Local health groups in Wales: the first year (July 2000)

Citation

(2001), "Local health groups in Wales: the first year (July 2000)", International Journal of Health Care Quality Assurance, Vol. 14 No. 1. https://doi.org/10.1108/ijhcqa.2001.06214aab.017

Local health groups in Wales: the first year (July 2000)

Local health groups in Wales: the first year (July 2000)

This briefing by the Audit Commission outlines the development of the local health groups (LHGs) in Wales. It is based on survey returns completed by 21 of the 22 LHG general managers in January/February 2000, supplemented by health authority questionnaires, telephone follow-up and interviews and meetings with officials of the National Assembly for Wales.

The LHGs in Wales were established to bring a more local perspective to planning and service development through:

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  contributing to a health improvement programme (HIP);

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  developing primary care;

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  integrating care delivery;

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  commissioning services.

Although these functions are broadly similar to those of English Primary Care Groups (PCGs), there are differences between the focus of LHGs and that of primary care groups (PCGs) in England. They operate through partnerships rather than a primary care lead, deal with a wider range of issues affecting local health and health care, and have an emphasis on achieving stability and a financial balance. These differences are reflected in LHG structures and responsibilities. Larger boards represent local communities and all primary care professions; there are no discrete "levels" of delegated responsibility or provision to become independent trusts; and there are common boundaries with unitary local authorities.

The briefing says that LHGs have made a good start in some areas, for example, in developing new collaborative relationships with local clinicians, health care providers, voluntary organisations and local authorities, in collecting local data to inform health improvement programmes and action plans, and achieving a fairer distribution of primary care resources. Progress on many issues has been steadier than that of leading English PCGs. However, this development is on a broader front than English PCGs and they have consequently made less progress than many PCGs on specific aspects of clinical governance, primary care development and commissioning.

LHG boards appear generally to be working well, and arguably have done more than PCGs to prepare a firm foundation for future development. However, surveyed managers noted a number of factors that are inhibiting LHG development:

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  time pressures and inadequate staffing (averaging 8 WTE);

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  poor information and IT;

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  insufficient funds to facilitate change;

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  loss of interest due to a perceived lack of influence and of clarity as to future LHG roles.

LHGs need to make effective use of their limited resources, and the report recommends pursuing selective agendas with prioritised activities and working collaboratively and formalising support arrangements with HAs and NHS trusts. It also says that each LHG needs an agreed development path, using organisational audit to identify development needs and clarifying delegated responsibilities. LHGs also need a clear long-term goal that is tailored to local circumstances.

In terms of immediate tasks, their accountability to the health authority (HA) and the public must also now be put on a firmer footing. NAW policy is that the new Performance Management Framework for NHS Wales should in future underpin accountability arrangements for all health bodies.

Local arrangements for LHG accountability will need to be clarified as early as possible in 2000/2001 and progress milestones agreed between LHG boards and HAs. Additionally, efforts to involve patients and the local community should be strengthened.

Further information: Local Health Groups in Wales: The First Year is available as a full briefing with diagrams, for download as an Acrobat PDF file in English (1,242Kb) and in Welsh (1,205Kb) from the Audit Commission Web site or hard copy is available free of charge from Communications Department, The Audit Commission, 1 Vincent Square, London SW1P 2PN. Tel: 020 7396 1494.