Beefed up health and wellbeing boards extend council powers

The change to the reforms, outlined on Tuesday, state that the boards will have a “formal role in authorising clinical commissioning groups” and have input into annual assessments of the groups, which will be carried out by the NHS Commissioning Board.

They will also be able to bounce back any commissioning plans they feel are not in line with local health and wellbeing strategies.

Local government expert Tony Travers, of the London School of Economics, said: “Local authorities will be enthusiastic about playing a role in the NHS – probably more enthusiastic than people in the health service would wish.”

He predicted councils would seek to use their democratic mandate to prioritise tackling health inequalities and said the NHS should remember that “politicians are under pressure to be seen to be delivering results” in the short and medium terms.

The document outlining the government’s changes said: “Though they will not have a veto, health and wellbeing boards will have a clear right to refer plans back to the group or to the NHS Commissioning Board for further consideration.”

The document also said it will be left to local authorities to “determine the precise number of elected members on a health and wellbeing board, and they will be free to insist upon having a majority of elected councillors”.

The Health Bill had previously said there should be a minimum of one councillor on each board, along with around five other representatives from health and social care.

The changes follow recommendations from the NHS Future Forum that the role and influence of boards needed to be strengthened to drive integration between local health and social care.

But National Association of Primary Care chair Johnny Marshall warned that giving councillors too much power could lead to an imbalance in decision making.

He said: “If it comes down to one party vetoing the other, then that hampers joint commissioning. It’s got to be about creating a genuine relationship.”

Faculty of Public Health vice president John Middleton said there was a danger the boards would become just another council committee, unless there were controls on which councillors could be involved.

He said: “We need councillors with portfolios like children’s services and environmental services to sit on them to give them clout. There is a danger of them becoming politicised.”

But Future Forum member David Rogers, a councillor and chair of the Local Government Association’s community wellbeing board, said giving the boards “teeth” to hold GPs to account was “essential”.