This morning at the LGA conference I attended the plenary session on how councils can make the best of the reforms in the NHS. A new LGA report was published on the LGA webiste in tandem with this session and you can download it from there. It was opened by Cllr David Rogers OBE who set the scene form a local authority point of view. The meat of the session however, was provided by Sir David Nicholson KCB CBE, CE of the NHS in England.
In Sir David’s view the current drive for reform was an opportunity to re-imagine the relationship with local government. In processes like these it was important to remember that people and quality were the issues with primacy he said. The NHS has driven savings through efficiency. Primarily through greater productivity and better quality of services. This approach is reaching the limits of its ability to deliver further. Therefore there is a strategic switch to prevention.
This is where local councils come in. The shift from the NHS to LA owned services is being driven through the Health and Wellbeing boards (HWB). Ironically central NHS has greater control now than ever before over the some 38,000 commissioning bodies that make up the NHS. This is due in most part to the fact that they control the money for the national services like pay, management and procurement.
Up to now the efficiency agenda was about moving costs out from the centre and looking for better ways to do things. Now we are looking at a fundamental shift in the way the NHS is delivered. The whole process begins with the role of GP practices.
Sir Nicholas said that he viewed the Joint Strategic Needs Assessment (JSNA) process as a vital opportunity to establish the working relationship with local government going forward. He said he wanted to ‘sign a compact’ with the LGA and its members to deliver a new devolved system of health care with a wider perspective encompassing preventative measures and the wider social care agenda. This would include a transfer of resources into social care.
He warned conference not to under-estimate the resolve of the NHS to make these changes.
He finished by comparing this shift to the fundamental changes in mental health provision in the 1990’s where it was the model of care that was changed not a re-arrangement of the current model.
There is also a group specifically concerned with HWB's on Knowledge Hub called Learning Network for Regional Support Health and Wellbeing Boards.
