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Such a change would enable a greater shift towards true integration from above-

not a board governing a system at arms' length, but to actually be a management

board of an integrated budget/system.

Figure 3: How great a positive impact could your Health and

Wellbeing Board have on improving health and social care outcomes, were it to be given more powers and responsibilities?

32%

53%

15%

0% 0%

Very significant Substantial Noticeable No impact Negative impact

Stakeholders think this could work-from a survey of more than 100 local health

leaders, a third of respondents thought that a strengthened HWB would have

a 'very significant' impact on health and social care outcomes, and a further

53 per cent thought it would have a 'substantial' impact (see figure 3). As one

interviewee said, a strong HWB Board chair could "pull council, CCG, acutes

together in a room" and "take the silliness out of the way". But to have the

requisite teeth, we believe it is essential that everyone is engaged, and for this to

happen, we believe there needs to be statutory seat on HWBs for acutes.

Recommendation: Acute trusts to be made a statutory member of

the HWB.

Impact: This would:

• Help to break down the fragmentation that exists between the NHS and

local government by building stronger relationships at the local level.

• Enhance local healthcare system leadership.

• Improve the co-ordination of care and delivery of local services.

• Develop greater understanding and more effective communication between

the sectors.

4.3 Integrated commissioning budget for older people

But what additional powers should HWBs get? Our survey responses were

interesting, and it is worth noting that only one respondent felt that HWB's should

have no further powers and responsibilities.

Chapter 4 - What Are Our Proposed Solutions?

31

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