North East Leading Improvement for Health and Wellbeing Programme Masterclass 19 April 2012

Ginny Edwards, Head of Learning Network for health and wellbeing boards, Department of Health

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What am I going to cover?

• The role of health and wellbeing boards (HWBs) and their place within

the Health and Social Care Bill

• How will HWBs make a real difference in improving care services, and

improving health and wellbeing outcomes?

• Joint Strategic Needs Assessments (JSNAs) and Joint Health and

Wellbeing Strategies (JHWS)

• The role of Healthwatch

• Public Health transition

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19 April 2012

Health and wellbeing boards

The Health and Social Care Bill:

• Sets up health and wellbeing boards (HWBs) as council Committees

• Establishes a core membership, with flexibility to expand locally

• Mutual obligation on councils and NHS commissioners to undertake Joint Strategic Needs Assessment (JSNA) and joint health and wellbeing strategies

• Sets expectation of alignment of health, social care, public health (and other) commissioning plans

• Promotes joint commissioning and integrated provision

• Sets a duty for HWBs to involve users and the public in JSNA and JHWS

• Gives HWBs a role in annual assessment of clinical commissioning groups (also a non-statutory role in their initial authorisation)

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Vision for health and wellbeing boards

1. To provide collective leadership to improve health and wellbeing

across the local authority area, enable shared decision-making and

ownership of decisions in an open and transparent way

2. To achieve democratic legitimacy and accountability, and empower

local people to take part in decision-making

3. To address health inequalities by ensuring quality, consistency and

comprehensive health and local government services are

commissioned and delivered in the area

4. To identify key priorities for health and local government

commissioning and develop clear plans for how commissioners can

make best use of their combined resources to improve local health

and wellbeing outcomes in the short, medium and long-term

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Health and wellbeing

board members &

partners

GPs

AHPs

Practice Managers

Practice nurses

Patients

Cabinet members

Local people

LiNKs

Social care professionals Local care

providers

Social care professionals

Local care providers

Public health professions

Wider determinants of health – eg. directors of housing

PALs

Voluntary/Community sector

FT Governors

PPGs

Director of Public HealthDirector of

children’s services

Director of adult social

services

Local Healthwatch

Councillors

CCGs

Health and wellbeing board members & partners

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Transition and implementation; key timings

• By April 2012;

– Health and wellbeing boards established to operate in “shadow” form

• July 2012;

– Clinical commissioning groups preparing for authorisation - emerging JSNA and joint health and wellbeing strategies to underpin 2012/13 commissioning plans

• October 2012

– HealthWatch England and Local HealthWatch start date

– Clinical commissioning groups prepare commissioning plans for first year of authorisation

• April 2013

– Health and wellbeing boards in statutory form

– PHE established, PH responsibility transferred to local government

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How do Health and wellbeing boards fit into the new “landscape”?

Health Watch

DPH

CCGs

Members

DASS+DCS

HWB

Adult Social Care

Services

Healthcare Services

Healthwatch/ Public

Engagement

Public Health Services

Children & Families

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JSNA and joint health and wellbeing strategies; the vehicle for shared leadership

HEALTH & WELLBEING BOARD

What does our population & place look like? – evidence and collective insight

What services do we need to commission (or de-commission), provide and shape, both separately

and jointly? –

So what are our priorities for collective action, and how will we achieve them together? – JHWS

So what does that mean they need, now and in the future and what assets do we have? – a narrative on the evidence –

JSNA

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19 April 2012

Local and national Healthwatch

Strengthening the voice of patients, users of services and the public• Local Healthwatch

organisations to be the local consumer voices

• Healthwatch England will be a national independent consumer champion

Continuity of existing arrangements• Local authorities will have

duty to deliver local Healthwatch

• It will cover health and social care for both adults and children

What will be different• From influence to decision

making with a seat on the health and wellbeing board

• Help individuals as well as understand and present community views

• Healthwatch England will be used nationally by Secretary of State, Monitor, NHS Commissioning Board and CQC

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Current hot topics

• How can process support CCG development and help develop strong relationships within the health and wellbeing boardCCG authorisation

• Widening the scope of the JSNA to develop a ‘picture of place’JSNA

• Agreeing a first cut of the strategy by July 2012JHWS

• Using the strategy to shape individual commissioning plans for 2013-14

Commissioning plans

• Agreeing who needs to be a member, and who needs to be fully engaged by members of the boardBoard membership

• Challenge of building shared leadership approach during the transition phase when some key players may not yet be in place

Building shared leadership

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Local authorities’ role in Public Health

• Public Health transition to local govt coincides with establishing HWBs

• DPH is a core (and key) member of the Board

• Improving public health is a clear priority - across national and local govt.

• New opportunities to align public services to improve health and wellbeing

• “Place shaping”; the impact on the causes of ill-health

• Health inequalities-the Marmot Review and the focus on “life-course”

• The local authority “core offer” on public health to the NHS

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Collaboration for Health and Wellbeing

Boards will have a role in improving health and care services;

•a joint strategy to underpin commissioning of services,

•ensuring alignment of service commissioning plans (health and social care, children and adults),

•promoting integrated commissioning and provision

•integrated around individuals, (“personalisation”), groups of individuals with common needs, and individual communities,

•enabling service change and reconfiguration where required,

•engaging the public and listening to the public’s views

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Boards working in partnership on the causes of ill-health

• Promoting health and wellbeing (messaging, engagement and aligning multiple public services to a common goal)

• Prevention and protection

• Tackling the causes (including housing, employment, education)

• The “life course” approach

• Addressing health inequalities

• Aligning the actions of local leaders

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Health and wellbeing boards and wider partners

• HWBs will want to establish effective partnerships with leaders across sectors to

– understand and tackle the wider determinants of health, and

– to bring together services around what individuals and families need

• This could include working with Criminal Justice Services, Education, local VCS,

local businesses, etc.

• HWBs will need to collaborate with VCS locally to ensure views of communities

are fed in, including less well heard groups

• VCS also likely to be partners in delivering the joint health and wellbeing

strategy

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Health and wellbeing boards: approach to supporting transition to date

• 140 early implementers

• National Learning Network

– National learning sets; on shared leadership, and key challenges (90

boards participating)

– National events to share learning

– Online Knowledge Hub (over 800 members)

– LGA developing tailored support offer for local health and wellbeing

boards

– Aligned with local and regional work, support for CCGs, Healthwatch, Public

Health

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How can we learn together, the national contribution

The Health and Wellbeing Board National Learning Network

Learning community which includes:

– 11 Learning sets based around themes of common interest (95 HWB are members)

– Associates: all members of HWBs, experts, policy leads and key stakeholders

– An on-line “Knowledge Hub” to facilitate learning and sharing between network members and the learning community

– National events to stimulate new thinking and share learning

– Development support to individual HWBs (provided by the LGA)

– Leadership development programme for HWB members

– Aligning HWB development with other change programmes (Public Health transition, CCG development, establishing Local Healthwatch)

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Learning set themes

• Improving services through more effective joint working - including a specific

focus on Children & Young People

• Improving the health of the population

• Bringing collaborative leadership to major service reconfiguration

• Creating effective governance arrangements

• How do we “hard-wire” public engagement into the work of HWBs?

• “Raising the bar on Joint Strategic Needs Assessment and joint health and

wellbeing strategies

• Making the best use of collective resources

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19 April 2012

Get sharing now

Join the learning network’s Knowledge Hub athttp://knoweldgehub.local.gov.uk

Keep in touch by following us following us on twitter@johnwilderspin@ginnyedwards@janineatDH@AmyatDHand join the conversation at #hwblearn

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