In recent years, and with LGA leadership support, Merton Health and Wellbeing Board (HWB) has worked closely with the Leadership Centre to develop its capacity for strategic system leadership and to work together as a team. It has provided the overall vision, oversight and strategic direction for health and wellbeing, including the wider determinants of health.
Merton is part of South West London Health and Care Partnership, which has a commitment to delegate to borough level to ensure local accountability and delivery based on consistency, not uniformity. The partnership published draft health and care plans in March 2019. Merton Health and Care Together Board is responsible for producing and delivering Merton’s health and care plan, reporting to the HWB. Health and Care Together involves all major health and care providers and is co-chaired by Merton Clinical Commissioning Group’s (CCG’s) managing director and Merton Council’s director of communities and housing.
The health and care plan will align with and complement the joint health and wellbeing strategy. Both will take a life course approach but the plan will focus on service integration, while the strategy will focus on creating a healthy place. Health and wellbeing is also a ‘golden thread’ throughout the new Merton Local Plan.
“We have challenged ourselves and sought to develop our capacity to act as a system leader, actively trying to shape the health and wellbeing of the borough. This has been done by developing strong relationships based on trust and shared goals, and by focusing on issues that require a collaborative approach, such as diabetes. The working practices that have been developed stand us in good stead for the discussions now taking place about moving towards more integrated ways of working.”
Councillor Tobin Byers, Cabinet Member for Adult Social Care and Health, and Chair of Merton Health and Wellbeing Board
As well as their oversight role, each year members of the HWB focus on a few shared priorities for collaboration. They also reach out into communities to deepen their personal understanding of the challenges people face and to identify shared solutions. The ‘Diabetes Truth’ programme was the first phase of a whole-system approach to tackling diabetes. The programme connected each HWB member to a local resident with lived experience of diabetes for a series of one-to-one conversations. Combining this insight work with data analysis, a tackling diabetes action plan was produced. One new initiative is a signposted route to encourage physical activity – the Merton Mile. At its launch, the HWB chair and vice chair ran a mile with local school children pupils and local residents.
A social prescribing pilot delivered by Merton Voluntary Service Council in two GP surgeries resulted in positive outcomes – including a 33 per cent reduction in GP appointments, an increase in reported wellbeing, and an average reduction of £550 per patient in secondary care costs. Based on these findings, the CCG expanded the service to cover 13 GP surgeries and is now planning to roll out the scheme across all 22 Merton practices.
The HWB has three GP members and supports joint work between GPs and local councillors, such as GPs attending a ‘prevention matters’ workshop and ward councillors running advice surgeries in a GP practice. The HWB sees great potential for neighbourhood leaders to work with communities to shape healthier places and deliver integrated health and care support.
For more information
Dr Dagmar Zeuner, Director of Public Health