The nine months since health and wellbeing boards became fully operational have been busy and challenging.
As the recent ‘rapid review’ of the pilot peer challenges and The King’s Fund’s report, Health and wellbeing boards: One year on, indicate - the transfer of public health has gone well, and the boards have made a strong start. There is evidence of good local leadership, collaboration between board members, and engagement with clinical commissioning groups.
The rapid review report, prepared independently by Shared Intelligence, is equally clear about the nature of the challenges facing boards. As the report title indicates, now is the time to change gear to meet the challenges and maintain positive momentum. The report recommends the boards focus on three key challenges:
- Prioritising work: focusing on a small number of key issues for the local area
- Driving change on the big and difficult issues
- Increasing the effectiveness of engagement with stakeholders, particularly those not directly represented on the board.
As we tackle the issues inherent in the integration of health and care, and the reconfiguration of health services, the ability to have difficult conversations within boards and beyond will define the likelihood of success. Funding and budgets is clearly one of those difficult issues which is, at least in part, being played out through the integration transformation fund (ITF).
A recent letter from LGA chief executive Carolyn Downs and NHS England national policy director Bill McCarthy highlights the opportunities the ITF presents to begin a wider discussion on pooled resources. The ITF will not solve the financial challenges, but it should be a useful catalyst for these difficult conversations. To make the most of the resources available we need a step change in our current arrangements to share information, staff, money and risk.
My six months in post have made it clear to me that boards are up for the challenge and ambitious for their local areas. The transformation and cultural change facing them takes time. We have laid solid foundations for this change but we need to provide boards with support, be more effective at sharing good practice, and help cut through the noise to focus on priorities.
Caroline Tapster, national director for health and wellbeing board integration, LGA