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CCGs and HWBs must work together

That local authority councillors and GPs would think differently about the public’s health is no surprise. However, HSJ’s analysis of the relative priorities selected by clinical commissioning groups and health and wellbeing boards is enlightening for two reasons. It illustrates where that difference lies and the work needed to close the gap.

‘The most interesting thing will be to watch how these two bodies reconcile their differences as they are required to work together in allocating shared funding’

The areas of divergence will again surprise few, though it is revealing quite how little emphasis CCGs place on preventing ill health. One of the hopes of CCGs was that GPs’ daily experience of the impact of the determinants of health would mean the NHS paying more attention to prevention.

It could well be that CCGs are developing preventative strategies as part of plans to tackle “long term conditions” and other priorities − but at present their to-do list looks as focused on tackling healthcare demand as any primary care trust.

Likely bedfellows

The strongest area of agreement is, ironically, another Cinderella service. Mental health is the only priority to make HWBs and CCGs’ top fives.

‘If the partners need an incentive to work together, the thought of increased central oversight if progress is slow should be all they need’

However, the most interesting thing will be to watch how these two bodies reconcile their differences as they are required to work together in allocating shared funding. A belief that integrated care will mitigate the need for spending increases, as well as pleasing voters, will make it a priority for this and any forthcoming government.

Should they win power, Labour’s proposed council takeover of commissioning budgets is unlikely to be delivered within the parliamentary term, which means that under any scenario HWBs and CCGs are likely to be bedfellows for the foreseeable future.

It will be fascinating to see how the two bodies relate; what, for example, will cash starved local authorities make of the 20 CCGs underspending their budgets? If the partners need an incentive to work together, the thought of increased central oversight if progress is slow should be all they need.

Readers' comments (4)

  • Why is there no mention also of the responsibility of NHSE's 27/29 national Local Area Teams to commission all aspects of Primary Helalth Care, Specialist Services' Health Care and Imprisoned Offenders Health Care? Will they also join the Local Authority world? Anita Higham

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  • Integrated care is good in its self and so much the better if costs are reduced, but dont think it will solve the funding issues over the next 3 to 4 years and more likely to required front ended finance for what is likely to be a challenging programme. To become the centre of commissioning HWB board would have to change fundamentally and what little I have seen of Hertfordshire's is unimpressive. Labour needs to 'nuance' its proposals to have a practicable proposition for the next parliament.

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  • As the comments section in the original story points out, this analysis is almost completely bogus.

    If you actually read the content of any of these strategies (rather than just ticking off chapter headings) you won't find any evidence of differing priorities other than those due to the different emphasis of organisations set up with subtly different purposes.

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  • Hello anonymous 20/9 11:38
    I spent last Thursday and Friday with 45 CCG leads at the HSJ Commissioning Summit. At the end of the meeting - when asked what they would do when returning to base - many said they would seek to exercise much greater influence over their HWBs. I think that supports my argument.
    Alastair, Editor HSJ

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