Ways of working between the health and wellbeing board and integrated care partnership in Lincolnshire

Key benefits and outcomes

• Collective action in the preparation of strategies both at system and place level, and a unified response to deliver for local communities. 

• A joint local health and wellbeing strategy developed by system partners and the community and informed by evidence and insights from public engagement. 

• A comprehensive understanding of the local population’s health and care needs.

What the organisation faced

In its current form, updated draft guidance from the Department of Health and Social Care states that partners within ICSs should avoid duplication of existing governance mechanisms and duplication in the joint local health and wellbeing strategy, developed by the health and wellbeing board (HWB), and integrated care strategy, developed by the ICP.  Lincolnshire’s ICS was challenged with defining the difference between the two committees, how they would work with and within the system, and how the ICP should build on the work of the HWB in preparing an integrated care strategy.

What the organisation did

Lincolnshire’s approach as a coterminous system was to avoid duplication between the HWB and ICP by:  

• aligning the location and frequency of ICP meetings with the HWB 

• mirroring membership of the committees  

• having the executive councillor from Lincolnshire County Council as a representative on the ICP 

• aligning plans and building on strategies where possible, such as the joint local health and wellbeing strategy. 

Lincolnshire started by hosting a planning and development workshop, bringing system partners together to decide how the ICP and HWB should join up working. The session aimed to: 

• develop a shared understanding of the roles and responsibilities of the ICP and HWB 

• ensure that these align to the whole system’s shared ambitions and values 

• gain consensus on how the two committees should work together and the arrangements that need to be put in place to develop an effective, seamless relationship between the two. 

The workshop helped partners to achieve a collective understanding of how they should work together to improve the lives of their residents and explain simply how system working will make a difference to the health outcomes of the population.   

Lincolnshire’s ICS agreed on a set of values and behaviours it wanted the ICP to embody, with a particular focus on partnership working, engagement, openness and honesty, clarity on decision-making, and inclusion and transparency. Lincolnshire embedded these themes into the ICP’s terms of reference to ensure all partners in the system could act on them and work towards a shared vision.  

With the results from the workshop, Lincolnshire’s ICS set out the scope and responsibilities for both the HWB and ICP, clearly outlining the expectations of each committee, including what responsibilities they have (and don’t have), and where these conversations should take place. Their aim was to demonstrate the importance of collaboration and partnership working rather than operating in silos as the NHS and local government.

Results and benefits

Lincolnshire’s ICS built the foundations for effective partnership working, resulting in collective action in the preparation of strategies both at system and place level, and a unified response to deliver for its local communities.  

• The JLHWS was developed using a wide range of evidence and insights from public engagement thanks to partnership working and trust between system partners and the community.  

• The ICP has a comprehensive understanding of its local populations health and care needs (outlined in the JSNA) and is working with a wide range of partners to set out how the system can deliver better care for its population.  

• Clear responsibilities and accountabilities are outlined for members of the HWB and ICP, resulting in effective decision-making to achieve local and system-wide action.  

• Improved understanding of the expectations of each committee and the ability to explain to the public and stakeholders how partnership working will make a difference.  

• Working closely with partners helped to build trust between colleagues in the NHS and local government, embracing a culture of collaboration rather than finger pointing. 

Takeaway tips

• Take the time to develop the JSNA and JLHWS, building strong relationships and embracing partnership working over the long term.  

• Invest in community engagement, taking the time to understand your local populations needs and build trust and confidence in the process.  

• Help partners to understand what the ICP is and how it will make a difference. Ensure this can be explained simply to members of the public and other stakeholders.   

• Adopt a culture of openness and honesty, encouraging colleagues to speak up and point out when something can be improved.  

• Ensure decisions are based on evidence and reflect the values you have agreed with system partners.

Further information

For more information please contact Sue Woolley, chair, Lincolnshire Integrated Care Partnership on cllrs.woolley@lincolnshire.gov.uk or visit https://lincolnshire.icb.nhs.uk/