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Health and wellbeing boards offer the opportunity to develop health services targeted to meet the specific needs of local populations, but their success will depend on the commitment of all parties to improving service provision. The real test of their success however, will be whether all parties are still able to work together when difficult decisions have to be made around service redesign. With limited powers, only those built on strong relationships are likely be a success
—Sharon Cannaby, head of health sector policy, ACCA

A new Smith Institute and ACCA report, Getting Started: prospects for health and well-being boards, suggests the new health and wellbeing boards (HWBs) could enable integrated care, provide a more democratic approach and help develop a shared plan for their local populations

Health and wellbeing boards have had widespread support even amidst the controversy of the Health & Social Care Act. The shadow boards, which become fully fledged in April 2013, will bring together GP commissioners, local councillors, adult social care, children’s services, public health, providers, patients and the broader public. This new report endorses the objectives of the HWBs, but warns that they will need to evolve quickly and seek to build broader based partnerships.

The report, which includes chapters from leading experts and practitioners involved in the new HWBs, finds that:

  • HWBs must build good relations with commissioners represented on the board. As they don’t have enforcement powers, the success of HWBs in influencing activity and spending will depend on the quality of these relationships. 
  • Worryingly HWBs don’t include the commissioners of primary care, dentistry and pharmacy – the NHS Commissioning Board – which should be bought into the fold. 
  • HWBs need to have providers round the table to ensure they are driving integration. Arguably they should include private and third sector providers of social care.
  • There is a fear that HWBs will contradict and challenge commissioning plans, especially when they attempt to reduce unsustainable demand. This is a particular challenge for local politicians if it means decommissioning and closing local services which are popular with the public.
  • There is a confidence that HWBs could help deliver greater integration of health and social care. If they work well they could also encourage joined up working with other services such as housing and education and minimise duplication of services. 
  • However, there are three separate funding streams - CCGs, local authorities and NHS Commissioning Board. Local authorities are in the middle of year-on-year cuts and, in effect, the NHS budget being reduced too with funding frozen and demand continuing to rise. In the past, introducing joint arrangements when budgets are being reduced leads to funds being used to plug gaps rather than to integrate services and invest in prevention. 
  • HWBs are a great opportunity to involve and listen to the concerns and priorities of the public and different users. However, HWBs need to be clear about how people can influence their work and give credible responses to what they hear. They also must publish aims and outcomes in forms easily understood by the general public. 
  • If they are to provide the leadership to drive integration (and engage meaningfully with the public) then sufficient resources will be required. 

Paul Hackett, director of the Smith Institute, said: 'Health and wellbeing boards could play a leading role in enabling integrated care. But, given the cost pressure on NHS and adult social care budgets these new partnerships are going to have to demonstrate fairly quickly that they can make a difference and improve outcomes for local people.'

Sharon Cannaby, head of health sector policy at ACCA, added: 'Health and wellbeing boards offer the opportunity to develop health services targeted to meet the specific needs of local populations, but their success will depend on the commitment of all parties to improving service provision. The real test of their success however, will be whether all parties are still able to work together when difficult decisions have to be made around service redesign. With limited powers, only those built on strong relationships are likely be a success.'

-ends-

For more information, please contact:

Alana Sinnen, ACCA Newsroom
+44 (0)20 7059 5759
+44 (0)7725 498654
alana.sinnen@accaglobal.com 

Paul Hunter, Smith Institute
+44 (0)7760 476997
paul.hunter@smith-institute.org.uk 

Notes to editors

  1. The report is published by the Smith Institute and supported by the ACCA (the Association of Chartered Certified Accountants). 
  2. Contributors to the publication include; Neil Churchill (Chief Executive of Asthma UK), Madeleine Knight (Policy Analyst at the British Medical Association), Richard Humphries (Senior Fellow at the King’s Fund), Claire Mundle (Policy Officer at the King’s Fund), Cllr David Rogers OBE (Chair of the Community Wellbeing Board at the Local Government Association), Dr Michael Dixon OBE (Chair of the NHS Alliance and Senior Member of the NHS Clinical Commissioning Coalition), Professor Chris Drinkwater CBE, FRCGP, MFPH (Hon) (President and Public Health Lead at the NHS Alliance), Pam Creaven (Director of Services at Age UK), Ruthe Isden (Public Services Programme Manager at Age UK), Barbara Herts (Consultant and Commissioning Programme Manager for Schools, Children and Families at Essex County Council), Debbie Jones ( Executive Director for Children’s and Young People’s Services at Lambeth Council and President of the Association of Directors of Children’s Services), Dr Yvonne Doyle (Director of Public Health for NHS South of England), Sir Stephen Bubb (Chief Executive of the Association of Chief Executives of Voluntary Organisations), Kathy Roberts (Chief Executive of the Mental Health Providers Forum, and Annie Whelan of the Mental Health Providers Forum), Tim Gilling (Executive Director of the Centre for Public Scrutiny), Sharon Cannaby (Head of Health Sector Policy at the Association of Chartered Certified Accountants), Derek Miller FCCA (Independent Consultant)
  3. The Smith Institute is a leading independent think tank which promotes progressive policies for a fairer society. It provides a high-level forum for new thinking and debate on public policy and politics.
  4. ACCA (the Association of Chartered Certified Accountants) is the global body for professional accountants. We aim to offer business-relevant, first-choice qualifications to people of application, ability and ambition around the world who seek a rewarding career in accountancy, finance and management.

    Founded in 1904, ACCA has consistently held unique core values: opportunity, diversity, innovation, integrity and accountability. We believe that accountants bring value to economies in all stages of development. We aim to develop capacity in the profession and encourage the adoption of consistent global standards. Our values are aligned to the needs of employers in all sectors and we ensure that, through our qualifications, we prepare accountants for business. We work to open up the profession to people of all backgrounds and remove artificial barriers to entry, ensuring that our qualifications and their delivery meet the diverse needs of trainee professionals and their employers.

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