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HWBs need rhythm not teeth

Phil Swann, Si Managing Director writes

One of the more significant policy debates taking place during this pre-election period is whether health and wellbeing boards should be given responsibility for overseeing a single health and social care budget and, if so, whether they have the capacity to do so.

At Shared Intelligence we have had a role in facilitating these conversations and one of the recurring threads of debate has been a call for for HWBs to “have teeth”. The proponents of this idea argue that boards need some form of statutory power over the different parts of the local health and care system. Without this, they argue, HWBs will continue to be talking shops with no real traction over CCGs and health and care providers.

The phrase is not a new one. The dependency of effective partnership working on high quality dentistry has a long pedigree. During Tony Blair!s second term there was also a lot of discussion of the case for local strategic partnerships to have teeth. That was back in the day when LSPs spent far too much time reviewing microscopically detailed public service agreement performance reports and discussing how to spend a few quid’s worth of performance reward grant.

There is no doubt that HWBs do need to find a way of having more influence over what the organisations represented round the table actually do. But I think the issue is more about culture and ways of working than it is about powers and statutory requirements. HWBs need rhythm rather than teeth.

I recently saw American singer Gretchen Peters in concert at Kings Place in London. For much of one number she stood back and let band members Barry Walsh (on piano) and Christine Bourgie (on guitar) take the lead. Each of them was centre stage for a few minutes in turn, passing the musical baton back and forth in a way that shared the spotlight, egged each other on and produced an amazing sound.

What does this require? It needs an agreed score (at least in outline), trust in each other’s musicianship, confidence that the other will hand back the lead role at an appropriate point. At heart it requires a commitment to a shared endeavour underpinned by experience of playing together.

Make the necessary adjustments from music to health and social care and isn’t that just what HWBs need?

Play on!

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