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The Southwark Shadow Health and Wellbeing Board Background – The Health and Social Care Act The Health and Social Care Act passed into law in March 2012 and set out significant reform of existing health structures. These changes include: The transfer of public health accountabilities from the NHS to local authorities The abolition of Primary Care Trusts (PCTs) by April 2013 The establishment of GP-led Clinical Commissioning Groups (CCGs) in the place of PCTs The creation of patient champion groups HealthWatch in place of existing Local Involvement Networks (LINks). The Act also includes a requirement for the establishment of Health and Wellbeing Boards, which it will be a duty of the local authority to coordinate. Over the last few months, a significant reorganisation has taken place in the local NHS. This has included NHS Southwark, the local PCT, merging with the PCTs of Bexley, Bromley, Greenwich, Lambeth and Lewisham to create the NHS South East London Cluster. This resulted in the ending of many joint arrangements that previously existed between the Council and NHS and, with the establishment of a GP-led Clinical Commission Committee in the borough, provided an opportunity to refresh the way that the two organisations work together. In addition Southwark Council has agreed to share a Director of Public Health (DPH) and a specialist public health team with Lambeth Council. The decision was taken by the Cabinet at its meeting on 17 July and follows a similar decision by Lambeth's earlier this month in a move to improve health and wellbeing across two key London boroughs. With this arrangement, Lambeth and Southwark are looking to bring their teams together so that they can make a real impact across a wide area of inner London. Both organisations have now agreed that they will now undertake immediate work with the NHS to specify and establish the shared DPH and specialist public health team. Establishing a Health and Wellbeing Board As a member of the Department of Health’s Early Implementers Network, Southwark committed to establish a shadow Health and Wellbeing Board by April 2012, a year prior to the Board gaining statutory powers. In November 2010, the Leader of the Council agreed that the Cabinet Member for Health and Adult Social Care would oversee a programme of work to make preparations for the implementation of the changes in the Bill. This included a project to establish a new Health and Wellbeing Board. In order to commence this work, a Planning Group was established to: oversee work to establish a Health and Wellbeing Strategy and Board in Southwark, including to oversee our engagement approach and other work provide expert advice about the health and wellbeing issues and solutions in the borough to help inform our future prioritises The members of the Planning Group were 1: Cllr Dora Dixon-Fyle, Cabinet Member for Health and Adult Social Care (chair) Dr Patrick Holden, Southwark Health Commissioning 1A place on the Planning Group was allocated for a member of the Southwark LINk, although this was not taken up due to the independent review of this organisation which has been underway throughout the course of the Planning Group’s work. Dr Mark Ashworth, Southwark Health Commissioning Andrew Bland, Managing Director, NHS Southwark Business Support Unit Robert Park, NHS Southwark – Non-Executive Director (NED) Ann-Marie Connolly, Southwark Director of Public Health Romi Bowen, Strategic Director of Children’s Services, Southwark Council Gill Davies, Strategic Director Environment and Leisure, Southwark Council Susanna White, Strategic Director of Health and Community Services, Southwark Council Graeme Gordon, Head of Corporate Strategy, Southwark Council Jane Garnham, Interim Chief Executive - Community Action Southwark The Planning Group met four times between October 2011 and March 2012. In addition six work streams were established to support the work of the board, with different members of the group leading each one and reporting back at the meetings. The work streams were Principles and Behaviours, Priorities, Engagement, Governance, Learning and What’s working well. The Shadow Board The Board has been established in “shadow” form for one year, prior becoming a statutory committee of the Council. This timeframe provides the Council, the local NHS and other key partners with an opportunity to work together on the implications of the legislation through the “shadow year”, and to commence work with all partners in the borough to address the health and wellbeing challenges in Southwark. Membership of the shadow board comprises those individuals who are required to be members of the Board as set out in the Health and Social Care Act, as well as a number of additional members agreed by the Leader of the Council. This second group of members will serve a fixed-term on the shadow Board until 31st March 2013, prior to the establishment of the Health and Wellbeing Board as a statutory committee of the Council. The members of the Southwark Shadow Health and Wellbeing Board are: Cllr Peter John – Leader of Southwark Council Cllr Catherine McDonald – Cabinet Member for Health and Adult Social Care Cllr Dora Dixon-Fyle – Cabinet Member for Children’s Services Andrew Bland – NHS Southwark Business Support Unit (BSU) Managing Director Dr Amr Zeineldine – CCG Chair Dr Patrick Holden – Member of CCG Charles Griggs – Southwark Borough Commander, Metropolitan Police Service Professor John Moxham – Representative from King’s Health Partners Romi Bowen – Strategic Director for Children’s Services Susanna White – Strategic Director for Health and Community Services Dr Ann-Marie Connolly – Director of Public Health Fiona Subotsky – Representative of Southwark LINk/HealthWatch What the board will do The shadow Health and Wellbeing Board in Southwark will be a new forum where the Council, the NHS and other key partners will come together to do those things that each of these organisations cannot do alone. The shadow Board will be at the core of the Council’s new role in championing improvements to the health and wellbeing of the local population, and leading the transformation of public health in Southwark. In this work, the shadow Board will involve the communities that the Council, NHS and other partner organisations serve to help to address these challenges and to tackle health inequalities in the borough. Four areas of focus have in particular been identified where the shadow Board will have a role in leading change. These were scoped initially by the Planning Group and agreed at the first SHWB meeting on 10th July 2012. The four priorities were: Prevention or reduction of alcohol-related misuse Coping skills, resilience and mental wellbeing Early intervention and families Healthy weight and exercise The changes in the Health and Social Care Act, which provide for closer working relationships between the Council, local GPs and the health community, are an opportunity to deliver improved outcomes together both with the new organisations in the NHS and with other partners. One of the key roles of the shadow Board will be to champion joint working between the Council, NHS and other partners where this already works – but also to encourage integration across areas where this can improve the services that are delivered to patients, clients and families in the borough. The shadow Board will also develop and lead the implementation of a Joint Health and Wellbeing Strategy (JHWS), informed by a needs assessment of the borough’s population. Both the JHWS and the Joint Strategic Needs Assessment (JSNA) which will inform it are statutory duties of the board. The JHWS will sit within a policy framework in Southwark which includes the Council Plan and the NHS Clinical Commissioning Group five-year plan. The strategy will build on what already works in the borough, and also provides a framework for the Council to lead the transformation of public health. Southwark Strategic Partnerships The changes in the Health and Social Care Act envisage a new role for local authorities. The 2010 review by Sir Michael Marmot, Fair Society, Healthy Lives, set out the limitations of the current system in which “the perception among agencies is that responsibility for the delivery of health improvement lies with the NHS”. The review also identified that local government and other public sector partners hold many of the levers that shape and can have an impact on health inequalities. The new role for local authorities, as demonstrated through the establishment of health and wellbeing boards, will be to work with the NHS and other key partners to champion improvements in terms of the health and wellbeing of the local population. In 2010 the Government removed the statutory responsibility for Local Authorities to produce a Local Area Agreement. Since then the Localism Act has also given Councils more freedom to determine their own strategic partnerships. While there is little clarity about how this might work in practice, these changes would appear to give Southwark the opportunity to pursue a more flexible and dynamic model of partnerships that recognises the value and contribution of each partner to key issues. In addition to this new vehicle for local authorities and their partners to work together through the Health and Wellbeing Board, there are also a number of existing Strategic Partnerships in Southwark which demonstrate how the Council and its partners can come together to work in a constructive way. These are outlined below. Southwark Housing Strategic Partnership (SHSP) This is a multi-agency partnership whose purpose is to improve the lives of residents through developing and effectively responding to a sound and shared understanding of the housing needs of residents across all tenures, making the best use of resources. The focus of the SHSP will be on cross tenure strategic and partnership working rather than operational issues. The overriding strategic aims of the partnership are from the Housing Strategy 2009 to 2016. These are to: 1. Improve the quality of existing housing and use it more efficiently 2. Increase the supply of good quality housing 3. Enable choice while meeting housing needs 4. Prevent homelessness and reduce the use of temporary accommodation Safer Southwark Partnership The Safer Southwark Partnership (SSP) brings together the council community safety & enforcement team, the fire brigade, the probation service and the police to work together with other agencies to tackle crime and disorder issues in Southwark. The board is chaired by Borough Commander Charles Griggs and aims to aims to reduce crime and disorder in Southwark. The Safer Southwark Partnership (SSP) has agreed minimum standards of service for responding to antisocial behaviour and for victims and witnesses of crime. These are a commitment to residents that the SSP will continue to keep Southwark a safe place to live, work and visit. The board has a whole systems approach based on four tiers consisting of: Prevention Early intervention Intensive support and intervention Enforcement The SSP’s priorities for 2011/12 were agreed in the context of reducing financial resources and the need to target effectively to ensure maximum impact. The priorities are: Reducing harm (including the harm cause by serious ASB) Reducing offending Supporting families and those with multiple disadvantages Building sustainable community capacity and public confidence Southwark's Children and Families' Trust The Southwark's Children and Families' Trust is the main partnership between key agencies providing services for children, young people and their families in Southwark. It oversees how the joint partners will co-operate and work together to improve the well-being of children and families in Southwark. The key agencies involved include: Southwark Council, local health providers including GPs, Community Action Southwark, Southwark Borough Police and schools. The partners of Southwark’s Children and Families’ Trust helped to develop Southwark’s Children and Young People’s Plan for 2010 to 2013. The five priority themes identified in this plan were: Thinking family - making sure services meet families' needs Narrowing the gap - to ensure everyone in the borough has the same opportunities Raising the bar – providing high-quality services and excellent schools and settings Succeeding into adulthood - helping young people make the step to adulthood Working together to keep children safe - making sure everyone knows what to do if they have worries or concerns about a child From 31 October 2010 the Government changed the approach to Children’s Trusts with much of the statutory guidance being withdrawn and Children and Young People’s Plan (CYPP) Regulations revoked. This meant that Children’s Trust Boards were no longer required to produce a statutory Children and Young People’s Plan. Southwark has decided to retain and strengthen the work of the Southwark's Children and Families' Trust. Local Economy Group This partnership is under review as part of the refresh of the local economic well-being strategy, which is due to take place in autumn 2012.
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