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Matthew Ellis: Staffordshire health and wellbeing board
1. Staffordshire health and
wellbeing board
Opportunities, challenges and the way ahead
Matthew Ellis
Cabinet Member – Adults & Wellbeing
(HWbB Chair)
2. 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
3. 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
4. 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
5. 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?
6. 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
7. 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?
8. 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
9. 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