Suchergebnisse

Health and wellbeing Boards (HWBs) were established in England in 2013, bringing together partners from local government, health services and consumer champions, to ensure strategic planning based on local needs. Similar partnership-working arrangements have achieved limited success, particularly in terms of engaging members of the public in decision-making. Drawing on data collected in five heterogeneous case study sites, we examined the role of HWBs in enhancing local democracy and accountability. Interviews, focus groups and observations were used to explore relationships and interactions between HWB members and the public or their representatives. A dramaturgical perspective was then applied in analysing the data. HWBs were generally not perceived to have achieved their well-intentioned aims; instead, meetings represented carefully staged and scripted performances that tended to inhibit rather than enhance democratic accountability. Our dramaturgical analysis highlights key deficits in the governance of HWBs, which are explored in the paper.

Objectives The paper reports on an empirical study of Health and Wellbeing Boards (HWBs) in England. Established by the Health and Social Care Act 2012, HWBs act as place-based hubs for leaders in health, social care, local government and other sectors to come together to address health improvement and the wider determinants of health. Methods We conducted a three-year study of HWBs (2015–2017) in five localities across England. This involved collecting qualitative data from semi-structured interviews with key actors in the HWBs at strategic and operational levels, and focus group sessions with voluntary-sector participants at each HWB. Results HWBs have largely followed the path of previous partnerships in terms of a lack of clear aims and objectives, lack of ownership and accountability by partners, and an absence of any significant impact on health outcomes. Conclusions Many of the features of unsuccessful partnership working were largely displayed by HWBs. Boards require more executive power and ownership from the bottom up if they are to have any real impact.