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Health and wellbeing boards - roles and responsibilities

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This section explains how health and wellbeing boards operate and their main responsibilities. We recommend you read this before reading the 'Engaging and influencing health and wellbeing boards' page.

What is the purpose of health and wellbeing boards?

HWBs bring into one forum representatives from health, social services and the local community to decide what the main public health needs of the local population are, and to determine how best to meet them in an integrated and holistic manner. They have a statutory duty to encourage the integrated delivery of health and social care to advance the health and wellbeing of people in their area.

Where do health and wellbeing boards operate?

The local authority is responsible for establishing a HWB for its area. They are a statutory requirement for upper tier and unitary local authorities (i.e. county councils, unitary authorities in shire areas, London boroughs and metropolitan boroughs). Second tier councils (district, borough, city councils) may create a HWB (for instance as a sub-committee of the upper tier HWB) but this is not a statutory requirement.

Who sits on health and wellbeing boards?

The core membership of HWBs is prescribed by legislation and includes:

  • A councillor or elected mayor/executive leader of the local authority;
  • The director of adult social services;
  • The director of children’s services;
  • The director of public health;
  • A local Healthwatch representative; and
  • A representative from each CCG in the area.

The local authority also has latitude to include other people following a consultation with the rest of the HWB. In roughly half of HWBs, this includes one or more voluntary sector representatives.

What are health and wellbeing boards responsible for?

HWBs provide oversight of the local health and care system: they do not commission health services themselves and do not have their own budget (although the local authority may delegate some of its functions and budget to the HWB). It is worth noting that some are pushing for HWBs to have a more direct role in commissioning, particularly to ensure the provision of integrated care. The principal responsibilities of HWBs are:

  • Producing joint strategic needs assessments (JSNAs): JSNAs are assessments of the current and future health and social care needs of the local population. HWBs must consult with the local community when producing the JSNA and should take into account a broad range of issues, including demographics, the particular needs of disadvantaged or vulnerable groups and wider social, environmental and economic factors which might impact on health and wellbeing. The JSNA must be taken into account by local authorities, CCGs and NHS England when preparing or revising commissioning plans. For more information, see Regional Voice’s resources on JSNAs.
  • Producing joint health and wellbeing strategies (JHWS): JHWSs are strategies for meeting the local health needs identified in the JSNA. Like JSNAs, JHWSs must be taken into account by local authorities, CCGs and NHS England when preparing or revising commissioning plans.
  • Oversight of CCG commissioning plans: CCGs must liaise with the HWB when preparing or making significant revisions to their commissioning plans, and provide the HWB with a draft plan. The HWB opinion on the final plan must be published with the commissioning plan. The HWB can refer the plan to NHS England if it thinks the JHWS is not being taken account of properly and must be consulted by NHS England when the annual performance of each CCG is drawn up.
  • Better Care Fund plans: The Better Care Fund is a £5.3 billion pooled budget to allow health and social care services to work together in producing more integrated services.

A who’s who of health commissioning

To understand how HWBs work, it is important to be familiar with the other key bodies in the health commissioning landscape. These are summarised below.

  • NHS England The national body responsible for overseeing the commissioning of health services by CCGs; also commissions certain services directly.
  • Public Health England Executive agency providing expertise and information to public health teams in local authorities and the NHS.
  • Health and wellbeing boards Bring together relevant statutory agencies, Healthwatch and others to agree strategic priorities and ensure commissioned services meet local needs.
  • Clinical commissioning groups Groups of local GPs responsible for commissioning most local health and social care services.
  • Commissioning support units Providers of commissioning support services to NHS commissioners.
  • Healthwatch Responsible for engaging with users of health and social care services and ensuring their views are heard.
  • Strategic clinical networks Networks of commissioners, patients and providers which ensure a strategic approach to improving quality of care in priority areas.
  • Clinical senates Comprised of a steering group and broader forum of experts to provide strategic advice to commissioners in their local area.
Page last edited Jul 10, 2019

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