LEICESTERSHIRE’S SHADOW
HEALTH AND WELLBEING
BOARD: OUR JOURNEY AND
PROGRESS TO DATE
January 2013
Cheryl Davenport
Programme Director
Purpose of the
Health and Wellbeing Board
Primary purpose is to:• Promote integration and partnership working between
the NHS, Social Care, Public Health and other local
services; and
• Improve local democratic accountability.
Leicestershire’s Starting Point
• Track record as high performing council
• Members welcomed a greater role for the council in
Health and Wellbeing
• Chair:
– background in the health sector
– a strong personal commitment to improving outcomes
in partnership
• Joint Director of Public Health already in place and
reporting directly to LA Chief Executive
Laying the foundations (1)
• Joint Change Programme Board in place, steering
transition between NHS and LA
• Co-location of public health from January 2011
• Programme director focusing on H&WB Board
development from November 2010
• Early engagement between council and CCGs
Laying the foundations (2)
• Stakeholder mapping, stakeholder engagement plan,
development of core stakeholder and media product
• Early decisions on TOR and membership
• Agreement to “commissioner Board”, with clear sub
structures for wider engagement
• Engagement event held to shape substructures
How built early relationships
at system level
• Our early development sessions focused on:
• Building relationships and trust, understanding roles and
expertise, bios
– Sharing perspectives on what the “end state” will look
like post 2013, different expectations and risks
– Articulating what we wanted the H&WB Board to
achieve and what we wanted it to avoid
– How to add public value
System Level Themes
4 key themes emerged as the focus for our system level
work:
• Improving health outcomes
• Improving service integration
• Improving efficiency and balancing the economy
• Organisational transition
• The Shadow Board developed 8 strategic priorities under
themes 1-3, based on existing JSNA evidence and strategic
priorities of partners
• Organisational Transition - remit of our Joint Change
Programme Board.
Our Initial Strategic Priorities: 2011
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Increasing life expectancy and reducing inequalities
Reducing the prevalence of smoking
Reducing the harm caused by alcohol and drugs
Reducing the prevalence of obesity and physical
inactivity
Our Initial Strategic Priorities: 2011
5. Improving the care of older people with complex needs
and enabling more older people to live independently
6. Improving the care of adults and children with complex
needs and their carers, including those with:
– Mental health needs
– Complex disability needs
7. Shifting investment to prevention and early intervention
8. Making urgent care systems for adults and children
work
Shadow H&WB Board Members (1)
• Cabinet Lead Members for:
– Health (Chair)
– Adults and Communities
– Children and Young People
• 2 representatives of each of the Clinical Commissioning
Groups (GP Consortia) within the local authority area
• Directors of:
– Public Health
– Adults and Communities
– Children and Young People
Shadow H&WB Board Members (2)
• 2 LINk representatives (Local HealthWatch, when
established)
• The Chief Executive of the PCT Cluster (NHS
Commissioning Board, when established)
• 2 District Council representatives
• 1 Police representative
Relationship Building with CCGs (1)
February 2011:
• Introductory meetings for the LMC, CCGs, the Council
March – May 2011:
• GP clinical leaders, operating managers and their wider
teams join transitional work and governance
arrangements at an early stage e.g.
– H&WB Board implementation
– Development of joint commissioning
– Local Health Watch pathfinder
Relationship Building with CCGs (2)
June/July 2011:
Development sessions for CCG leaders on:
• The role of local government
• Working with members
• The council’s 2011/12 business plan
• Safeguarding
• Joint Commissioning priorities– e.g. Dementia
Key to success in building relationships
between board members
• Early informal opportunities for board members to build
trust individually with the Chair and each other
• Strong foundation of respect and understanding of each
other’s expertise and perspectives from participating in
development sessions.
Relationship building with Districts
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District councillors on H& WB Board
Elected member H&WB champions in each district
Regular meetings between DPH and district council CEs
Regular meetings with district councillor health
champions
• Co-location of PH staff in district council offices.
Relationship building with others
• Quarterly meetings: Chair of the H&WB Board with
Chair and CE of main local NHS providers.
• Introductory meetings with the council for LDC, LOC,
LPC focused on:
– How oral health needs, eye health needs, and the
pharmaceutical needs assessment can be better
integrated with the JSNA
– How the H&WB Board can access the advice and
expertise of other primary care professionals
• Connections with Voluntary Action Leicestershire
What the Shadow Board
achieved in 2011
• Development session in April 2011
– introducing the Board, relationship building, shaping
our vision
• Stakeholder engagement event in May 2011
• Board Meetings held in public in April, June, September,
December
• Initial strategic priorities agreed in June 2011
• Substructure finalised in September 2011
• Stakeholder bulletin and website in place
• Development session December 2011
– to align commissioning intentions for 2012/13
Some of the other issues
we addressed in 2011
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Membership and balance of the Board
Agenda and workplan via an executive steering group
Adding value, not duplicating
Identifying early wins and longer range work
Improving our stakeholder engagement plan
Respecting differences in organisational requirements,
language, styles
• Understanding Board members come from different
perspectives and experiences: ensuring board
materials/business is accessible to all
• Clarity on relationships with other groups/boards
• Developing our substructure
Our Early Wins
• Sports and physical activity commissioning
• £1m disabled facilities grant
• Joint plan for social care allocations (reablement,
dementia etc.)
• Multiagency dementia strategy (across 3 CCGs and 3
LAs)
• High profile locally, regionally and nationally of our
successful approach to NHS/LA transition in
Leicestershire, including the leading edge work of the
Shadow H&WB Board
Our Progress in 2012 (1)
In 2012 the Board met in public in March, May, October and
December
The Board held development sessions on the following
subjects:
– February: Frail Older People Strategy and Emerging
Vision for Health and Social Care in Leicester,
Leicestershire and Rutland;
– April: Joint Strategic Needs Assessment;
– August: Priorities for the Health and Wellbeing Strategy
– November: Commissioning Intentions for 2013/14
Our Progress in 2012 (2)
• The Board now has a fully operational sub structure
with supporting Boards leading work on:
– Integrated Commissioning
– Staying Healthy
– Substance Misuse
– Health Protection
• The Board also has a well-established steering group
which sets the forward workplan and agenda for the
Board, and supports all the preparatory work, including
the development sessions.
• The Board also has a well-established group which led
the work to refresh the Joint Strategic Needs
Assessment
Our Progress in 2012 (3)
• The main focus of the work of the Board in 2012 has
been to:
– Refresh and publish the Joint Strategic Needs
Assessment (JSNA) for Leicestershire and engage
with a wide range of stakeholders in this process.
– Identify and agree local priorities from this
assessment
– Develop and publish our first Health and Wellbeing
Strategy and engage with a wide range of partners in
this process
– Oversee the delivery of workplans from the
substructure groups
– Prepare for statutory status of the Board with effect
from April 2013.
Our Progress in 2012 (4)
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The Health and Wellbeing Board has also covered a number of other
important topics this year, for example:
– Local CCG commissioning strategies and authorisation
– The vision for local Healthwatch
– Local emergency planning arrangements
– The implications of the Adult Social Care White Paper
– Cancer mortality rates in Leicestershire
– The Annual Report of the Director of Public Health, which focused on
older people
– Future Special Educational Needs provision for Children
– The Better Care Together programme - planned changes in
healthcare services across the sub-region
– The introduction of the NHS 111 telephone number (a national
development)
Key features of our Joint Health and
Wellbeing Strategy (1)
• Based on the evidence and analysis of the JSNA
refresh , our Joint Health and Wellbeing Strategy
comprises three main components:
– A set of commissioning principles which will underpin
the commissioning decisions of the Health and
Wellbeing Board
– Setting out the priorities for health and wellbeing in
Leicestershire
– Setting out cross cutting themes that will involve
close joint work with other boards and other
stakeholders
Key features of our Joint Health and
Wellbeing Strategy (2)
The core of the strategy is to focus our collective efforts
on improving outcomes related to these 4 priorities:
•Getting it right from childhood;
•Managing the shift to early intervention and prevention;
•Supporting the ageing population; and
•Improving mental health and wellbeing
The cross-cutting theme within the Strategy is:
•Tackling the wider determinants of health by influencing
other boards
Finalising the Strategy
• Consultation on the strategy ended on 6 December 2012
• The Shadow Health and Wellbeing Board received a
report on the outcome of the consultation and final
version of the Strategy at their meeting on 14 December
2012.
• The Strategy was approved by the County Council’s
Cabinet on 18 December 2012
Preparation for Statutory Status (1)
• The Department of Health has held a consultation on the
regulations for Health and Wellbeing Boards
• Publication of the regulations is expected on 7 January 2013
• The regulations are expected to cover a range of matters
such as:
o Voting,
o Delegation of duties including through subcommittees,
o Codes of Conduct,
o Declarations of Interest,
o Clarification about the general provisions related to s.102
committees in Local Authorities and how these will apply
to Health and Wellbeing Boards
Preparation for Statutory Status (2)
In Leicestershire the following preparations are
proposed:•The Shadow Health and Wellbeing Board will hold a
development session to consider the local application of
the regulations;
•the Health and Wellbeing Board Steering Group and the
County Council’s Democratic Services Officers will make
the necessary preparations; and
•A formal paper setting out the implications and actions
locally will come to the next Health and Wellbeing Board
meeting (21 March, 2013).
Taking it to the next level….
• H&WB Board leadership to integrated commissioning
and staying healthy priorities
• CCGs influencing wider determinants e.g. affordable
housing plans with district councils
• H&WB Board system leadership for service
reconfiguration
• More systematic approach to community engagement
• Improved outcomes
• Greater investment in prevention through integrated
commissioning and system change
For further information about the
Shadow Health and Wellbeing Board:
www.leics.gov.uk/healthwellbeingboard.htm
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Terms of Reference
Presentations
Stakeholder Briefings
Frequently Asked Questions
Press releases
Meeting dates, agenda, papers
Useful links to other NHS transition information
To receive our Stakeholder Bulletin or for further information
Contact: Rosemary Palmer, Senior Committee Officer
[email protected]
0116 305 6098
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January 2013 - Leicestershire County Council