A new briefing from The King's Fund has highlighted the critical need for greater clarity regarding the roles and responsibilities of Health and Wellbeing Boards (HWBs) in relation to the recently established Integrated Care Systems (ICSs). The report underscores concerns that a lack of clear guidance could hinder effective local health planning and reduce public and local authority involvement in health decision-making across England.
Health and Wellbeing Boards, established under the Health and Social Care Act 2012, were designed to bring together local authorities, NHS organisations, and other partners to improve the health and wellbeing of their communities. Their remit includes developing Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs), which are crucial for identifying local health priorities and planning services. However, the introduction of Integrated Care Systems in 2022, which are statutory bodies responsible for planning and delivering health and care services across larger geographical areas, has created an overlap that the briefing suggests needs urgent attention.
The King's Fund briefing suggests that while both structures aim to improve population health, the precise division of labour and lines of accountability between HWBs and ICSs remain ambiguous. This ambiguity risks weakening the influence of local authorities and public representatives in shaping health policy, potentially leading to decisions being made further away from the communities they affect. The report warns that without clear delineation, HWBs could be sidelined, diminishing their ability to advocate for local needs and ensure a holistic approach to health and social care.
The report calls for national policymakers to provide more explicit guidance on how HWBs and ICSs should collaborate. It emphasises that HWBs are uniquely placed to ensure that local democratic accountability and public engagement are central to health planning. Maintaining their strong role is seen as vital for addressing health inequalities and ensuring that health strategies are genuinely reflective of local community requirements and priorities.
While the Government's overarching aim with ICSs is to foster greater collaboration and integration across health and social care, the briefing suggests that this must not come at the expense of local democratic oversight. The effective functioning of both HWBs and ICSs requires strong leadership at a local level to forge productive partnerships and define clear remits, ensuring that the strengths of each body are maximised for the benefit of the population.