Engaging with the new Health Landscape The Women’s Health And Equality Consortium (WHEC)

1. Engaging with the new Health LandscapeThe Women’s Health And Equality Consortium (WHEC) November 2012

2. Background to WHEC • Strategic Partner to the Department of Health in 2008 • Partners: Platform 51, FORWARD, Imkaan, Maternity Action, Positively UK, Rape Crisis and Women’s Resource Centre • Network of women’s organisations across England

3. Women’s Health “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Women’s health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology … major barrier for women to the achievement of the highest attainable standard of health is inequality, both between men and women and among women in different geographical regions, social classes and indigenous and ethnic groups.” Source: Fourth World Conference on Women (Beijing, September, 1995)

4. Women’s Health and Inequality • Poverty – 22% of women are on persistently low incomes • Low pay- two thirds of those working in low paid jobs are women • Discrimination - 30,000 women lose their jobs every year because they are pregnant • Caring responsibilities – over 50% of women will have been carers before they are 60 and are more likely to experience poor health and long-term condition • Violence Against Women and Girls (VAWG) – over one in four women experience domestic violence and 6,500 girls are at risk of FGM every year • Anxiety and depression – recorded rates are twice as high for women and girls

5. A changing Health Landscape: The Themes of Change Quality, Innovation, Production, Prevention Public Health Clinician-led commissioning KEY THEMES Patient voice Integration Localism Choice & Competition

6. A changing Health Landscape: Overview of Structure

7. A changing Health Landscape: Overview of Structure

8. The New Health Structure: Engaging Decision Makers • Clinical Commissioning Groups (CCG) • NHS budget • Pathfinders up and running • PCTs active until April 2013 • Local Authorities • Ring-fenced Public Health budget • Responsible for setting up their health and wellbeing board • Directors of Public Health • Responsible for local populations health • Moving to local authorities from PCTs • Sit on health and wellbeing boards

9. The New Health Structure: Engaging Decision Makers • Health and wellbeing boards • Strategic vision for local populations’ health and wellbeing • Integrated across NHS, Public Health and Social Care • Responsible for Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies • Shadow boards up and running • Members include a representative from CCGs in area, Director of Adult services, Director of Children’s services, Director of Public Health, HealthWatch, local elected councillor, others the local authority thinks relevant

10. The New Health Structure: Accountability • Local HealthWatch • Local elected Councillor • Health and wellbeing boards to assess CCG plans • NHS Commissioning Board to hold CCGs to account on spending and outcomes • Outcomes Frameworks (NHS, Public Health, Social Care) • New duty on the Secretary of State on health inequalities • Community level (the public, local organisations –using the new Equality Delivery System)

11. Commissioning health and social care: The role of the VCS Intelligence and expertise Providers (delivering ‘health-related’ services) Advocacy The crucial role of the VCS in health and social care Holding organisations to account Commissioning support

12. Commissioning health and social care: The role of the VCS • The new approach • Competing under Any Qualified Provider (AQP) tender with a range of organisations • Demonstrate impact, value and cost-effectiveness • Evidence of need and service outcomes • Working in partnership across agencies • Achieving designated outcomes

13. A new System – final thoughts • Opportunities to engage although local implementation may vary • Health and wellbeing boards / JSNAs • Opening up market to new providers • New joined-up working • Local needs assessment and local organisations • Focus on public health (e.g. VAWG) • Challenges for VCS and women and girls • A changing environment is hard to engage with • ‘Localism’ and fragmentation • Competitive environment • Focus on outcomes can be hard to demonstrate / capacity • Focus on individual voice may result in exclusion • Uncertainty, fast change and loss of expertise and staff • Cuts at national and local level

14. Programme Timescales – Health and Wellbeing Boards and HealthWatch HWBs operate on shadow basis, produce JHWS and input to commissioning plans Preparation for Shadow running HWBs, begin to refresh JSNAs By April; HWBs fully operational in every upper-tier local authority HWB early implementers, HealthWatch pathfinders, emerging clinical commissioning groups, share learning to support implementation October; Start date for Local HealthWatch organisations and HealthWatch England

15. Contact WHEC • Website: www.whec.org.uk • Email: zoe.palmer@platform51.org • USEFUL LINKS The Health and Social Care Bill explained: http://www.dh.gov.uk/health/2012/02/bill-factsheets/ CCGs: http://healthandcare.dh.gov.uk/context/consortia/ http://healthandcare.dh.gov.uk/gp-consortia-map/ Local HealthWatch: http://healthandcare.dh.gov.uk/local-healthwatch-pathfinders-announced/

16. Useful links Public Health Briefings: http://healthandcare.dh.gov.uk/public-health-system/ Public Health Outcomes Framework: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132358 Draft JSNA guidance (open to views and consultation): http://www.dh.gov.uk/health/2012/07/consultation-jsna/ Developing the NHS Commissioning Board: http://www.commissioningboard.nhs.uk/ The NHS Constitution: http://www.dh.gov.uk/health/category/policy-areas/nhs/constitution/