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Cllr. Jonathan OwenDeputy LeaderEast Riding of Yorkshire Council

‘A Focus on Wellbeing?’

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East Riding of Yorkshire

In context

• One of largest Unitaries by area – almost 1000 sq.miles

• 22.7% of the population is aged over 65• Very low BME population• Highest inward migration over past 8 years

nationally• Above average net out migration of young adults• Low population density • Hidden deprivation• No large centre of population – 168 Town/Parish

Councils• Market town economy• Long coastal strip

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Health and Wellbeing Strategy

Relies on robust strategies for the wider determinants of health:

•Economic development strategy•Children’s plan•Crime and disorder plan•Transport plan •Housing strategy•Cultural strategy

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Our Vision for our Health & Well Being Strategy

Better care, more locally, within budget through transformation

Everyone has to do things differently

GPs

Patients

Hospitals

Residents

Health & Social Care

professionals

Councils

LSP

BUT

“Dr Smith—The Councillor will see you now.”

Councillor Surgery

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What have we done - Locally

• Formed relationships – CCG/LSP/Senior Officers

• RAG (resource allocation group)• Elected member involvement with CCG

locality leads• Shadow Health and Wellbeing board

established• Workshops – joint with health• Agreed joint ‘vision’ HWBB and CCG.• Agreed our priority areas• Use of LSP sub groups

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What have we done - Regionally

• Public Health Transition Group• Local government Y&H transition

group• Lead member for Health and

Wellbeing LGYH

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• Flexibility of Budgets• Voluntary Sector• Partnership working• Local Authority Corporate Identity

and Loyalty• Health and Wellbeing Strategies• Good Scrutiny• Focus on Wellbeing – crosses all

directorates

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Three key words

•LEAD•COLLABORATE•ENGAGE

David BehanDirector General Social Care, local Government & Care

Partnerships, Department of Health. Presentation Tuesday 24th. April

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John Wilderspin – National Director Health and Wellbeing Board Implementation

Leading Transformation; how do Health and Wellbeing Boards best add value?

National Networking Event 9th May 2012

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What am I going to cover?

• The value that Boards can add

• The jobs they are required to do

• Key relationships (including Healthwatch and NHSCB)

• Making a difference

• What’s on people’s minds

• Supporting development

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Health and Wellbeing Boards - The Vision

• Collective leadership leading to integrated services that better meet individual and community needs

• Connect NHS and local government activity, with all public sector spending to improve health and wellbeing of local communities

• Genuine practical collaboration between Councils, the NHS and communities, users and the public

• Greater democratic legitimacy and accountability to local people

• Potential to transform services and outcomes

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What is the “added value” that Boards can bring?

• Collective responsibility for shared leadership

• Executive decision makers;

• Engaging the public; but also other key stakeholders

• Aligning plans and resources

• Shared priorities and therefore shared outcomes

• Mutuality; holding each other to account to deliver improvements

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JSNA and joint health and wellbeing strategies; why are these the “core jobs” of Health and Wellbeing Boards?

HEALTH & WELLBEING BOARD

What does our population & place look like? – evidence and collective insight

What services do we need to commission (or de-commission), provide and shape, both

separately and jointly? –

So what are our priorities for collective action, and how will we achieve them

together? – JHWS

So what does that mean they need, now and in the future and what assets do we have? – a narrative on the

evidence – JSNA

EXPLICIT LINK

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Local and national Healthwatch

• Strengthening the voice of patients, users of services and the public and to help achieve this:

Local Healthwatch organisations to be the local consumer voice Healthwatch England will be a national independent consumer

champion

• Continuity of existing arrangements:

local authorities will have duty to deliver local Healthwatch It will continue to be for health and social care

• What will be different:

from influence to decision making with a seat on health and wellbeing board.

help individuals as well as understand and present community views Healthwatch England will be used nationally by Secretary of State,

Monitor, NHS Commissioning Board as well as CQC

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Health and wellbeing boards and the NHS Commissioning Board

• Key relationship of HWB is with local clinical commissioning groups

• But; they also need to work with the NHS Commissioning Board

– As commissioners of primary care and specialist services– As holders of the contract with clinical commissioning

groups (eg on authorisation and annual assessments)– With a national role to ensure the NHS delivers better

outcomes within available resources– With a shared interest in the Outcomes Frameworks

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How can Boards make a real and sustainable difference?

• A clear purpose and shared priorities– Improved Health and wellbeing outcomes

– High quality and well-integrated services

• Strong and effective relationships– “Norming, storming and forming”, leading to…..

– A genuinely shared leadership approach

• Managing the Board’s performance– Clear and agreed outcomes, linked to the Board’s purpose and priorities

– Self assessment (effectiveness of relationships as well as delivery of priorities)

• Effective governance; - Is not an end in itself; but it is necessary

- It is there to ensure the Board is effective, and to ensure they meet any statutory obligations

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What are Board members currently talking about? (Part 1)

Purpose

• How can we make a real difference to outcomes, not just services?

• Are HWBs mainly about commissioning? Or system leadership?

• How do we remain ambititious, and not retreat to the “lowest common denominator”?

• Relationships

• How to engage stakeholders, including providers, without making everyone a Board member?

• How will we build momentum as a Board, when we still have new members (e.g. Healthwatch) to incorporate?

• How do we learn to appreciate each others’ cultures and strengths, so we can forge a genuinely collective approach?

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What are Boards currently talking about? (Part 2)

• Good Governance• How do we use our formal roles (eg CCG authorisation, JSNA) to

develop productive long term relationships?• Maximising joined up working (eg Housing) in 2 tier local

authorities• What does a Board decide? What does it delegate? And what

does it keep a “weather eye” on/monitor?

• Accountability and ensuring we make a real difference

• Self assessment for development, as well as public accountability• Balancing short-term “wins” with real strategic change

• How do we genuinely involve the public in the debate about e.g. prioritisation, or re-shaping services to meet current day challenges?

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Implementation; supporting development of shared leadership at a local level

• All areas have shadow Boards already; how do we support them to be effective?

• Focus on purpose, leadership and behaviours

• Need for shared learning to accelerate local progress

• Learning through doing; a National Learning Network, bringing together all Boards to learn together how to make health and wellbeing boards a success

• Aligning with HealthWatch pathfinders, transition of public health, and support for clinical commissioning groups

• Multi “media”; eg themed learning sets, Community of Practice, national events

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Joining the HWB “Community of Practice”

The National Learning NetworkGet involved in the latest discussions, news and events and join the

National Learning Network for Health and Wellbeing Boards.

The network is open to leaders from local government, the NHS, public health and other partners.

The Community of Practice transferred to the The Knowledge Hub, follow this link to sign up:

http://knowledgehub.local.gov.uk

And follow us on Twitter at:

http://twitter.com/johnwilderspin

#HWBlearn