Reforms to the health and social care system in the Health and Social Care Act have placed an emphasis on integrated care. The establishment of statutory health and wellbeing boards is intended to encourage local authorities to adopt a strategic approach to integrated health and local government services.
This King’s Fund report summarises a survey of 50 local authority areas. The survey attempted to discover how they (and their health partners) are implementing the new boards and delivering integrated care in England. It includes case studies based on the experience of two early implementers (Lambeth and Surrey), exploring new arrangements, the size, composition and ways of working emerging in shadow boards. Four main objectives of boards are:
- Delivery of locally identified priorities.
- Closer integration.
- Pooled budgets.
- Improved planning of care pathways.
Boards, it seems, are more likely to succeed via influence and relationship-building, rather than through formal managerial control or accountabilities; health and wellbeing boards have no powers to sign off the commissioning plans of clinical commissioning groups. Some concerns remain over budget constraints; whether national policies might override local priorities; and how far boards might influence the NHS Commissioning Board.
Humphries, R. Galea, A. [and] Sonola, L. [et al] (2012). Health and wellbeing boards: system leaders or talking shops? London: King’s Fund, April 2012.