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DCT Consulting Ltd

Primary Care, Commissioning, Clinical Effectiveness


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Posted on 15 December, 2011 at 17:41 Comments comments (251)
                        Health and Wellbeing boards
Full paper at Articles
 ‘The poor have remained beloved by the Gods being afforded excellent opportunities for dying young’.  R.H.Tawney    
The overarching priority for health and wellbeing is to enhance social capital, community solidarity and sustainable development for individuals and communities. 
Will the Health & Well Being Board be another ‘talking shop’ or a significant force for the public’s health and wellbeing? If the latter it will need to be a visible accountable leader and position itself as a commissioner albeit without a statutory authority nor budget. That lack of statute could be its weakness and yet its strength being unencumbered by the forces that induce statutory organisations to be so transactional in approach. The Health & Well Being Board is not an organisation so to deliver on such an ambitious approach it will need to be a commissioner that leads, facilitates, supports and where necessary follows. A model approach for statutory commissioners also but so often unrealised. Consequently a first task for The Board must be to choose their positional leaders who truly possess the attributes to be effective leaders.
There are already complainants saying how can we deliver on public health given the identified budget is too small?  A compartmentalised mind-set that fails to recognise the assets that abound in the community-statutory, formal and informal
The initial priority for all with formal public health responsibilities whether statutory or not is to engage in Asset Based Community Development. A joint health and well being needs assessment and strategy must incorporate local community engagement and involvement but ideally needs to go much further by adopting clear community organising principles
There are many areas of public concern that impinge on the public’s health. Most of these priority problems are predominately affected by social class but within that overall frame specific issues and opportunities manifest. The Board must set a small number of its own achievable priorities but also be facilitating, enabling and supporting other organisations and/or individuals who wish to engage and lead on other areas of public concern. Their topics will not necessarily be the overarching priorities for the board itself but nevertheless they should be enabling people or organisations with a particular passion and skill in community involvement to flourish. A commissioner who nurtures, enables and supports to enhance social capital and not simply administers or interprets their role in too reductionist a manner. And to succeed where so many public health policies have underachieved, Health and Well Being Boards as for statutory commissioners must be rigorously held to account by their communities.
As a starting point for action and where a population and individual care both clearly conflate and as a national priority is in better support and care for those with long term conditions. Conditions that have a major impact on health inequalities. To achieve a more holistic approach to prevention (and indeed early diagnosis) involvement of local authorities, community based organisations and local leaders is essential

Blog intro

Posted on 13 December, 2011 at 18:48 Comments comments (211)
Welcome to my Blog.
Most of my entries will be about implementing the current reform agenda. I subscribe completely to the three overarching principles as if I may quote from part of a letter published in The Independent ‘The NHS was set up to be underpinned by the concept of social justice and long may that remain. Its underperformance however most underserves those it was set up to help and enable. Our poor clinical outcomes, though we have improved, disproportionally affects the poor. The frail elderly frequently get a bad service whether it was specifically at Mid Staffs hospital or generally as identified by the Ombudsman (and more recently the CQC). And when we perceive our needs as urgent despite valiant initiatives by successive governments, the NHS is often unresponsive’.
How is that social justice?