1. Norfolk’s Shadow Health and Wellbeing Board & Clinical Commissioning Groups 25 April 2012

2. Intro - the NHS Reforms Health and Wellbeing Boards Clinical Commissioning Groups Health Watch Scrutiny Public Health transfer Integration of health and social care

3. Changes in the NHS in Norfolk Five new Clinical Commissioning Groups with £1.2bn budget (spend on healthcare) and subject to authorisation One new NHS Commissioning Board (with local offices) with budget for primary care and specialised services One new Commissioning Support Service, subject to authorisation One new Local Healthwatch – consumer voice Public Health responsibilities

4. What’s staying the same GP as main gateway into NHS Commitment to health and social care join up for commissioning and provision Commissioner and provider split – with Foundation Trust as the NHS provider model and other Qualified Providers

5. A map of Norfolk CCGs

6. Role of Health & Wellbeing Boards Providing local systems leadership across health, social care and public health Convening role in health improvement – tackling the causes of ill-health Improving health and social care services Promoting integration of health and social care

7. H&WBs Development Legislation now in place Informal, pre-shadow year – 2011 Now in Shadow year – 2012-13 H&WBs formally come into effect - April 2013

8. What have we been doing in Norfolk? First year ‘pre-shadow’ phase: Understanding function to determine form Workshop style Scenario testing: mental health; homelessness; obesity; smoking Task & Finish - Tobacco control

9. What have we been doing in Norfolk?...2 Now in our Shadow Year: Terms of Reference agreed Initial membership agreed Aim - to ensure manageable size committee whilst retaining broad engagement

10. LGC Award presentation25 January 2012 Identify dependencies Broker and drive integration Test, challenge commissioning Convene all commissioners Health and Wellbeing Board Collective priorities for: Norfolk Citizens patients and service users Context Challenges What the Board will do Task and finish hot topics Broker solutions JSNA Diminishing resources Rising expectations and demands Policy drivers Localism Influence, not authority Sub-structures Doing, rather than commentating Identifying critical issues for collective action Balance between wellbeing and health care Evidence, best practice, patient and citizen views and experience Hold each other to account

11. Membership Norfolk County Council Leader* Cabinet Members - Children and for Community Director of Public Health* NCC Chief Executive Directors of Children’s Services and of Community Services* Chair of LINKs*

12. Membership…2 Representative from each CCG* All 7 District/City/Borough Councils Chief Exec – NHS Norfolk and Waveney Chair – NHS Norfolk and Waveney NHS Commissioning Board - tbd Three representatives from the voluntary and third sector Rep from Norfolk Police

13. Norfolk’s Shadow Health & Wellbeing Board…1 Held first meeting – 18 April 2012 ‘Transition’ year – to formal C’ttee Operating Context = emerging commissioning priorities (CCGs & wider health improvement) plus emerging ‘architecture’

14. Joint Health & Wellbeing Strategy & JSNA Joint H&WB Strategy and Joint Strategic Needs Assessment (JSNA) - approach agreed Building on partners working plans, building from localities Assess & constructively challenge By 2013 – able to answer key questions

15. Voluntary & 3 rd Sector Representation Process to identify appropriate representatives Led by CEXs Vol Norfolk/West Norfolk VCA Joint Health, Social Care and Voluntary Sector Strategic Forum – proposal agreed

16. Voluntary & 3 rd Sector Representation…2 Clear routes for accountability back to the Forum Providing a voice and link/not rep individual orgs Critical role in cascading back – inc via Vol Sector Engagement Project

17. A Local Healthwatch for Norfolk From April 2013 Building on existing LINks activity as the voice of the patient Extensive consultation with stakeholders

18. A Local Healthwatch for Norfolk…2 Partnership based Pathfinder project – LGA/ACEVO Mar to June – setting out what we want from Healthwatch Norfolk July – agree who is going to deliver it Oct – Shadow local Healthwatch starts

19. What next for the Health & Wellbeing Board? Next meeting - 18th July 2012 H&WB Strategy and emerging CCG priorities Building and fostering sound working relationships Working through the challenges

20. What next for the Health & Wellbeing Board? Develop Joint Health & Wellbeing Strategy Contribute to CCG authorisation Establish an overview of the system Work through relationships Establish locality working Develop engagement mechanisms