Calls grow for presumption in favour of data sharing for local health bodies

The Government should move to a presumption in favour of data sharing for local health bodies to enable effective collaboration between councils and local partners, a leading thinktank has argued.

In its In Sickness and in Health report, which examined the move towards a more localist health system, Localis also recommended that the Government should review the new health system in 2015 to ensure that Health and Wellbeing Boards (HWBs) have real influence over commissioning.

“If their democratic voice is not being heard, [it should] consider granting local government greater – even complete – responsibility for health commissioning,” the thinktank said.

Other recommendations in the report were:

• The Government should consider making the Minister for Public Health a joint Department of Health/Cabinet Office position, “in order to aid integration across departmental silos and make a statement that it is embedding public health at the heart of all its policies”.
• Local authorities should maintain public confidence in the reforms by only spending public health funds on things that are demonstrably related to improving health outcomes for local people.
• Local authorities must seek to broaden local understanding – in a clear and user-friendly format – of what their Joint Strategic Needs Assessment (JSNA) is. This would involve “explaining the data about the area in which they live, what its conclusions are (the health priorities that flow from that data), and what that means for local services”.
• A representative body for HWBs – perhaps divided into regional sub-groups – should be created to assure two-way accountability between NHS England and HWBs.
• Local Healthwatch should be given a free role to offer their support or criticism for policies and/or their implementation without regulatory or political interference.
• To help foster GP engagement in the new system, practices should send additional GPs to Clinical Commissioning Group (CCG) board meetings when feasible. GPs should be invited to play a more prominent role in the development of key documents such as JSNAs.
• The Government should maintain its position that strategic commissioning must be ‘provider neutral’, focusing on local need and the best pathways to deliver services to meet that need.

The report meanwhile suggested that there was “plenty of optimism" in local government about the changes brought in by the Health and Social Care Act 2012 “and a belief that they will lead to improved health outcomes for local residents”.

Localis added: “While acknowledging that, as with any transformation, it will take time to bed in, in most areas the changeover to the new system has gone well, with the ease of transition being influenced by two main factors.

“Firstly, local government geography: in ‘shire counties’ where two-tier arrangements define the local government landscape, their greater organisational complexity has made progress markedly slower. Secondly, the extent of prior collaboration between local authorities and NHS public health teams: as many public health teams and councils work together for the first time, a key challenge has been to overcome their cultural and organisational distinctions.”

The report suggested that real gains were being made where GPs were effectively engaged, but a number were not.

It also said the early signs were mixed when it came to the ability of CCGs to work effectively with Health and Wellbeing Boards.

Localis chief executive Alex Thomson said: “Local government has a long and proud history of improving the health of the nation so these reforms represent a real homecoming.

“It’s heartening that there is such a sense of optimism about the opportunity to once again help local people live longer, happier lives. Things are looking good so far, but only time will tell if additional powers are needed.”

Speaking at the launch, Norman Lamb, Minister of State for Care and Support, described integrated care as “the only game in town”.

He added: “We want the whole system to move fundamentally towards integrated care, shaping services around the individual and not the institution.”

On the issue of data sharing, the minister agreed that problems in sharing data between local authorities and health partners were “absolutely critical”. He added: “The way the system works at the moment is a nonsense.”