Bath and North East Somerset is one of the three ‘places’ in the Bath and North East Somerset, Swindon and Wiltshire Sustainability and Transformation Partnership (STP), which is working to become an integrated care system. This case study forms part of our integrated care system (ICS) resource.
B&NES Health and Wellbeing Board (HWB) provides strategic leadership for health, care and wellbeing, including tackling the wider determinants of health. The HWB has extended its role and membership to take a whole-place approach, involving providers, the voluntary and community sector (VCS), blue light services, housing, the university and others.
B&NES already operates joint commissioning and pooled budgets in mental health, children’s services and learning disabilities, and other NHS and adult social care budgets are aligned. Partners are keen to deepen integration and have recently established B&NES Health and Care Board. This is a ‘committee in common’ involving members of the clinical commissioning group's (CCG) governing body and the council’s cabinet. It will have delegated responsibilities for service transformation, joint commissioning and budget alignment within a newly agreed joint working framework.
“Bath and North East Somerset has developed and built on the close working between the NHS and the council to establish a wider collaboration across the public sector to impact on the wider determinants of health. This has helped shape the extensive and deep integration between the council and the clinical commissioning group, as well as setting the tone and brief for the B&NES Integrated Care Alliance. At the root of all this work is the belief that those involved are all trying to serve the same end for our population, set out in our joint health and wellbeing strategy – B&NES will be a place with a strong social purpose and a spirit of wellbeing.”
Dr Ian Orpen, GP and Co-Chair, Bath and North East Somerset
In its work to tackle the wider determinants of health, the HWB is looking at how partners can develop an asset-based approach to neighbourhood development, recognising the important contribution of communities to improving health and wellbeing. It has adopted a ‘statement of commitment’ setting out principles for working in an asset-based way, and is supporting a local VCS group to develop a project called ‘Compassionate Communities’ aimed at building community resilience. The HWB also supports the ‘Three Conversations’ model, to establish a new relationship between workers and individuals based on building strengths and making links with communities.
B&NES delivers community services through a pooled budget contract for integrated neighbourhood teams. The HWB will consider how this neighbourhood approach can be developed over time, potentially involving primary care networks, the VCS, mental health providers, other public services, communities and ward councillors.
Local authorities have been well represented on the emerging ICS, which supports the principle that most planning and delivery happens at place level. The collective role of HWBs will be considered as the ICS develops, to ensure there is a consistent approach, as far as possible, across the wider aspects affecting an individual’s health.