Whitehall launches probe into health and wellbeing boards

The Department of Health will also work alongside Monitor, the Trust Development Authority, the NHS Confederation and the Local Government Association to “support” HWBs to secure health providers “crucial” input, the DH told HSJ.

“It is essential that HWBs and providers work closely together to ensure that all parties are involved in discussions about the planning, commissioning and delivery of local services,” a spokeswoman for the DH said.

“We will be working with partner organisations to look at how we can support areas to make sure this is the case.”

The push on health provider involvement comes after an analysis of local better care fund plans by DH officials identified an apparent lack of provider engagement by HWBs.

This in turn led to a joint DH and Department for Communities and Local Government launch event- scheduled for April- being pushed back to June.

The DH says the better care fund policy had not been delayed and would be implemented in full at the beginning of 2015-16, as set out in last year’s Spending Round.

The decision to examine HWBs follows concerns from providers that they were being excluded from discussions. Ministers and NHS England have also urged HWBs to involve providers in discussion of their better care fund plans.

Although the DH enquiry will not amount to a formal review, the department has no current plans to alter the legal basis of HWBs or the rules around their board membership. 

Instead, it is intended to result in offering “support” to local areas to ensure providers are properly involved. 

Although the review has been prompted by better care fund planning, it will examine and could potentially affect all aspects of HWB work, HSJ understands.

Provider engagement by HWBs is currently considered to be variable; around 30 per cent of HWBs voluntarily include providers in their membership at present.

King’s Fund chief executive Chris Ham told HSJ that extra assurance work on better care fund plans was “closing the stable door after the horse has bolted”.

“The decision has been taken to transfer the money,” he said.

“The plans have already been submitted. Very late in the day there is a realisation in Whitehall that the plan is not as it should be.”

However the move was welcomed by the Foundation Trust Network.

Spokesman Nick Samuels said: “We are pleased that the DH has taken our concerns seriously and promptly acted to ensure providers play a full role in planning local health and social care services.

“The better care fund is an opportunity to align health and social care that must not be undermined by lack of involvement from those will make the changes and deliver the services.”

Martin Green, chief executive of Care England, which represents independent care providers, said: “I don’t think they’re looking at social care providers properly.

“The system is completely obsessed with the NHS. HWBs will never find the solutions that are required by only engaging with one part of the system.”

His views reflect a wider concern over how many small independent social care providers can be brought into HWB discussions on an equal footing to NHS provider trusts.

He added that there was no systematic approach to monitoring the performance of HWBs, based on the outcomes they achieve for their populations.

Another source added that, although the 2012 Health Act allows HWBs to control funding, they are fundamentally designed to be advisory bodies, rather than commissioners.