By Ged Devereux, Policy Lead, Health and Wellbeing Board Implementer Team, North West Employers 

Health and wellbeing boards (HWB) – they are the best thing since sliced bread and they will solve the problems of the world. So that’s okay then, job done, new members, new board, and a new strategy and off we go again. I get the feeling that after 23 years in local government, l have been here before.

All HWBs went live on 1st April 2013, meaning that they are now going to be tested in the full glare of the public. So what’s so different about them?

Well for one thing, the board brings the local clinicians and politicians face to face over the boardroom table with Healthwatch keeping a close eye on them both as it tries to represent local people’s views. They are supported by a range of council officers including the Director of Public Health, and in some cases providers including the voluntary sector and a representative from NHS England. In fact it is the rich and diverse mix of board members that presents both a challenge and an opportunity to the boards.  

Getting people together from such different backgrounds, some more powerful then others and without precedence of working together before to work collaboratively, is not going to be easy. Add to this the task set for them. To implement government and local policy on health and care reforms at the same time as dealing with eye watering public sector cuts. The equality of board members is sure to be tested; some may be more equal than others and the chair and others will need to make sure that all have an equal say and are able to exert equal influence.

However, there is the tantalising prospect that the HWB does present an opportunity to get it right this time and use the collective power and influence of these key local players in the health and care economy to make a real and lasting impact on local people’s health and wellbeing and to narrow the inequalities gap. The word collective is an interesting one – it will be the most important and telling word that you will hear mentioned in the same sentence as HWB. The boards and their members have to think and act differently, no more turning up to represent and protect your bit of the system, if we do not do something radical then there will not be a system. I am not too sure if this is what the powers that be were thinking of when they termed the phrase we are all in this together but that’s where we are folks.

The HWB is a partnership and we are not new to partnerships but getting them to work is not easy, not least because it means bringing together diverse groups of people with different professional cultures, expertise and expectations of what should be achieved. The key challenge for any partnership is to find common ground that everyone shares and ensure that these differences do not obstruct or slow down progress but are recognised as features that will add value to the work of the board.

Getting health and wellbeing boards to work well will not be easy but they need to avoid falling into the trap of:

  • relying on traditional ways of doing things
  • replicating and battling through the problems that often beset traditional partnership models and which hamper achievement

If they are to have the impact that people are expecting then HWBs need to:

  • think radically and creatively and be prepared to take managed risks
  • turn traditional professional, organisational and cultural norms on their head in order to achieve better outcomes with fewer resources
  • build robust strategic structures with a common purpose and agreed ways of doing things
  • lead and champion change with determination and persistence across and within public sector organisations and the private sector
  • develop and manage the accountability frameworks that will deliver the desired change at all levels

Okay, HWBs are not the best thing since sliced bread and they will not solve the problems of the world. Relationships may become strained  but there is a chance that given the membership, driven by necessity and local determination, they could succeed in addressing some long standing barriers to improving health and wellbeing and at the same time improving people’s outcomes when using local services.

Even after 23 years l remain an optimist. 

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