Dr Ruth Hussey OBE

1
Leading Across Boundaries What Makes
Partnerships Tick?

• Dr Ruth Hussey OBE
• Regional Director of Public Health / Medical
  Director
• NHS / DH North West

2
Health and Well Being
3
Inequalities Begin from Birth
4
The New Agenda
PCTs rely on local government
PCTs are increasingly seeking to become more
engaged with their populations in order to
translate their needs and effectively commission
services in order to improve health and well
being
Local government rely on PCTs When asked Which
services were most important in making somewhere
a good place to live? 82 of people in local
authorities rank health services as the first or
second most important factor.
5
The Value of Partnerships

• Solutions to problems that single agencies cant
  solve
• Improve service delivery and coordination across
  agency boundaries
• Makes better use of resources

6
Delivery System

• Joint strategic needs assessment
• Local Area Agreements
• Joint budgets
• Practice based commissioning /social care
  commissioning
• Comprehensive Area Assessment

7
The Task

• Public expectations met
• Personal / self care and population based action
• Addressing inequality across all services
• Efficiency cost avoidance
• Effectiveness

8
PCT Relationships with Local Government in the
North West

• Questionnaire sent to all 24 PCT Chief
  Executives
• Assess current relationships and integration
  that PCTs have with local government
• Results..

9
Formal Positions..

• 22 of PCT Chief Executives in the North West
  hold a formal position within the local
  government structure
• Include membership of
• - Partnership delivery board
• - LAA programme board
• Only two are joint appointments
• salary paid by LA formal role within LA
• Accountable to PCT Chair and Joint Partnership
  Board

10
Informal Positions.

• 48 of PCT Chief Executives in the North West
  hold an informal position within the local
  government structure
• Include membership of
• - Health and Well-being Partnership Board
• - Local Strategic Partnership Executive
• - Joint Commissioning Partnership
• Local Chief Executive Forums
• Health Act Partnership Board

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Joint Appointments between Local Government and
PCTs
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Joint Appointments between Local Government and
PCTs
Joint Commissioning Posts
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Do you have existing formal joint arrangements
with Local Government for the
Provision of services in the local area? Yes
83 No 17 Commissioning of Services in
the local area? Yes 92 No 8 All who
responded No to either of the above questions,
said that they intended to implement formal joint
arrangements with local government in the
future.
14
Strong strategic achievement
Goodgovernance
Personal commitment
GoodLeadership
What factors help partnership working with local
authorities?
Shared goals / priorities
Good relationships
Quality Communications
Clear financial arrangements
Clear Structure
Coterminosity
Fewer PCTs
15
Different PerformanceReportingRegimes
Lack ofClarity ofRoles
Systems
What factors hinder partnership working with
local authorities?
Financial Arrangements
Politics
2 tier Arrangements
Other
Lack of clear leadership
16
Partnerships Require

• Leadership and vision
• Strategy and coordination
• Involvement and sustained priorities, commitment
  and investment role of projects?
• Evidence based decision making
• Intelligence
• Resources
• Trust and communication
• The ability to lead and follow!

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Challenges

• Effective multi agency governance / multiple
  accountability
• Genuinely productive joint working
• Involving middle managers and front line staff
• Gaining legitimacy with the public

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Effectiveness of Partnerships

• Performance (over time and current)
• Partnership evaluation

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Role of Regional Level Organisations

• Strategic overview
• System management
• Improvement and performance focussed
• Collaborate with regulators
• Develop their own partnerships for strategic
  delivery e.g. Government Office/ Strategic Health
  Authorities/ Development Agencies

20
Journey of Engagement
Far-reaching
Health Space