In more detail
The National Health Service (NHS) Constitution says: ‘You have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.’
The GP practices serving your neighbourhood are the first stop for engaging with the local health service. There are about 8000 GP practices in England. The numbers of people they serve varies from fewer than 10 to more than 50,000 (and the number of GPs involved in each practice also varies). The median list size for a GP practice is about 6800 people.
GP practices may have PPGs or PRGs (Patient Participation Groups and Patient Reference Groups respectively). They are small groups of people who provide a patients’ voice in the work of the practice. They may also be involved in health campaigns in the neighbourhood. Some Clinical Commissioning Groups may also organise Local Patient Networks which are public forums for health related issues covering an area with several GP practices.
You can, of course, invite GPs and staff employed by GP practices to come to neighbourhood meetings and forums which are not specifically health related. Depending on the practice and the people involved, there may be other ways in which are able to support and participate community planning aimed at making a healthier neighbourhood.
Initiatives which local GP practices have led or become involved in include:
- social prescribing – where GPs ‘prescribe’ social activity in the local community or physical activities in the park or at a local community centre to patients alongside medical treatments
- promotion to health centre users of cycling and walking for short trips in the neighbourhood as an alternative to car use
- promoting and supporting community gardens and their use.
GP practices work together to form and run Clinical Commissioning Groups.
Clinical Commissioning Groups (CCGs)
Clinical commissioning groups are the bodies responsible for planning and commissioning most healthcare services in a local area. They are led by clinicians – GPs, nurses and other medically qualified staff. There are 209 CCGs in England. The areas they cover vary widely in size and population. For example: Corby CCG covers the town of Corby in Northamptonshire with a population of about 70,000 people; Birmingham CrossCity CCG serves a population of nearly 720,000 people. The average size is roughly equal to a borough or district council. CCGs are made up by individual doctors’ practices which means they can have slightly ‘fuzzy’ looking ‘interwoven’ boundaries with each other. The video below is by the CCG in Tower Hamlets - it explains what CCGs do:
Between them, CCGs manage about 60% of the NHS budget. They commission most secondary care services which includes things like: planned hospital care; rehabilitative care; urgent and emergency care (including out-of-hours and NHS 111); most community health services; mental health services; and services for people with learning disabilities. CCGs are able to commission any service provider that meets NHS standards and costs, including NHS hospitals, private sector providers and charities and social enterprises. In deciding whether they meet NHS standards, they are guided by the National Institute for Health and Care Excellence (NICE) guidelines and the Care Quality Commission's (CQC).
CCGs have a duty to involve their patients, carers and the public in decisions about the services they commission. Each CCG publishes a plan and has its own means by which people can engage in decision making about health and care priorities. CCGs are likely to particularly interested in ways in which better neighbourhoods might support community care. CCGs are also members of Health and Wellbeing Boards which are run by the local council and integrate health and care services.
Councils and Health and Wellbeing Boards
Health and wellbeing boards were set up by Parliament to integrate local health and care services. They are organised by local authorities and draw together representatives from the council, local NHS commissioners, public health and other relevant services. As well as strengthening working relationships between health and social care and enabling integrated commissioning, Health and Welll-Being Boards aim to increase democratic input into strategic decisions about local health and care services. Health and Wellbeing Boards meet in public and may run consultations or invite public views on issues they consider.
Local councils in England now have the primary responsibility for commissioning public health services. These include things like health promotion, diet, exercise and physical activity, sexual health services, services aimed at reducing dependence on drugs and alcohol and smoking cessation. Local councils continue to be responsible for environmental health services including food safety, pest control and disinfestation, air pollution, animal welfare, noise nuisance and certain aspects of health and safety. You can influence your local council including by working with your local elected councillors and by responding to annual consultations on council budgets, plans and initiatives.
Healthwatch
Healthwatch is a network of local bodies that aim to champion users of health and care services. They represent ‘the voice of the consumer’ to those who commission, deliver and regulate health and care services. There is a Healthwatch in every local council area.
The video below is by Healthwatch UK and explains what the organisation aims to do:
NHS Trusts
An NHS Trust is a part of the NHS with a given responsibility either in terms of geography or function. They include hospital (or acute) trusts; mental health trusts; ambulance service trusts; and community health trusts. They are, in effect, public sector corporations which are part of the NHS and are commissioned by CCGs to provide services as part of the NHS. They can also sell some of their services outside the NHS.
Any NHS Trust can become a Foundation Trust, depending on the quality of its performance and systems. Foundation status enables greater autonomy. Rather than being led by a board of directors (as non-Foundation trusts are), a Foundation trust has a Council of Governors. Governors are appointed by members of the Trust. Anyone with a connection to the Trust – such as living in the broad area it serves or working for it can join it as a member.
All NHS Trusts produce plans and Foundation Trusts have their governing bodies elected by an open membership. They operate as public sector businesses and are likely to be influenced by ideas and initiatives which will increase their ability to offer competitive services to commissioners.
The video below is by the independent charity The Kings Find and presents an 'Alternative View of the NHS' organisation:
NHS England
NHS England is the body which oversees the National Health Service; sets priorities and direction; and manages the NHS budget of about £96bn a year. It passes about £66bn of that budget to Clinical Commissioning Groups in each area of the country and uses most of the rest to commission primary care services and pay for the costs of drugs and prescriptions. Primary care services are things like GPs and medical centres, pharmacy services, dentists and opticians.
NHS England publishes a Five Year Forward View, which sets out the direction for the NHS as a whole.
| Key Facts:
Influencing the way the NHS serves your neighbourhood may be more relevant to improving the locality than making a local neighbourhood spatial plan. Or it may be that - through community planning - you can do both. There are a number of levels at whoch you can influence the NHS. The starting point is the local GP surgeries and health centres serving the neighbourhood; there is also the CCG, Health & Wellbeing Board, Healthwatch and NHS Trusts (which run things like hospitals). All have ways of engaging with and involving the public in their plans and the delivery of their services. |
Page Links from here
Public Health England provides an easy way in to locate GP practices nad view information relating to them including perfornance measures .
NHS England has a list of links to Clinical Commissioning Groups and publishes a Guide to the NHS as a PDF
The independent health charity The Kings Fund has a directory of contacts for local Health and Wellbeing Boards and has published an Alternative Guide to the NHS
Find your local Healthwatch
In this toolkit, see also:
OR you can use the navigation menu above right to look at other parts of the toolkit.
BIRMINGHAM COMMUNITY PLANNING TOOLKIT DEFINITION SHEET This sheet may be reproduced in paper or electromic or any other form but please mention it was made by Chamberlain Forum Limited for Birmingham City Council supported by Department for Communities and Local Government.
| created: 2016-07-01 13:53:20 | by: admin | status: f published |