Health and wellbeing board

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Health and wellbeing boards are statutory bodies introduced in England under the Health and Social Care Act 2012, whose role is to promote integrated working among local providers of healthcare and social care.

Contents

Establishment

The 2012 Act required each upper-tier local authority in England to form a health and wellbeing board as a committee of that authority; more than 130 "shadow" boards were created before April 2013, [1] when they all became fully operational. [2]

Duties

The aim of the boards is to improve integration between practitioners in local health care, social care, public health and related public services so that patients and other service-users experience more "joined up" care, particularly in transitions between health care and social care. The boards are also responsible for leading locally on reducing health inequalities.

Joint strategic needs assessment

Each board produces a joint strategic needs assessment (JSNA) for its local authority area, replacing the JSNA formerly prepared by local authorities and primary care trusts (PCTs), under Section 116 of the Local Government and Public Involvement in Health Act (2007). [3] A JSNA provides local policy-makers and commissioners with a profile of the health and wellbeing needs of the local population. The aim of the JSNA is to improve commissioning and reduce health inequalities by identifying current and future health trends within a local population. It is expected that the JSNA should be based on analysis of:

Department of Health guidance recommends that JSNAs are refreshed every three years. [3]

Joint health and wellbeing strategy

The boards are also responsible for producing a joint health and wellbeing strategy. The first of these were published by the "shadow" boards at the end of 2012. Priority areas identified from JSNAs are key for the development of joint strategies, which in turn feed into commissioning plans. [5] The boards also look at which areas may need deprioritising and decommissioning. [6] The strategic direction of implementation and service delivery for health and wellbeing boards is outlined in the joint strategy documents.

Involvement in commissioning

Health and wellbeing boards have no statutory obligation to become directly involved in the commissioning process, but they do have powers to influence commissioning decisions made by clinical commissioning groups (CCGs). However, CCGs and local authorities may delegate commissioning powers to health and wellbeing boards so that they can lead on joint commissioning. [7] JSNAs and joint health and wellbeing strategies, produced by the boards, are key tools that CCGs use in deciding what public health services need to be purchased. In this sense the boards have a role in shaping the local public health landscape, and helping CCGs to commission services in an effective and targeted manner.

An early survey of 50 local authorities found that the majority of the respondents thought that joint health and wellbeing strategies would be influential in relation to the decisions of CCGs. [8]

There is also a statutory requirement that CCGs consult health and wellbeing boards throughout the commissioning process in order to align with the local joint health and wellbeing strategy. [7] The boards can also report any concerns regarding commissioning decisions to the national body responsible for the governance of CCGs, the NHS Commissioning Board.

Structure and composition

Structure of the health and social care system

Structure of the NHS England from April 2013 NHS structure from April 2013.jpg
Structure of the NHS England from April 2013

From April 2013 the changes enacted by the Health and Social Care Act 2012 saw the creation of new local and national bodies within the system, such as health and wellbeing boards, clinical commissioning groups and the NHS Commissioning Board. Within the local health and social care system, health and wellbeing boards sit below local authorities and clinical commissioning groups. However, the boards sit above local Healthwatch groups and health and social care providers.

Structure of the boards

Health and wellbeing boards sit within unitary and top-tier local authorities as committees of those authorities. Although they hold responsibility for public health at the local level, the administration and governance of the boards is not part of the NHS.

Composition of the boards

There is a minimum membership required for a health and wellbeing board, as follows:

Beyond this minimum membership other interested local stakeholders may also be invited to hold membership of a health and wellbeing board. These may include representatives of third-sector or voluntary organisations, other public services, or the NHS.

Future possibilities

The boards could be put in charge of commissioning combined health and social care services if they beefed up their contingent of clinicians according to Kate Barker, who chaired the King’s Fund commission on the future of health and social care. [11] Andy Burnham suggested that the boards could be in charge of the process of integration of health and social care which he wants to see. [12] Clinical commissioning group leaders were not enthusiastic about Labour suggestions of making health and wellbeing boards “system leaders” for services for people with multiple long term conditions, disability or frailty. [13]

In March 2015 London Councils called for Health and wellbeing boards to be handed responsibility for managing pressures in the health and social care system next winter. [14]

See also

Related Research Articles

<span class="mw-page-title-main">Health and Social Care Act 2012</span> United Kingdom legislation

The Health and Social Care Act 2012 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date. It removed responsibility for the health of citizens from the Secretary of State for Health, which the post had carried since the inception of the NHS in 1948. It abolished primary care trusts (PCTs) and strategic health authorities (SHAs) and transferred between £60 billion and £80 billion of "commissioning", or healthcare funds, from the abolished PCTs to several hundred clinical commissioning groups, partly run by the general practitioners (GPs) in England. A new executive agency of the Department of Health, Public Health England, was established under the act on 1 April 2013.

<span class="mw-page-title-main">Clinical commissioning group</span>

Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022 they were abolished and replaced by Integrated care systems as a result of the Health and Care Act 2022.

<span class="mw-page-title-main">NHS England</span> Oversight body for the National Health Service in England

NHS England, officially the NHS Commissioning Board, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the National Health Service in England as set out in the Health and Social Care Act 2012. It directly commissions NHS general practitioners, dentists, optometrists and some specialist services. The Secretary of State publishes annually a document known as the NHS mandate which specifies the objectives which the Board should seek to achieve. National Health Service Regulations are published each year to give legal force to the mandate.

Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.

Healthcare in Dorset was primarily the responsibility of Dorset Clinical Commissioning Group until July 2022. Dorset County Council is leading in the development of an electronic health record, to be called the Dorset Care Record, provided by Orion Health. It is intended to enable all health and social care providers to share records.

Healthcare in Devon was the responsibility of two clinical commissioning groups until July 2022, one covering Northern, Eastern and Western Devon, and one covering South Devon and Torbay. It was announced in November 2018 that the two were to merge.

Healthcare in Worcestershire was the responsibility of three Clinical Commissioning Groups until July 2022, covering, respectively Redditch and Bromsgrove, Wyre Forest and South Worcestershire.

<span class="mw-page-title-main">Healthcare in Kent</span>

Healthcare in Kent has, from 1 July 2022, been mainly the responsibility of the Kent & Medway Integrated Care Board. Certain specialised services are directly commissioned by NHS England, coordinated through the South East integrated regional team. Some NHS England structures are aligned on a Kent and Medway basis, others on a South East basis and there is liaison with London to provide many tertiary healthcare services.

Healthcare in Bedfordshire is the responsibility of Bedfordshire and Luton Integrated Care Systems.

Healthcare in Somerset, England was the responsibility of three clinical commissioning groups (CCGs) until July 2022. These covered the ceremonial county of Somerset, which comprises the areas governed by Somerset County Council and the unitary authorities of North Somerset and Bath and North East Somerset.

Healthcare in Sussex was the responsibility of seven Clinical Commissioning Groups covering: Brighton and Hove; Coastal West Sussex; Horsham and Mid Sussex; Crawley; Eastbourne Hailsham and Seaford; Hastings and Rother; High Weald; and Lewes-Havens from 2013 to 2020. From April 2020 they were merged into three covering East Sussex, West Sussex, and Brighton and Hove.

Healthcare in Staffordshire was the responsibility of six clinical commissioning groups until July 2022, covering Stafford & Surrounds, North Staffordshire, South East Staffordshire and Seisdon Peninsula, East Staffordshire, Cannock Chase, and Stoke-on-Trent.

Healthcare in Cornwall, United Kingdom, was, until July 2022, the responsibility of Kernow clinical commissioning group, a National Health Service (NHS) organisation set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in England. As far as the NHS is concerned, Cornwall includes the Isles of Scilly.

The "Greater Manchester Model" of NHS health care was a system uniquely devolved within England, by way of close integration with the Greater Manchester Combined Authority and local authorities, led by the Mayor of Greater Manchester. In July 2022 the Greater Manchester integrated care system took over responsibility for health and social care in the conurbation. The financial plan for 2022-23 had an initial shortage of £187 million.

Healthcare in Essex is now the responsibility of six clinical commissioning groups: Basildon and Brentwood, Mid Essex, North East Essex, Southend, Thurrock and West Essex.

Healthcare in Northumberland was the responsibility of the Northumberland, Newcastle Gateshead, and North Tyneside clinical commissioning groups from 2013 to 2022 before being replaced by integrated care systems.

Healthcare in Leicestershire was the responsibility of three clinical commissioning groups covering West Leicestershire, Leicester City and East Leicestershire and Rutland until July 2022. As far as the NHS is concerned Rutland is generally treated as part of Leicestershire.

Healthcare in Northamptonshire was the responsibility of Northamptonshire Clinical Commissioning Group until July 2022, with some involvement of Cambridgeshire and Peterborough CCG.

Healthcare in Norfolk was the responsibility of five clinical commissioning groups: Great Yarmouth and Waveney CCG, Norwich CCG, North Norfolk CCG, West Norfolk CCG and South Norfolk CCG, they merged in April 2020 becoming the Norfolk and Waveney CCG until they were replaced by an integrated care system in July 2022. Social Care is the responsibility of Norfolk County Council.

United Kingdom health law concerns the laws in the United Kingdom concerning health care and medicine, primarily administered through the National Health Service.

References

  1. ↑ "Health and Wellbeing Board directory map". The King's Fund.
  2. 1 2 "A short guide to health and wellbeing boards". Department of Health.
  3. 1 2 "Guidance on joint strategic needs assessment" (PDF). Department of Health.
  4. ↑ "The joint strategic needs assessment: a vital tool to guide commissioning" (PDF). NHS Confederation. Archived from the original (PDF) on 13 August 2011.
  5. ↑ "Joint strategic needs assessment and joint health and wellbeing strategies explained: commissioning for populations" (PDF). Department of Health.
  6. ↑ Kuznetsova, Daria. "Healthy places: councils leading on public health" (PDF). New Local Government Network.
  7. 1 2 "Health and wellbeing boards: GPC guidance" (PDF). British Medical Association.[ permanent dead link ]
  8. ↑ Humphries, Richard (12 April 2012). "Health and wellbeing boards: system leaders or talking shops?". The King's Fund.
  9. ↑ "Overview of health and care structures - The Health and Social Care Bill" (PDF). Department of Health.
  10. ↑ "Health and Social Care Act 2012".
  11. ↑ "Beefed up HWBs 'could commission health and social care'". Health Service Journal. 4 September 2014. Retrieved 29 September 2014.
  12. ↑ "Burnham: I will 'not mandate' structural change". Local Government Chronicle. 26 September 2014. Retrieved 29 September 2014.
  13. ↑ "CCGs oppose bigger health role for councils". Local Government Chronicle. 5 September 2014. Retrieved 29 September 2014.
  14. ↑ "Call to boost local government role in managing NHS winter pressures". Local Government Chronicle. 6 March 2015. Retrieved 10 March 2015.
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