Meeting documents

To receive the presentation and discuss.

The Board considered and commented on the information and presentation.

SCC’s Director of Public Health spoke on the coming ICP and noted that this update carries on from earlier conversations regarding ICS, ICP and the Health and Wellbeing Board’s role.  Somerset has a tidy ICS system, better than in other places, with one central Health and Wellbeing Board in the county.  The new legislation calls for Integrated Care Partnerships (ICPs), which are designed to cover large geographical areas with multiple authorities and boards.  She pointed out that there is a degree of duplication between the ICS and the Health and Wellbeing Board, the benefit of which is Somerset’s strong system narrative of the Improving Lives agenda, which needs to be kept in place.  We need to keep the coming system simple and avoid complicating it; we have made great steps forward toward joining up work, commissioning, etc.  It is a requirement that there be an ICP, which is a statutory body, unlike the Health and Wellbeing Board, which is an organisation.  There are similarities within the delegated responsibilities of both the proposed ICP and the Health and Wellbeing Board, such as addressing inequalities, improving health, etc.  The Health and Wellbeing Board has had clear statutory responsibilities since 2013, but there will be a number of new duties and responsibilities coming with the ICP, where the focus will be more on services.  The Health and Wellbeing Board and the local authority will have to have due regard for the ICP and vice versa.  Statutory membership for the Health and Wellbeing Board has been proscribed by the Health and Care Act, whereas the ICP does not have this; the only requirements are members of local authority and the local NHS, with the recognition in the guidance that not all partners need to be included and the membership can be quite flexible.  As far as governance, the Health and Wellbeing Board is a committee of the full Council and is a public meeting; the ICP will also be a public meeting, and it should be subject to scrutiny, but the guidance doesn’t say.  The Health and Wellbeing Board has not received delegated authority from the full Council; the ICP could delegate, but that has not been decided yet. 

It was noted that there had been a discussion some time ago about the difference between a Health and Wellbeing Board system and a health and social care system, and the diagram they formulated may be needed to help design the HWB/ICP system, because the overlap of functions needs to be dealt with.  With respect to the Improving Lives strategy and other related bodies/issues, she noted that some are statutory, and some boards have statutory responsibilities, so it needs to be determined how to place the ICP within that system.  Health organisations that are involved include the Growth Board, Safeguarding, Housing, Education, Safer Somerset, Climate Change Agenda, Fit for My Future, Homelessness Reduction, and others.  They all need to be brought together, with a stronger focus on neighbourhoods at the local level. 

There will be no conclusions regarding the HWB/ICP issue today, but the aim is to provoke thought about it.  It is important to note that Somerset MUST have both boards; they cannot merge them, according to the guidance.  She proposed that the Health and Wellbeing Board members have an informal workshop to discuss the matter and bring forward proposals to be presented to full Council. 

The Committee made comments and enquiries, asking if, although it is clear they cannot have only one combined board, can the two have common membership?  It was also stated that there was a need to ensure that enough organisations were included for economic activities, such as Chambers of Commerce.  The Director of Public Health agreed that both needed to be discussed, noting that Chambers of Commerce sit on the Growth Board, and that they have brought in links with the wider determinants of health.  The Chief Executive-Somerset CCG offered that he and the Director of Public Health were aligned on this issue and noted that his Slide 7 discusses partnerships having coordination of members.  However, the guidance on this is still working its way through Parliament.  It was suggested that more people could always be brought into each board and would include members from the NHS and health/social care. 

The Somerset Health and Wellbeing Board received and discussed the presentation and decided to move forward with a workshop on this issue.