By Sarah North
This session at the FPH conference was led by Dr Sarah Aitken, Dr Alison Talbot-Smith and Mrs Clare Wichbold, all from Herefordshire PCT – an early adopter of the white paper proposals, they have already health and wellbeing board.
The health and wellbeing board must provide effective leadership, an integrated commissioning role, whilst understanding the comprehensive and wide ranging needs across the entire community. It must establish clear priorities and set strategy accordingly to improve all sectoral outcomes.
Clinical commissioning groups (CCG) will not have a direct link to the local authority. But this is where the role of the health and wellbeing board is important as it will have the power to appeal any decision that the group takes. Herefordshire has recognised the importance of having a circumscribed role for a public health consultant to sit on the CCGs. Herefordshire has conducted a county-wide joint strategic needs assessment involving the CCG which has been important.
As part of the session Mrs Wichbold conducted an exercise where members of the audience were handed a local paper and asked to identify the articles affecting population health and wellbeing. After identification, they were placed on the ladder of intervention (Nuffield Council of Bioethics, 2008). This was used by Herefordshire as part of engaging the wider public and community in identifying population health and wellbeing; it was also used with a variety of health professionals, environmental health professionals amongst others. This showed the audience the large number of incidents/reports that actually do relate to population health such as environmental, epidemiological and mental health.
Herefordshire, as an early adopter, is establishing a workable system. It remains to be seen if all areas can produce an effective system particularly with the number of CCGs which may be established across the larger regions, and how these will interact with the health and wellbeing boards.