Alan lotinga jsna workshop


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Alan lotinga jsna workshop

  1. 1. Birmingham Health and Wellbeing Board Experience Alan Lotinga, Director of Health and Wellbeing
  2. 2. National Context <ul><li>The Health and Social Care Bill - getting the best from clinical commissioning and local democratic accountability </li></ul><ul><li>One of few major new responsibilities for local government </li></ul><ul><li>Public health transfer/transformation critical but not the only thing to lead on </li></ul>
  3. 3. National Context <ul><li>Health and Wellbeing Board (HWBB) crucial &quot;common denominator&quot; and vital to show leadership to manage system risks during massive change </li></ul><ul><li>Requires new thinking and mindset beyond traditional committees. Its about capitalising on relationships, with offers and asks from key partners. </li></ul>
  4. 4. Birmingham Context <ul><li>Population of 1.1 million, relatively young, very diverse. 30%+  black and ethnic minority backgrounds </li></ul><ul><li>Health inequalities - people generally sicker, younger and for longer </li></ul><ul><li>From 4 PCTs to 3 to 1 to a ‘Cluster’, to 12, now 4, Clinical Commissioning Groups (CCGs) in just 8 years </li></ul>
  5. 5. Birmingham Context <ul><li>13 Chief Execs of health commissioners </li></ul><ul><li>Very large NHS Foundation Trusts across acute, community and mental health </li></ul><ul><li>From 4,600 to 2,900 staff employed on adult social care </li></ul><ul><li>0 - 3 stars adults, 0 to 1 to 0 stars children </li></ul>
  6. 6. Experience to Date <ul><li>Early value of bringing together strategic management of health and care, with a true democratic mandate </li></ul><ul><li>Closer links to communities with poorest health outcomes </li></ul><ul><li>Birmingham would have to adapt more traditional approach to deal with large number of partners and interests and diversity </li></ul><ul><li>Avoid ‘talking shop’ – get a balance between representation and decision-making </li></ul><ul><li>Early adopter, Shadow HWBB </li></ul>
  7. 7. Experience to Date <ul><li>Worked with University of Birmingham Health Services Management Centre </li></ul><ul><li>Workshops of Cllrs., GPs, Third Sector/LINk, NHS and BCC officers </li></ul><ul><li>Expectations from the HWBB, how to achieve good outcomes from complex issues </li></ul><ul><li>Scenarios, getting real added-value and buy in </li></ul><ul><li>Additional discussions with LINk, etc. </li></ul>
  8. 8. Experience to Date <ul><li>9 months before Shadow HWB met, key players changed, need to return to &quot;OD&quot; work </li></ul><ul><li>Necessary governance forming, meaty issues starting to be dealt with </li></ul><ul><li>Crucial to relate to needs and aspirations of residents and engage truly with communities. </li></ul>
  9. 9. Some Challenges <ul><li>Integration of Children's Services and JSNA - HWBB must look across the lifespan </li></ul><ul><li>Managing risks of unintended consequences </li></ul><ul><li>HWBB to agree its own measures of success </li></ul><ul><li>Public health transition not just about move to local govt. </li></ul><ul><li>HWBB's role in CCG authorisation process </li></ul><ul><li>HWBB can't be a ‘magnet’ for all considerations and decisions </li></ul>
  10. 10. Some Challenges <ul><li>Make full use of existing and emerging networks and groups </li></ul><ul><li>Ensuring political balance and stability for GPs around major policies </li></ul><ul><li>Role of Scrutiny </li></ul><ul><li>Right balance between representation and manageable numbers to make decisions e.g. CCGs, public and patient view, providers, third sector? </li></ul>
  11. 11. Early Wins? <ul><li>City Director of Public Health appointment well-advanced </li></ul><ul><li>3 or 4 big early public health transfers in hand </li></ul><ul><li>Structures/networks in and around HWBB properly ‘wired in’ </li></ul><ul><li>Clear criteria for judging joint commissioning success and agreed way forward in childrens’ and older adults’ joint commissioning and service integration </li></ul>
  12. 12. Early Wins? <ul><li>Clarity on shape and content of Health and Wellbeing Strategy </li></ul><ul><li>Clarity on way forward on local HealthWatch </li></ul><ul><li>HWBB role in CCG authorisation confirmed and happening </li></ul><ul><li>No more than 5 high-level HWBB performance/success measures agreed e.g. regarding system risks and setting up new arrangements. </li></ul>