Strategic Consultancy for Local Health Board: Challenges, Controls and Public Involvement

Challenges faced by a publicly funded health system's health board

You have recently been appointed as a strategy consultant to a local health board, part of a state funded wider health system. The health board provides strategic direction in the provision of local healthcare services, undertakes ongoing evaluation of services and is ultimately responsible for overseeing the operational management of the different organisations. There are two hospitals run by the health board – one large teaching hospital and one smaller general hospital – and six primary care centres. Each hospital has its own Chief Executive who directly reports to the health board, and each primary care centre is run by the doctors who staff it in the form of a partnership (as seen in the UK’s system), who also report to the health board. Social care is provided separately and funded by local government, although current provision does not meet demand and often leads to major delays in the discharge of patients from hospital. In recent months, the neighbouring health board has suffered from significant financial pressures and is likely to be declared bankrupt, with the resignation of the Chair. The failures appear to be systemic, but there also appears to have been a mixture of poor strategic direction and insufficient audit and internal controls. Part of your role is to avoid the same happening in your own health board. Both your health board and the neighbouring board are set in areas of significant social deprivation, with large portions of the population showing a lack of engagement in the political process. Your task is to do each of the following: a) Describe the strategic and operational challenges brought about by being a health board with the outlined responsibilities, specifically within a publicly funded health system (30 marks) b) Discuss the key elements you would include in your recommendation to the board on ensuring effective audit and internal controls are in place at the health board level (30 marks) c) Draw up an executive summary for the board that details how you would attempt to involve the public in future strategic planning (40 marks) Other than the specific information given above, you may make assumptions based on comparable situations available in the public domain in order to come to a decision – but you must be explicit where you have done this. Your answers should be based on evidence available in publicly available literature and take into account material presented in the first five modules of this course. You should include your own experience and views, and these should be clearly identified as such. The total word-count for this assignment is 2,500 words; you are encouraged to allocate words in a similar proportion to marks available for each section. References are not included in your word count. You should avoid the use of appendices on this occasion. The use of 4 | P a g e diagrams and pictorial representation are encouraged, and any words used are included in the word count. Your executive summary for the board should be concise and should recommend a clear direction for the boar