LGA ConferenceBirmingham28th June,2011

Phil Coppard, OBEChief ExecutiveBarnsley MBC

Is this what the doctor ordered?

Context

• New territory for all of us

• Prisoners of our own experience?

• Still changing?

• HWBs now put local authorities centre stage

• New direct connection with GPs

• Opportunity for real influence through thorough needs assessment, challenging strategy AND oversight of actual commissioning

Role of HWB

• Clinical commissioning groups co terminus with local authority boundaries and hence HWB

• Responsible for JSNA and Health and Well Being strategy

• Role in promoting joint commissioning and integrated provision between health, public health and social care, inc. as vehicle for “lead commissioning”

• Role in authorising clinical commissioning groups

• Lead on local public involvement

• Ability to refer back commissioning plans not in alignment with HW Strategy

• Membership determined by local authority including the ability to have a majority of elected councillors

Practical issues for local authorities

• Health and social care needs dependent on social-economic and other circumstances of place

• Need to instil preventative agenda and tackle health inequalities when resources consumed by

– Ageing population– Pressure of continuing health care needs– Dependency and the worried well– Insatiable cost of secondary/acute care

• Need to dissolve distinction between health and social care but

– Health and social care funding allocated separately– Health care free at the point of delivery

• Need to avoid cost shunting

• Access to and modernisation of health care facilities – local hospitals?

• Common assessment of individual’s needs

• Continuation of drives for personalisation

A model of “needs”

The place where you live

Community

Family

Peers

Jobs

Worklessness

Income levels

Crime and disorder

School organisation

Housing

Public realm

Facilities and amenities

The behaviours you choose

Lifestyle

Exercise

Diet

Smoking

Drugs

Anti-social behaviours

Education and skills

The services you use

Clinical and social care services

Local authoritiesand others

mitigatingthese risk factors

put in placeprotective factors- community based- Big Society- social capital- self esteem- happiness

NHS Local AuthoritiesPublic Health

social marketingpreventative programmes

Clinical commissioning groupsAcute TrustsLocal AuthoritiesPublic Health

treatmentservice improvementjoining-uppersonalisation

Source: with apologies to DoH Health Inequalities: Progress and Next Steps – June 2008