The Health and Social Care Bill that is going through Parliament now is intended to give effect to the reforms requiring primary legislation that were proposed in the NHS White Paper Equity and Excellence: Liberating the NHS. The Bill introduces a statutory duty for all upper-tier local authorities to create a Health and Wellbeing Board and develop a new joint health and wellbeing strategy.
The Director of Adult Social Care and the Director of Public Health will explain to members what the latest position is in planning and developing the new Board. Members will be able to follow up on their comments at the last meeting that the Board should be subject to the scrutiny of the HOSC.
Minutes:
The purpose of health and wellbeing boards is “to improve health and care services, and the health and wellbeing of local people”. Subject to Parliamentary approval, health and wellbeing boards will be established from 2013, running in shadow form from 2012. 2011/12 will be a transitional year.
Local Councils have an important strategic leadership role in developing the boards and a number, including Oxfordshire, have joined an “early adopter network” with an aim to get the new Board set up in advance of the Government’s deadlines and share the benefits of each other’s experience.
John Jackson and Jonathan McWilliam updated the Committee on the present situation in the development of the new Health and Wellbeing Board. They explained that the PCT and the County Council are working closely together in developing proposals for the new Board and made the following points:
1. What the Government has said should happen
Health and Wellbeing Boards
• Will be a statutory requirement and a key element in increasing local democratic accountability for the NHS
• Must develop a “Joint Health and Wellbeing Strategy”
• Joint Strategic Needs Assessment (JNSA) at heart of the role – but flexibility to broaden this
• Core purpose will be to join up commissioning across the NHS, Social Care, Public Health and related services & improve outcomes
• Support and oversee the use of NHS Act s75 for formal partnerships and support informal arrangements
• Could have functions delegated to them by local authorities
• Should support the involvement of local stakeholders in the preparation of plans
• Should consider whether GP Consortia and local authority commissioning strategies have proper regard to the Health and Wellbeing Strategy.
• NHS Commissioning Board (the new central board responsible for overseeing the NHS) would attend when required for local commissioning issues
• Scrutiny would remain separate but enhanced (Current scrutiny powers enable local authorities to request NHS bodies to attend before them to answer questions and to provide information. Powers in future would be extended to enable scrutiny of any provider of any NHS-funded service, and any NHS commissioner including private sector providers and local public health services).
Membership
• The Board would be an upper tier responsibility but districts involvement encouraged
• Duty to participate placed upon GP Consortia
• Could be joint across local authority boundaries
• Core membership must include a locally elected Councillor, Healthwatch and Directors of Adult Social Services, Children’s Services and Public Health
• Flexibility around who other members could be; for example voluntary sector, clinicians and providers
2. What is already in place in Oxfordshire
Oxfordshire
• Long established history of joint working between local government and health including pooled budgets
• Well regarded JSNA
• Evidenced based Community strategy, strong partnership arrangements
• Highly effective DPH acting as a bridge between NHS and other partners
• The existing Health & Wellbeing Board has been co-chaired between the County Council and the PCT from the beginning. There is an active Children’s Trust. Therefore a strong basis in experience on what is need for effective joint working
3. Emerging issues that have come out of discussion with other areas
Key messages from the Early Implementers Group
Key points from early work of the Early Implementers Group are:
• Local arrangements must be strong to drive engagement across areas and up the decision making chain
• Need to recognise different perspectives & develop shared agendas
• The importance of engaging with emerging GP consortia is well understood – but this is matched by uncertainty over how to achieve this locally and nationally
• JSNA should underpin the strategies: crucial for establishing the evidence base for defining outcomes and what works
• The Board is for the whole population - children and families part of it too
• Need to break out of the traditional pathways thinking
The detailed form of the new Board is still to be finalised and it will be the subject of consultation.
Members asked to be kept informed of further developments.