Collaboration between organisations is a fundamental principle of the health and social care reforms that will be operational from April 2013.
Yet to date there has been very little debate about how the two new key collaborative forums, Health and Wellbeing Boards (HWBs), and Academic Health Science Networks (AHSNs) will relate to each other, and importantly how they might support each other to deliver their agendas.
This may be because the two have grown out of different agendas (the Health and Social Care Act, 2012, for HWBs, and DH’s Innovation Health and Wealth, 2011, for AHSNs).
Whilst communication around HWBs has been extensive across the health and social care sector, there is relatively little knowledge of AHSNs in local authorities, despite the fact that it is envisaged that AHSNS will be a “collaboration between academia and the NHS working with industry, public health and social care partners on innovation”1.
AHSNs will be focused on driving collaboration regionally across health providers, to achieve the aim of improving “patient and population health outcomes by translating research into practice and developing and implementing integrated health care systems”2. Meanwhile HWBs were conceived initially as being a local collaboration of commissioners to lead on local health improvement and prevention activity in their area through integrated care.
However as HWBs have evolved there is an increasing number of providers involved, such as acute trusts, reflecting the King’s Fund’s early concern that delivering integrated care at the scale and pace demanded, requires the involvement of both commissioners and providers3.
Similarly, it is not clear that in order to be successful AHSNs, provider and commissioning plans need to be aligned.
The relationship between HWBs and AHSNs is likely to be complex, but there will be three key areas where the relationship will need to be particularly strong to ensure that the two entities help each other to achieve their individual agendas:
- Shared change of health and social care: Effective HWBs will be the engine to drive changes to the size, shape and nature of health and social care services across their local area to achieve service and financial sustainability.
AHSNs need to understand the individual HWB visions for changing the shape of health and social care services in their region.
They will need to help HWBs drive the delivery of the required transformation consistently across all health providers to meet these visions and improve patient outcomes as best as they can through the use of AHSN approved innovation and best practice. AHSNs will need to be flexible and recognise that plans across HWBs will vary, but the underlying principles of changing the shape of health and social care will be the same.
- Industry engagement: HWBs and AHSNs are both interested, locally for HWBs and regionally for AHSNs, in creating jobs to improve wealth and to improve people’s mental and physical health through work and the workplace.
Local authorities, linking through to HWBs, will be aiming to attract new companies locally and help existing local companies to succeed and grow. This will become even more important to local authorities with the business rates retention scheme from April 2013. AHSNs by having a regional presence and because of their promise to make working with the NHS easier, will be able to engage more effectively with sectors of industry including at an international level. This engagement should be particularly effective with companies involved in research and developing innovative products - including pharmaceuticals, medical technologies and devices.
The SME nature of many medical technologies and devices companies means the AHSNs have a particularly important role in helping SMEs overcome barriers to entry and delivery in health, and succeed where they should do. This is a major opportunity for HWBs and AHSNs to work together to achieve a common objective.
- Health improvement and public health: In a survey of more than half HWBs in November 20124, most had health improvement and/or public health, or some aspect of these, as their main priority.
One of the aims of the AHSNs is to improve patient outcomes as priorities, which they will do by providing health services that are of a more consistent standard across the region. In addition there are advantages to a regional drive on health improvement, such as getting consistent measures across the region for key health indicators e.g. obesity and physical activity. It may also be easier to engage with external partners at a regional level to help drive health improvement, and to deliver population level interventions. Both HWBs and AHSNs will need to engage closely with the regional offices of Public Health England in their plans.
Both HWBs and AHSNs will need to create an effective working environment for collaboration - creating ownership amongst all organisations involved whilst making delivery of transformation timely and appropriate. It will not be easy to achieve this but there will be lessons learnt that they can share around overcoming different languages and cultures. It is crucial that both types of collaboration do succeed and AHSNs and HWBs need to align their plans to make sure that this is the case.
Georgina Owen, Finnamore Ltd
- Guidance for Academic Health Science Networks, Department of Health, June 2012.
- Innovation Health and Wealth, Department of Health, December 2011.
- Health and Wellbeing Boards - System leaders or talking shops?, The Kings Fund, April 2012.
- Report of the national summit for health and wellbeing boards, National Learning Network for health and wellbeing boards, November 2012
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