The Health Select Committee of Wiltshire Council met on 14 January 2026 to discuss the Wiltshire Health and Wellbeing Joint Strategic Needs Assessment 2025 and the findings of a rapid scrutiny exercise on urgent care services. The committee also received updates on the Unpaid Carers contract and the Trowbridge Integrated Care Centre.

Wiltshire Health and Wellbeing Joint Strategic Needs Assessment 2025

The committee received a comprehensive overview of the Wiltshire Health and Wellbeing Joint Strategic Needs Assessment (JSNA) 2025, a statutory document designed to inform strategic planning and decision-making regarding the health and wellbeing of Wiltshire residents. Mike Rose, Public Health Principal for Intelligence and Wider Determinants, and Nicky Murch, Manager of the Public Health Intelligence Team, presented the findings.

The JSNA highlights several key areas of concern and focus for Wiltshire:

• An ageing population: Projections indicate a significant increase in the number of residents aged 65 and over by 2045, with the 85+ population expected to double. This demographic shift presents challenges for service planning and delivery.
• Health inequalities: While overall life expectancy in Wiltshire is higher than the regional and national averages, there is a marked disparity for those living in more deprived areas.
• Prevalent health conditions: Conditions such as hypertension and diabetes are significantly influenced by lifestyle factors, including smoking, diet, and physical activity levels. Data indicates that 10.1% of adults in Wiltshire currently smoke, 60% are overweight or obese, and a quarter do not meet recommended physical activity levels.
• Housing and homelessness: Nearly one in ten households experience fuel poverty, and in 2023-24, approximately 1,600 households were at risk of or experiencing homelessness.
• Education and employment: There is a growing number of pupils eligible for free school meals and those with identified special educational needs, indicating diverse and increasing needs within the school population.
• Cost of living and deprivation: The current economic climate is a significant underlying challenge, with more people experiencing financial hardship. The report noted that detailed deprivation data from the English Indices of Deprivation 2025 had only recently become available and would be incorporated into future analyses.

The presentation also emphasised the link between the JSNA findings and the NHS 10-year health plan, highlighting the need to shift from hospital-centric care to community-based services, embrace digital solutions, and prioritise prevention. Specific attention was drawn to ensuring that technological advancements do not disadvantage vulnerable groups, such as older people or those with learning disabilities, who may have limited access or understanding of digital platforms. The importance of utilising existing trusted relationships and community networks to deliver health interventions was stressed, particularly for groups like the Gypsy, Roma, Boater, and Traveller communities, and those in contact with the justice system.

The committee discussed the accessibility of the JSNA data, which is hosted on the Wiltshire Intelligence website, and the interactive nature of the charts and graphs. The presentation also covered specific population groups with unique needs, including military communities, individuals with learning disabilities, and those in rural areas, all of whom require tailored approaches to healthcare access and delivery.

Urgent Care Services in Wiltshire

A rapid scrutiny exercise on urgent care services in Wiltshire presented its findings and recommendations. The exercise aimed to understand how well urgent care services are performing, how residents are accessing them, and whether there is equitable access across the county.

The scrutiny group identified several key areas for focus:

• Definitions of Urgent Care: The committee highlighted the need for clear definitions of urgent care across primary and secondary care, noting that same-day GP appointments are considered part of urgent care.
• Performance Data: The report recommended the inclusion of detailed performance data for GP access, Minor Injury Units (MIUs), and Accident & Emergency (A&E) departments. This data should include appointment numbers, waiting times, referral rates, and ambulance response and handover times, with comparisons to national and regional averages.
• Access and Patient Experience: The committee sought to understand how residents are actually accessing services, including the use of pharmacies and NHS 111, and whether patients are being directed to the most appropriate level of care. The role of patient navigators and the impact of digital exclusion were also raised.
• Health Inequalities: The report recommended an examination of how deprivation data is used in the planning and provision of urgent care services to ensure equitable access.
• Vaccination Uptake: Data on flu, COVID-19, and RSV vaccination uptake by locality and vulnerability, with comparisons to national and regional averages, was requested.
• Systemic Approach: The committee acknowledged the interconnectedness of the health system and proposed breaking down the scrutiny into three separate reports: access to urgent care, discharge delays, and preventative work. This approach aims to provide a more focused and understandable analysis for lay members.

The committee resolved to request three reports focusing on: 1) Access to urgent care, including performance data and how residents are accessing services; 2) Discharge delays; and 3) Preventative work. These reports will include definitions of urgent care and aim to be as jargon-free as possible.

Unpaid Carers Contract Overview

An overview of the Adults Unpaid Carers contract, commissioned by Wiltshire Council and the Wiltshire Integrated Care Board (ICB), was presented. The contract, awarded to Carers Together Wiltshire (CTW), a consortium led by Age UK Wiltshire, aims to provide comprehensive support to unpaid carers across the county.

Key aspects of the contract and its delivery include:

• Statutory Responsibilities: CTW is responsible for undertaking carer assessments and support plans, as mandated by the Care Act 2014.
• Support Services: The service provides information, advice, and signposting, supports transitions for young adult carers, and raises awareness of carers' rights and available support.
• Consortium Approach: The consortium model, comprising several voluntary groups, aims to leverage diverse expertise and reach a wider range of carers.
• Performance Improvements: Significant progress has been made in reducing waiting times for carer assessments and addressing backlogs, with average wait times now at 19 days.
• Community Engagement: CTW runs numerous carer cafes and groups across Wiltshire, offering peer support and a space for carers to connect. They also conduct roadshows and engage with GP surgeries and hospitals to raise awareness and identify carers.
• Challenges and Solutions: The report acknowledged initial challenges, including inherited backlogs, staff training, and system access issues. However, close collaboration with Wiltshire Council has led to improvements in processes and service delivery.
• Feedback: Positive feedback from carers highlights the value of the support in providing breaks, reducing isolation, and offering practical assistance.

The committee noted the report and requested that information on the impact of training, learning from complaints, and long-term trends be included in future reports. They also resolved to request that area board teams invite CTW to give presentations at each area board meeting to further promote awareness of the support available to carers.

Trowbridge Integrated Care Centre Update

An update was provided on the Trowbridge Integrated Care Centre (TIC), which is scheduled to open in April 2026. The centre aims to provide a range of local health services, reducing the need for residents to travel to acute hospitals.

Key points from the update included:

• Opening Date: The centre is anticipated to open in April 2026, with a provisional date to be confirmed.
• Engagement: Significant engagement with the local community has taken place over the past six months to understand residents' priorities, such as reducing travel times and increasing the opening hours of the Minor Injury Unit (MIU), which will now be open until 8 pm.
• Benefits: The TIC is expected to increase access to services, improve urgent care provision through the MIU, and form part of a wider campus approach that includes refurbished rooms at the health centre and relocated teams.
• Net Zero: The building is designed to be net zero in use, with projected annual savings of £45,000. Questions were raised about the assumptions behind these savings and the environmental payback period, including the impact of construction and equipment.
• Future Scope: There is potential to add further services to the TIC in the future, aligning with the NHS 10-year plan's focus on developing local services. A mobile unit for diagnostics will also be available.
• Site Redevelopment: Following the move to the new centre, the old hospital site will be sold, with plans managed by NHS Property Services.

The committee noted the report and congratulated the ICB and Wiltshire Council on the development of the centre, requesting an update on its operation once it opens.

Cabinet Member Updates

Cabinet members provided updates on various initiatives:

• Pharmacy Provision in Amesbury: Councillor Dr Monica Devendran raised concerns about the lack of adequate pharmacy services in Amesbury. The Cabinet Member confirmed that this would be kept under active review and liaised with the ICB to ensure timely and equitable access for the growing population.
• Healthy Man Programme: Councillor Gordon King highlighted the success of the Healthy Man programme, a 12-week physical activity and wellbeing initiative for men, which has seen its first cohort in Chippenham become self-sustaining. The programme is now rolling out in Corsham and Trowbridge.
• NHS 10-Year Plan Impact Statement: Councillor Clare Cape shared insights from the NHS 10-year plan impact statement, noting its focus on improving productivity, health outcomes, and user experience. However, she highlighted omissions, including the limited mention of local authorities' roles in prevention, the digitally excluded, mental health, and wider determinants of health.
• Bradbury House Respite Centre: Councillor Gordon King praised Bradbury House, a short breaks care centre for adults with physical and learning disabilities, which received a good rating from the Care Quality Commission (CQC) across all five lines of inquiry.
• Wiltshire Support at Home: Councillor Gordon King also commended Wiltshire Support at Home, a service that empowers residents to live independently, which achieved a good rating from the CQC.

Forward Work Programme

The committee reviewed and approved its forward work programme, noting that separate reports on urgent care, discharge delays, and preventative work would be added following today's discussions. An update on the Integrated Community Based Care contract was also scheduled for future meetings.

The meeting concluded with a book recommendation from the Chair: Bloody Social Worker by Richard Wills, described as an illuminating and engaging account of three decades in social care. The date of the next meeting was confirmed as 11 March 2026, with an online budget meeting for Health Select members scheduled for 23 January 2026.