Health and Wellbeing Boards

1. Health and Wellbeing Boards Avril Imison LaMPS conference Southampton 5 July 2013

2. Health and Wellbeing Boards • Were in Shadow form April 12 – March 13 • April 13 forwards; real and have to meet in Public-fully constituted Council committee • Boards of Commissioners not Commissioning Boards • Strategic Boards-shared vision and principles has to have an agreed HWB Strategy (using JSNA) • Has responsibilities but no decision making power • Memberships of Boards vary • Health Oversight and Scrutiny Committee (HOSC) are able to comment on HWB activity

3. Statutory Functions delegated to Director of Public Health /LA • Council’s duty to take steps to improve public health • SoS’s public health protection or health improvement functions • Planning and responding to emergencies that present a public health risk • Role to co-operate with the police, probation and prison services • Plus anything else the SoS sees fits to delegate • The DPH has to write a Public Health report and the LA has a responsibility to publish it • DPH is a mandated member of the HWB

4. The Role of the Board; Use of the JSNA and PHE data provided to the CCG and to Councils to inform the production of; • A Joint Health and Wellbeing Strategy • Updated JSNA • Pharmaceutical Needs assessment Plus responsibility • to increase and develop integration of health and social care • to expand joint commissioning • to ensure Public Engagement; Healthwatch are members of the Board(community and Vol sector) and strengthen local accountability

5. Membership of Board • Unusual for Councils as have Councillors and Officers of the Council working together • Power of Health varies from place to place according to the number of CCGs • Voting and Quorums also vary • No providers- as it is a grouping of commissioners • Director of Public Health mandated position; PHE say as “honest broker”, not easy- now also the arbitrators in HCAI disputes • Unlikely that any of us would be a member

6. Health agenda similarities with Local Government • Supporting the movement of secondary healthcare services into community based settings saving over £8 billion in England • Moving towards a healthcare system in which private providers are able to deliver over 20% of services by 2020  • Effectively managing change throughout a period of transition  • Working with private sector healthcare companies looking to obtain community health contracts with local and NHS health services  • Encouraging alternative providers of health services within the community setting • Supporting the creation of successful social enterprises within the health sector  • A fundamental shift in the NHS shift towards a personalised system: Changing the way health services are designed, commissioned and delivered • as described by Bob Ricketts Director of Strategy and Provider Development

7. The Emerging role of Local Authorities • The emerging role of health and wellbeing boards as a pivotal aspect of delivering community health services • Strengthening working relationships between health and social care professions  • Encouraging the development of more integrated commissioning of services • Effectively implementing statutory functions from April 2013 • The role of local authority members in health and wellbeing boards • Encouraging community engagement in community health services: Ensuring accountability  • Supporting the work of health and wellbeing boards: Building relationships across the health social care sector to improve patient outcomes in the community  • As described by a County Council leader and LGA

8. How to influence a HWB • Know who is on your local Board; chose an appropriate person to lobby-E.g. councillor or Healthwatch • Councillors are new to the Health agenda • Councils are political and so lobbying and briefing will be necessary, but watch your relationship with your Commissioners • Health Commissioning is still in the hands of the CCG, so lead GPs will also need to be lobbied • Ensure you link your subject to the agreed priorities ; HWB Strategy and the CCG Integrated plan( plus JSNA) • Localism agenda v Competition and AQP • Councils are used to procuring services from the Private and Voluntary sectors- threat or opportunity • Councils tend to be “poorer” than the NHS and are subject to greater efficiency savings (CSR minus 10%)- have savings in mind as ever • New integrated Health and social care plans are the new requirement- so make friends with your Borough Colleagues

9. New Mechanisms to Deliver the Agenda for the HWB • On the Horizon are Integrated Care organisations (ICO) ; this will definitely affect your services and your staff • Norman Lamb MP announcement was on national TV • These organisations will be the mechanism to save money by integrating H&SC teams to create savings • There is a national working group looking at how these will function; Legal status, operating model ,financing, staffing etc

10. Key actions for you • Go and listen to the HWB in Public • Keep up with and read commissioning documents for priorities • Lobby when you can, whilst having an eye to your main commissioners views- use the priorities • One Councillor will have Public health and HWB in their portfolio • Join in on any developments; ICO’s, Social enterprises, new developments in pathway redesign

11. Thank you