BANES is one of the least deprived authorities in the country, but 20 per cent of the population lives in communities where there is deprivation, shorter life expectancy, increased prevalence of long-term conditions and poorer general health. Reducing this health inequality is an overarching aim of the health and wellbeing board (HWB).
The council and PCT in BANES have worked in close partnership since the early 1990s. There have been joint health and social care management arrangements since 2006 and a formal Health and Wellbeing Partnership Board since 2009. In 2011, the entire commissioning of adult health and social care was aligned to create an independent social enterprise to provide integrated community health and adult social care services.
The success of these arrangements has been underpinned by good working relationships and the political drive of the Health and Wellbeing Partnership Board (now the HWB).
This integration has not been without challenge. In 2012, the clustering of the BANES PCT, the creation of the CCG, and a lack of knowledge and commitment from new players put these local integration arrangements at risk. The BANES CCG has since confirmed its commitment to the integrated arrangements and is willing to explore options for further service integration.
The CCG is engaged and committed to the board. There has been open board discussion on the CCG plan and its alignment with the priorities of the joint health and wellbeing strategy (JHWS) and, from April 2013, Healthwatch will also be represented on the board.
This approach is working well; it provides the structural space for statutory members to define the local situation while there is a commitment to developing the conversation with providers and engaging the public by keeping board meetings open and held in public venues.
The 2012 JSNA was used to define seven strategic priorities for the HWB and will form the backbone of the JHWS, once published. These local priorities offer the HWB the opportunity to define its purpose and to assert the local picture against the backdrop of national outcomes frameworks. They are a step towards doing things differently and a catalyst to culture change; moving away from a performance management culture, which was a critical feature of what went before, to a focus on local intelligence and the bigger health and wellbeing picture.
Alongside these strategic priorities, a formal partnership agreement that sets out the joint health and social care management arrangements, integrated commissioning and service provision between the council and the CCG is being confirmed. This agreement is based on the premise that the council and the CCG will achieve more together.
Relationship-building and negotiation has resulted in real ownership across the partnership of the board and its emerging vision and priorities. It has helped partners to consider what is important locally and how this can sit alongside national requirements. Importantly it has already begun to influence delivery and commissioning plans.