A crucial part of the government's health White Paper deals with the relationship between the NHS (GP commissioning consortia) and local authorities in their new proposed role of 'health and wellbeing boards'.
Setting out plans to simplify partnership working, the White Paper states: 'These arrangements will give local authorities influence over NHS commissioning, and corresponding influence for NHS commissioners in relation to public health and social care.'
Although much of the attention has focused on the role and function of GPs as commissioners, the relationships of consortia with local authorities is no less important.
Local authorities will also be responsible for HealthWatch, the local patient representative bodies set to replace local involvement networks and co-ordinated at national level by the quality regulator the Care Quality Commission.
HealthWatch will represent the views of patients to commissioners, including concerns about the quality of providers, and will play an important role in the government's pledge to make healthcare more locally accountable.
The public health functions of local authorities are set out in the White Paper, but can be summed up in one line: 'Joining up the commissioning of local NHS services, social care and health improvement.'
The benefits of joined-up care are obvious: fewer hand-offs between services mean better continuity, less frustration and less anxiety for patients.
Less duplication and better co-ordination of services will also reduce costs. Better health education and support for parents, and more effective social care interventions will deliver long-term health benefits.
Better management of long-term conditions and access to better services in the community will allow people to live in their own homes for longer and reduce hospital admissions.
Commissioners and local authorities working together will improve the experience of patients, deliver better health outcomes and make more efficient use of the resources available.
Integrating service delivery
Joint working is not just about getting managers together across organisational boundaries but about integrated delivery of services, changing front line working practices and adapting the mix of services to meet local requirements.
The best advice for emerging commissioning organisations thinking about how to work with local authorities is to concentrate on what's really important - those aspects of a joint working strategy most likely to produce better health.
As with GP commissioning, organisational form is the wrong place to start.
If there was a blueprint or universal model for joint working it would have been discovered already. Fledgling consortia can start taking simple practical steps now.
The governance arrangements and performance metrics will follow in due course.
|Top tips for working with local authorities|
1. Start with care pathways
2. Common goals
3. Joint strategic needs assessments
4. Consider opportunities to co-locate or move services into different settings
5. Communication is key
6. Patient and public engagement
7. Managing emergencies
8. Keep people out of hospital
9. Share services There may be savings to be made from sharing back-office functions, such as procurement, analytical services, communications and training.
10. Start now