Neighbourhood health cannot exist without local government

As the Local Government Association launches a new online Neighbourhood Heath Hub this week, Cllr Dr Wendy Taylor says excluding councils from ICBs could risk weakening neighbourhood health partnerships.

Cllr Wendy Taylor (c) LGA

Cllr Wendy Taylor (c) LGA

One year on from the launch of the Government's 10-Year Health Plan, there is a clear focus on bringing health and care closer to people's everyday lives and communities. But the role of councils needs to be fully reflected, both in the journey and the destination.

The ambition to shift from hospital to community, from treatment to prevention and from sickness to health is one that local government has long championed, working closely with communities and the voluntary sector to improve outcomes.

Early progress has focused on the NHS. But neighbourhood health presents a real opportunity to go further and build a genuinely place-based model. This is a moment to move beyond an NHS-led model to one that fully reflects the role of place, partnership and communities. Neighbourhood health cannot exist without local government.

Councils know their communities and understand local need. Working with health, care and the voluntary, community and social enterprise sector (VCSE), councils already co-ordinate joined-up, place-based services.

The Neighbourhood Health Framework, published in March, reinforces many of the right themes: prevention, early intervention, partnership working and bringing health and care closer to home. Effective delivery, however, will depend on councils having a strong voice at every level.

Under current proposals, local authorities would not have representation on ICBs, despite being central to delivery. Excluding councils from ICBs could risk weakening neighbourhood health partnerships.

This is being taken forward through the Health Bill, which introduces Neighbourhood Health Plans and the importance of neighbourhood-level planning. It presents an opportunity to strengthen prevention, improve co-ordination and deliver more joined-up services closer to home.

But legislation alone will not guarantee success. How these plans connect with local services will be critical.

This is where local Health and Wellbeing Boards have an important role to play. Neighbourhood Health Plans will need to reflect local needs and priorities, including the wider determinants of health.

Building on existing insight and partnerships will help ensure a genuinely place-based approach shaped by communities and local partners.

Neighbourhood health arrangements must empower local leadership. Councils should be equal partners from the beginning in designing, governing and delivering plans.

Existing structures, particularly Health and Wellbeing Boards, provide a strong foundation for this and should be supported and strengthened. For this to work in practice, system-level arrangements will also need to support local government's role.

Under current proposals, local authorities would not have representation on ICBs, despite being central to delivery. Excluding councils from ICBs could risk weakening neighbourhood health partnerships.

Strong local government influence within system leadership can ensure decisions reflect local realities and support effective neighbourhood working.

Giving a meaningful voice to councils will ensure services are shaped around communities and the way local people live their lives, rather than around organisational boundaries.

Alongside this, communities themselves and the VCSE sector must have an active role in shaping neighbourhood health.

The proposal to abolish Healthwatch is deeply concerning. The Health Bill removes the existing independent public and patient voice function without setting out a clear replacement.

At precisely the time when the focus is on integration and neighbourhoods, we risk weakening one of the few mechanisms that gives local people an independent voice in how services operate.

The LGA is working with councils and partners to develop a sector-led vision for neighbourhood health.

As part of this, the LGA has launched a new online Neighbourhood Health Hub bringing together guidance, information and learning to support councils in delivering neighbourhood health and enable shared learning across the sector.

In the coming months, we will work to set out a clear local government and community-led perspective on what good neighbourhood health looks like in practice, with councils at its centre.

This will connect neighbourhood health with wider public service reform, including Family Hubs, the Test, Learn and Grow programme, Pride in Place and local government reorganisation.

Together, these reforms have the potential to bring services closer to communities and improve co-ordination across local public services. If we get this right, neighbourhood health could transform outcomes and reduce inequalities.

Cllr Dr Wendy Taylor is chair of the Local Government Association's Health and Wellbeing Committee

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