Facilitating shared ownership on Health and Wellbeing Boards 11 February 2014 Hallam Conference Centre, London Follow the conversation on Twitter #hwblearn
Welcome & introduction Dr Graham Jackson, Clinical Leader & Chair of Governing Body, Aylesbury Vale CCG; NHS England Clinical Champion & member of Buckinghamshire Health & Wellbeing board Will Tuckley, Chief Executive, London Borough of Bexley #hwblearn
Facilitating shared ownership on Health and Wellbeing Boards NHS Confederation NHS England Local Government Association Dept Health NHS Clinical Commissioners North West Employers #hwblearn Bringing clinical leadership to local health needs www.aylesburyvaleccg.nhs.uk Chief Officer: Louise Patten Clinical Chair: Dr Graham Jackson
Shared Ownership JSNA Agenda Setting Aligned Strategies Shared vision and commissioning intentions Bringing clinical leadership to local health needs www.aylesburyvaleccg.nhs.uk Chief Officer: Louise Patten Clinical Chair: Dr Graham Jackson
BUT: Need to understand partners, and cultural differences LA has many priorities outside of direct health issues How do we maintain the shared vision when times get tough? How do we move from shared to corporate, with accountability? How does the governance work? Bringing clinical leadership to local health needs www.aylesburyvaleccg.nhs.uk Chief Officer: Louise Patten Clinical Chair: Dr Graham Jackson
Your thoughts: My Health & Wellbeing Board works well for all partners round the table #hwblearn
What s happening now? Phil Swann, Shared Intelligence #hwblearn
Change Gear! Learning from the pilot health and wellbeing peer challenges Phil Swann Shared Intelligence
How are boards developing? Enthusiastic, good leadership and relationships; Good use of evidence, but could be used to help drive change; In different positions in terms of robustness of prioritisation and impact on delivery; Impact of status as committee of the council; Complex partnership landscape and challenge better engagement with those not on the board.
The core challenge Now is the time to.increase the pace change gear drive change.respond to rising expectations in order to..prioritise and deliver key outcomes;.provide leadership and oversight of action on key challenges including health and social care integration and reconfiguring healthcare.
Changing Gear: the challenge Bullet 1 Bullet 2
Changing Gear: the drivers
Questions?
1 Naoroji Street, London WC1X 0GB 020 7756 7600 www.sharedintelligence.net solutions@sharedintelligence.net
Joint working on Health & Wellbeing Boards lessons learnt Robert Kenyon, Chief Officer, Health Partnership, Leeds Tim Furness, director of partnership and planning, NHS Sheffield CCG Cllr Roger Gough, Chair, Kent Health & Wellbeing Board Dr Darren Cocker, Clinical Chair, NHS South Kent Coast CCG #hwblearn
NHS Confederation Facilitating Shared Ownership on Health and Wellbeing Boards 11 February 2014 Joint Working on Health and Wellbeing Boards: Lessons Learnt Tim Furness, Director of Business Planning and Partnerships, NHS Sheffield Clinical Commissioning Group
An Overview of Sheffield s Board (1) Equal partnership between Sheffield City Council and NHS Sheffield Clinical Commissioning Group, which includes: Co-Chaired by Leader of the Council and Chair of the CCG. Equal number of GPs and councillors. Shared budget for Board s operations and officer resource. Only one CCG, coterminous with the local authority.
An Overview of Sheffield s Board (2) No providers on the Board maintaining a commissioning focus. A range of work to engage, consult and communicate with providers and members of the public.
Example: What does this shared approach mean for the integration agenda? Joint Commissioning Executive. Integration Advisory Group. A range of events and consultations.
Challenges Finding our feet in a crowded partnership market and with influential providers managing expectations. Integrating the work of Healthwatch Sheffield and NHS England into the work of the Board. Having a shared language and direction, for example with integration work. Keeping focussed agendas while making sure we cover the key issues.
Achievements Progress on integration Single Investment Fund and commitment to single health and social care budget. Strong relationship and shared sense of purpose between councillors and GPs. Well-received Joint Health and Wellbeing Strategy. Context for business between us. Communication and engagement approach.
What Helped? Pre-existing strong relationships joint commissioning, Sheffield Executive Board, Right First Time, Future Shape Children s Health. Continuity from PCT to CCG boundaries, people Co-production of proposal for the Health and Wellbeing Board. The local authority open to approach of partnership. Equal numbers of GPs and councillors creates sense of real partnership.
Key Lessons Learnt Taking time to build relationships is time well spent. Taking time to review development and progress is beneficial we are currently in the process of doing this. Communications and engagement work is worth doing but requires resource, energy and consistency.
Next Steps Review of 2013-14 and planning for 2014-15 and beyond. Focus of work on integration, which includes the Better Care Fund. Health inequalities a major priority for Sheffield. Continued emphasis on communications and engagement, especially with our providers, Healthwatch Sheffield, NHS England and a focus on the wider determinants of health. Find out more: www.sheffield.gov.uk/healthwellbeingboard Contact for further information and questions: louisa.willoughby@sheffield.gov.uk
Health and Wellbeing Boards: Driving Integration Our Vision: Leeds will be a healthy and caring city for all ages, where people who are the poorest will improve their health the fastest Leeds JHWS 2013 Rob Kenyon: Chief Officer Health Partnerships, Leeds City Council
Leeds: Best City in the UK
Leeds Health and Wellbeing Board
Impact on the care of individuals I want to do the same as everyone else, and only have to talk to one person I am fully involved in the decisions and know what is in my care plan I didn t have to wait in all day for lots of different people to come at different times There are no gaps in my care The team always talk to each other to get the best care for my son My care is planned with people who work together to understand me and my carer(s), put me in control, coordinate and deliver services to achieve my best outcomes I always knew who was in charge of my care and who to contact It is less time consuming if all services are together in one place I don t have to keep repeating myself to lots of different people
Integration, integration, integration
Aims and objectives Improving quality of experience: Innovate - Commission - Deliver
The Perfect Storm Better Care Fund Care Act Pioneer Programme Demographic changes Increased expectations National and local political drivers NHS funding formula and public sector cuts Call to action Children & Families Bill
Summary
Year 1 Programme plan Year 3 Year 5 Target Leeds Innovation Health Hub established Hub expands across sectors Recognised as a leading centre for health innovation 10,000 New Jobs Adoption of Leeds Pound and Leeds Cost Care Model Prototype Cost benefit and predictive model fully populated across Leeds Tool influences national new model of integrated care 500M++? Financial Savings Target operating model delivered by integrated teams Integrated teams provide seamless care Choice, control & personalisation fully established across adults & children's 800,000 People Impacted
Governance and programme management Health & Wellbeing Board Children s Trust Board Integrated Commissioning Executive Leeds Innovation Health Hub Transformation Board
What the outcomes might be Apps Leeds Lab Research Better Services Leeds Health improvement & Economic growth
Measuring success
Evidence of impact
Issues and challenges? Who s on the board & what it does Governance [council and partnership] National & local Strategy & detail Long game & immediacy Power, politics & perception Capacity Engagement Money & where it is
What have we learnt? Complex & wicked - keep talking- keep it simple Principles, values & outcomes are key Size is important Local and national drivers will create tension People develop relationships not organisations Its different for all- so expectations need managing Agree what you re doing and not doing
What next? Making the Leeds Pound a reality [BCF ++] Refresh vision & strategy Hardwiring engagement Use Pioneer flex & freedoms Invest to save [for real this time ] Develop single organisation approach Health & Wealth But.be careful what you wish for!
Beware Greeks bearing gifts
Facilitating Shared Ownership on Health & Wellbeing Boards The Kent Health and Wellbeing Board Roger Gough Chair of the Kent Health and Wellbeing Board Cabinet Member for Education & Health Reform
Achievements so far Kent HWB meeting in shadow form since September 2011. Formal committee of KCC since April 2013 All CCGs represented on the Board and 3 District reps JSNA published district & CCG chapters Health & Wellbeing Strategy published. Developing Strategy for 2014-2017 HWB s priorities linked to the 5 outcomes in HWBS: Young people, prevention of ill health, LTC, mental health and dementia March 2013 - Endorsement of the 7 CCG operating plans Established 7 locally-focused HWBs that align with the CCG structure. Now sub-committees of Kent HWB Awarded Pioneer status November 2013 Better Care Fund the ability to operate as a system leader
Facilitating Shared Ownership A new relationship between Local Authorities and the NHS - local authority elected members on the boards County/District dynamics - the relationship between the 2 tiers of boards Complexity of the Kent landscape & finding a system that can reconcile the (potentially) competing interests Kent, health economy, CCG and district level The need to have a common understanding of one system one budget BCF has enhanced the need to deliver at pace and have joint collective / distributive leadership System redesign and re-engineering will be a test of the boards ability to operate as a system leader Where does the accountability and risk sit within the system? Engagement of providers is critical
Integrated Health & Social Care teams (Kent wide, focus on Dover & Shepway) Urgent care work (East Kent) Integrated Commissioning Groups for each CCG HWB Health & Social Care Co-ordinators (Kent wide, focus on West Kent, Canterbury & Swale) Pro-Active Care (Folkestone) Integration Pioneer Bid Better Care Fund New Ways of Working Integrated care around the family Patient Records (across Kent) Assisted Technology Connecting Communities (Thanet) Children s Centres (across Kent) Integrated Adolescent Support Service (Thanet, Dartford, Ashford, Tunbridge Wells) Year of Care Tariff (across Kent) Mapping the Future (West Kent) Health Visitors (across Kent)
The CCG perspective Dr Darren Cocker Clinical Chair NHS South Kent Coast CCG
Localism Local HWBB co located with districts Pathfinder status Building the local relationships Translating strategy into delivery Local delivery using partnerships-housing third sector etc Personal health budgets, healthy living pharmacies
Local Health Economy Working as a system with providers in E Kent Building relationships and shared public value across the health and social care system Develop a sustainable approach to BCF Responding to strategic objectives of County HWBB transforming them into local strategy
Outcomes Local partnership working Local integrated commissioning Local delivery Shared public value across organisations in our health and social care economy Responsive commissioners and providers Kent wide integration through building and implementing the BCF and local articulation of Kent HWBB objectives via local HWBB
Group discussions What are the challenges to facilitating shared leadership in your area? How will you address these changes, what actions will your area take? What are headline lessons to share with others on your board and beyond? #hwblearn
Conference summary and close Dr Graham Jackson, Clinical Leader & Chair of Governing Body, Aylesbury Vale CCG; NHS England Clinical Champion & member of Buckinghamshire Health & Wellbeing board Cllr Roger Gough, Chair Kent Health and Wellbeing Board #hwblearn