Staffordshire health and wellbeing board

Opportunities, challenges and the way ahead

Matthew EllisCabinet Member – Adults & Wellbeing

(HWbB Chair)

Staffordshire partnerships – before HWB

• CONTEXT June 2009 – one council – restructure

• Integrated health and social care partnership trust

• Staffordshire sector committed in principle to integrated

commissioning and health and wellbeing

• Cabinet member for public health/community safety

• Joint DPH appointment – located in county council

• Joint health and wellbeing strategy

• Joint commissioning unit

• Strategic plan with health and wellbeing outcomes

Establishing the health and wellbeing board – the early days

• Commitment and interest from many partners in the HWB – But!

• Managing expectations of wider partners difficult – dealing with who isn’t on the board, rather than who is – distracting and time consuming – INWARD FOCUS

• Learning from past LAA partnerships – a need for more strategic, outcome focused partnership – not ‘usual suspects’

• Stakeholder events

• Engagement and relationships of clinical commissioning groups – county led on GP events – ‘understanding new partnerships, each other’s worlds, trust and new opportunities – limited knowledge of social care

Staffordshire health and wellbeing board membership

• 3 cabinet members: adults wellbeing (Chair), children, public

health and community safety

• 2 district councillors (rep. 8 districts and borough councils)

• Director of public health

• Director for people

• 5 clinical commissioning groups – GPs (not co-terminus)

• Chair LINk

• Chief Constable – community safety link to health and

wellbeing

• PCC – future

Where are we now? • HWB meeting monthly since October 2011• Focus on strategic leadership, common purpose, trust• Agreed HWB vision, purpose, principles and approach• Limited commitment to pooling and aligning resource where

sensible to do so – words easy! – achieving more difficult• Endorsed JSNA• Agreed early outcomes and priorities – alcohol, long-term conditions

(risk strategy), obesity, children and troubled families• Work on enhanced JSNA and Joint Health and Wellbeing Strategy• Working integrated Health and Social Care Community Partnership

Trust now making a practical difference• Developing options for integrated commissioning • Ambition to develop sector wide resource investment, repay,

reward formulaic approach – is it possible?

Strengths and opportunities

• 2 (out of 3) ‘Acutes’ dedicated workstreams

• New approach for integrated engagement of public and

patients across large geographical areas and services –

through ‘Engaging Communities Staffordshire’ (host

Healthwatch)

• Integrated Staffordshire public health team – across ‘people

and place’

• Commitment to integrated commissioning – specialist support

from The King’s Fund – working with the county and cogs on

options for integrated commissioning

Challenges

• Diversity and complexity of a two-tier county• Rural and urban, financially diverse population • Layers of complexity to partnership not found in unitary• 5 clinical commissioning groups• 8 districts (2 tier responsibilities / LEP / transport negotiations)• Many providers – how to meaningfully engage?• Power, influence, as is. Will the ‘centre’ genuinely liberate

and enable localism in the NHS? CSS?

Challenges cont…

• Trust, ceding power, politics/tough decisions/GPs prepared?• NHS long-term strategic infrastructure planning• Doing the right thing and managing unpopular messages with

the community – eg, the strategic shift to prevention and greater focus on community means fewer hospitals

• Early days – CCGs keen and willing – but all at very different levels of development

• Double funding change• Strategic provider engagement with HWB

Where are we going? The journey ahead?

• Relationships and partnership with developing CCGs remains key

• Reviewing commissioning plans

• Enhanced JSNA & JHWS

• Ongoing work with The King’s Fund, county council and

CCGs on integrated commissioning – options in October

• More investment in prevention

• Social media

• Public engagement