National learning network for health and wellbeing board publications 2012

National learning network for health and wellbeing board publications 2012 The National Learning Network for, supported by the Department of Health, NHS Confederation, Local Government Association and NHS Institute for Innovation and Improvement, has been working with learning sets made up of health and wellbeing board members to develop the following publications, to share learning and support the establishment of well functioning boards. These publications are intended as a contribution to ongoing debate and thinking as to how can be most effective. They do not necessarily showcase definite best practice, but represent key learning on the issues. All the below publications can be found on the Knowledge Hub an online community and resource: https://knowledgehub.local.gov.uk and the NHS Confederation website: www.nhsconfed.org/hwb

1 Integration Encouraging integrated working to improve services for adults and older people A practical guide for November 2012 Individual boards will need to identify their own optimum approach to joint working. Time and experimentation will be necessary. Demonstrable sensitivity to local factors in how members interrelate and interoperate will help strengthen commitment to joint working. Agreeing a set of principles to underpin joint working will support effective joint commissioning and prevent it being destabilised by distracting factors. Changing mindsets, as much as changing ways of working, should be a priority focus for board members. A key duty on is to promote integration and partnership across local government, public health, the local NHS and the third sector, with the ambition of improving local services and tackling health inequalities. Integrated working involves a crosscutting, wide-ranging and holistic approach. It is as much about joint working and relationship building as about joint commissioning. It means looking beyond the provision of health and social care services and considering the wider spectrum of issues that impact on people s health, independence and wellbeing outcomes. A whole systems approach involves board members, partner organisations and local people working together and putting local people s needs and aspirations at the very heart of the system. To achieve this requires changing mindsets as much as changing ways of working. Audience: This summary guide is aimed at health and wellbeing board (HWB) members and supporting officers. Purpose: To provide HWBs with some practical approaches to consider and use in promoting closer joint working. Background: This guide was developed by a HWB learning set, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, the NHS Confederation, the Local Government Association and the NHS Institute for Innovation Operating principles for Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies: enabling joint decision-making for improved health and wellbeing Joint Strategic Needs Assessment (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs) are statutory responsibilities for. This report complements the Department of Health s guidance and is designed to support areas to develop successful JSNAs and JHWSs. It provides operating principles to guide key processes and practical examples of how these have been put into practice. Encouraging integrated working for adults and older people: a practical guide for health and wellbeing boards A key duty on is to promote integration and partnership across local government, public health, the local NHS and the third sector, with the ambition of improving local services and tackling health inequalities. This guide provides with some practical approaches to consider and use in promoting closer joint working. Poster: Health and wellbeing boards: developing a local outcomes framework for adults and older people This poster provides a visual map of each of the national outcomes frameworks for adult social care, the NHS and public health. It aims to help to develop local outcomes frameworks linked to priorities set out in Joint Health and Wellbeing Strategies. 2

Health and wellbeing boards and criminal justice system agencies: building effective engagement Effective joint working between criminal justice system agencies and health and wellbeing boards will support improved commissioning to achieve better health, justice and community safety. Improving health outcomes for offenders can significantly reduce re-offending rates, so bringing health benefits to a wider population. Local community safety A key responsibility of each October 2012 Offenders, ex-offenders and those at risk of offending experience significant health inequalities, compared to the general population. They experience higher rates of mortality and suicide; drug and alcohol misuse; mental and physical health problems; homelessness, literacy and numeracy difficulties, and unemployment; and poor access to and uptake of health and care services. Since there is an identifiable link between health inequalities and offending behaviour, improving their health outcomes can markedly reduce re-offending rates. In turn, a reduction in re-offending is likely to bring health and wellbeing benefits to a wider local population as a result of improved community safety. partnerships, criminal justice boards and health and wellbeing boards will have some of the same member agencies and responsibility for delivering some priority shared outcomes. members and criminal justice system agencies. health and wellbeing board is to undertake Joint Strategic building effective engagement between health and wellbeing Needs Assessments ( JSNAs) boards and local criminal justice system agencies. and develop Joint Health and Wellbeing Strategies ( JHWSs). group which was part of the National Learning Network for (see back cover) and is supported mechanisms by which health by the Department of Health, the NHS Confederation, the and wellbeing boards will Local Government Association and the NHS Institute for engage with their local partners. Innovation JSNAs and JHWSs are the key Reforms to the health and social care system and criminal justice system (CJS) in England present new opportunities for effective joint working at the local level between and CJS agencies, to improve commissioning and achieve better health outcomes for people in contact with the CJS, including those at risk of offending and re-offending, as well as victims. Audience: This guide is aimed at all health and wellbeing board Purpose: To provide practical information and learning on Background: This document was developed by a working Criminal justice Health and wellbeing boards and criminal justice agencies: building effective engagement Offenders, ex-offenders and those at risk of offending experience significant health inequalities, compared to the general population. This briefing provides practical information and learning on building effective engagement between and local criminal justice system agencies. Children and young people Poster: Health and wellbeing boards and children and young people This poster provides the key success factors, questions and challenges for to consider to make an effective contribution to improving children and young people's health and wellbeing. Children and young people s health and wellbeing review of documents Early intervention is the most effective way to promote the health and wellbeing of children and young people. people engage with so many agencies and services that effective partnership working is the only way to successfully support them. local services is needed to overcome the often confusing patterns of provision and planning. and young people in the design of their services is a priority. participation of children and young people is an essential element of successful service delivery. This briefing summarises the key policy documents on children and young people s health and wellbeing that have been published over the last two years. It provides a useful literature review to members of health and wellbeing boards on an issue where local inter-agency cooperation is much needed, and where there have recently been several significant policy developments. This briefing was commissioned by the health and wellbeing board learning set for children and young people, part of the National Learning Network for health and wellbeing boards. A remarkably consistent body of knowledge The past two years have seen a raised profile for child health in the UK, with numerous high-level reviews, reports and policy documents Audience: This document is aimed at health and wellbeing board (HWB) members and others involved in planning, coordinating, commissioning or providing services that affect children or young people. Purpose: To give HWB members an understanding of the policy environment around children and young people s health and highlight the most important documents to be aware of. Background: This document was developed by the health and wellbeing board learning set for children and young people, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, NHS Confederation, the Children and young people and Putting policies into practice Each health and wellbeing board will need to find its own best way of serving children and young people. Aligning the priorities of different agencies involved in providing services for children and young people is an important task for health and wellbeing boards. relationships between the relevant board members in this area should be a key priority. outcomes for the health and members to achieve is a powerful way of improving joint working. The unique history and needs of different localities mean that each health and wellbeing board will need to find its own best way of serving children and young people. Nonetheless, the following practical examples may be helpful in providing board members with some specific illustrations of how others have sought to improve the coordination and leadership of this important issue. This paper was developed by the health and wellbeing board learning set for children and young people, part of the National Learning Network for health and wellbeing boards. Integrated governance between the health and wellbeing board and children s trust Nottinghamshire In Nottinghamshire, the shadow health and wellbeing board was formed in 2011 as part of the Government s early adopter programme. The early Audience: members and others involved in planning, coordinating, commissioning or providing services that affect children or young people. Purpose: organising themselves to deliver coordinated services for children and young people. Background: is supported by the Department of Health, NHS Confederation, the Children and young people s health and wellbeing: review of documents This briefing summarises the key policy documents on children and young people s health and wellbeing. It provides a summary literature review for members of health and wellbeing boards on an issue where local inter-agency cooperation is much needed. Children and young people and health and wellbeing boards: putting policies into practice The unique history and needs of different localities mean that each health and wellbeing board will need to find its own best way of serving children and young people. This publication provides practical examples of how others have sought to improve the coordination and leadership of this important issue. 3

Leadership A guide to governance for health and wellbeing boards Many of the critical success factors for health and wellbeing boards (HWBs) hinge on the governance arrangements that members establish early on. governance mechanisms exist to give board members a framework for working together. will need to concentrate on developing strong includes aligning priorities where possible and developing collaborative leadership styles built on trust and shared values. are developing a range of solutions to issues such as how broad their membership should be and how they relate to other local partnerships. Councils and councillors work very differently to GPs and the NHS, but their work is integral to health and health services. backgrounds, culture and structure of local government can present barriers or benefits to joint working, depending on how they are approached. are the most important first steps for GP commissioners wanting to foster strong, productive relationships with local government. Health and wellbeing boards will give oversight and strategic leadership across many complex organisations and systems. To do this, they will need clear frameworks for accountability and action. Although they won t necessarily be commissioning or providing services themselves, governance will be as important an issue to the boards as it is already to their member organisations. This guide was developed by the governance health and wellbeing board learning set, part of the National Learning Network for. Many of the critical success factors for hinge on the governance arrangements that members establish early on. Will the right local organisations engage? Will the health and wellbeing board s decisions carry real weight? How can genuine partnerships be developed? Working with local government: a guide for GP commissioners Audience: (HWB) members and stakeholders. Purpose: and informal mechanisms for holding HWBs and their members to account. Background: National Learning Network (see back cover) and is supported by the Association and the NHS Institute for Innovation August 2012 This short guide summarises some of the need-to-know structural and operational features of local government and presents advice from GPs, NHS managers and local councillors on the important cultural stumbling blocks that often occur when working across the NHS-local government divide. Health and wellbeing boards (HWBs) bring together NHS, local government and Healthwatch representatives to improve the lives of their local populations. The model relies on strong productive partnerships and mature individual relationships. To succeed, board members will need a good understanding of how their partner organisations differ from their own. For GP commissioners, this includes learning how to work with council officers and councillors. Audience: This document is aimed at NHS members of health and wellbeing boards, in particular GPs active in their local clinical commissioning group. Purpose: To help GP commissioners understand some of the structural and cultural differences between the NHS and local government and suggest ways of bridging these to build strong, productive local partnerships. Background: This document was developed by a health and wellbeing board learning set (see back cover) and supported by Government Association and the NHS Institute for Innovation Working with GP commissioners: a guide for local councillors and officers August 2012 This short guide summarises some of the major changes in NHS commissioning and what this means for partners in local government. It presents advice from GPs, one of the most significant NHS managers, local councillors and officers on how organisational changes in its to handle some the differences that often arise when working across the NHS-local government divide. Health and wellbeing boards (HWBs) bring together NHS, local government and Healthwatch representatives to improve the lives of their GPs, who have taken on local populations. The model relies on strong productive partnerships and commissioning responsibilities. mature relationships that are sustainable in the long-term. To succeed, board members will need a good understanding of how their partner organisations differ from their own. For councillors, this includes learning councillors can expect to benefit how to work with GP commissioners and the new clinical commissioning from these new relationships, but groups. difference, show understanding, and be open and honest with their new partners. Audience: This document is aimed at councillors, as well as local boards. Purpose: To help local councillors and officers understand some of the structural and cultural differences between local government productive local partnerships. Background wellbeing board learning set (see back cover for details) and supported Government Association and the NHS Institute for Innovation and Improvement. A guide to governance for Health and wellbeing boards will give oversight and strategic leadership across many complex organisations and systems. To do this, they will need clear frameworks for accountability and action. This briefing aims to strengthen understanding and application of formal and informal mechanisms for holding health and wellbeing board members to account. Working with local government: a guide for GP commissioners This short guide summarises some of the need-to-know structural and operational features of local government and presents advice from GPs, NHS managers and local councillors and officers on working across the NHS and local government. Working with GP commissioners: a guide for local councillors and officers This short guide summarises some of the major changes in NHS commissioning and what this means for partners in local government. It presents advice from GPs, NHS managers and local councillors and officers on how handle some the differences between the NHS and local government. Health, adult social c and ageing A new development tool for health and wellbeing boards A new development tool for This tool aims to assist to explore their strengths and opportunities to improve and to inspire their ambition to develop a clear sense of purpose and an approach which will help transform services and outcomes for local people. 4

Collective resources Making the best use of collective resources An introduction for Taking a systematic, planned approach to joint working is more likely to produce success. There are a variety of ways that resources can be shared with different degrees of formality. Collaborative use of resource types such as finances can help local agencies get more from the same. A focus on building trust and a genuinely shared vision and strategy should be a first-order priority for emerging health and wellbeing boards. A longer version of this summary guide is available on the LGA knowledge hub. The examples in this document are drawn from the experiences of individuals from the following organisations and programmes: Knowsley Metropolitan Borough Council and NHS Knowsley, which have a single leadership team, pooled budgets and integrated service provision. Gloucestershire County Council and NHS Gloucestershire, which are providing welfare advice in GP surgeries. Leeds Health and Social Care Transformation Programme, which is a city-wide agreement among service providers and commissioners within the Leeds health and social care economy. This summary guide is meant to help health and wellbeing boards understand how to collectively use the resources available in their local area. Money is one part of this, but the guide also highlights how other kinds of resources can be used collaboratively to greater effect. This summary guide was produced by the health and wellbeing board learning set for the use of collective resources. Health and wellbeing boards have been created to enable leadership of local health and social care systems and encourage partnership working between these services. A key component of this role will be the ability to join-up the resources available to each of the organisations that make up the board sharing, reducing duplication and getting more from the same. The current context of financial pressure on public services and need for savings makes the lessons contained in this guide all the more valuable. As money gets tighter, it is vital that local organisations resist the temptation to retrench or become inward-focused and instead pursue the opportunities that using their limited resources collaboratively can bring. Audience: This summary guide is aimed at all health and wellbeing board (HWB) members and supporting officers. Purpose: To provide HWBs with some top tips and suggested questions to use when considering how to make the most of the resources available to each member. Background: This guide was developed by a HWB learning set, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, NHS Confederation, the Making the best use of collective resources: examples in practice To illustrate the messages of Making the best use of collective resources: an introduction for health and wellbeing boards, the learning set have put together a few of their own experiences. The following three examples give practical outworkings of the principles in the introductory guide, including the different levels of formal-informal joint working. This paper was developed by the health and wellbeing board learning set for the use of collective resources, part of the National Learning Network for. Joint commissioning in Knowsley Knowsley Metropolitan Borough Council and NHS Knowsley have a single leadership team, pooled budgets and integrated service provision under a Health and Wellbeing Section 75 Agreement. This covers health, adults and children s services, public health, leisure and culture. This has been in place for the last eight years. Independent evaluation has shown that over the same period, Knowsley has achieved greater improvements in health and wellbeing than the England or spearhead authority average Audience: This paper is aimed at all health and wellbeing board (HWB) members and supporting officers. Purpose: To provide HWBs with some examples of different approaches to using resources collaboratively. Background: This paper was developed by a HWB learning set, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, NHS Confederation, the Making the best use of collective resources: an introduction for This summary guide aims to help health and wellbeing boards understand how to collectively use the resources available in their local area. Money is one part of this, but the guide also highlights how other kinds of resources can be used collaboratively to greater effect. Making the best use of collective resources: examples in practice To illustrate the messages of Making the best use of collective resources: an introduction for health and wellbeing boards, the health and wellbeing board learning set put together examples of their own experiences. This briefing provides three practical examples to illustrate the principles in the introductory guide. 5

Improving population health Health impact assessment: a useful tool for Health impact assessments (HIAs) can bring a public health perspective to decision-making areas that are traditionally viewed as outside the remit of public health. to the reduction of health inequalities by identifying the different groups which will experience health gains or losses from proposed developments. health sector proposals on health and wellbeing may not be well understood unless a HIA is completed. and qualitative data from for HIAs but it will also give direction on the local health priorities. This document provides an overview of the health impact assessment (HIA) process. It was developed by one of the health and wellbeing board learning sets, for improving the health of the population, part of the National Learning Network for. Drawing on the work of NHS South of Tyne and Wear, it outlines the key stages of the process and provides a case study which demonstrates how this process might be used to influence decision-making and service delivery. What is a health impact assessment? A health impact assessment (HIA) is a tool that enables health and wellbeing boards (HWBs) to assess what impact a particular change of policy or new development, service or strategy will have on the health of the local population. It is particularly valuable in bringing a public health perspective to decision making areas that are traditionally viewed as being Audience: (HWB) members, particularly those who have little experience with health impact assessments. Purpose: To enable HWB members to understand the process of assessing the health impact of a particular change of policy or new development, service or strategy in order to include HIAs within their local joint health and wellbeing strategy or commissioning plans. Background: Improving population health: action learning for Tackling health inequalities should be seen as the role and responsibility of every health and wellbeing board member and be mainstreamed into everyday working practices and processes. The Joint Health and Wellbeing Strategy (JHWS) is a key mechanism to embed a local focus on reducing gaps in local life expectancy. Essentially, health and wellbeing boards have a mandate to undertake place-shaping given their responsibilities to develop strategies that integrate services to genuinely meet local community needs and collaborate effectively to improve local population health. Place-shaping requires not just the joining up of resources and activities, but also a leadership and influencing role. November 2012 Tackling the broader determinants of health to improve local population health is a priority for. There are opportunities for boards to take the lead on addressing health inequalities and the structural, environmental and material barriers that inhibit local communities achieving their potential. Each health and wellbeing board will face its own specific challenges and opportunities given the particular local context and needs of its local community. Nonetheless, the real examples of place-shaping and reducing health inequalities presented in this paper offer valuable learning of how others have addressed some of the difficult strategic and policy issues involved. Four key themes provide a useful framework for health and wellbeing boards to use: What is it that needs to be achieved? Who needs to come on board to make this happen? What are the anticipated challenges? What does success look like? Audience: This practical guide is aimed at all health and wellbeing board members. Purpose: To provide practical learning of how other boards are approaching problem briefs in relation to improving local health and wellbeing outcomes. Background: This document was developed by a health and wellbeing board learning set which is part of the National Learning Network (see back cover) and is supported by the Department of Health, NHS Confederation, the Local Government Association and the NHS Institute for Innovation Health impact assessment: a useful tool for health and wellbeing boards This document provides an overview of the health impact assessment (HIA) process. Drawing on the work of NHS South of Tyne and Wear, it outlines the key stages of the process and provides a case study which demonstrates how this process might be used to influence decision-making and service delivery. Improving population health: action learning for Tackling the broader determinants of health to improve local population health is a priority for health and wellbeing boards. The real examples of place shaping and reducing health inequalities presented in this paper offer valuable learning of how others have addressed some of the difficult strategic and policy issues involved. 6

1 Patient and public engagement Patient and public engagement for A review of resources Engaging patients and the public in the commissioning and provision of services is recognised as best practice The multiplicity of models and is also a statutory requirement under the Health and definitions for patient and and Social Care Act (2012). However, the multiplicity public engagement (PPE) can make decisions about how of models and definitions for patient and public and when to engage appear engagement (PPE) can make decisions about how difficult. and when to engage appear difficult. This review was PPE decisions are most commissioned by the engagement health and wellbeing appropriately taken and board learning set, part of the National Learning implemented when there is Network for. clarity about who needs to be engaged and for what purpose. PPE decisions are most appropriately taken and implemented when there People s needs are better is clarity about who needs to be engaged and for what purpose. The term met when they are involved PPE includes members of the public, carers and the range of people using in an equal and reciprocal services. relationship with professionals and others, working together The following list of documents provides different ideas of how, when to get things done. and why to do patient and public engagement; it is not an exhaustive list. Two over-arching principles emerge for from Engagement is needed most this body of information and guidance. while HWBs are developing, new key cultures are being established and priorities are being set. Audience: This review is aimed at health and wellbeing board (HWB) members. Purpose: To give HWB members an overview of the policy context in relation to public and patient engagement and to signpost to resources. Background: This review was developed by a HWB learning set, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, NHS Confederation, the Patient and public engagement (PPE) should take place from the start of the life of health and wellbeing boards and be woven into the DNA of boards throughout their work. There will be different types and levels of appropriate engagement depending on the situation, from involvement of individual members of the public in shared decision-making about their own health and care, to local community engagement in co-production of services. PPE is the business of every board member. All members must be assured that appropriate PPE, shown to make a difference, is taking place in relation to the work of the board. Patient and public engagement: a practical guide for November 2012 Engaging patients and the public in the commissioning and provision of services is recognised as best practice and is also a statutory requirement under the Health and Social Care Act (2012). This guide is designed to help health and wellbeing board members think through, plan and deliver their responsibilities in relation to patient and public engagement (PPE). It provides practical learning on how and when to engage, and ways this can work alongside the responsibilities of partner organisations, in particular local Healthwatch. Seven key principles every health and wellbeing board should consider Following a review of policy and research evidence, 1 and discussions with key stakeholders, a series of principles have been identified to help underpin the patient and public engagement (PPE) work of, detailed overleaf. Audience: This document is aimed at health and wellbeing board members, including councillors, as well as local authority and NHS staff. Purpose: To provide with some top tips on hardwiring patient and public engagement. Background: This document was developed by a health and wellbeing board learning set, which is part of the National Learning Network (see back cover) and is supported by the Department of Health, the NHS Confederation, the Local Government Association and the NHS Institute for Innovation Patient and public engagement for health and wellbeing boards: a review of resources Engaging patients and the public in the commissioning and provision of services is an essential part of these processes as well as a statutory requirement under the Health and Social Care Act (2012). This briefing provides a summary review of key resources to help health and wellbeing boards think about different ways of going about it. Patient and public engagement: a practical guide for This guide is designed to help health and wellbeing board members think through, plan and deliver their responsibilities in relation to patient and public engagement. It provides practical learning on how and when to engage, and ways this can work alongside the responsibilities of partner organisations, in particular local Healthwatch. Support and resources for heath and wellbeing boards This summary provides information on organisations that deliver support and produce resources to enable health and wellbeing boards develop and operate effectively. It aims to spread networking and learning opportunities for health and wellbeing board members. 7

Further information Email hwb@nhsconfed.org www.nhsconfed.org/hwb INF33601