Expanding Patient Choice Of Provider For NHS Funded Services Form - deadline 24th October 2011.
The health service is undergoing considerable change and these pages are designed to help you make sense of these changes. The changes are complex but we have tried to make this information as clear as possible. Please see here for our list of health and adult social care terms.
Clinical Commissioning Group (CCG) - formerly known as GP Consortia
GPs will play a critical role in influencing the NHS budget. They will work with other health and social care professionals and will commission the majority of NHS services. They will be responsible for commissioning £80bn worth of spending and contracting arrangements. Much of the CCG's role is currently the responsibility of the Primary Care Trust, PCT (NHS Brighton and Hove). You can read more about the PCT on their website: www.brightonandhovepct.nhs.uk
According to Lord Howe: GP consortia will ensure greater accountability direct to the ground. GPs navigate the system every day for their patients. GPs should be able to design better and more accountable services. Although he recognises that moving to a new system is always challenging. GP consortia must have a full range of clinical input. IT is up to the GP consortia to decide what commissioning activities GPs do themselves or contract out. GP consortia will grow organically in the best interests of their patients.
Brighton and Hove has set up a transitional CCG, which is chaired by a Brighton and Hove GP, Xavier Nalletamby. The CCG will formally take responsibility in April 2013 or when they are ready to do so. Please see below for a diagram of the structure of the CCG. The LINk has been asked to sit on this group which will meet monthly.
Health and Well-being Boards (HWBs)
Background, the Broader Picture
The HWBs are part of the broader plans to modernise the NHS, joint, integrated working is essential to developing a personalised health and care system that reflects people’s health and care needs. It is necessary to keep up with the increasing demand on services, an ageing population and rising costs of new drugs and treatments and ensuring high quality, efficient services for patients.
The Localism Bill should mean that Local Authorities (LAs) will have the freedom and flexibility to do what’s best for their local area. Clinical Commissioning Groups (formerly known as GP consortia) will have responsibility for 80% of the NHS budget and be responsible for commissioning (how and on whom public money should be spent) services such as acute hospital care, community care, mental health services.
Personalisation
Personalisation means that people receiving services have more freedom to determine both the type of support they receive and the services that provide this support. The HWB will need to ensure that there is a true open market – this means that there are a variety of services to choose from which reflect the needs of the people using them.
Health Inequalities
The focus has been on lifestyle factors, meeting targets e.g. stopping people smoking, not looking at why people smoke in the first place. More money is usually spent on hospital care, treating people who are ill rather than preventing ill health by working on the wider factors (commonly known as determinants) that affect health such as poverty, housing.
Funding
Over the next four year the NHS has to make £20 billion savings and Brighton and Hove City Council has to save £82 million. There is also a tightening of the eligibility criteria for social care. These savings will undoubtedly have an impact on health and wellbeing.
What is a Health and Wellbeing Board (HWB)?
HWB are a statutory requirement (required by law). HWBs will bring together elected representatives, Local HealthWatch (who will represent people who use services) and health and social care commissioners, such as GPs and directors of public health, to plan the right services for their area. HWBs should help give communities a greater say in the services needed to provide care for local people and tackle the wider influencers of health such as transport, housing and leisure services.
Core Duties
• Undertake a joint strategic needs assessment (understanding the future health, care and well-being needs of their community. The JSNA aims to support action to improve local people's well-being by ensuring that services meet their needs. The JSNA is designed to inform and drive future investment priorities to help to plan services more effectively. It is known in Brighton and Hove as the City Needs Assessment).
• Develop a joint Health and Wellbeing Strategy between the Council, the GP Commissioners and the NHS Commissioning Board.
• Encourage integrated working between providers, including the use of pooled budgets and other financial arrangements
The minimum membership:
• The Leader, or a member appointed by the Leader (as Chair)
• Director of Adult Social Care
• Director of Children’s Services
• Director of Public Health
• A representative of the local HealthWatch
• A representative of each of the GP commissioning consortia in the local area (one consortium can represent all of the consortia if the Board agrees)
• A representative of the NHS Commissioning Board (who will contribute to the Joint Strategic Needs Assessment and the Health & Well-being Strategy and to discuss issues related to services commissioned by the NHS Commissioning Board)
The council may appoint anyone else it thinks appropriate. Once the Board is established, the local authority must consult with the Board before appointing any additional members.
What’s the LINk’s role in HWBs?
Local HealthWatch (LHW) will be given a place on the HWB, this strengthens our role in commissioning decisions. The LINk (to transform into LHW) were invited to the HWB seminar 26th July which is welcomed as it’s the first step in ensuring partners are able to shape the HWB and feel part of it – essential for true partnership working. The LHW representative’s role will be to gather and represent views about local health and social care needs and the performance of services.
What’s the latest news on HWBs?
There are 132 early implementers which will create ‘shadow’ health and wellbeing boards in their council. Brighton and Hove is not an early implementer so arguably will have less influence on central government to shape HWBs. It is hoped that all local authorities will have shadow boards in place by April 2012. Fully-fledged boards will be up and running in April 2013 at the same time as GP consortia (clinical commissioning group) take on responsibility for the NHS budget, subject to Parliamentary approval. Nearly £1million has been made available to support the development/start-up of health and wellbeing boards. HWB early Implementers webpages: http://healthandcare.dh.gov.uk/category/early-implementers/