The comments from DH national director for health and wellbeing board implementation John Wilderspin come less than a year before the boards become statutory bodies.
Speaking at a Westminster Health Forum seminar on implementing the boards, this month in central London, Mr Wilderspin said: 'They need to make sure they actually do something, that they don't try and take on everything, manage expectations, engage widely, and if you are going to start service reconfiguration, start at the beginning, rather than halfway through the story, and maintain enthusiasm.'
From next April councils will host the boards, which will include representatives from clinical commissioning groups (CCGs). Health and wellbeing boards will have no specific power of veto over CCG decisions, but their thinking will 'inform' commissioning decisions at a time when local authorities take control of public health budgets.
|HEALTH AND WELLBEING BOARDS|
Minimum requirements for health and wellbeing board membership
Doubts over commitment
Doubts remain that councils will have the appetite or the money to plan an overhaul of services after going through painful service cuts when faced with steep reductions in their grant from central government.
Some are lobbying ministers for more funding, and others are looking to merge public health functions with neighbouring councils.
But if health and wellbeing boards prove effective, there will be clear incentives for GPs and CCGs to get involved.
NHS Confederation deputy policy director Jo Webber says health charities will start lobbying health and wellbeing boards and councillors rather than the DH.
She says: 'We will get a lot of the smarter single national issue charities lobbying health and wellbeing boards, lobbying councillors. The place at which a lot of those decisions about priorities will be taken is the health and wellbeing boards.'
South Devon and Torbay CCG co-chairman Dr Derek Greatorex admits this wider focus may not come naturally. 'We are very good at getting caught up in our contracts, our relationships with other providers. There is a lot going on out there we don't know about, that hinges on the health of a wider population.'
GPs are also being warned to become accustomed to local politics to get things done.
Director of public health at Sandwell PCT, Dr John Middleton, told the Westminster seminar that the boards were the 'least contentious' part of the Health Act, but would rely on co-operation. He said: '[CCGs] must understand what local politics can do for them, how they can fall foul of it.'
But all of this could add up to a bureaucratic nightmare, according to GPC negotiator Dr Chaand Nagpaul. 'It is important for the boards to help CCGs and not become another bureaucratic hurdle. We are concerned about the move of public health out of the NHS.'
As with any new structures, successes and failures are inevitable. Mr Wilderspin says integration is the current NHS buzzword - it may also prove the marker of success for health and wellbeing boards.
If CCGs can engage GPs, and health and wellbeing boards link them in turn with public health through councils, NHS integration could yet become more than just an empty mantra.