Health and Wellbeing Boards: a digested read…

I keep being asked about Health and Wellbeing Boards, and what they are for exactly, so I’ve written a one-page Health and Wellbeing Board Briefing Paper summarising the basics.

Lots of people seem to think that Health and Wellbeing Boards are high-powered people (ok, that bit is about right…) sitting around a big bag of cash and pondering whether it should be spent on local charities, pot-holes or a nice yachting holiday. The reality is not quite as exciting, what with the bags of cash being somewhat depleted with the current economic situation etc etc…

Anyway, I thought this briefing paper might be useful for other people to hand out too, so here it is:

Health and Wellbeing Board Briefing Paper

Health and Wellbeing Board Briefing Paper

All about… Health and Wellbeing Boards

Health and Wellbeing Boards are a new idea, to bring together local commissioners to work together to jointly plan more efficient and effective services for local people.

Health and Wellbeing Boards bring together commissioners – who plan and buy local health, social care and children’s services – from the NHS, Public Health and Social Care, as well as local councillors and a patient representative (from LINk/Local Healthwatch).

What will Health & Wellbeing Boards do?

  • Challenges: The big pressures on public services include rising demand, rising health treatment costs – and the state of public finances.
  • Planning services: With increasing pressures on public finances, it will be the job of the board to work together to plan services that meet the needs of local people, while achieving best value for money.
  • Joint Strategic Needs Assessments: They will look at the evidence of what works best to help target plans and resources. They will be responsible for making sure that the local Joint Strategy Needs Assessment is written and that plans for services are based on this (the JSNA is a piece of research that every local authority has to undertake, which ‘tells the story’ of local people’s needs).
  • Joint Health & Wellbeing Strategy: They will be responsible for developing a local ‘Joint Health and Wellbeing Strategy’, based on their JSNA. The Board will need to make sure that local services are in line with this Strategy.
  • Look at the big picture: The Board will look at people’s health and social care needs together, as well as taking into account the bigger picture – things like transport, housing, jobs and leisure – so that services help people stay healthy and independent.

A bit of background:

  • The idea for Health and Wellbeing Boards came from the Health and Social Care Bill, which is currently going through parliament. The Bill is part of the Government’s plans to change health and social care services and the way they are commissioned.
  • Some of the Bill’s key plans include giving clinicians, such as GPs, responsibility for commissioning health services, and strengthening ‘local accountability’ – for which Health and Wellbeing Boards will have a crucial role and responsibility.
  • All local authorities will have ‘shadow’ Health & Wellbeing Boards up and running by April 2012 and permanent boards will be in place by April 2013.

>> Download the Health and Wellbeing Board Briefing Paper in Word
>> Download the Health and Wellbeing Board Briefing paper in pdf

What to do with this information?

  • Carry this briefing paper around with you to helpfully hand out to members of the public who want to know all about Health and Wellbeing Boards. Or to third sector people who are convinced that the Board is sitting around a big pot of cash…
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Joint Strategic Needs Assessments (JSNAs)

Today I attended a conference about JSNAs, which has inspired me to write with some basic JSNA info for you!

Joint Strategic Needs Assessments (JSNA): What’s that then?
JSNAs are generally big fat documents with lots of accompanying documents.  Sometimes they are big fat web-based “E-tools” – different things happen in different areas. Either way, they are:

  • Joint: Jointly researched and written by the local NHS and local authority (council) but also involving other partners;
  • Strategic Needs Assessment: Assessing the health and wellbeing needs of local people in order to strategically inform commissioning decisions (what services do we need?).

They are local documents looking at the local area – and every local authority area has to have one.  Or as the Department of Health puts it:

The Local Government and Public Involvement in Health Act 2007 requires PCTs and local authorities to produce a Joint Strategic Needs Assessment (JSNA) of the health and wellbeing of their local community.

JSNAs tell the local story: they include a great deal of data in terms of statistics about the local population from as many sources as the JSNA team can get their paws on.  The idea is to compile as full a picture as possible about what is happening in the local area in terms of health, wealth, housing, social care, education, age, caring responsibilities, demographics, and as many things as you can craft into a pie chart or bar graph as humanly possible. It also includes lots of qualitative data and information from local people about their views of life in the area.

JSNAs are re-published every three years, which involves lots of new research and report writing (and more bar charts). This is called a “refresh” of the JSNA.

How do I find my local JSNA?
If you don’t already have a copy taking up most of your desk, then you should be able to find your local JSNA by searching your local authority’s website. It might be hard to find this document, or it might be split into smaller documents. If you can’t find it, drop your local friendly LINk commissioner an email and ask where you can find it (and maybe whine a bit about it not being easily accessible on their website).

What is the JSNA used for?
The JSNA is used to inform commissioning of services. For example, if there is a lack of mental health provision in one area, then the JSNA would provide the evidence to support commissioning a service there.

Are JSNAs staying in the new reformed world of health and social care?
The JSNA is one of the few things that will survive into the new reformed world intact: with both the same name and the same – but enhanced – function.  The JSNA will be the research that underpins and informs the Health & Wellbeing Strategy, which will be the ‘actions’ that come out of the ‘research’ of the JSNA. The Health & Wellbeing Strategy will be the responsibility of the Health & Wellbeing Board, which, as I’m sure you are bored of hearing by now, will comprise commissioners of both Health and Social Care, with the added bonus of a HealthWatch Representative to be the voice for local residents at the commissioning table.

One thing that will change is that in the future, responsibility for the production of the JSNA will be given to the local authority, as PCTs are being abolished.  (In the past, some PCTs have lead on producing the JSNA.)

What does this have to do with the LINk?
Every areas JSNA is different. But ideally, JSNAs should include ‘the public voice’; a reflection of what local people say about health and wellbeing.  This is where the LINk can come in. The LINk should work closely with the JSNA project team in order to ensure that the local voice is heard and represented in the JSNA. There are many ways of doing this. You could create a survey specifically to gather information for the JSNA. You could collect information and stories from local people, or feed in the issues that you already have. You could run workshops or public events.

Working with voluntary groups:
The JSNA is a very important piece of work for voluntary, community and user-led groups (civil society groups). This is because those groups are often excellent sources of what is working, and what is not working, in the local community. They may know where there are gaps in services. It is also important for voluntary and community organisations because through the JSNA they can raise awareness of the needs that they are meeting in the local community. What would happen if they were not providing their services? What would happen if existing services were no longer commissioned through them?  This is a great opportunity to drive those points home to the people who actually commission services.

The LINk could help by coordinating a means for voluntary and community groups to have their say in the JSNA: perhaps through meetings, or through surveys, or through establishing a ‘civil society forum’. You can also make sure that civil society groups know about the JSNA by publicising  information through your newsletters and informing people who their key contacts into the JSNA should be.

Websites for useful information:

What to do with this data:

  • Find your JSNA: Look up your local JSNA on your council’s website.
  • Find out who your JSNA Leads are: You should have one in the NHS and one in the local authority (very possibly someone with ‘Information’ in their job title).
  • Find out what is happening in your area with regards to the JSNA: Different areas have different timescales. Some areas might “refresh” their JSNA regularly, perhaps looking at certain themes or certain smaller areas. Find out what is happening in your area.
  • Email councillors and ask them how they are using their JSNA to inform their decisions and debate: Some might look at it regularly, in order to back up their decisions. Others might not have heard of it. Now is the time to remind people that the JSNA is going to be an essential part of service planning in the future.
  • Plan how you will contribute to the JSNA: There are some Best Practice Examples here to give you some ideas.
  • Plan how you will involve user-led, voluntary and other organisations: How will you raise awareness of the JSNA? How can you bring commissioners and these groups together? And how will you make sure that groups from across all sectors of society are represented and have the chance to have their voice heard?