North East Leading Improvement for Health and Wellbeing Programme Masterclass 19 April 2012

1. North East Leading Improvement for Health and Wellbeing Programme Masterclass 19 April 2012 Ginny Edwards, Head of Learning Network for health and wellbeing boards, Department of Health

2. What am I going to cover? • The role of health and wellbeing boards (HWBs) and their place within the Health and Social Care Bill • How will HWBs make a real difference in improving care services, and improving health and wellbeing outcomes? • Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWS) • The role of Healthwatch • Public Health transition

3. Health and wellbeing boards The Health and Social Care Bill: • Sets up health and wellbeing boards (HWBs) as council Committees • Establishes a core membership, with flexibility to expand locally • Mutual obligation on councils and NHS commissioners to undertake Joint Strategic Needs Assessment (JSNA) and joint health and wellbeing strategies • Sets expectation of alignment of health, social care, public health (and other) commissioning plans • Promotes joint commissioning and integrated provision • Sets a duty for HWBs to involve users and the public in JSNA and JHWS • Gives HWBs a role in annual assessment of clinical commissioning groups (also a non-statutory role in their initial authorisation)

4. Vision for health and wellbeing boards • To provide collective leadership to improve health and wellbeing across the local authority area, enable shared decision-making and ownership of decisions in an open and transparent way • To achieve democratic legitimacy and accountability, and empower local people to take part in decision-making • To address health inequalities by ensuring quality, consistency and comprehensive health and local government services are commissioned and delivered in the area • To identify key priorities for health and local government commissioning and develop clear plans for how commissioners can make best use of their combined resources to improve local health and wellbeing outcomes in the short, medium and long-term

5. Director of Public Health Councillors Local Healthwatch Director of children’s services CCGs Health and wellbeing board members & partners Director of adult social services Local people GPs Cabinet members AHPs Wider determinants of health –eg. directors of housing Practice Managers Health and wellbeing board members & partners Practice nurses Public health professions FT Governors LiNKs Social care professionals Patients PPGs PALs Local care providers Voluntary/ Community sector Social care professionals Local care providers

6. Transition and implementation; key timings • By April 2012; • Health and wellbeing boards established to operate in “shadow” form • July 2012; • Clinical commissioning groups preparing for authorisation - emerging JSNA and joint health and wellbeing strategies to underpin 2012/13 commissioning plans • October 2012 • HealthWatch England and Local HealthWatch start date • Clinical commissioning groups prepare commissioning plans for first year of authorisation • April 2013 • Health and wellbeing boards in statutory form • PHE established, PH responsibility transferred to local government

7. CCGs Health Watch DASS+DCS DPH Members How do Health and wellbeing boards fit into the new “landscape”? Adult Social Care Services Healthcare Services HWB Healthwatch/ Public Engagement Children & Families Public Health Services

8. JSNA and joint health and wellbeing strategies; the vehicle for shared leadership What services do we need to commission (or de-commission), provide and shape, both separately and jointly? – So what are our priorities for collective action, and how will we achieve them together? – JHWS So what does that mean they need, now and in the future and what assets do we have? – a narrative on the evidence – JSNA What does our population & place look like? – evidence and collective insight HEALTH & WELLBEING BOARD

9. Local and national Healthwatch • Strengthening the voice of patients, users of services and the public • Local Healthwatch organisations to be the local consumer voices • Healthwatch England will be a national independent consumer champion • Continuity of existing arrangements • Local authorities will have duty to deliver local Healthwatch • It will cover health and social care for both adults and children • What will be different • From influence to decision making with a seat on the health and wellbeing board • Help individuals as well as understand and present community views • Healthwatch England will be used nationally by Secretary of State, Monitor, NHS Commissioning Board and CQC

10. Current hot topics CCG authorisation • How can process support CCG development and help develop strong relationships within the health and wellbeing board JSNA • Widening the scope of the JSNA to develop a ‘picture of place’ JHWS • Agreeing a first cut of the strategy by July 2012 Commissioning plans • Using the strategy to shape individual commissioning plans for 2013-14 Board membership • Agreeing who needs to be a member, and who needs to be fully engaged by members of the board Building shared leadership • Challenge of building shared leadership approach during the transition phase when some key players may not yet be in place

11. Local authorities’ role in Public Health • Public Health transition to local govt coincides with establishing HWBs • DPH is a core (and key) member of the Board • Improving public health is a clear priority - across national and local govt. • New opportunities to align public services to improve health and wellbeing • “Place shaping”; the impact on the causes of ill-health • Health inequalities-the Marmot Review and the focus on “life-course” • The local authority “core offer” on public health to the NHS

12. Collaboration for Health and Wellbeing Boards will have a role in improving health and care services; • a joint strategy to underpin commissioning of services, • ensuring alignment of service commissioning plans (health and social care, children and adults), • promoting integrated commissioning andprovision • integrated around individuals, (“personalisation”), groups of individuals with common needs, and individual communities, • enabling service change and reconfiguration where required, • engaging the public and listening to the public’s views

13. Boards working in partnership on the causes of ill-health • Promoting health and wellbeing (messaging, engagement and aligning multiple public services to a common goal) • Prevention and protection • Tackling the causes (including housing, employment, education) • The “life course” approach • Addressing health inequalities • Aligning the actions of local leaders

14. Health and wellbeing boards and wider partners • HWBs will want to establish effective partnerships with leaders across sectors to • understand and tackle the wider determinants of health, and • to bring together services around what individuals and families need • This could include working with Criminal Justice Services, Education, local VCS, local businesses, etc. • HWBs will need to collaborate with VCS locally to ensure views of communities are fed in, including less well heard groups • VCS also likely to be partners in delivering the joint health and wellbeing strategy

15. Health and wellbeing boards: approach to supporting transition to date • 140 early implementers • National Learning Network • National learning sets; on shared leadership, and key challenges (90 boards participating) • National events to share learning • Online Knowledge Hub (over 800 members) • LGA developing tailored support offer for local health and wellbeing boards • Aligned with local and regional work, support for CCGs, Healthwatch, Public Health

16. How can we learn together, the national contribution The Health and Wellbeing Board National Learning Network Learning community which includes: 11 Learning sets based around themes of common interest (95 HWB are members) Associates: all members of HWBs, experts, policy leads and key stakeholders An on-line “Knowledge Hub” to facilitate learning and sharing between network members and the learning community National events to stimulate new thinking and share learning Development support to individual HWBs (provided by the LGA) Leadership development programme for HWB members Aligning HWB development with other change programmes (Public Health transition, CCG development, establishing Local Healthwatch) 16 16

17. Learning set themes Improving services through more effective joint working - including a specific focus on Children & Young People Improving the health of the population Bringing collaborative leadership to major service reconfiguration Creating effective governance arrangements How do we “hard-wire” public engagement into the work of HWBs? “Raising the bar on Joint Strategic Needs Assessment and joint health and wellbeing strategies Making the best use of collective resources 17 17

18. Get sharing now Join the learning network’s Knowledge Hub at http://knoweldgehub.local.gov.uk Keep in touch by following us following us on twitter @johnwilderspin @ginnyedwards @janineatDH @AmyatDH and join the conversation at #hwblearn