1. 24 September 2011 NHS, Public Health and Social Care Reforms – how can we influence our services? Yusef Azad, Director of Policy and Campaigns, and Susan Cole, Policy Officer (Community Engagement), NAT

2. New NHS arrangements Clinical commissioning groups (GP practices) will commission secondary care (hospitals etc) NHS Commissioning Board will commission primary care (GP services etc) NHS Commissioning Board will also commission HIV treatment and care

3. New public health arrangements New Executive Agency, Public Health England (PHE), will lead on public health nationally Local authorities will lead on public health locally, using a ring-fenced budget given them by PHE As part of their public health role, local authorities will commission local sexual health services including the sexual health clinic, HIV prevention work etc

4. New social care arrangements Social care will continue to be commissioned by local authorities Continuing ‘HIV/AIDS Support’ line in local authorities’ financial grant from central government – but not ring-fenced Increased emphasis on ‘joining up’ social care, public health and NHS

5. The Health and Wellbeing Board Emphasis on healthcare, public health and social care being ‘joined up’/coordinated at the local level, and responsive to local need Key way to achieve this is the local authority Health and Wellbeing Board – which includes representatives from clinical commissioning groups, local councillor/s, Directors of Adult Social Care, Public Health, Children’s Services, HealthWatch Others? e.g Local voluntary sector?

6. Indicators Emphasis is on assessing performance by outcomes rather than activity Key way to do this will be to have an agreed outcomes frameworks with a set of indicators – locally available data for NHS, public health and social care – which identify important outcomes and how the local services are performing, compared with other local areas For example – late HIV diagnosis

7. Questions 1 What improvements would you like the NHS Commissioning Board to make to how HIV treatment and care is planned and resourced? Do you find that the different parts of your healthcare and (if relevant) social care work well together? Or are there ways they can be better coordinated? GPs are going to have an increasingly important role in planning local NHS services – how should GPs become more knowledgeable and more involved in healthcare for people with HIV?

8. How can we influence our services? 1 Clinical commissioning groups and the NHS Commissioning Board will have a legal obligation to involve and consult on their plans Influencing the Health and Wellbeing Board (HWB), which has legal duty to involve users/public in their work The two key documents for local services produced by the HWB will be the Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS) – all local commissioning must ‘have regard’ to these documents

9. How can we influence our services? 2 HealthWatch will be set up in every local area to promote patient/public involvement, seek views on local services etc The local authority Overview and Scrutiny Committee (consists of local councillors) will hold the local NHS/social care to account for its performance There will be published indicators where you can see how well healthcare and social care are performing locally e.g on late diagnosis, employment of people with long-term conditions

10. Questions 2 How can we make sure interests of people with HIV are well represented at a local level? – what opportunities are there for people with HIV to influence local services? and what are the potential difficulties?

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