MD3162 London Estates Delivery Unit grant agreements to health and care partners

1.1.    The London Estates Delivery Unit (LEDU) is hosted by the GLA on behalf of the London Devolution partners committed to health and care devolution in London, as set out in the London Health and Social Care Devolution Memorandum of Understanding signed in November 2017 (Appendix 1)
1.2.    The LEDU was formed to implement the work of the London Estates and Infrastructure Board (LEIB). The LEIB provides a single forum for estate discussions in London and ensures early involvement of London government partners. As it matures, the LEIB will also provide a forum within which NHS capital investment decision-making, including delegated business case approvals and capital allocation considerations, can be exercised, so far as statutory powers permit this and within national approval thresholds.
1.3.    The LEDU is match-funded by the GLA and NHS partners. This partnership budget is held by the GLA in line with the hosting arrangement agreed by NHS and GLA partners. A 2022 independent review of the LEDU’s work recommended continuing the current funding and hosting arrangements and noted wide-ranging support for the role played by the LEDU over the previous three years. The total annual LEDU budget equates to £800,000, funded on a 50-50 basis between the GLA and NHS partners. Approximately one-fifth of this budget is allocated to operating costs and priority workstreams that form part of the LEDU workplan. The balance of the budget funds the cost of established posts in the LEDU team.
1.4.    The LEDU has identified workstreams, based on system priorities and recommendations from the LEDU review, to be funded from the LEDU partnership budget this financial year. 
 

Provision of a chair’s professional services to the LEIB 
2.1.    The governance framework and hosting arrangements for the LEDU state that the LEIB will be led by an independent chair, alongside the NHS England Regional Director. 
2.2.    Outside of the LEIB, the independent chair undertakes a system partnership role supporting all members to engage in collaborative, constructive conversations about the optimum use of health and care assets, across the London system, to maximise value. The independent chair works with LEIB members to ensure they consider the impact of decisions on member and non-member bodies, and their communities. The independent chair also directs and assists the work of the LEDU and chairs several LEDU forums.
2.3.    The LEDU seeks authority to make provision for the payment of the independent chair’s services from the financial year 2023-24 and 2024-25 budgets via a GLA grant agreement to South East London ICS as per prior year arrangements. This arrangement was agreed by system partners. This arrangement is reflective of the level of leadership support required by the system and consistent with prior year arrangements.
LEDU accommodation at 169 Union Street 
2.4.    In line with the agreed hosting arrangements, LEDU occupies accommodation at Union Street. The LEDU comprises a core team of seven posts; and a virtual team of 16 posts. Following a review of corporate estate across NHS partner and other organisations, working in partnership with South East London ICS, eight desk spaces on the second floor at Union Street have been identified and secured by the ICS, which has made these desks available for use by the LEDU. The LEDU seeks authority to grant South East London ICS  £110,000 (£88,000 full financial year 2023-24 and £22,000 for the Quarter 4 of 2022-23) and £88,000 for financial year 2024-25 for this accommodation via GLA grant agreement. 
Receipt of Healthy Urban Development Unit funding for the delivery of jointly commissioned small projects
2.5.    The NHS Healthy Urban Development Unit (HUDU) team, hosted by North East London ICS, is co-located with the LEDU and forms part of the virtual team. The ICS would like to make an additional partnership funding contribution of £78,000 to the LEDU in financial year 2023-34, to be ringfenced to support the work of NHS HUDU to maximise the opportunities that aligning the health and planning agendas can bring to improve health and narrow health inequalities. This may involve a review and update (if required) of the HUDU Planning Contributions Model.
2.6.    Additional funding will be managed in line with current GLA financial management procedures. Any unspent funding will be carried forward into 2024-25, with prior agreement from the NHS HUDU Programme Lead.

3.1.    Section 149(1) of the Equality Act 2010 provides that, in the exercise of their functions, public authorities must have due regard to the need to: eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010; and advance equality of opportunity, and foster good relations, between persons who share a relevant protected characteristic and persons who do not share it. Due regard must be had at the time a decision is being considered. The duty is non-delegable and must be exercised with an open mind.
3.2.    The protected characteristics under section 149 of the Equality Act are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation, and marriage or civil partnership status.
3.3.    The LEDU works in partnership with the GLA, the NHS and other key stakeholders to ensure the delivery of health and care services in fit-for-purpose estates; and to support the Mayor in his commitment to addressing health inequalities and access to clinical services. 
3.4.    Considering the obligations under section 149(1) of the Equality Act 2010, the delivery of the heath and care services through fit-for purpose estates will help to meet health needs of Londoners. It is likely to have a positive impact upon groups with protected characteristics, such as age, disability, pregnancy and maternity, race and sex as it will enable access to the relevant health care services. 
 

Link to Mayoral strategies and priorities
4.1.    The LEDU supports the LEIB and the collaborative working of the London health and care partners. The partnership’s commitment to delivering key objectives for Londoners is solidified in the London Health and Care Estates Strategy.
4.2.    By delivering the workstreams detailed in this paper, system partners, including the GLA, will be enabled to meet their collective ambitions. These are to:
•    meet the health needs of a growing population (it is expected that the London population will grow by circa 450,000 to 600,000 people within the next 10 years)
•    improve the health outcomes and care experience of patients and their families in fit-for-purpose facilities
•    support and accelerate changes in health and care service model delivery, to reflect and drive best practice
•    foster greater system-wide working and strategic planning
•    deliver significant transformation in the NHS estate across London.
4.3.    No one involved in the drafting or clearance of this document has any conflicts of interests to declare.
Risk and issues
4.4.    The risks and issues of not proceeding with expenditure on the workstreams identified in this decision form are outlined in the table below. 

5.1.    Mayoral approval is sought for expenditure of up to £160,000, that will be funded from the LEDU 2023-24 partnership budget. Section 2 of this MD details the planned expenditure for 2023-24 and is summarised below: 

•    £50,000 for provision of a Chair’s professional services to the LEIB
•    £110,000 to South East London Integrated Care System for the provision of accommodation for the LEDU at Union Street.

5.2    In addition, Mayoral approval is sought for expenditure of up to £138,000, that will be funded from the LEDU 2024-25 partnership budget, subject to the GLA 2024-25 budget setting process and confirmation of the LEDU funding allocation. Section 2 of this MD details the planned expenditure for 2024-2025 and is summarised below: 

•    £50,000 for provision of a Chair’s professional services to the LEIB
•    £88,000 to South East London Integrated Care System for the provision of accommodation for the LEDU at Union Street.

5.3    Lastly approval is also requested for the receipt and expenditure of £78,000 from North East London Integrated Care System to support the work of the NHS Healthy Urban Development Unit.

5.4    This expenditure and funding will be managed by the LEDU part of Land and Delivery Unit within the Housing and Land Directorate.

6.1.    The foregoing sections of this report indicate that the decisions requested of the Mayor concern the exercise of the GLA’s general powers, falling within the GLA’s statutory powers to do such things considered to further or that are facilitative of, or conductive or incidental to, the promotion of economic development and wealth creation, social development or improvement of the environment, in Greater London.
6.2.    In implementing the proposals in respect of which a decision is sought, officers should comply with the GLA’s related statutory duties to:
•    pay due regard to the principle that there should be equality of opportunity for all people
•    consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom
•    consult with appropriate bodies.
6.3.    In taking the decisions requested, as noted in section 3 above, the Mayor must have due regard to the Public Sector Equality Duty under section 149 of the Equality Act 2010 – namely the need to eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010; and to advance equality of opportunity, and foster good relations, between persons who share a relevant protected characteristic (race, disability, age, sex, sexual orientation, religion or belief, pregnancy and maternity, and gender reassignment) and persons who do not share it. To this end, the Mayor should have particular regard to section 3 (above) of this report.
6.4.    Section 1 of this report indicates that part of the sought budget will amount to the provision of grant funding, and not payment for services. Officers must ensure that the funding is distributed fairly; transparently; in accordance with the GLA’s equality policy and subsidy control rules; and in a manner that affords value for money in accordance with the GLA Contracts and Funding Code. Officers must ensure that appropriate funding agreements are put in place and executed by the GLA and the relevant recipients before any commitment to funding is made. In respect of the grants for the accommodation and chair’s services, such agreements should contain provisions in relation to the return of any amount of grant not fully used once the grant recipients have procured the accommodation and chair’s services and the final costs of the foregoing are known.

7.1.    The planned delivery approach and next steps are outlined in the table below. 

Appendix 1 – London Health and Social Care Devolution Memorandum of Understanding