With health and wellbeing boards well into their first full year of operation, few would have predicted they would have emerged from the maelstrom of controversy surrounding the 2012 Health and Social Care Act as the new poster boy of partnership working.

History is clear that if the Boards didn't exist, they – or something like them – would need to be invented. Amidst the plethora of new bodies and the organizational complexity of the new NHS, the Boards are the only place that brings together key players from local government and the NHS alongside Healthwatch as the patient and public voice.

As both sets of services confront the severest financial and service pressures in history, the primary purpose of the Boards – to promote the integration of services around the needs of individuals – is more vital than ever.  Political consensus seems to favour Boards having a stronger role in the future, raising fears that expectations are racing ahead of what the fledgling Boards can realistically deliver. Our survey of Boards carried out earlier this year presents a generally positive picture of progress. Most councils have supplied strong leadership in establishing their Boards with a clear governance framework that represents a big step forward from the fuzziness of previous partnership vehicles. Nearly all have produced a local joint strategic needs assessment and health and wellbeing strategy with evident priority given to public health and health inequalities, thus allaying anxieties about the transfer of this role to local government. Boards are keen to raise their game and play a bigger role in commissioning but there are wide variations in the progress they have made.

For this aspiration to be taken seriously Boards need to demonstrate that they can really get to grips with the pressing issues facing their local public services such as those which involve major reconfiguration and transformation of services. 

This will demand a much a deeper mutual understanding of the profoundly different cultures and ways of working between the NHS and local government.  Wise Boards are investing time in nurturing relationships so that partners can have honest conversations and better understand each other's issues.

The next key milestone is the new requirement for Boards to sign off local plans about how their share of the new integration transformation fund (ITF) will be used. Winter approaches and pressures on critical services show no signs of abating. The stakes are high. Securing agreement to a plan that gives the local NHS and social care the biggest bangs for their buck is no mean feat.

It will be a taster of what is to come if the Boards are given a bigger role in relation to integrated commissioning, noting that Boards in their current guise are partnership bodies with no executive decision-making powers.

This will have massive implications for their role, composition and the professional support they will need. In the meantime Boards should build on the progress they've made so far and use the opportunity of the ITF process to raise their game and show that they can offer unifying local leadership.

Richard Humphries is senior fellow, social care at The King's Fund