A workshop presentation for community groups on engaging effectively with the new health system. Includes links to films and videos/html models

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Getting involved in the new health and care
system
The nuts and bolts for community
agencies
Jim McManus
Director of Public Health

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The top tips
1. Understand why you want to get involved in
the new system
1. Do you want to provide services and get funding?
2. Do you want to achieve a policy position or change?
2. Understand the system and get a mentor or
buddy or guide
3. Build and work through relationships
4. Identify what value/benefit/capability you bring
to the table
5. Do your research on who you work with

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Talking you through the new system
• Interactive html version here
• http://healthandcare.dh.gov.uk/system/

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Importance of Healthwatch
Healthwatch - What we do
• We make sure that the overall views and
experiences of people who use health and
social care services are heard and taken
seriously at a local and national level.

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The new system – who should you go to?
Health and Wellbeing Board
1. Clinical Commissioning
Groups
2. NHS England
3. Director of Public Health
4. Adult Social Care
5. Childrens Services
6. Healthwatch
All of them on Health and
Wellbeing Board
Brings all partners together
with local strategy
1. Commission most health
services
2. Commission primary care
and specialist services
3. Commissions services, leads
on JSNA,
4. Commissions adult social
care
5. Commissioning child care
6. Advocacy, Monitoring, Voice

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The JSNA and getting it to work for you

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Health and Wellbeing Boards
• Requirements of
HWBB – JSNA,
Prioritisation,
Strategy, Delivery,
Integration
• Evidence,
Interventions, Cultural
and Behavioural
Competences,
Attitude to Delivery

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The Herts Health and Wellbeing Board
Functions of Health and Wellbeing Boards
The aim of the board is to make health and social care planning and
decision making everyone’s business. Its aims include:
• Development, interpretation and use of the Joint Strategic Needs
Assessment (JSNA) to shape commissioning and spending plans
• Development and agreement of a health and wellbeing strategy
• Consideration of commissioning plans for health and social care
• Agreement of joint commissioning plans and oversight of
performance against outcomes

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The Herts HWB Strategy Herts Healthwatch
• Herts Health and
Wellbeing Strategy
Video
• http://www.youtube.co
m/watch?v=xXIf7nMz
sao&feature=youtu.be
• Herts Healthwatch
Launch Video
• http://www.hertfordshi
relink.org.uk/

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What is the JSNA
• Statement of health and social care needs
• “What are our problems, what are we not doing?
What do we not know enough about?”
• Suggestion of priorities
• Part of the roadmap from need to services
• Supports prioritisation of investment
• New guidance
• http://healthandcare.dh.gov.uk/draft-guidance/

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Two resources for community agencies on using
and influencing the JSNA
• Royal Society of Public Health guide
• http://bit.ly/12nTbWU
• The Voluntary Organisations Disability Group quick guide
• http://www.vodg.org.uk/uploads/jsna/BriefingNote-
JSNAandLINksWPed230710.pdf
• A case study – the JSNA and the Irish communities in Britain
http://www.irishinbritain.org/demo/files/files/JSNA.pdf

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The Golden Thread
Marmot
JSNA
CCG Plans
Priorities
Strategy
Commissioning
Outcomes
(New
Outcomes
Frameworks)
Need, Outcomes Priorities, Interventions

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Key Documents
• Local Govt and Public Involvement in Health Act
• JSNA Guidance 2008
• Health and Social Care Act 2012 and associated
papers
• Draft guidance 2012 – copy on memory stick
• JSNA Toolkit 2011 – copy on memory stick
• JSNA Data Inventory 2011 – copy on memory
stick

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Commissioning Roadmap
Identify
Priorities
What Works
in delivery
Commission
Monitor and
Evaluate
Assess
NeedJSNA
Health &
Wellbeing Strategy
Commissioning
Plans

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Data Inventory (LGID)
• Domain one: Population
• Domain two: Social and place wellbeing
• Domain three: Lifestyles and health
improvement
• Domain four: Health and wellbeing status
• Domain five: Service utilisation
• Domain six: Priorities for action

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Case Study – Bristol and RNIB
• the Royal National Institute of the Blind (RNIB) presented new
evidence to suggest significant increases in Bristol’s blind and
partially sighted population.
• Local Authority held details of registered
• suspected that those with sight loss are significantly undercounted
because of stigma the lack of a single trigger or referral system to the
register.
• Other data supported the growth cited in the national research,
including local outpatient /admission rates.
• RNIB gave epidemiological evidence on prevalence and the most
cost effective interventions for reducing blindness. RNIB believe the
improved section supported case for the new patient support service
in Bristol eye hospital.
• For further information contact – Andrew.kaye@rnib.org.uk

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The Challenge for Third Sector and Community
Sectors
• Seen as a junior partner
• They’re not sure what you have to offer
• Are you sure what you have to offer?
• Health inequalities?
• Access?
• Engagement?
• Enforcement?
• Ignored within the wider politics
• Caught up in the maelstrom of change

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The Tactics
you are not on a level playing field
• Analyse the Stakeholders and their Fora
• Understand their priorities
• Be clear on your Capabilities
• Identify your Contributions
• Link it to their frameworks
• Be solution focused
• Exploit the trade off – you need to understand the evidence etc
world. Public health and CCGs need to understand community
sectors and voices

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Distributed leadership =
• Managing service?
• Corporate roles?
• Art and Science
• Technical Domains
of Skill
• Personal Resilience
• Influencing, Negotiation,
Persuasion, Orchestration,
• Style
• Emotional Intelligence
• Strategic Vision and
Prioritising
• JSNA into reality
• Challenges nested
across system
Shaping and
Sense-Making
Relational and
Interpersonal
Transactional
(lot of noise on
this so far)
Integrational
and
Systematisation

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Adult Social Care Outcomes Framework
1. Enhancing quality of life for people with care
and support needs
2. Delaying and reducing the need for care and
support
3. Ensuring that people have a positive
experience of care and support
4. Safeguarding adults whose circumstances

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Clinical Commissioning Groups
• Helping them understand and link with local
authorities
• Help them understand their population –
CCG Profiles, Local Plans, JSNA,
• Helping them achieve authorisation
• NHS Outcomes framework
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_131700