Title of the Health Board Report

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1 Agenda Item 6.3 Title of the Health Board Report Well-Being of Future Generations (Wales) Act 2015 Executive Lead: Director of Planning & Performance Author: Head of Health and Wellbeing Contact Details for further information: Nicola Davies on or Purpose of the Health Board Report The Well-Being of Future Generations (Wales) Act became law in Wales on 29 th April The Act strengthens existing governance arrangements for improving the well-being of Wales to ensure that present needs are met without compromising the ability of future generations to meet their own needs. This report provides an update on the details of the Act and the implications for the UHB. Governance Link to Health Board Strategic Objective(s) Supporting evidence The Board s overarching role is to ensure its Strategy outlined within Cwm Taf Cares 3 Year Integrated Medium Term Plan and the related organisational objectives, aligned with the Institute of Healthcare Improvement's (IHI) Triple Aim are being progressed, these in summary are; To improve quality, safety and patient experience. To protect and improve population health. To ensure that the services provided are accessible and sustainable into the future. To provide strong governance and assurance. To ensure good value based care and treatment for our patients in line with the resources made available to the Health Board. The Act will have implications for the UHB. We will need to develop well-being objectives and ensure we make decisions and deliver services in line with the sustainable development principles. Well-Being of Future Generations (Wales) Act 2015 The Act can be accessed from the link below: enacted Well-Being of Future Generations (Wales) Act Page 1 of 7

2 Engagement Who has been involved in this work? The UHB s Partnerships Team has been keeping abreast of legislative and policy development as they have progressed. The UHB has proactively contributed to consultation on the Bill and a guidance discussion document. We have also engaged with our Local Service Boards on the implications for partners. Health Board / Committee Resolution (insert ) To; APPROVE ENDORSE DISCUSS NOTE Recommendation NOTE the requirements of the Well-Being of Future Generations (Wales) Act 2015 and the implications for the UHB. NOTE that further updates will be brought to the Board as detailed guidance is issued by Welsh Government and timescales are clarified. Summarise the Impact of the Health Board Report Equality and diversity Equality and diversity impact assessments and plans are to be developed for any major programmes of collaborative working. The Well- Being of Future Generations (WBFG) (Wales) Act, by its very nature, is about improving the wellbeing of Wales as a whole and will therefore need to ensure there is a positive impact on those people with protected characteristics. Legal implications Population Health The UHB will be required to address the requirements of the WBFG Act which imposes a number of statutory duties on public bodies, including the UHB. The intention is that the UHB s new internal Strategic Partnerships Group will provide assurance that the requirements of the Act are fully understood, ensuring the UHB is ready to appropriately and adequately discharge its statutory duties under the Act. The current Single Integrated Plans developed with our partners are underpinned by a comprehensive health needs assessment and contain a range of prioritised actions to improve population health. These plans will be replaced under the WBFG Act by new local Well-Being Plans which will also require a population assessment and have to address issues of population health. Well-Being of Future Generations (Wales) Act Page 2 of 7

3 Quality, Safety & Patient Experience Resources Risks and Assurance In addressing the requirements of the Act such as well-being and quality of life issues and also by following sustainable development principles (such as an emphasis on prevention, integration and collaboration), quality, safety and patient experience should be improved. Any resource implications to the UHB as part of the collaborative implementation of these requirements will be considered as part of the development of the 3-Year Integrated Plan. Opportunities are also being explored as to where working in partnership can improve quality whilst also reducing costs. The UHB commented at the time that the Regulatory Impact Assessment on the Bill undertaken for Welsh Government did significantly underestimate the time and resources Health Boards and Local Authorities currently employ in supporting the existing arrangements associated with Local Service Boards and Single Integrated Plans. It is not clear whether any additional funding will be made available for implementation. As the risks associated with the implementation of the WBFG (Wales) Act are assessed they, along with their mitigating actions, will be incorporated in the UHB s corporate risk register. Health & Care Standards The 22 Health & Care Standards for NHS Wales are mapped into the 7 Quality Themes: Staying Healthy Safe Care Effective Care Dignified Care Timely Care Individual Care Staff & Resources Workforce The statement considers many of the quality themes. Any workforce implications will be included within the 3-Year Integrated Plan. Well-Being of Future Generations (Wales) Act Page 3 of 7

4 Well-Being of Future Generations (Wales) Act SITUATION / PURPOSE OF REPORT A report was presented to the Executive Board in November 2014, which introduced the requirements of the Well-Being of Future Generations (WBFG) (Wales) Bill. The Bill became law on 29 th April The purpose of this report is to provide further detail on the Act and its implications for the UHB as Health Boards are one of the public bodies included in the Act. 2. BACKGROUND / INTRODUCTION The WBFG (Wales) Act is about public bodies improving the social, economic, environmental and cultural well-being of Wales in accordance with sustainable development principles. It is intended to make the public bodies listed in the Act think more about the long term, work more effectively with people, communities and each other and take a more preventative and joined up approach to solving problems. The key purposes of the Act are to: set a framework within which specified Welsh public bodies will seek to ensure the needs of the present are met without compromising the ability of future generations to meet their own needs (the sustainable development principle), put into place well-being goals which those bodies are to seek to achieve in order to improve well-being both now and in the future, set out how those bodies are to show they are working towards the wellbeing goals, including the use of national indicators that will measure the difference being made, put Public Services Boards and local well-being plans on a statutory basis and, in doing so, simplify current requirements as regards integrated community planning, and establish a Future Generations Commissioner for Wales to be an advocate for future generations, who will advise and support Welsh public bodies in carrying out their duties under the Act. 3. ASSESSMENT / GOVERNANCE AND RISK ISSUES 3.1 Sustainable Development Principle The Act puts in place a sustainable development principle which means we must act in a manner which seeks to ensure the needs of the present are met without compromising the ability of future generations to meet their own needs. The UHB will need to make sure that when making decisions it takes into account the impact it could have on people living their lives in the future. To show it has applied the sustainable development principle and tackle long term challenges, the Act sets out five ways of working that need to taken into account: Long term - balancing short term needs with the need to safeguard the ability to also meet long term needs. Well-Being of Future Generations (Wales) Act Page 4 of 7

5 Prevention - acting to prevent problems occurring or getting worse. Integration - considering how our well-being objectives impact upon each of the well-being goals, on our other organisational objectives and those of other public bodies. Collaboration - acting in collaboration with others to help meet the wellbeing objectives. Involvement - involving people with an interest in achieving the goals and ensuring that they reflect the diversity of the local population. 3.2 Statutory Well-Being Goals and Well-Being Duty The Act sets out seven statutory Well-being Goals, as below, which provide a shared vision for public bodies to work towards. Work must be undertaken to achieve all seven goals, not just one or two. A prosperous Wales A resilient Wales A healthier Wales A more equal Wales A Wales of cohesive communities A Wales of vibrant culture and thriving Welsh language A globally responsive Wales The Act describes each goal. For example, a healthier Wales is a society in which people s physical and mental well-being is maximised and in which choices and behaviours that benefit future health are understood. Whilst the cross cutting nature of the seven goals is recognised, it is welcome that there is a specific goal for a healthier Wales. This is an area that the NHS will wish to influence heavily, not least in relation to health outcomes that can only be achieved with contributions from other partners. The Act places a Well-Being Duty on public bodies that we are expected to carry out including: Each public body must carry out sustainable development. Actions must include setting and publishing well-being objectives that are designed to maximise the organisation s contribution to achieving each of the well-being goals. Taking all reasonable steps in exercising the organisation s functions to meet those objectives. When the UHB sets its well-being objectives, we will need to publish a Well- Being Statement. This must include an explanation as to why we feel the objectives will help us achieve the well-being goals and how we have applied the sustainable development principle. We must also explain how we propose to involve other people; timescales; review and governance arrangements. The well-being objectives of a public body that is also a member of a Public Services Board (see section 3.3 below) may be included in that Board s local Well-Being Plan (see section 3.4.below) The Act also requires an annual report showing the progress we have made. Well-Being of Future Generations (Wales) Act Page 5 of 7

6 3.3 Public Service Boards The Act establishes Public Service Boards (PSBs) for each Local Authority area in Wales. The statutory members of each PSB are the LA, the LHB, the Welsh Fire and Rescue Authority and National Resources Wales. In addition to these members, each PSB must invite the following to participate on the Board - Welsh Ministers, Chief Constable, Police and Crime Commissioner, Probation, Third Sector. The PSB can also invite other people who carry out public functions, for example Public Health Wales, Higher Education sector, National Park Authority. Each PSB must improve the economic, social, environmental and cultural wellbeing of its area by working to achieve the well-being goals. The Act provides the ability for PSBs to merge voluntarily or collaborate if they consider it would be beneficial to the local aims of each Board. The Act also states that Welsh Ministers may direct two or more PSBs to merge or collaborate. The UHB is a member of the two existing Local Service Boards for RCT and Merthyr Tydfil but we also have a Cwm Taf Regional Collaboration Board chaired by the Chief Constable which brings together the two LSBs and addresses issues of common interest across the Health Board footprint. The work of this Board was given as a positive example in the guidance notes that accompanied the Bill in its consultation phase. We would not want to lose this flexibility and constructive approach as a result of any changes introduced to meet the requirements of the Act. 3.4 Local Well-Being Plans In order to achieve the well-being goals in accordance with the sustainable development principle, the PSB will be required to prepare and publish a local Assessment of well-being develop a local Well-Being Plan setting out its local objectives and the steps it proposes to meet them carry out and publish an annual review of their plan showing progress consult widely 3.5 Other requirements The Act establishes the role of Future Generations Commissioner for Wales who will act as a guardian for the interests of future generations and to support public bodies in achieving the well-being goals. The Commissioner can make recommendations to a public body and they must publish a response. Welsh Ministers must publish national indicators to measure progress. They must also set milestones to show expectations of what progress the indicators should show at certain points in the future. Welsh Government must produce an Annual report. Twelve months before an Assembly election, Ministers must publish a Future Trends Report. Well-Being of Future Generations (Wales) Act Page 6 of 7

7 3.6 Conclusion The WBFG (Wales) Act places a number of statutory duties and requirements on the UHB as outlined above. However, in order to deliver these effectively, we will need to continue working with our partners. Wherever appropriate, we already promote a partnership approach which spans both Local Authorities and we would wish to adopt a similar approach to the requirements of the WBFG (Wales) Act wherever possible. Timescales have still not been confirmed but it is anticipated that PSBs will be established and hold their first meetings early in 2016, with local well-being assessments being published in early 2017 before the production of the first local Well-Being Plan in Public bodies well-being objectives will need to be set by the beginning of We will need to continue over the coming year to take account of and engage with the proposed changes to ensure the UHB, alongside its partners, is ready for the implementation of the Act. We have already contributed to a discussion paper produced by Welsh Government to inform the implementation guidance but will also respond to any consultation once it is issued. 4. RECOMMENDATION The Health Board is asked to:- NOTE the requirements of the Well-Being of Future Generations (Wales) Act 2015 and the implications for the UHB. NOTE that further updates will be brought to the Board once detailed guidance is issued by Welsh Government and timescales are clarified. Well-Being of Future Generations (Wales) Act Page 7 of 7