Terms like ‘person-centred care’, ‘place-based health and wellbeing’ and ‘population management’ could be perceived as the latest fad, soon to pass. But they could also be an opportunity.
As a new non-executive director with a Nottinghamshire hospital trust, our proposed new vision includes a focus on ‘wellbeing’. The strategy includes community engagement, with the county council and district councils seen as playing a key role in shaping the new strategy.
It did not happen overnight, but is the latest in a strong sustainability and transformation partnership between local government and the NHS in Nottinghamshire. It is also seen as an example of the direction of travel that the NHS Long Term Plan aspires to.
Whilst we struggle with adequate social care funding, we are asking whether we can create the capacity to realise some of the resources that will be allocated to integration and prevention. We also wonder whether we can influence how this funding is allocated through the Local Government Association and the Society of Local Authority Chief Executives (Solace) so that it supports the changes needed in local government.
Without that, the vision for prevention or person-centred care cannot be truly realised. So how can we also influence the voice of our NHS partners at local and national levels to make more of the case for local government’s role and funding? One thing is certain: we need to build those relationships at all levels.
As a former chief executive at district council and a unitary council, and now an NHS non-executive director, I’ve seen many examples of the positive intent by NHS partners to build local relationships and understand place-based services.
At West Lindsey DC we contacted our clinical commissioning group and the hospital-based health partners to carve out a role for how we could work with GPs and address condition mismanagement. This would sit alongside the public health work in our sport development and community development services, and was followed by shared ambitions for community hubs that avoided the shuttering of a local hospital.
In my role at Solace as policy adviser on health and wellbeing, I hear similar positive stories. But I equally hear the frustration of how we both can talk different languages or the difficulty of not getting the same level of funding for social care.
I agree we must lobby hard for decisions on social care funding and make the case for how we have delivered outcomes with public health budgets. But partnerships are a long journey.
Over the last four years, the learning from STPs and other integrated care partnerships shows a lot of good practice between local government and health partners across the country. This learning has been reflected in the NHS Long Term Plan and our opportunity is to embrace the NHS partners who are keen to build relationships.
In Wokingham BC the chief executive of our CCG, hospital trust and community trust worked with the three local authority chief executives to understand how we could progress our vision. Our NHS colleagues realised that solutions were not as simple as combining three health and wellbeing boards, and they sought to better understand our democratic mandates.
This was possible due to the systems leadership and the mature relationships, developed through our better care programme and good work on improving delayed transfer of care targets.
Local government must positively build the relationships and be seen as a partner in helping deliver the Long Term Plan for our communities. Equally, where we build the constructive relationships our leadership can help health partners adapt to realise person-centred care and prevention.
We also need to move beyond fixing delayed transfer of care targets and be more than a reactive helper. The aim should to support sustainable change on the ground, including helping in the areas where the partnerships may be more challenged.
Manjeet Gill, associate for health and wellbeing, Local Government Association; and policy adviser on health and wellbeing, Society of Local Authority Chief Executives