(1) Katie Stewart (Director of Environment, Planning and Enforcement (EPE)) explained that the EPE Division had a net budget of £14m and was responsible for the provision of 19 services including Strategic Planning, Flood Risk, Ecology, Environment, the Energy and Low Emissions Strategy, Planning Applications, Public Protection (i.e. Trading Standards Community Safety, etc) and Green Infrastructure such as Country Parks and Public Rights of Way.
(2) Katie Stewart continued by saying that a vital component of the Division’s and Directorate’s work was the goal of creating a place which provided access for all to Kent’s Landscapes and Environments. When asked what from GET’s perspective were the main causes of social isolation and/or loneliness in the elderly, Katie Stewart described how poor health was a major contributor leading to social isolation where people missed out on the County’s social networks and physical activity opportunities and also prevented them accessing community assets such as Libraries, Public Footpaths and Country Parks. More more widely across GET, it was also through the planning of GET services such as Libraries, Trading Standards, Sport, and Planning.
(3) Stephanie Holt-Castle (Head of Countryside, Leisure and Sport) explained that a crucial part of her role as GET’s public health subject matter expert was to ensure that community assets were available, physically accessible and welcoming to a range of demographics, including older residents and those less physically able. This was achieved by practical measures such as the provision of a sufficient number of toilets, shelters, seating and signage to supplement the creation of health walks and ranger-led walks. The latter included the creation of easy, half-mile walks and trails.
(4) Katie Stewart then explained that Community Wardens also played a key role in connecting people, particularly those who were socially isolated to such green spaces as well as social networks. Meanwhile, the Countryside Partnerships ran community volunteering conservation projects that connected communities to the parks and green spaces across the county.
(5) In response to a question from Mr Balfour as to whether there was empirical evidence of the work in the Division in supporting wellbeing and overcoming social isolation, Stephanie Holt-Castle said that the Kent Wildlife Trust calculated that each pound spent on green space reaped £3.75 in health benefits. There was a range of Social Return on Investment data that the Directorate captured, as well as some clinical data, but the challenge for the GET Directorate was to gather sufficient clinical data to demonstrate to public health, health and social care providers that the rewards of its endeavours were significant in preventing ill health. This could only be achieved by working hand-in-hand with health commissioners. Stephanie Holt-Castle emphasised the evidence paradox that a lack of good data about the benefits of prevention became a reason not to invest in capturing the data that could demonstrate this. Many ‘place based’ services were wholly or largely discretionary in nature, and did not have sufficient budget to capture clinical evidence of impact, whether short or long term.
(6) The Officers were asked what KCC should invest in if it were given a blank cheque. Katie Stewart agreed that there was a need for such investment in order to enable the Division to pilot its work against clinical evidence criteria. Stephanie Holt-Castle replied by informing the Select Committee of a draft report being prepared by Public Health, Social Care and GET which was proposing a joined up approach across the three Directorates to engaging with 13 communities in Kent with the highest health inequalities. The three Directorates were sharing their own practices in order to identify the most effective way to work together. It had already become clear that there was no single solution. Such an approach should inform KCC how to invest for the short and long term prevention of social isolation and loneliness in the elderly. Katie Stewart agreed to provide a copy of the draft report to the Select Committee.
(7) Katie Stewart warned that there was an incorrect public (and health commissioner) assumption that the provision and maintenance of many of the assets which EPE and GET managed such as Country Parks and Public Rights of Way were free. Country Parks were currently almost 80% self-funding, but ultimately a number of the services still required public funding, albeit with budgets that were much smaller than those of other parts of KCC. If services which were academically and commonly recognised as providing the much lauded preventative ‘offer’ essential to achieve a step change improvement in England’s long term health outcomes, then the demise of such services had to be avoided.
(8) In response to a question about the role of green spaces, Katie Stewart went on to say that the Kent and Medway Growth and Infrastructure Framework had mapped the green spaces such as country parks, AONBs and other green assets across Kent. It also clarified that green space was more than simply a desirable extra that was “nice to have.” The District and Borough Councils were under intense pressure to provide housing, so it was encouraging that many had adopted the Kent Environmental Strategy with the aim of ensuring that housing development did not compromise their environmental aspirations.
(9) Katie Stewart replied to a question by saying that Community Wardens were mainly at Grades KR6 and KR7 within the Kent Scheme (between £19.8k and 24.7k per annum rising to some £30k in overall costs.) Volunteers cost about £12k per annum in the first year, reducing thereafter once the training had been completed. Parish Councils did not have sufficient finances, so GET part-funded them. However, Katie Stewart did commit to confirming these costs in order to double check the estimates she had provided. Katie Stewart has since confirmed that a Community Warden costs £28k a year with on costs, and that a volunteer warden costs £800 to 1,000 in the first year with an annual cost of £400 to 500 in future years.
(10) In response to a reference to flood wardens and the link to volunteer support wardens, Katie Stewart said that work was being undertaken to connect and co-ordinate the work of the Community Wardens across the County with flood wardens in order to keep both sets of volunteers more engaged and to maximise the value of their efforts across a community. This had been identified by the Kent Resilience Forum as a priority if communities were to become more resilient at a time when resources were becoming increasingly scarce.
(11) Stephanie Holt-Castle underlined the need for the role and potential of the GET Directorate to be fully recognised both politically and across all Directorates in respect of GET’s very real ability to impact on the social isolation and wider public health agenda. She said that the health remit must not be confined to those who worked for Social Care and Public Health. The draft report referred to earlier aimed to complement the STP process. It was essential to make a conscious effort to stop working in silos, if the ‘step change’ in prevention described by the Marmot Health Inequalities Review, the Care Act and the NHS Five Year Forward View was ever to be achieved.
(12) Katie Stewart said that the GET Directorate was very well placed to contribute to any strategy for overcoming loneliness and social isolation because it touched the lives of all residents, literally from birth to death. It provided many services that everyone knew about (from pot hole repairs to Libraries) and was therefore in a unique position to connect with people whether KCC corporately knew about them or not.
(13) Stephanie Holt-Castle said that the GET Directorate was working on a number of studies with the 5 East Kent Districts to identify and improve the community assets to deal with social issues such as smoking and obesity. An example of this was Social Prescription where GPs referred patients to non-clinical services such as groups who organised walks in Country Parks.
(14) Committee Members variously commented that there were a number of activities such as archaeology, equestrianism and even darts that could benefit from the Social Prescription approach. Volunteering itself was an activity that prevented social isolation. It was also considered to be important to offer as wide a range of activities as possible in order to reach people regardless of personality, social background or any other disadvantaged circumstance.
(15) When asked how GET could embed consideration of social isolation and loneliness in the elderly, Stephanie Holt-Castle noted that Equality Impact Assessments already captured both the intention to not disadvantage older age groups with policies/programmes/projects and a Business as Usual culture, but also identified the opportunities to improve the lives of older residents. This could fairly easily be supplemented through GET’s internal communication channels by shaping and delivering a ‘hearts and minds’ awareness-raising campaign so that all GET staff understood social isolation and loneliness in the elderly in Kent.