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| Health and Wellbeing Boards | |
|---|---|
| Name | Health and Wellbeing Boards |
| Formation | 2013 |
| Type | Statutory local partnership |
| Region served | England |
| Parent organization | Department of Health and Social Care |
Health and Wellbeing Boards provide a statutory forum in English local areas intended to align NHS England commissioning, local authorities' social care and public health strategies, and community needs assessments, emerging from reforms introduced in the Health and Social Care Act 2012 and implemented alongside changes to Clinical Commissioning Groups and the creation of Public Health England.
Health and Wellbeing Boards originated in policy reforms driven by the Health and Social Care Act 2012 under the Cameron ministry and were shaped by consultations involving Department of Health and Social Care, think tanks such as the King's Fund and the Health Foundation, and local government bodies including the Local Government Association. Early pilots drew on precedents from joint commissioning arrangements involving National Health Service (England), Care Quality Commission reports, and strategies from cities like Manchester and Leeds, while Parliamentary debates in the House of Commons and the House of Lords framed statutory duties and integration goals.
Boards aim to produce joint strategic needs assessments and Joint Health and Wellbeing Strategies to inform commissioning by bodies such as NHS England, Clinical Commissioning Groups, and local authority directorates like Director of Public Health offices; they promote integration across services including adult social care, children's services, and mental health trusts such as Camden and Islington NHS Foundation Trust or South London and Maudsley NHS Foundation Trust. Functions include aligning priorities with national frameworks such as the Five Year Forward View, addressing determinants highlighted by the Marmot Review, and fostering partnerships with voluntary sector organizations like Age UK, Citizens Advice, and Mind.
Typical boards are convened by a council leader or elected mayor from authorities such as Birmingham City Council or Liverpool City Council and include statutory members from bodies including Clinical Commissioning Groups, Healthwatch organisations (e.g., Healthwatch England), and local directors such as the Director of Public Health and Director of Adult Social Services. Additional representation often comes from NHS provider trusts like Guy's and St Thomas' NHS Foundation Trust, police bodies such as Greater Manchester Police, and community partners including Barnardo's and Shelter (charity). Chairs have varied between council cabinet members and independent figures in regions such as Tower Hamlets and Newcastle upon Tyne.
Statutory responsibilities require producing the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy and influencing commissioning decisions by organisations like NHS England and Clinical Commissioning Groups, though boards do not directly commission in most configurations; they can promote pooled budgets under mechanisms such as the Better Care Fund and support integration initiatives seen in local vanguards from the NHS Vanguard programme. Boards may convene multi-agency responses to public health crises alongside bodies like Public Health England and agencies involved in emergency planning such as NHS England Regional Offices.
Decision-making occurs through formal meetings subject to local authority governance rules and scrutiny by bodies like the Overview and Scrutiny Committee of a council and external inspectors such as the Care Quality Commission. Accountability lines interact with national accountability via NHS England commissioning assurance and local democratic accountability through elected mayors or council leaders from municipalities including Cambridge and Bristol. Boards publish strategies and meeting minutes to enable scrutiny by organisations like Healthwatch England and parliamentary committees such as the House of Commons Health and Social Care Committee.
Boards themselves typically hold limited budgets, relying on contributions from local authorities (e.g., County Councils and Unitary authorities), clinical commissioning groups, and pooled funds such as the Better Care Fund and, historically, grants administered via Public Health England allocations. Resource constraints have led to reliance on shared staffing with partner organisations like NHS Trusts and commissioning support units, and partnerships with charities such as NHS Charities Together for project funding.
Critiques have focused on limited statutory teeth relative to ambitions set out by the Health and Social Care Act 2012, tensions between elected representatives and NHS bodies including NHS Improvement, variability in effectiveness between areas like London boroughs versus rural counties, and concerns raised by think tanks such as the King's Fund and Institute for Fiscal Studies about inconsistent impact on outcomes highlighted in reports by the National Audit Office. Controversies have also arisen around transparency and conflicts when commissioning decisions involve large providers such as Serco or corporate partners, and debates persist in the House of Commons over whether boards need stronger statutory powers or sustained funding to meet integrated care objectives.
Category:Healthcare in England