Health & Well Being Boards

A short guide to health and wellbeing boards  from the Department of Health (28 Feb 2012) 

The role of Health & Wellbeing Boards

the place where local commissioners (NHS and local authority) explain and are challenged on how they are involving patients and the public in the design of care pathways and development of their commissioning plans” p5
In: Patient Involvement and Public Accountability: a report from the NHS Future Forum,

Building on the power of the local authority to promote local wellbeing, we will establish new statutory arrangements within local authorities – which will be established as “health and wellbeing boards”… to take on the function of joining up the commissioning of local NHS services, social care and health improvement. These health and wellbeing boards allow local authorities to take a strategic approach and promote integration across health and adult social care, children’s services, including safeguarding, and the wider local authority agenda.” (p34)
In: Equity and excellence: Liberating the NHS (Department of Health, July 2010)

Health and wellbeing boards could become a vehicle for driving wider place-based initiatives, ….focussed on helping turn around the lives of families with multiple problems, improving outcomes and reducing costs to welfare and public services by enabling a more flexible and integrated approach to delivering the help these families need.” (p107)
In: Liberating the NHS: Legislative framework and next steps (CM 7993, December 2010)

Health and wellbeing boards will bring together elected representative and the key NHS, public health, social leaders and patient representatives to work in partnership. This will ensure services are joined up around the needs of people using them, and that resources are invested in the best way to improve outcomes for local communities.”
In: Local Democratic Legitimacy: Factsheet (Department of Health, December 2010, 3pp)

Health and wellbeing boards will need strong public health support in all areas of their work. This should include advice and strategic oversight from the DPH and public health consultants, bridging health, local authority and other services and facilitating integration. Access to timely, comprehensive and accurate data and analysis will be essential.” 
In: FPH response to Liberating the NHS: Local democratic legitimacy in health (Faculty of Public Health, 2010, 3pp)

New statutory Health and Well-Being Boards in each upper-tier local authority will bring together local leaders in the NHS, public health and social care to produce joint strategic needs assessments and joint health and well-being strategies for their communities, and encourage partnership working. The Boards will play a key role in collaboration between GP consortia and local authorities”. (p21)
In: National Health Service Landscape Review (National Audit Office, January 2011)

Health and Well-Being boards in every upper tier local authority will have a proposed minimum membership including elected representatives, GP consortia, Directors of Public Health, Directors of Adult Social Services, Directors of Children’s Services, local HealthWatch and where appropriate, the participation of the NHS Commissioning Board, as well as at least one local elected representative.” (p24)
In: National Health Service Landscape Review, (National Audit Office, January 2011 )

“[HWBs] have a role in authorising clinical commissioning groups and assessing their performance. The right to refer NHS commissioning plans back to clinical commissioning groups if plans aren’t consistent with the local health and wellbeing strategy.”
In: Health and Wellbeing Boards have no right of veto over NHS commissioning plans so what powers do they have?
An answer from the King’s Fund Pilot Clinical Commissioning Q&A Service for East of England, September 2011
(Reprinted in Appendix 1)

Supporting their work

 

Getting the best of Health and Wellbeing Boards – Health and Wellbeing Board Information Resource: information about publications and websites which should be of value to Health and Wellbeing Boards (Local Government Association)

New partnerships, new opportunities: a resource from Healthy Communities programme (Local Government Association) aimed at all those involved in, or with an interest in, setting up and running effective HWBs.

Health and Wellbeing Boards (Department of Health)
A collection of DH publications, learning resources and case studies to support HWBs

National Learning Network for Health and Wellbeing Boards (Department of Health)
The Learning Network aims to support health and wellbeing board members to develop knowledge and behaviours that will enable them to work effectively to deliver their shared purpose.

The National Learning Network for Health and Wellbeing Boards is one of the Communites of Practice for public services. (Registration with Communities of Practice required)

“This community is a space for the network of early implementers of health and wellbeing boards to share ideas, questions and progress. It is also a platform for discussion and debate with the Department of Health and the Local Government Association on the future development of health and wellbeing boards. The community is open to leaders from local government, the NHS and other stakeholders.” The space includes a library of documents, case studies, forums and blogs.

Health and wellbeing boards: Making them work (Kings Fund)
This project has three main aims:

  • To gain insight into how local authorities and their health partners are implementing health and wellbeing boards in the context of the government’s NHS reforms, its vision for adult social care and the localism bill.
  • To capture the overall approach of a sample of English councils in establishing these new arrangements, supported by a more detailed examination of the experience of two early implementer sites whom The King’s Fund has been assisting.
  • To identify the lessons that could be applied to the roll-out of health and wellbeing boards elsewhere, the issues that local authorities and their health partners need to address in the next stage of their development and the implications for policy.

You can also sign up for : Kings Fund Health and wellbeing boards monthly bulletin – Latest news, policy developments and guidance.

Joint strategic needs assessment toolkit for shadow health and wellbeing boards (Local Government Improvement & Development, April 2011)
A guidance and best practice toolkit for all members of new shadow health and wellbeing boards.

Supporting the partners

Influencing the New Health System in a Local Area- A Briefing for Local Voluntary and Community Groups (NCVO, Sept 2011, 4pp)

Board Assurance Prompt – Health and Wellbeing Boards (Good Governance Institute, Sept 2011, 3pp)
A briefing targeted at those developing HWBs, or who need to understand and work with HWBs in the future. It includes a brief introduction to the structure and function of HWBs, success and assurance criteria.

Engaging with primary healthcare professionals to improve the health of the local population (Sept 2011, 8pp)
A guide produced by the professional bodies representing dentistry, eye care, pharmacy and general medicine, to support local authorities in identifying good local sources of clinical information. Including:

  • Why should health and wellbeing boards work in partnership with primary healthcare professionals?
  • How do health and wellbeing boards engage with primary healthcare professionals?
  • Check list for health and wellbeing boards

Exploring the central role of health and wellbeing boards in NHS reforms (PCC event July 2011)
A 2 page briefing from the event assesses the central role of health and wellbeing boards and the risk of mandate wars between clinicians and councillors.

Better joined-up working: Productive relationships with local authorities (PCC, March 2011, 3pp)
Ten top tips for working with Local Authorities.

Commissioning for the future Learning from a simulation of the health system in 2013/14 (Kings Fund, 2010)
Findings of a simulation exercise run by NHS Lincolnshire with The King’s Fund in November 2010 which aimed to test the behaviours and dynamics that might develop under the rules of the new system and help local GP consortia prepare for this new world.
“The simulation called for a strong health and wellbeing board that was well supported by public health needs analysis. The board began the simulation with some enthusiasm and sought to develop a strategy for the local area. … As the simulation progressed, the health and wellbeing board and local HealthWatch felt marginalised, so enthusiasm was dampened.” (p120)

Appendix 1: An answer from the King’s Fund Pilot Clinical Commissioning Q&A Service for East of England, September 2011

Question : Health and Wellbeing Boards have no right of veto over NHS commissioning plans so what powers do they have?
Answer: They were already going to have a strong role and now that is going further.

They have a role in authorising clinical commissioning groups and assessing their performance. The right to refer NHS commissioning plans back to clinical commissioning groups if plans aren’t consistent with the local health and wellbeing strategy.

It has been agreed there shouldn’t be a right of veto. That would create an incoherent system and cut across the accountability of NHS commissioners to the NHS Commissioning Board and the Secretary of State.

One recommendation which arose out of the recent NHS Future Forum report was around the issue of public accountability. The Forum acknowledged that the role and powers of Health and Wellbeing boards needed to be strengthened and that they “should be the place where local commissioners (NHS and local authority) explain and are challenged on how they are involving patients and the public in the design of care pathways and development of their commissioning plans.” (Patient Involvement and Public Accountability: a report from the NHS Future Forum, p5 )

Furthermore, the Forum’s report advised that Health and Wellbeing boards should have responsibility for “identifying any potential or actual conflicts of interest in respect of commissioning consortia decisions.” (Patient Involvement and Public Accountability: a report from the NHS Future Forum, p5)

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