How do the new health structures work and how do I engage?

Understanding the context

On 1 April 2013 the Health and Social Care Bill came into effect, fundamentally altering the way in which the healthcare system operates. The Act represents one of the most radical shake-ups of the NHS ever seen, setting out a major reform programme to restructure healthcare services and reallocate public health responsibilities.

The new system focuses more on prevention and on empowering local communities to plan services according to their local priorities. This is led by local authorities who are now directly responsible for the health of their local populations and receive ring-fenced funding accordingly.

Each local authority has a director of public health who is responsible for exercising public health functions. They will contribute to revising the local annual Joint Strategic Needs Assessment (JSNA) and develop the annual Joint Health and Wellbeing Strategy (JHWS).

The JSNA is the process and document through which local authorities, the NHS, service users and the community and voluntary sector research and agree a comprehensive local picture of health and wellbeing needs. The development of the JSNA will be the responsibility of Clinical Commissioning Groups (CCGs) and councils through Health and Wellbeing Boards (HWBs).

Local authorities are legally required to establish a Health and Wellbeing Board, which include a wide range of expertise including councillors, GPs, health and social care officers and representatives of patients and the public. It will lead and advise on work to improve health and reduce health inequalities among the local population. Each Board is required to produce a JHWS for the local area based on the needs identified in the JSNA.

Alongside this are CCGs made up of a range of healthcare professionals including GPs, nurses, hospital doctors and others. CCGs will commission the majority of health services including emergency care, elective hospital care and community and mental health services and will work closely with HWBs to ensure that services are integrated and deliver the best quality health and care outcomes for their population.

How can Sport England help?

What's the result?

By using the material from these tools you will be able to:

  • Understand who are key players and what their priorities are
  • Influence your Joint Strategic Needs Assessment
  • Influence your Health and Wellbeing Strategies to make sport and wider physical activity a priority
  • Develop relationships with directors of public health, commissioners and others.