MD2631 Thrive LDN work programme 2020/21

Type of decision: 
Mayoral decision
Code: 
MD2631
Date signed: 
11 May 2020
Decision by: 
Sadiq Khan, Mayor of London

Executive summary

This MD seeks approval for funding for the Thrive LDN work programme for 2020/21. Thrive LDN is the GLA’s delivery partner for a range of mental health programmes. This is the third year of this partnership, commencing in 2018, and this MD includes the continuation of programmes started in 2019/20. Previous MDs relating to spend in previous years are MD2265, MD2323, MD2439 and MD2510.

Decision

That the Mayor approves:

Expenditure of up to £725,000 for Thrive LDN to deliver the work set out in section 2 relating to Londoners mental health and wellbeing (healthy minds chapter of the London Health Inequalities Strategy).

Part 1: Non-confidential facts and advice

Introduction and background
  •  

The GLA Health Team has developed a programme of work to lead and implement the Mayor’s ten-year London Health Inequalities Strategy (HIS) 2018-28 (October 2018) with relevant partners and stakeholders, and to support his leadership role as chair of the London Health Board. The vision and aims of this approach are:

  • healthy children - every London child has a healthy start in life;
  • healthy minds - all Londoners share in a city with the best mental health in the world;
  • healthy places - all Londoners benefit from an environment and economy that promotes good mental and physical health;
  • healthy communities- all of London’s diverse communities are healthy and thriving;
  • healthy living - the healthy choice is the easy choice for all Londoners; and
  • supporting the Mayor’s leadership role for health.

 

  •  

The Healthy Minds chapter of the London Health Inequalities Strategy has the following five objectives:

  • mental health becomes everybody’s business. Londoners act to maintain their mental wellbeing, and support their families, communities and colleagues to do the same;
  • Londoners’ mental health and physical health are equally valued and supported;
  • no Londoners experience stigma linked to mental ill health, with awareness and understanding of mental health increasing city-wide;
  • London’s workplaces support good mental health; and
  • action is taken across London to prevent suicide, and all Londoners know where to get help when they need it.

 

  1.  

Thrive LDN is a public mental health partnership supported and funded by the Mayor of London, London’s Sustainability and Transformation Partnerships, London Councils and London local authorities, NHS England and Public Health England. This MD for £725,000 is the GLA’s contribution to Thrive LDN, with other partners identified above contributing funding in addition to this. Thrive LDN has financial hosting arrangements in place with both the Greater London Authority and Healthy London Partnership, with other partner contributions being received by Healthy London Partnership. The majority of the team are based at Healthy London Partnership, however, there is one member of staff at the Greater London Authority working on Thrive LDN. The partnership approach is governed by the Thrive LDN Advisory Group and reports to the London Health Board. Thrive LDN formally launched in December 2016. For 2017/18 a one-year business case was agreed with partners. Following this, a three-year business case (2018-21) was agreed with partners.

 

  1.  

The table below gives a breakdown of the decisions being sought for 2020/21 expenditure for Thrive LDN as part of the Healthy Minds workstream.

 

 

 

 

Workstream

Approval to spend through this MD

  • Mental Health First Aid (YLF)

£375,000

  • Thrive LDN Mental Health Programme

£350,000

TOTAL for Healthy Minds Aim

£725,000

 

  1. Expenditure will take the form of grant awards or contracts for services which will be procured depending on the nature of the work / services concerned and in line with relevant GLA procedures including the GLA’s Contracts and Funding Code.
Objectives and expected outcomes

Healthy minds: all Londoners share in a city with the best mental health in the world

The Mayor wants all Londoners to feel comfortable talking about their mental health, and to see an end to the stigma people face due to mental health problems. He also wants people and organisations across the city to work together to reduce suicide rates. The Mayor’s key ambition is for more Londoners to be trained in mental health first aid informed approaches, starting with young Londoners.

 

This aim is articulated across a range of programmes including:

  • Mental Health First Aid; and
  • Thrive LDN Mental Health Programme.

 

Mental Health First Aid

 

Purpose: Fund the training of Youth Mental Health First Aid (YMHFA) instructors, covering all London boroughs, and fund the delivery of Youth MHFA training in all state schools and further education colleges

 

Ambition: To ensure that every state-funded school and further education college in London has access to a Youth Mental Health First Aider by 2021.

 

  •  

Expenditure approval already in place:

  • approved under cover of MD2265 (March 2018) for spend of £375,000 in 2019/20 and £375,000 in 2020/21 for YMHFA. YMHFA is funded by the Young Londoners’ Fund.
  • MD2510 (August 2019) approved extra spend of £375,000 from the Young Londoners Fund unallocated scale-up funding to provide Mental Health First Aid training to the youth sector including youth clubs, universities, faith communities and other settings.

 

  1.  

The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2020/21 expenditure.

 

Deliverable

Decision being sought for 2020/21 spend

Fund year 3 of the YMHFA programme. Year 3 deliverables are: 1) train twelve YMHFA Instructors; and 2) for instructors to deliver YMHFA training in 2,000 schools.

 

Due to the coronavirus pandemic, the training is currently on hold until September 2020. That will still give ample time to meet the deliverables outlined above by April 2021.

 

A two year grant agreement is in place with Mental Health First Aid England, covering this year and last year.

 

The change in timeline has been discussed with Mental Health First Aid England and they can deliver the training within the shortened timeline.

Approval to spend £290,000

Funding for project management of the delivery of the programme.

 

A Project Officer post is based within the North East London Commissioning Support Unit (NEL CSU) with a grant agreement between GLA and NEL CSU (Thrive LDN’s NHS financial host in 2020/21) to ensure delivery of programme objectives and specify the funds to transfer.

Approval to spend £60,000

Fund year 3 of the YMHFA programme evaluation. The evaluation is jointly funded from Thrive LDN Mental Health Programme budget (outlined below) and this budget (YMHFA).

 

A grant agreement between GLA and NEL CSU to ensure delivery of the evaluation and specify the funds to transfer.

 

Approval to spend £25,000

 

  1.  

Total expenditure approval requested under this section: £375,000.

 

Thrive LDN Mental Health Programme

 

Purpose: Thrive LDN is a citywide movement to ensure all Londoners have an equal opportunity for good mental health, supported by the Mayor of London and London Health Board partners.

 

In addition, Thrive LDN has been asked by partners, including the Mayor’s Office and the Greater London Authority, to coordinate the public mental health response to COVID-19 in London on behalf of the Public Health England Office for London, to support the mental health and resilience of Londoners during and after the pandemic.

 

Ambition:

  • mental health becomes everybody’s business. Londoners act to maintain their mental wellbeing, and support their families, communities and colleagues to do the same;
  • Londoners’ mental health and physical health are equally valued and supported;
  • no Londoners experience stigma linked to mental ill health, with awareness and understanding of mental health increasing city-wide;
  • London’s workplaces support good mental health; and
  • action is taken across London to prevent suicide attempts, and all Londoners know where to get help when they need it.

 

The overall aims of a coordinated public mental health response to COVID-19 are to:

  • buffer the effects of COVID-19 on Londoners’ mental health and wellbeing and do this in a way which does not entrench inequalities; and
  • decrease the vulnerability of people experiencing greater social and economic disadvantage.

 

  1.  

The table below gives a breakdown of deliverables for this programme and the decisions being sought for proposed 2020/21 expenditure.

 

Deliverable

Decision being sought for 2020/21 spend

Commission an evaluation to establish the collective impact of Thrive LDN, including the coordinated public mental health response to COVID-19.

 

Thrive LDN has developed an academic partnership with the Mental Health Foundation, the National Institute for Health Research’s Mental Health Policy Research Unit and King’s College London’s Centre for Society and Mental Health to evaluate Thrive LDN. The existing academic partnership is also supporting the evaluation of the coordinated public mental health response to COVID-19.

 

A grant agreement between the GLA and NEL CSU (Thrive LDN’s NHS financial host in 2020/21) to ensure delivery of the evaluation and specify the funds to transfer.

Approval to spend £25,000

Fund year 3 of the YMHFA programme evaluation. The evaluation is jointly funded from Thrive LDN Mental Health Programme budget and the YMHFA budget (outlined above).

 

A grant agreement between GLA and NEL CSU to ensure delivery of the evaluation and specify the funds to transfer.

 

Approval to spend £25,000

 

World Mental Health Day: Deliver young Londoner-led festival on World Mental Health Day (10 October 2020). Due to the coronavirus pandemic, festival planning is currently on hold until June 2020. We anticipate this being ample time to deliver a festival in October 2020.

 

This will be a combination of 20-30 small grants made to third parties and a budget transfer to the GLA Peer Outreach Team.

Approval to spend £50,000

Right to Thrive: Fund year 2 of the Right to Thrive grants scheme. The grant scheme funds mental health projects with and for intersectional and marginalised communities. The grant scheme has already been reframed around the coronavirus pandemic.

 

This grant scheme was established in 2019. The GLA Small Grants Framework was used for the Right to Thrive grants scheme with the assistance of Transport for London Commercial. In accordance with this framework, Groundwork were awarded the call off contract to administer the grants. The original call off contract only covered the first year of the grants scheme. Therefore, a further call off contract will be agreed between GLA and Groundworks to administer the second-year of the grants scheme.

 

Approval to spend £100,000

 

Campaigning: Fund Thrive LDN campaigning activity for 2020/21, this will include the This is Me campaign, Mental Health Awareness Week (18-24 May 2020), #ZeroSuicideLDN campaign and campaign collateral to support the mental health strand of the #LondonTogether campaign.

 

A grant agreement will be agreed between the GLA and Lord Mayor’s Appeal for This is Me campaign.

Other campaigning activity will be commissioned through a public procurement tenders process.

Approval to spend £60,000

Social capital and community resilience: To support the public mental health response to COVID-19, fund activity to work with Thrive LDN Champions and partners to develop a social capital and community resilience offer for London now and as the first step to the ‘recovery phase.’

 

A grant agreement between the GLA and NEL CSU to ensure delivery of the project and specify the funds to transfer.

Approval to spend £80,000

Programme costs: Flexible budget to cover miscellaneous programme costs throughout the year, such as staff expenses and venue hire.

Approval to spend £10,000

 

  1.  

Total expenditure approval requested under this section: £350,000.

 

  1.  

Total approval being sought for the Healthy Minds aim: £725,000:

 

Programme

Decision being sought for 2020/21 spend

Mental Health First Aid

 

Approval to spend £375,000

Thrive LDN Mental Health Programme

 

Approval to spend £350,000

TOTAL for Healthy Minds aim

Approval to spend £725,000

 

Equality comments

Under Section 149 of the Equality Act 2010, as a public authority, the GLA must have ‘due regard’ of the need to:

• eliminate unlawful discrimination, harassment and victimisation; and
• advance equality of opportunity and foster good relations between people who have a protected characteristic and those who do not.

The Mayor’s Equality, Diversity and Inclusion strategy sets out how the Mayor will help address the inequalities, barriers and discrimination experienced by groups protected by the Equality Act 2010. This strategy includes objectives relating to mental health which are reflected in our mental health work programme. The GLA Health Team provide regular updates on their work for the Equality, Diversity and Inclusion action plan, and feed into the Mayor’s Annual Equality Report (MAER). Publication of the MAER is a legal requirement and outlines the arrangements put in place by the GLA over the last financial year to demonstrate that due regard has been paid to the principle that there is equality of opportunity for all people in the exercise of the Mayor’s general powers.

An Integrated Impact Assessment, which included an Equalities Impact Assessment within its scope, was conducted as part of the development of the Health Inequalities Strategy. This identified major positive and negative impacts of the programme for groups protected under the Equality Act 2010 and proposed ways to strengthen benefits and mitigate negative impacts, as well as identify issues concerning the four cross-cutting themes under the GLA Act 1999. The Health Inequalities Strategy was adopted in October 2018 (https://www.london.gov.uk/what-we-do/health/health-inequalities-strategy), and the integrated impact assessment was published at the same time (https://www.london.gov.uk/sites/default/files/the_mayor_of_londons_healt...).

The mental health programme delivered through Thrive LDN has taken a proportionate universalism (a key principle in addressing health inequalities) approach to all activity, by addressing the whole population while providing bespoke support for individuals, communities and groups who need it. Thrive LDN is committed to widening participation and reach across London to give everyone the equal opportunity to good mental health and wellbeing. Thrive LDN recognises that certain cohorts are over-represented in mental ill-health stats and this will be taken into consideration in future programme development. In particular, the Right to Thrive workstream focuses on those at higher risk of unfair treatment based on their identity, beliefs or their social class. The aim is to improve opportunities across London for marginalised and intersectional communities in London (intersectionality is the interconnected nature of social categorisations, e.g. the protected characteristics in the Equality Act). By recognising intersectionality we are, for example, recognising that experiences of discrimination may differ for Black LGBTQ+ community and Asian LGBTQ+ community.

Other considerations

Major risks and issues

 

  1.  

Risk are assessed and managed on a programme basis. Cross-cutting and major risks are reported quarterly through the GLA’s corporate performance management process. At the time of writing, the major risks are as follows:

Risk

Mitigation

Ongoing restrictions relating to COVID-19 especially social distancing measures creating challenges in holding public events, e.g. World Mental Health Day.

Virtual events are being explored. Thrive LDN are supporting Virtual Pride and Virtual Creativity and Wellbeing Week to learn more about the potential for this and logistics.

The World Mental Health Day Festival is led by the GLA’s Peer Outreach Team, with Thrive LDN supporting.  Options for Virtual events will be explored with them in June 2020 if social distancing restrictions are ongoing.

Ongoing restrictions relating to COVID-19 social distancing requirements creating challenges for providing Youth Mental Health First Aid Training (e.g. relating to schools and other education settings).

The timeline for the delivery of training has flexibility built in and there is scope to deliver training at scale and at pace if needed.

A digital alternative to Youth Mental Health First Aid training is being explored with Mental Health First Aid England. Should ongoing restrictions be extended for some time and delivery of training at scale/pace is no longer feasible, we will offer a digital alternative to the training programme. There would not be additional costs for this but would need to obtain agreement to reassign existing funding commitments to a digital alternative.

Partners (e.g. Voluntary, Community and Social Enterprise (VCSE) organisations) experience financial challenges meaning they are unable to fulfil the programme.

Thrive LDN has already undertaken engagement with existing VCSE partners to understand current challenges and restrictions. Mitigation measures are in place with existing partners to ensure the continued delivery of activities.

Enhanced due diligence will be undertaken for any contracts with new partners to understand challenges and restrictions in the context of COVID-19.

Staff unavailable due to ill health.

The Thrive LDN team have implemented a dual responsibility process (i.e. a single member of the team isn’t solely responsible for an activity). Therefore, staffing cover is in place if staff become unavailable due to ill health.

In addition, there is some flexibility within our Sustainability and Transformation Partnerships’ funding contribution to recruit short-term agency workers to provide cover if necessary.

Lack of programme oversight due to the unavailability of senior stakeholders due to COVID-19 related issues.

New governance arrangements have been agreed with the Thrive LDN Leadership Team and Thrive LDN Advisory Group during the current COVID19 period to ensure robust governance arrangements are in place.

In addition, Thrive LDN are now reporting directly into Public Health England Office for London and the Strategic Coordination Group to ensure alignment with wider COVID-19 efforts.

Change in programme deliverables due to emergent mental health issues around COVID-19 that need addressing.

Thrive LDN have implemented a 4x4 of considerations to manage capacity and timings of activities. There are two dimensions: planning (operations, activities, communications and strategy) and time (this week, next 2-4 weeks, next 1-3 months and next 3-6 months). This enables the programme to be agile and responsive to any emergent mental health issues.

Any significant change in programme deliverables would be raised with the Assistant Director for Health, Education and Youth, and formal approval would be sought.

   

 

  1.  

The GLA health programme is directly related to delivery of the Mayor’s Health Inequalities Strategy, a statutory duty under the GLA Act 1999.

          Impact assessment and consultations

  1.  

Impact assessments have been conducted on the key elements of the programme, as detailed above.

 

  1.  

Participation is the driving force of Thrive LDN and the partnership regularly publish insights from outreach and engagement work with Londoners. For example, in 2017/18 Thrive LDN facilitated 18 community conversations in half of London boroughs attended by over 1,000 Londoners. A meta-analysis from the community conversations was published here. In 2020, this was followed up in the Londoners Did report, which outlined how this work developed and how those conversations made a difference locally.

 

  1.  

In 2019/20, more than 1,500 people from the Black LGBTQ+, Asian LGBTQ+, Latino, Gypsy, Roma and Traveller, and transgender communities, as well as people seeking refuge in London, co-produced and participated in a series of activities and events to celebrate and protect their diversity and explore and improve mental health and wellbeing in a safe space. The primary outcome of this work has been over 1,500 people from London’s most disadvantaged communities are better placed to make decisions about their own health and care, reducing the gap of inequality and improving outcomes on an individual and community level. Following this, Thrive LDN launched the Right to Thrive grants scheme to support mental health projects with and for intersectional and marginalised communities in London. Grants totalling £200,000 have been awarded so far.

 

  1.  

There are no known conflicts of interest to note for any of those involved in the drafting or clearance of this decision.

Financial comments

Approval is being sought for expenditure of up to £725,000 on the Health Team’s “Healthy Minds” Work Programme for 2020-21. This expenditure is for Thrive LDN to deliver the work relating to Londoners’ mental health and wellbeing (the Healthy Minds chapter of the London Health Inequalities Strategy).

Of this amount, £375,000 for Mental Health First Aid will be funded by the Mayor’s Young Londoner’s Fund (as approved via MD2265); the remaining £350,000 will be funded by the 2020-21 Healthy Minds programme budget held within the Health Unit.

Activity table
  1.  

A detailed business plan for the work of the Health Team will be developed, setting out the full range of programmes, policy and advocacy work the team plans to undertake in 2020/21 alongside a timeline for each specific deliverable.

 

Milestone

Date

Evidence

Train twelve YMHFA Instructors and for instructors to deliver YMHFA training in 2,000 schools

April 2021

An external evaluation of the programme has been commissioned.

Evaluation of Thrive LDN programme published

April 2021

An external report will be published.

Young Londoner-led festival on World Mental Health Day (10 October 2020) delivered

Oct 2020

Whether event is delivered. Will be evaluated as part of Thrive LDN programme evaluation.

10-15 grants awarded as part of Right to Thrive grant scheme.

June 2020

Will be evaluated as part of Thrive LDN programme evaluation.

Deliver 5 campaigns throughout 2020/21.

Various – all by April 2021

Will be evaluated as part of Thrive LDN programme evaluation.

Publish guidance on psychological first aid for community groups (as part of social capital offer).

June 2020

Will be evaluated as part of Thrive LDN programme evaluation.


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