Transcript Insert main title here - Local Government Association

Local leadership of health reform
Alyson Morley
Senior Adviser
LGA
21 November 2012
www.local.gov.uk
Presentation outline
• Overall context for local government
• Key elements of the reform agenda
• Preparing for transition - support offer to
HWBs and new partners
• Critical success factors
What’s the overall context for local
government?
• Overall financial context for local
government – 28% reduction
•
Localism
•
Place-based budgets – joining up the
public sector to get better services,
better outcomes and to do more for
less
•
Public health architecture – still
awaiting operating framework for
PHE, public health outcomes
framework, indicative allocations of
public health grant
•
Promoting choice, diversity and
personalisation
Progress of health reform
•
•
•
Bigger than the Bill to create the NHS
A bumpy journey through the political process
LGA has focused on 4 areas affecting local
government
1. Health and Wellbeing Boards
2. Commissioning and provision of NHS services
3. Proposals for public health
4. Patient and public involvement
5. Transitional arrangements
Key elements of the reform
1. Health and Wellbeing Boards (HWBs)
• HWBs will be the drivers of system reform
• Minimum membership specified but most areas will go further
• Main responsibilities
– To promote coordination and integration of services
– To develop the joint strategic needs assessment
– To agree the joint health and wellbeing strategy
• Duty of cooperation between HWBs, CCGs and NHS
Commissioning Board
• Provide democratic accountability for health and wellbeing
commissioning
• Vital role for districts, town, parish councils and
neighbourhood assemblies to direction and delivery
HWBs – developing relationships
Key elements of the reform agenda
2. Commissioning and provision of
services
• More integration of health and social care
• 80% of NHS spend through clinical
commissioning groups
• Promotion of diversity through ‘any qualified
provider’
• Leading role for local authorities in setting
priorities for commissioning
Key elements of the reform agenda
3. Public health
• Creation of Public Health England (PHE) – mainly
responsible for health protection
• Public health responsibilities transferred to local
government – including employment of Directors of
Public health
• Ring fenced public health budget to LAs from 2013
• Focus on outcomes – improved health and reduce
health inequalities – not processes or outputs
• Vital role of districts in delivery of public health
LA Public health responsibilities – 2013
• Weighing and measuring
children
• Dental public health
• Fluoridation
• Medical inspection of school
children
• Sexual health
• Seasonal mortality
• Accidental injury
• Physical activity
• Drug, alcohol and tobacco
misuse
• Obesity
• NHS health check
programme
• Health at work
• Reducing and preventing
health defects
• Prevention and early
intervention
• Children’s public health (5 –
19)
• Social exclusion
PHE/NHS CB responsibilities - 2013
Public Health England
• Infectious diseases
• Immunisation
• Standardisation and bio
medicines
• Environmental hazards
• Emergency preparedness
• Health intelligence
• Nutrition
NHS Commissioning Board
• Screening
• Children’s public health (0 –
5)
• Public health of prisoners
Key elements of the reform agenda
4. Patient and public engagement
• “Nothing about me without me”
– Personalisation
– Choice
– Engagement in needs assessment
– Engagement in commissioning
• Health Watch – the new ‘consumer champion’
for health and care services
Support offer for Health and Wellbeing
Boards
• HWB early adopters – 93% of LAs have
signed up
• National Learning Sets launched on 15
November
• Community of Practice up and running
• Support to system leaders
• Early lessons already being disseminated
Conclusions and critical success
factors
•
•
•
•
•
Relationships not structures
Shared culture not silos
Outcomes not processes
Cascaded leadership and ownership of health
Early and ongoing engagement with all
stakeholders
• Quick wins balanced by long-term objectives
Further information
For information on LGA policy on health reform:
[email protected]
Questions for small group discussions
1. Do the LGA key messages reflect your
concerns?
2. What is your local experience of the health
reforms?
3. What is your view of the LGA programme to
develop collaborative leadership?
4. Are there any other issues, concerns and
questions that you want to address?