NHS reforms explained We explain how health and wellbeing boards will be crucial to securing pharmacy services
Catch up with the other parts of this six-part guide on C+D's NHS reforms homepage.
What are they?
Health and wellbeing boards – which have been quietly getting on with things in shadow form for a while now – are the committees that will join up health, social care and local authorities under the new NHS.
With one board per local authority, their role is to strengthen links between healthcare and social care, encourage integration in commissioning, determine local priorities and drive up local health and wellbeing while driving down health inequalities. They are also the forum through which communities are to have a greater say in their health and social care needs.
As set out in the Health and Social Care Act, each board must comprise membership from one local elected representative, a local Healthwatch (an independent ‘consumer champion' body) representative and someone from each local clinical commissioning group (CCG), as well as the local authority directors for adult social services, children's services and the director of public health.
Beyond these requirements, boards can build membership as they wish, including representatives from local charities or voluntary organisations.
What will they do?
Health and wellbeing boards will provide the strategy for commissioning decisions across health, public health and social care in a given locality. The factors they have to take into consideration include: local demographics; epidemiology; lifestyle factors such as smoking and drinking; access to services; quality standards and Nice guidelines; the social determinants of health, such as crime and employment; and the patient experience of services and views of local communities. The Department of Health is keen to emphasise that they give "democratic legitimacy" to the NHS by giving a voice to local people and interested parties.
Importance to pharmacy (out of five) Health and wellbeing boards: ● ● ● ● ●
Number in England Health and wellbeing boards 152 Many have been working in shadow form for more than a year
Weeks until the NHS reforms go live 4
This week, you should: Find out when your next health and wellbeing board meeting is being held and consider attending either as a pharmacy representative or local community member.
They will also be responsible for putting together joint strategic needs assessments (JSNA) – which will shape NHS public health and social care services, as well as integrated care. The involvement of local authorities means the boards will also address issues such as housing and education, which can have an impact on health.
Importantly for community pharmacies, the boards will also take over responsibility for pharmaceutical needs assessments (PNAs) from PCTs. From April, these will just switch over in existing form unless there is a pressing need for redrafting.
Because health and wellbeing boards are responsible for creating the strategy for improving the health of local populations through the JSNA, they will be key to commissioning and, for pharmacists, health and wellbeing boards could well turn out to be more important than CCGs themselves.
How do they fit into the new NHS?
Health and wellbeing boards will be statutory bodies that come into force in April 2013. Their role will be to support both CCGs and the NHS Commissioning Board, although a report from the Kings Fund pointed out that they will likely have most influence at a local level.
What do pharmacists need to do?
It is absolutely vital that pharmacy engages with local health and wellbeing boards, both through LPCs and local professional networks (LPNs) and as members of the community; meetings are being and will be held in public as there is a statutory obligation to consult with local people in developing the JSNA.
For pharmacy to have a central role in primary care, it needs to be included in the strategies set out by the health and wellbeing board. Ash Soni, a pharmacist member of the NHS Future Forum panel, says in his experience there has been an incredibly positive response to local pharmacy from health and wellbeing boards – which are not necessarily wedded to the traditional medical model.
"We have had councillors turn around and say: ‘In my area there is a new housing development and we want a pharmacy there before we want a GP'," Mr Soni says.
He adds that pharmacies have a "real opportunity" through health and wellbeing boards to put forward their case as a profession. For example, if there is a local assessment of sexual health services, pharmacies could demonstrate that they can meet an unmet need and improve the service currently on offer.