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Engaging and influencing health and wellbeing boards

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In this section we set out a five step practical plan on how to engage and influence health and wellbeing boards. We recommend you read the ‘Health and wellbeing boards - roles and responsibilities’ page before using the plan.

Health and wellbeing boards - roles and responsibilities

1. Do your homework

It is useful to begin by making sure you have a clear idea of how HWBs work in general and how your local one works in particular. The previous section provides an introduction on the first question; the list below lists key pieces of information to help you answer the second:

  • The membership of the HWB, including who the chair and vice chair are and whether there are any representatives in addition to statutory members
  • The terms of reference for the HWB; this sets out governance arrangements for the HWB (where and when it meets, conflict of interest procedures, voting procedures etc.)
  • The current Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy (JHWS)
  • How often the HWB meets and what its mix of formal and informal meetings is
  • The agenda and minutes for the most recent meetings (to give you an idea of how the HWB works in practice)
  • Any working groups, priority delivery groups, sub-committees or other bodies which have been set up by the HWB to consider specific issues, including their members, powers and governance arrangements
  • The identity of the local authority officer(s) responsible for supporting the HWB
  • The identity of the local Healthwatch member(s)
  • Whether there is a voluntary sector member on the HWB, what their background and involvement is, and how they engage with other voluntary sector organisations in the area
  • The other forms of stakeholder engagement outside of representation on the HWB (for instance, networks or open meetings)
  • The main deadlines that are coming up for the HWB
  • Who the elected members are and what their priorities are in terms of health and social care.

This information will give you an overview of how the HWB works in practice, and crucially, where the influence lies. HWBs deal with an enormous amount of information and a voluntary sector representative sitting on the HWB is likely to have limited resources to consider it all; getting a feel for where decisions are made is therefore very important.

In many HWBs it is rare for decisions to be made at the HWB meeting itself – important aspects of strategy may for instance be decided by the planning committee that sets the agenda for the meetings, or in other sub-committees. Contact and other basic information for each HWB is available from various sources including the King’s Fund Directory and Regional Voices’ “Who’s Who in Health and Social Care Guides”. The King’s Fund’s free monthly bulletin also contains the latest news, policy developments and guidance around HWBs. For local information, most HWBs have their own webpages on the local authority website. This LGA interactive map summarises local priorities and contains links to health and wellbeing strategies.

2. Making contact

The best way to contact the HWB is through contacts that you already have. Your local voluntary support organisation is likely to have had some involvement in their work – if you are not sure who they are, have a look at NAVCA’s directory of local support and development organisations in England. In some cases, however, pressure on local authority spending and the introduction of a number of new bodies means that older relationships no longer exist and new contacts need to be made. In either scenario, it can help if the voluntary sector is co-ordinated in its approach to the HWB as HWB members may not have the resources to look through information sent by each individual voluntary organisation.

The following list sets out some points to consider before contacting your HWB:

  • What are your objectives in engaging with the HWB? Why is the HWB the right body to approach, rather than the CCG, a commissioning support unit, the public health team or a local GP directly? Remember that HWBs have a strategic role rather than commissioning directly.
  • If there is a voluntary sector member on the HWB, they are the obvious person to approach. Work out what engagement channels exist already and use those rather than trying to bypass them or invent new ones.
  • If there is no voluntary sector representative or other form of voluntary sector engagement, think carefully about who to contact. A useful starting point is the HWB supporting officer who will know the best channels of communication.
  • Research the members and identify any who seem aligned with your objectives. A targeted approach is likely to work better than sending a generic letter to the chair. The Healthwatch member is likely to be sympathetic to the voluntary sector, but remember that they represent the patients and the public and not the voluntary sector (see below).
  • Consider whether you are better off targeting your approach at a particular sub-committee if this is where ideas are formulated before going up to the main HWB

Making the case for voluntary sector involvement

In many cases, individuals on the HWB may not have had much previous contact with the voluntary sector or may have preconceived ideas of how the sector operates. In such circumstances it helps to be able to make a concise case for the value of the sector and its economic contribution. The following list sets out five reasons why public bodies should work with voluntary sector organisations:

Expertise: by working with geographic or thematic communities – often over the course of many years – voluntary sector organisations have detailed and granular knowledge of local health and social issues

Value driven: the ultimate goal of the voluntary sector is to meet the needs of its beneficiaries, so it will often deliver added value.

Innovation: voluntary sector organisations can often identify problems and start experimenting with solutions more rapidly than the statutory or private sector – particularly when they are grant funded. 

Preventative services: the voluntary sector excels in early intervention, prevention and holistic services which reduce the need for individuals to rely on statutory services later on.

Contact with underrepresented groups: voluntary sector organisations reach people who are less likely to be heard by government, ensuring that policies take into account the needs of all sections of society.

In order to relieve the strain on public resources, government is having to fundamentally rethink how public services are delivered, including by breaking down silos between health and social care and investing in preventative and early intervention services. It helps to remind the HWB that these are areas in which the voluntary sector already has significant expertise.

3. Determine the best form of engagement

A voluntary sector representative on the board is only one of a number of ways in which the voluntary sector can engage with the HWB. Some of the possible routes are set out below and are also explored in more detail by Regional Voices in “Influencing the Agenda”. Whatever method is used, it is important that the voluntary sector is able to present a united front and ensure that is the views of the sector as a whole that are put forward, rather than just the organisation with the loudest voice.

Possible routes for voluntary sector engagement with HWBs

  • Secure voluntary sector representation on HWB board
  • Give presentation to HWB on local health issues
  • Hold workshops for HWB to help engage with sector and understand local issues
  • Facilitate community forums or public meetings before HWB meetings
  • Create network that feeds into HWB plans or sub-groups
  • Provide input into the JSNA
  • Gather and provide evidence for HWB

It is important than any voluntary sector representative on a HWB has the attributes that make them appropriate for the job – in particular, think seriously about how they are selected and how they communicate with the sector. These elected representatives must work together to gather and share information with the rest of the sector. A representative from a provider of health services who is appointed in a closed process and who does not have regular contact with other voluntary organisations will be more vulnerable to accusations of unfair advantage, even if these are completely unfounded. A transparent selection, or better yet, election process, and clear lines of communication minimises the potential for conflict later on.

For example, the voluntary sector advocate to the Health and Wellbeing Board in Bristol is elected by the local voluntary sector. The work of supporting advocates (there are several in Bristol who sit on strategic boards and partnership groups) is undertaken by Voscur, the local support and development organisation and funded by the local authority. The voluntary sector advocate’s term on the Health and Wellbeing Board is for four years, with the option to stay for a further year. This gives the advocate a chance to really get into the role.

The Regional Voices publication ‘Influencing health and wellbeing boards – reviewing your role on the board’ is a useful resource for new voluntary sector representatives on HWBs.

When considering other ways to influence the HWB, look at the methods of engagement that already exist. It is easier to use these than trying to establish completely new processes.

It is important that the sector does not rely solely on the Healthwatch representative to put forward its views. Healthwatch is the representative for patients and the public, not voluntary organisations and the specific communities they serve, and is unlikely to have the capacity to speak for the voluntary sector. That said, a good relationship between Healthwatch and the voluntary sector representative can be crucial for sense checking and providing support. For further information, see the Regional Voices briefing ‘The voluntary sector: a key partner in local Healthwatch’. It also pays to find out more about how you can work with the Patient Participation Group.

4. Demonstrate your impact

The crucial point is to be able to demonstrate that you are solving a problem that the HWB cares about. This means being able to show both value for money and good outcomes. The NHS Confederation, Regional Voices and the LGA have provided a useful briefing ‘Comparing apples with oranges? How to make better use of evidence from the voluntary and community sector to improve health outcomes’ advising HWBs on useful ways in which they could approach using evidence from the voluntary sector.

The following list provides some questions to consider when making your case:

  • How could your experience contribute to the JSNA and JHWS so that it more fully reflects the needs of the community?
  • How does the issue you care about fit in with the priorities and strategy already identified in the JSNA and JHWS?
  • Do you have any relevant experience in providing integrated services that could assist the HWB?
  • Who are the groups of people that you could help connect the HWB with?
  • Have you got evidence or could you collect evidence which could feed into the commissioning process?
  • Could you found or contribute to a special interest group which addresses a particular relationship?
  • Have you in place robust evaluation processes which demonstrate that you are delivering real social value and value for money?

Public Health England’s Data and Knowledge Gateway, the Office for National Statistics, and the Health and Social Care Information Centre a data catalogue) provide open source data sets which can help the voluntary sector make its case to clinical commissioners and other funders in health and wellbeing.

5. Encourage Compact working

The national Compact and local Compacts

The Compact is the agreement between government and the voluntary sector in England. It sets out key principles which establish a way of working that improves their relationship, in order to achieve common goals for the benefit of communities in England.

Local Compacts are often based on the national Compact but tailored to reflect the needs of each community. Local Compacts have signatories from both sectors, such as the local Council for Voluntary Service, the local authority and Clinical Commissioning Group. Some HWBs are also signed up to their local Compact. This map of local Compacts will help you find your local Compact and the main point of contact.

Using Compact principles

The national Compact is made up of five key principles, each of which sub-divides into a number of specific undertakings on government and/or the voluntary sector:

1. Strong, diverse and independent civil society

2. Effective and transparent design and development of policies, programmes and public services

3. Responsive and high quality programmes and services

4. Clear arrangements for managing change

5. A fair and equal society

Each principle is sub-divided into a number of undertakings made by government and / or the voluntary sector. These undertakings are more than abstract concepts – they are concrete steps which can help ensure that the voluntary sector is not an optional extra, but a co-producer and provider. Using the national Compact as an example, the table below shows how undertakings within Compacts can be used by the voluntary sector to push for real change.



Application to HWB


Ensure greater transparency by making data and information more accessible

Encourage the HWB to hold more of their debates in public, to tweet and to live stream meetings


Work with civil society at the earliest possible stage to design policies, programmes and services

Convince the HWB to let the voluntary sector become more involved in the committees that set agendas and send papers out


Ensure all bodies distributing funds on the Government’s behalf adhere to the commitments in this Compact

HWB constituent members (including CCGs, social services and public health teams) to take the Compact into account in their own activities


Acknowledge that organisations helping specific disadvantaged or under-represented group(s) can help promote social and community cohesion

Encourage the HWB to make links with voluntary groups working with seldom heard groups in order to fulfil its own duty to involve such groups

Embedding the Compact in your local community

The Department of Health’s statutory guidance on JSNA and Joint Health and Wellbeing Strategies (JHWS) sets out the expectation that the relevant local Compact should be considered and recognised within the JSNA and JHWS process. The 2015 annual survey of local Compacts showed that roughly a quarter of Compacts were signed by the local HWB. While exactly who is signing up and in what capacity can mean different things in different areas, the important point is that HWBs are increasingly becoming more engaged with the Compact.

It is important to remember that the voluntary sector also must uphold certain standards of behaviour in order to ensure productive relationships. This involves being open, constructive and using a robust evidence base to back up positions.

The following list provides some pointers on how to encourage good partnership working:

  • Encourage explicit reference to the principles of the Compact in commissioning plans, thinking about the practical implications of each principle in your local context.
  • Establish routes of communication between the HWB and the local Compact group.
  • Encourage the HWB to sign up to the local Compact if they are not already – this can be part of a broader renewal. This might be the chair signing on behalf of the entire board or encouraging each of the constituent members to sign up.  
  • Remember the other levers for good partnership working – in particular the public authority’s duties under the Public Services (Social Value) Act 2012 and the public sector equality duty under the Equality Act 2010.
  • Make the most of the HWBs duty to involve the local community, including people living in different geographic areas, communities of interest and seldom heard groups when developing its JSNA and JHWS.

Finally, good partnership working between voluntary organisations can be as crucial as good partnership working between the voluntary sector and the public sector. While competition between voluntary sector organisations can make this more difficult, the sector can have more influence when it presents a co-ordinated front.

Examples of voluntary sector engagement with health and wellbeing boards

Page last edited Mar 28, 2017

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