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?
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
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
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?