Few people would dispute that councils, the NHS and the third sector could work together more effectively to improve health and wellbeing in local communities. But there are finally signs that this could happen.

The Government has said it wants to devolve decision-mak-ing in health, which paves the way for local people to have a greater say in services.

Now a report published by the Local Government Association Health Commission last month has added to the impetus for more collaboration.

The LGA established the independent, cross-party commission last year to consider how health services could be made more locally responsive and accountable. Chaired by Niall Dickson, chief executive of the King’s Fund think-tank, the commission consisted of 12 members from health, local government and the voluntary sector. Its report Who’s Accountable for Health? revealed that most people don’t have a clue how the NHS is run or who is responsible for decisions. Seventy-one per cent of the public could not name their local primary care trust (PCT); 52 per cent did not know what a PCT does, and the fourth most-popular answer among those who did claim to know was “emptying the bins”.

“It is not the general public’s fault that they are unclear who is responsible for their local health services – the system is complex and in the past has been focused towards national accountability,” Dickson says.

“The public does want to feel it is being listened to about how local resources are being used and how local services are run. Current arrangements are unable to achieve that.”

Because the NHS has been through so much upheaval recently, the commission decided not to recommend new mechanisms to improve matters. Instead it calls for existing ones to be strengthened and for better cross-sector arrangements to be put in place.

It says local government should be involved in selecting PCT board members and appraising PCT performance, and that councils should have a greater role in commissioning health services.

The commission also recommends that the chair of each PCT should attend the council Cabinet for health-related matters, and that the council executive member for health and social care should sit on the PCT board in a nonvoting capacity. The report also calls for local involvement networks to be strengthened.

Anne McDonald, programme director for community wellbeing at the LGA, says that the commission’s recommendations should feed into the review of the NHS, by Lord Darzi of Denham, the Health Minister. “Some would fit particularly well into his idea for an NHS constitution,” she says. “The public don’t know who the people are who run health services, how to complain to them or how to influence their decisions, yet these people make decisions about services worth hundreds of millions of pounds.”

Three local authorities – South Tyneside Council, Manchester City Council and Hertfordshire County Council – are already involved in a pioneering partnership to improve local health.

The Local Wellbeing Project is a three-year scheme led by the Young Foundation, exploring how new approaches to local services can enhance happiness and wellbeing. The three councils got involved because of their interest in the issue.

Each council runs schemes with partners to tackle a particular social issue it has decided to focus on, such as parenting.

It is hoped the initiative creates new ways of working, which could then be replicated.

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