Tuesday, 15 January 2013

How health and wellbeing boards will work

How health and wellbeing boards will work: As the healthcare sector gears up for April, the national director of health and wellbeing board implementation explains how he envisages the boards working.

Amid the noise and debate surrounding the implementation of the Health and Social Care Act, one of its key elements, the creation of health and wellbeing boards was the subject of almost universal political support and (presumably because of this agreement) went almost unreported in the media.
Perhaps because of their low media profile, there remains a low level of public awareness and some uncertainty across the health and care sector about what health and wellbeing boards are, and what they might achieve.
On the ground, local government and health leaders are enthusiastic about the proposals and have formed more than 150 "shadow" boards which are gearing up for statutory running from April 2013.
When I visited shadow boards around the country, I saw much more than perfunctory willingness, but a sense of excitement that there is a real chance to get things right.
Each board has a core membership which includes at least one:
• Elected member of the local council
• The council's director of adult services
• Director of children's services
• Director of public health
• Member of the local Healthwatch, who will represent the voice of patients and the local community
• Representative of each clinical commissioning group in the local area
Each board is free to expand their membership to include a wide range of perspectives and expertise, such as representatives from the charity or voluntary sectors.
Their core role is to set a joint health and wellbeing strategy (JHWS) for each upper tier council area (for example county and city councils and London boroughs).
Drawing from the widest evidence base as well as the insights of the board members, the board is also jointly responsible for producing a comprehensive "picture of place", the joint strategic needs assessments (JSNAs) on which to base the joint strategy.
They are looking to engage the widest possible set of partners, such as police, housing, education and transport as well as service providers and the voluntary sector.
JSNAs will highlight the health and wellbeing needs of particular groups and communities (eg, older people with dementia, or young people with a disability) and also the assets that exist within communities such as local voluntary organisations, facilities, buildings or open spaces.
JSNAs and JHWSs will also drive the commissioning plans of the respective members of the board and beyond.
This reflects the original intention for boards to take on much more than a strategic planning role, important though that is.
Over the last 18 months, it has become clear to shadow boards that the real value they will add is not just as a place where priorities are debated but as the "system leaders" in the new health, care and local government environment.
Having such key players around the table means that boards are uniquely placed to spot gaps and drive forward improvements in health, care and prevention that are tailored to the needs of the local population and are integrated across organisational boundaries.
Health and wellbeing boards will need to develop their aims and ambitions with their community and partners, and enable local people to hold them to account. Board members will need to develop strong relationships which enable them to constructively challenge each other and do things differently.
They will have to develop a sense of collaboration which allows them to make the best use of their collective resources in a time of austerity, as well as make decisions which may sometimes be hard for their respective organisations, but right for the people that they serve.
I'm confident that the new boards will step up to these challenges and will succeed to a level that partnership working hasn't necessarily delivered in the past.
You can find out more about health and wellbeing boards as they move towards their formal establishment in April 2013 online here, and follow the conversation on Twitter using #HWBlearn.
John Wilderspin is former national director of health and wellbeing board implementation at the Department of Health. Guardian Professional.

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