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Boards must become vehicles of change

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Earlier this summer, the LGA published a development and self-assessment tool for shadow health and wellbeing boards (bit.ly/PPKBht). It may not have made it on to everybody’s holiday reading pile, but it is a key contribution to the development of the new boards.

When health and wellbeing boards were first proposed, they were warmly endorsed, but there were concerns they could become ‘talking shops’ rather than a real vehicle for change. Bringing together partners from different cultures, with different accountabilities and governance arrangements, is notoriously difficult.

Too often, decisions can be taken on the basis of the lowest common denominator simply to preserve the facade of partnership working. At worst, there is no give and take between partners to reach mutually acceptable agreements, and relationships break down. Delivering goals that are ambitious and genuinely shared is a tough process requiring sustained commitment from all the partners. 

The board self-assessment tool recognises that it takes time to develop that level of maturity. It helps board members assess where they are now, so they are clear about their development needs. It also enables them to define what they want to achieve, so they can measure their progress. This is vital if boards are going to make a real difference; agreeing a joint strategy is important, but boards will also want to ensure outcomes are actually being achieved. 

As well as checking their own progress, health and wellbeing boards will want to demonstrate credibility to local people. An important way in which they will be able to do this is via the proposed council health scrutiny arrangements that are now out for consultation (bit.ly/Q3Mmay). These reflect the changes brought about by the Health and Social Care Act, including the importance of effective partnerships between local government and the NHS.

Given the key role of health and wellbeing boards in the new health and care system, it seems likely that as part of the process of health scrutiny, councillors will look at the work of the boards, for example the joint strategic needs assessment. Combined with their own self-assessment, this will help boards to avoid being ‘talking shops’, and instead to deliver on their ambitions for the people they serve.

John Wilderspin, national director for health and wellbeing board implementation, Department of Health

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