finance to deliver investments and major maintenance and repairs.
Provide the capability to undertake an asset transfer should the Council wish to eliminate future risk.
Provide the capability to develop a wider range of services both commercial and to deliver social / health impact.
Provide the capacity and expertise to compete for new contracts / commissioned work.
The Council commissioning a smaller number of providers.
Active Tameside may be unattractive to potential partners due to its poor financial standing.
Some investment in the Assets may be required in advance of any merger.
Remodel the existing partnership based on a medium term financial strategy and 5 year business plan.
Local company.
Not for profit organisation.
Strategic purpose aligned with the Council.
Existing partnerships with New Charter, local schools and other bodies will be retained/developed.
Continued financial risk to the Council.
Limited opportunities for direct investment.
8.3 The strategic review will also include the development of a refreshed Sport and Physical Activity Strategy for Tameside and will re-examine/reshape the Council’s plans to develop a new Aquatics Centre.
9.0 RISKS
9.1 The risks associated with the Council’s current partnership with Active Tameside continue to be mitigated and managed. However, the existing partnership model must be reshaped and developed to meet future financial and health improvement challenges. The risks for the partnership going forward are as follows:
Current performance indicates that Active Tameside will not be capable of delivering the required reductions to the management fee without investment to grow income and therefore cost reduction must be adopted which will involve significant reductions to services. Investment priorities include; construction of the proposed aquatics centre and the conversion of Medlock sports hall into the Active Play Zone. There is a risk that investment will not deliver the desired outcomes around increasing participation. The business case for the Medlock development is strong. The business case for the aquatics centre will need revisiting when the preferred site is known.
Active Tameside may be required to partner with an organisation that has appropriate scale and defined/acceptable attributes if the Council requires further subsidy reductions from 2017/18.
10.0 SUMMARY
10.1 In order to ensure that public health outcomes are maintained and improved a short term agreement is proposed with Active Tameside which includes direct public health commissioning of the service with the introduction of a robust performance/outcome framework to enhance the current core offer.
10.2 This will deliver a broad offer for residents which will include access to high quality,
accessible sport and physical activity facilities alongside an enhanced community offer focused on getting local people and families more active more often.
10.3 Increasing levels of physical activity continue to be a priority for the Council. The review will
illustrate a more detailed understanding of future opportunities, consequences of different approaches and operating models for Active Tameside and at the same time will define the Council’s vision for the future of sport and physical activity provision in the Borough.
11.0 RECOMENDATIONS
11.1 As set out at the front of this report.
