The Lancashire Health and Wellbeing Board met to discuss a range of issues including the future of the board itself, the Better Care Fund, neighbourhood health plans, and a prevention strategy for Lancashire. The board endorsed recommendations from a Local Government Association (LGA) review aimed at strengthening the board's role and approved the Better Care Fund quarter two report. Members also heard about steps being taken to improve health outcomes at a neighbourhood level, and a developing prevention strategy for the county.

Review of Health and Wellbeing Board Arrangements

The board endorsed the recommendations of a Local Government Association review of the Lancashire Health and Wellbeing Board. The review sought to identify ways to strengthen the board's role and ensure it remains effective in a changing health and care landscape.

Key recommendations from the review include:

• Further developing the vice-chairing arrangement between the County Council and the NHS.
• Strengthened attendance from the voluntary, community and faith sector and provider organisations.
• Enhanced district council representation to ensure effective local engagement and connectivity with local health and wellbeing partnerships.
• Aligning the board's priorities and sub-group activity with key national policy frameworks, including the NHS 10-Year Plan for Health¹, the Neighbourhood Health Service, and Better Care Fund reform.
• Developing a Neighbourhood Health and Wellbeing Delivery Framework by April 2026.
• Maintaining oversight of Better Care Fund performance metrics.

Helen Coombes, from Adult Services at Lancashire County Council, clarified that the recommendations aim to broaden participation in conversations, rather than making immediate changes to the core statutory membership.

Councillor Chris Sinnott, representing the Lancashire Chief Executive Group, supported greater links with local health and wellbeing partnerships, emphasising the importance of the board having clear priorities to support local partnerships.

Jackie Moran, attending for Asim Patel from the NHS Lancashire and South Cumbria Integrated Care Board, presumed that the four subgroups that were proposed would have an interrelationship.

The board agreed to develop detailed implementation proposals for approval in early 2026, reflecting the outcomes of the review and the findings of the stakeholder consultation.

Better Care Fund Update

The board formally ratified the Better Care Fund Quarter 2 submission. Matthew Emerson, Director of Strategic and Integrated Commissioning, outlined progress against emergency admissions, discharge delays, and residential admissions, as well as spending within the fund.

Councillor Daniel Matchett, Chair of the Health and Wellbeing Board, requested more transparency in reporting, with breakdowns of where funding is allocated and data on the effectiveness of services.

Helen Coombes acknowledged the need for better understanding of where money sits within budget lines and how to track delivery against key metrics. She stated that over the next six months, the Better Care Fund board would work to ensure that investments deliver improved outcomes for Lancashire residents.

Councillor Dr Lorenzo More commented that a more granular accountability should be possible at the same time as the work that Helen Coombes was suggesting.

Jackie Moran raised questions about the level of risk around performance and finance, and how the Better Care Fund aligns with priorities around neighbourhood health and the NHS 10-year plan.

Councillor Margaret France noted that Lancashire has a high number of admissions to residential care for over 65s, and that this should be considered in the context of deprivation and ill health in the county.

Neighbourhood Health Plans

The board received information on the development of Neighbourhood Health Plans in Lancashire, and were asked to endorse the arrangements being put in place. Dr Sakthi Karunanithi, from Public Health, Wellbeing and Communities, explained that these plans are a key part of the national shift in health and care policy, and involve a cross-departmental effort to improve the health and wellbeing of communities.

Key aspects of the Neighbourhood Health Plans:

• They cover the whole neighbourhood, including services, community assets, and the environment.
• They aim to improve the wider determinants of health, such as housing, employment, and education.
• The definition of a neighbourhood will be determined locally, in consultation with communities and stakeholders.
• The plans will be developed by a working group of key partners, including local government, the Integrated Care Board, provider organisations, and the voluntary, community, faith and social enterprise sectors.

Councillor Chris Sinnott emphasised that neighbourhoods should represent places that people recognise, and that neighbourhood working should focus on wider determinants of health, using existing core services rather than commissioning new programmes that replicate existing services.

Jackie Moran highlighted the importance of education and schools in defining communities, and the need to involve children and young people in shaping the plans.

Councillor Graham Dalton, Cabinet Member for Adult Social Care, stressed the need for flexibility within the plans to address the specific needs of different communities, and the importance of integrating health and social care.

Councillor Liz McInnes asked how much autonomy the board has in defining a neighbourhood, and whether their definition could be rejected by higher authorities.

Councillor Terry Stephenson raised concerns about the impact of local government reform on the plans, and the need to involve the voluntary sector as early as possible.

Prevention Strategy

The board received an overview of the work underway to develop a unified prevention strategy for Lancashire County Council. Dr Sakthi Karunanithi explained that the strategy aims to establish a single, coordinated approach across council services, with an emphasis on achieving better outcomes, reducing inequalities and managing demand more effectively.

The strategy will address areas for improvement identified by the Care Quality Commission², particularly the need for a more integrated, council-wide focus on prevention and value for money. A key element is the creation of a neighbourhood health model to facilitate local service integration and reinforce place-based approaches, empowering residents to maintain their health and independence.

The strategy is being developed in three phases:

1. Council-focused: Immediate decisions that need to be taken to feed into 2026/27 budget setting.
2. Building the strategy: Using local government reorganisation as a catalyst for strategic change and setting the conditions for whole-system working.
3. System-wide & sustainable: Establishing a single, integrated prevention & early intervention strategy.

Other Business

The board noted the calendar of meetings for 2026/27 and received a statement regarding the publication of the Pan Lancashire Pharmaceutical Needs Assessment 2025.