05 April 2013
Local authorities are now responsible for co-ordinating local efforts to protect and improve the public's health and reduce health inequalities. Responsibilities for a range of public health functions have transferred from the NHS to local authorities, including:
- Vascular health check assessments for men and women aged 40-74;
- the National Child Measurement Programme;
- public health services for children and young people aged 5-19;
- comprehensive sexual health services including testing and treatment for sexually transmitted infections, contraception outside the GP contract and sexual health promotion;
- public health advice to NHS commissioners;
- responding to health protection incidents, outbreaks and emergencies;
- health improvement services including:
- tobacco control and smoking cessation services;
- alcohol and drug misuse services;
- interventions to tackle obesity such as community lifestyle and weight management services;
- dental public health services;
- accidental injury prevention; and
- local initiatives on workplace health.
Local authorities receive a ring-fenced budget to provide these services. Each local authority must appoint a director of public health as its lead professional officer for delivering public health services.
Local authorities already run a number of services that have an important bearing on the health and wellbeing of local people including housing, education, environmental health, planning and leisure services. Combining these services with their new public health responsibilities will give local authorities real opportunities to influence the social and economic determinants of health and address health inequalities.
Health and Wellbeing Boards
Every authority must establish a health and wellbeing board (HWB), whose membership should include:
- One or more elected councillors from the authority;
- the authority's Director of Public Health, Director of Adult Social Services and Director of Children's Services;
- a representative of local Healthwatch;
- a representative of each clinical commissioning group in the authority's area; and
- a representative of NHS England.
HWBs take the lead in promoting integration between health and social care. Specifically, they are responsible for preparing a joint strategic needs assessment (JSNA) and joint health and wellbeing strategy for the local authority's area.
The aim of the JSNA is to provide a comprehensive analysis of the current and future health needs of adults and children in the authority's area, based on a wide range of quantitative and qualitative data, including patient, service user and community views. Its purpose is to inform and guide the commissioning of local health and social care services, with the aim of improving health outcomes and addressing persistent health inequalities.
The Joint Health and Wellbeing Strategy sets out how proposals on how the needs identified in the JSNA will be met. It will inform the decisions of those bodies that commission health and social care services in the area, including local authorities, clinical commissioning groups and NHS England - all of whom will have regard to the JSNA and Joint Health and Wellbeing Strategy as they draw up their commissioning plans, so that those plans are fully aligned with the jointly agreed priorities.
Working together through the HWB will enable local partners to reach a consensus on the priorities to be addressed across the local health and social care system, and to consider how they can use their collective resources to meet them.
Local authorities in the North East have already been operating their HWBs in ‘shadow' form and on 1 April 2013 HWBs took over statutory responsibility for the functions set out above. In most cases, the council's leader or elected mayor is also chair of the HWB.
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