Health boards could be catalyst for integrated care says report

A new report from The King’s Fund, suggests that health and wellbeing boards could be the catalyst for delivering integrated care.

Health and wellbeing boards will bring together the NHS, public health and local authorities to co-ordinate health and other local services.

Based on interviews with 50 local authorities and detailed case studies in two areas, the report looks at the experience of the shadow boards so far, boards which had to be in place from the beginning of April.

The report identifies real optimism about the prospects for success, with almost all those surveyed expecting boards to deliver on their identified priorities and promote closer integration between the NHS and local authorities, a key aim.
The report found:

Strong senior level buy-in on a local level, with more than a third of shadow boards chaired by council leaders or deputy leaders and the majority chaired by the lead for health, adult social care or children’s services

Engagement in the work of shadow boards has been especially strong among public health and adult social care, with clinical commissioning groups (CCGs) less engaged but still closely involved

The involvement of providers has been low (less than a quarter of shadow boards include representatives of acute providers)

While nearly three-quarters of those surveyed think that boards will influence the work of CCGs, less than 1 in 5 think they will influence the NHS Commissioning Board.

Building on the work undertaken so far to ensure health and wellbeing boards deliver on their potential, the report recommends that:

Sufficient time and resources must be devoted to the boards to ensure they deliver strong, credible and shared leadership between local organisations

Responsibilities and roles of all new bodies in the new health system must be clearly defined to balance national and local priorities

A national framework for integrated care be developed to provide clearer joint accountabilities across health and social care, and to ensure joined-up care

To provide a catalyst for driving integrated care, local authorities must look afresh at local partnership arrangements and ensure that providers are involved in their work.

Richard Humphries, senior fellow at The King’s Fund and the report’s lead author, said: "This report is the first in-depth review of how shadow health and wellbeing boards are being set up in England. Despite the significant financial and logistical challenges they face, there is unprecedented support for closer relationships between the NHS and local authorities.

"This is reflected in the energetic and innovative ways in which the boards are being set up. This is a promising start, but it is important that the pace and enthusiasm is maintained."