Itching to get on with real action

In his third blog, John Wilderspin, National Director for Health and Wellbeing Board Implementation, describes how new parts of the health and care system are preparing for shadow running from 1 April 2012.

We’ve reached an interesting stage in the development of health and wellbeing boards, which mirrors the strengthened relationship between local government and new systems in the NHS.

I was at an excellent development event for boards the other day, and someone described the current moment as like “coming to the end of the Phoney War”. In other words, people involved in the boards know they have to gear up for statutory form in April 2013, but it has always felt a long way off. All of a sudden, it feels very close and the implications and opportunities are becoming ever more real.

The boards will move into full shadow form from 1 April. Although many emerging boards have been meeting together for some months, this still marks a key transition point. Board members are also conscious that substantive tasks within their remit are coming up on the horizon.

Clincial commissioning group (CCG) authorisation is the nearest and most obvious; for the CCG members of boards this is currently all-consuming, but other partners around the board table are equally keen to ensure that process goes well. CCGs are a very visible element of the localism agenda which is clearly important for the CCGs and local government, but also for those who are currently starting to create local Healthwatch.

Gearing up for CCG authorisation doesn’t just mean that members of health and wellbeing boards will need to give a view on their CCG colleagues’ application, CCGs will need to show evidence of being actively engaged in partnership work such as the Joint Strategic Needs Assessment (JSNA). Their future commissioning plans will need to demonstrate a clear link back to the JSNA, and to emerging joint health and wellbeing strategies. That means boards need to be refreshing their JSNA now, and considering the focus and priorities of their future joint health and wellbeing strategy.

In parallel with CCG authorisation, local councils are gearing up to take responsibility for public health. Alongside the important tasks associated with public health transition, local councils and their NHS partners are thinking strategically about the opportunities to improve health outcomes, tackle health inequalities, and address the many issues that impact on people’s wellbeing.

In turn, this will influence the issues that health and wellbeing boards want to address collectively, leading to priorities which may not previously have featured so highly on the NHS agenda, or even the partnership agenda. An example of this is employment – particularly for young people. I see a lot of lateral thinking about how local partners can make a real difference on an issue which has a fundamental impact on health and wellbeing.

The other issue which boards are considering is the involvement of Healthwatch. My last blog described how boards want to hardwire public involvement in their work, but they face a logistical challenge because local Healthwatch will not be in place for some time to come.

So, at the same time as they are looking to build strong and productive relationships amongst board members, they have to ensure those relationships do not exclude key partners who may come later to the process, such as Healthwatch. It also affects how they agree the core purpose of the board; finalising joint priorities without the engagement of Healthwatch would clearly not be right. So, although boards are commendably itching to get on with the real action, they will need to think about what can rightly be done now, as opposed to what needs to wait for a few more months. I’m confident that boards will make good judgments on how to achieve the right balance.

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In Commissioning, Health and wellbeing boards, Healthwatch, John Wilderspin, Local government, Pathfinder Learning Network, Public health

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