Health Reforms in Barking & Dagenham
The Government has now published its Health & Social Care Bill, bringing together reforms to the health and social care system set out in a raft of recent white papers, constultation documents and announcements. In Barking & Dagenham, we are well on our way to implementing the broad thrust of the reforms, and this page will give you some idea of overall progress.

Keeping updated
The main documents will get published here as and when they become available, as well as a continuing update about the overall 'state of play'. If you are not yet signed up to the Partnership website, then get on to it now, as we'll be using the 'bulletins' feature to send out snippets of news and activity as they become available.

Briefings and publications

The key Government publications include:

• NHS White Paper: Liberating the NHS: Equity & Excellence (DH website)
• Public Health White Paper: Healthy People, Healthy Lives (DH website)
• Vision for Adult Social Care: Capable Communities and Active Citizens (DH website)

Barking & Dagenham documents include some briefings on the above announcements:

• Briefing - Health & Social Care Bill 2011
• Brieing - Vision for Adult Social Care
• Briefing - Public Health White Paper
• Briefing - Health White Paper
• Briefing - Healthwatch in the H&SC Bill
• B&D Response to NHS White Paper consultation

The Board will change over the coming weeks as it begins to meet the new duties placed on it. In particular, we expect the Health & Social Care Bill to confer statutory status upon it, which means (broadly) that it is mandatory for the main partners to participate and that Government can place responsibilities on, or devolve finance to, the Board itself rather than just individual partners.

And the changes? Well, they are contained in the review of governance document which was discussed at the September meeting of the Board. In summary:

addition of the GP consortia reps and a revision of membership in line with the spirit of Liberating the NHS;
a broader focus on joining up the commissioning activity of all partners;
strengthening of its coverage of social care as part of a broader 'whole system' view of health and social care.
New dates are being agreed for the Board, and its Forward Plan is being drawn up for the year ahead. We are also reviewing the recently-announced legislation to see what it says as to the future direction of the Health & Wellbeing Board. For example, in response to consultation, the Government has decided not to pursue plans that it laid out in the NHS White Paper to include 'overview and scrutiny' functions (currently the work of our Health & Adult Services Select committee) into the work of the Health & Wellbeing Board.

With so much organisational change about to take place in the NHS, it's important that we have clear agreements that cover our joint commissioning and service delivery.  Officers have been working hard over the past few weeks to get explicit legal agreements drawn up to cover our historic joint working practices.  An overarching contract between NHS Barking & Dagenham and the Council will include different specific agreements under Sections 75 and 256 of the NHS Act.  Broadly, the agreement will include:

• Public Health, including the proposed transfer of the public health function to the Council in advance of the legislation that is expected to make this a statutory transfer;
• Adults', including reablement and mental health employment, drop-in and accommodation provisions, also integrated care;
• Children's, including a range of activities relating to looked-after children, special educational needs provision, play therapies;
• Drugs and alcohol, including the commissioning budgets for drug treatment;
• Learning disability, focused around the joint Community Learning Disability Team;
• Family Nurse Partnership

The total value of the agreements is still being negotiated, but hovers around £28m, so it is a significant development.  The agreements have been authorised by the Council, and the Board of NHS Barking & Dagenham subject to some additional work on finances.  We expect formal signing towards the end of February.

A major plank of the health reforms, as laid out in the Public Health White Paper, concerns the transfer of responsibility for Public Health to the Council.  Staff in the Public Health/Health Improvement functions of the PCT are being formally consulted about interim relocation to the Council, having already been involved in discussions about the proposals. 

The Council is working to identify its contribution to the public health agenda from its mainstream activities, such as environmental health, parks and leisure, licensing, planning and occupational health.  It will not mean changes to how the services operate, but it will identify the major partners from within the Council for the emerging Health & Wellbeing Division.  Once the Section 75 agreement is signed, the relocation will commence, with the team being based in the Town Hall.

This gives us a great opportunity to get a real headstart on implementing Healthy Lives, Healthy People.