Exclusive: Wellbeing boards must avoid becoming 'a side show'

The King’s Fund report warned that although some progress had been made in the boards’ first year they were in danger of becoming “a side show rather than a source of system leadership” if they failed to tackle their areas’ biggest health challenges.

The report, based on responses from 70 of the 152 boards, shows 79 per cent of respondents had drawn up new joint strategic needs assessments of their area and 88 per cent had a health and wellbeing strategy in place.

However, the study by King’s Fund assistant policy director Richard Humphries and researcher Amy Galea said there was little sense that the boards were taking a lead on “immediate and urgent strategic challenges” specific to their local area, including the integration of care and reconfiguration.

Only nine respondents mentioned integration as being among their priorities, despite expenditure under the new £3.8bn integration transformation fund requiring sign-off from the boards.

Mr Humphries said: “They’re expected to hit the ground running and they have got this big hurdle to jump over for getting everybody to agree how to spend this £3.8bn fund.”

This is the second survey of health and wellbeing boards the King’s Fund has undertaken. Last year’s findings suggested boards feared they would have a lack of input over commissioning decisions. This remains an issue, with 77 per cent of respondents saying they feel their board has no influence over NHS England, raising fears that national priorities will overshadow local ones.

In contrast, they had a better relationship with clinical commissioning groups, with 89 per cent of respondents indicating they felt their strategy would have an impact on local commissioning decisions.

Mr Humphries said: “I think NHS England in its commissioning role needs to be around the table as equal partners

with health and wellbeing boards. We got a sense they were still part of the hierarchy rather than sitting down with the boards.”

NHS providers are only slightly more engaged than before, with them being represented on 34 per cent of boards compared with 24 per cent last year. Mr Humphries said he

was more satisfied than last year that “even where providers were saying they weren’t on boards they were still engaging with boards”.

Shadow health secretary Andy Burnham has proposed giving the boards responsibility for all local NHS spending. Sixty-two per cent of respondents said they would like a bigger role in commissioning services for their local population.

The survey also showed 83 per cent of boards were chaired by a senior elected member of the local authority and nearly half by council

leaders. However, two local authorities had an independent chair and two had no chair in place in May, when the survey took place.

When it came to the make-up of boards, all respondents reported they had a director of public health or public health representative, children’s services lead, adult social care lead and Healthwatch representative.