NHS Reform Blackburn with Darwen Dominic Harrison Director of Public Health Blackburn with Darwen Care Trust Plus /Borough Council

Health Governance – Not a new role for Local Government? Poverty: 1864:.A single Union workhouse Sewers:1860s: Corporation builds 30 miles of sewers in 1850/60s employing up to 1000 unemployed mill workers laid off during the cotton famine Water:1875 Corporation buys out Blackburn Waterworks Company Gas: 1878 – Corporation bought out the Gas Company Fire:1882 took over the volunteer fire service Burrials:1893 Corporation cemetery Waste:1898 Corporation provided four disposal plants and kept seven tips 60 horses to carry out collection Housing:1901 the council obtained the power to convert pail closets into water closets (10,000 pail closets in 1850). HWB 2011: Health and Wellbeing Board established 1800, “endemic and ubiquitous ill health” generated regular outbreaks of disease: –scarlet fever-1811,1825,1852, –typhus 1824, 52,54, –smallpox 1826, –cholera 1832, 1834, 1847 Improvement Commissioners appointed under an act of Parliament: code of bye-laws for “better and more efficient government of the town 1851 the new town council established after ‘incorporation’ Blackburn with Darwen c.1880s

NHS Reform & HSC BILL 1) Reform of the Public Health Function in Blackburn with Darwen including: –Transfer of NHS Specialist Public Health Service to Blackburn with Darwen Borough Council. –The transfer of NHS prevention spend to Blackburn with Darwen Borough Council (and NHS National Commissioning Board / Public Health England) – determined by national ‘formula’. 2) Re-design and re-specification of Health and Wellbeing Services 3) The development of GP Commissioning Consortia 4) The development of Blackburn with Darwen Health and Wellbeing Board. 5) The development of Health Watch and the new NHS complaints service (in local government) 6) The development of Clusters’ of PCTs (2011) ?? 7) Abolition of SHAs (2012) PCTs (2013) 8) NHS National Commissioning Board (2011) 9) Public Health England (2011/12)

HwB Aims 1.To provide local accountability for improved health & wellbeing, (morbidity, mortality, quality of life) and health equity outcomes for the population of Blackburn with Darwen. 2.To promote integration and partnership working between the NHS, social care, public health and other local services and 3.To improve local democratic accountability.

HwB Functions 1.To provide a governance structure for local planning and accountability of health and wellbeing related services. 2.To asses the needs of the local population and lead the statutory integrated strategic needs assessment (JSNA) and local Health and Wellbeing Strategy. 3.To promote integration and partnership across areas through promoting joined–up commissioning plans across the NHS, social care and public health. 4.To support joint commissioning and pooled budget arrangements, where all parties agree this makes sense. 5. To review major service redesigns of health and wellbeing related services provided by the NHS and Local Government.

Voting MembersNumberNomination Process Neighbourhood level Representatives2Elected by BwD Neighbourhoods Voluntary and Community Sector representative 1Nominated by Community Forum Social Housing Sector Representative1Nominated by BwD Social Housing partnership Health Watch1Nominated by Health Watch GP Consortia2Nominated by GP Consortia. One of which to be the ‘Accountable Officer’ Local Authority Elected Members3Nominated by Cabinet (2 ruling group 1 opposition group member) BwD BC / CTPlus Chief Executive (up to April 2013) 1Statutory Chief Executive Chair1This will be the existing Chair of the Care Trust Plus during the transition period up to April Director of Public Health1Statutory DPH BwD Borough Council1Deputy Chief Executive of the Integrated Management Team BwD Strategic Director of Families Health & Wellbeing (DCS/DASS) 1Statutory Officer Existing Care Trust Plus Board members not already identified above 9 BwD Head Teacher1TBC Total Voting Members 25 Members (upto April 2013) HwB Voting Members

Members in AttendanceNumberNomination Process BwD BC / CTPlus Chief Executive (from April 2013) 1Statutory Chief Executive Executive Member Children’s Services 1BwD BC Executive Board Nominee Total members in attendance2 Invited Members (when relevant) NumberNominated by Local Authority/CT Plus DirectorsAs appropriateHWB invitation Service ProvidersAs appropriateHWB invitation Regional NHS Commissioning Board As appropriateHWB invitation Representative of LEPAs appropriateNominated by LEP Additional Clinical representatives (e.g. Pharmacy, Dental etc) As appropriateHWB Invitation Members in Attendance & Invited

Accountability Health Scrutiny Members in Attendance Blackburn with Darwen Health and Wellbeing Board Quality & Outcome Improvement Drivers Executive Board

Adult Social Care/Public Health/NHS Outcome Frameworks

Highest and Lowest Life Expectancies – out of 324 Local Authority Districts

NAO (2010) Tacking inequalities in Life Expectancy in areas with the worst health and deprivation

Source: (2010) WHO

Neighbourhood Health Profiling : BwD North East Matching Integrated Public Sector Resources and Health Needs

Total Health System & Co-Production