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Conquering the Twin Peaks

Research on how London's health and wellbeing boards are doing two years after they took up their statutory roles

  • By Judith Hendley

In March 2015, London Councils published Conquering the Twin Peaks - London's Health and Wellbeing Boards. Based on a survey, interviews, focus groups and in-depth case studies, the research provides a comprehensive picture of the position of health and wellbeing boards in London, their direction of travel and their future ambitions.

The research, carried out by Shared Intelligence, identified a number of examples of where boards had added real value on specific issues. However, the vast majority of interviewees described their board as being on a journey or "work in progress". 

The key challenge facing all boards was described by one interviewee as the "twin peaks" - the need to take action to both tackle the wider determinants of health and to play a system leadership role, particularly in relation to the integration of health and care.

In the light of the challenges facing health and care, including as set out in the NHS Five Year Forward View, boards were identified as having an important role to play in creating the conditions in which discussions can take place between councils, Clinical Commissioning Groups (CCGs) and providers on the future shape of the health and care system in their area.  

The research found little evidence of boards yet providing genuine system leadership across the piece, although the vast majority of respondents reported that their board aspires to do so and that many are taking steps to enable them to achieve this.

The research suggests that an effective health and wellbeing board would:

  • create the conditions in which there is genuine collaboration between key players in the local health and wellbeing system
  • ensure the existence of effective system leadership
  • ensure effective engagement with the public and other stakeholders.

As a result of this there would be:

  • focussed, prioritised action which impacts on the wider determinants of health
  • a shared vision for the future of health and care in a place, which has traction with the strategies and business planning processes of the key local organisations
  • a work programme to deliver and monitor this.

The research found that most of the factors that determine the effectiveness of health and wellbeing boards are within their own control. It identified key determinants of effectiveness for boards, as well as some of the things that can impede effectiveness. 

This research provides information that will help boroughs and their partners to fulfil their ambitions to strengthen London's health and wellbeing boards.

We will support them to do this and continue to make the case for enhanced powers, responsibilities and freedoms to enable them to fulfil their potential as powerful system leaders driving improvement in outcomes and services for their citizens.

The report was launched at a major conference on 12 March involving members of health and wellbeing boards from across London - check out the Storify of tweets from the conference and pictures of the day.

Judith Hendley, Head of Health & Adult Services