What’s the point of Health and Wellbeing Boards?

You may have been following the changes to the NHS over the last few years. Or perhaps you are just a user of services, going to your General Practitioner and then to a local hospital. Either way, you should know that your local Council has been given some wide-ranging powers to provide local health and social care services. Who cares? It’s a reasonable response to all of the changes. But there are some things should concern you.

Look at these three data points about health services in England.

  • One in two hundred babies are stillborn in England
  • Young people can wait months to receive mental health services
  • In the UK young men die younger than in just about any other European Country.

in the light of these issues I want to look at what Local Health and Wellbeing Boards are discussing in their meetings.

Using a search engine of your choice, you will quickly find the papers of you local HWB on the internet. And that’s where it pretty much turns to rat shit. The jargon and impenetrable language are there in the first paragraph. Here is the explanation of what the HWB does in Brighton.

The purpose of the Board is to provide system leadership to the health and local authority functions relating to health & wellbeing in Brighton & Hove. It promotes the health and wellbeing of the people in its area through the development of improved and integrated health and social care services.

The HWB is responsible for the co-ordinated delivery of services across adult social care, public health, and health and wellbeing of children and young peoples’ services. This includes decision making in relation to those services within Adult Services, Children’s Services, Public Health and decisions relating to the joint commissioning of children’s and adult social care and health services (s75 agreements).

Are you any the wiser? Perhaps the focus on young people caught your eye. Although you may now be worrying about the three data points I highlighted.

Reading the Agenda and the Minutes of the meetings won’t help you. They’re even more Delphic.

The most concerning element for any Public body are the meetings they held in camera. They regularly exclude the public from their discussions.

Members are often keen to show they have no conflict of interests, and it’s usually the first agenda item. But no one seems concerned that as mainly elected officials they are in conflict with their electorate for excluding them. You might also reasonably ask why there are so many doctors and so few nurses as members of your HWB. Perhaps too much interest all round.

So, if you have the time to attend an HWB meeting, go and listen to their arcane discussions, see if you understand what they are doing in your name.

The next meeting here in Brighton is in September. I will be there.

Sepsis – NHS England’s Plan A failed!

Did you notice the rise in cases in Sepsis reported by the NHS? You may know that NHS England has an action plan

Bottom line;  the NHS England plan has not worked.   So I guess we need Plan B.

Here are three things that NHS England could do now:

  • Create a Sepsis Registry – we would then know the extent of the problem. NHS England currently doesn’t have a succinct policy for Registries (perhaps they could get round to that).
  • Adopt the international standards of Sepsis treatment. Making sure the poor primary care practices are called out and addressed. (although you need a Registry to do that).
  • Refer every Sepsis death to a Coroner to investigate.

That should cut the number of entirely avoidable deaths.

 

Who pays for local journalism – we do?

You may have felt a little schadenfreude when you read the $Billion reduction in the value of Facebook. Not unlike the 2008 crash, this money has gone to money heaven, and will probably never reappear.

However, something else is also dying as the Facebook and Google scorched earth policy rips the heart out of the paid-for newspaper advertising revenue. It’s journalism, as the business model of newspapers comes under threat, the newsroom can no longer afford a full roster of journalists.

The effect is both National and Local, but the local impact is much more significant as there is no one else to scrutinise local political and public services.

In New Jersey, the state’s lawmakers will begin to  fund community journalism, and this will include for-profit as well as non-profit groups.

I sadly can’t see this coming to our communities anytime soon; who would be prepared to pay for such a subsidy? It’s a real dilemma, failure to scrutinise local political decision making will lead to poorer decisions. In turn, this will lead to a more significant waste of public money. Undoubtedly more than the cost of the subsidy in the first place.

I think there may be three practical steps we can all take:

  • Find our local news site; it may be a newspaper or a community group, sign up and join the discussion.
  • Attend local Council and Public service meetings and remember to ask a question, how they handle the response may tell you a great about how they feel about scrutiny.
  • Support national and regional newspapers through their subscription services, pay a little to benefit a great deal.