The Health Overview and Scrutiny Committee is scheduled to discuss a review of the Adult Learning Disability Service, receive an update on NHS Gloucestershire's 5 Year Strategy focusing on online, digital, and technology aspects, and review performance reports for the Gloucestershire Integrated Care System and NHS Gloucestershire Integrated Care Board. The committee will also consider its work plan for future meetings.

Adult Learning Disability Service Review

The committee is scheduled to consider the Adult Learning Disability Review, which has been undertaken by the Gloucestershire Health and Care NHS Foundation Trust, user groups, individuals with lived experience, and key stakeholders. This review, referred to as Phase 1, will be noted by the committee. For Phase 2, the committee is asked to confirm an agreed approach for developing a community model of care and to consider the best model for inpatients. This approach has been endorsed by regional NHS colleagues and involves co-production with service users, staff, and key stakeholders, rather than a wider public consultation. The aim is to create a sustainable NHS model of care for adult non-forensic learning disability health services in Gloucestershire that meets local needs and is modelled on future demographic growth, in line with best practice and NICE guidance. The review identified strengths in current community services, such as responsiveness and a passionate workforce, but also highlighted challenges including insufficient capacity for escalating needs, families feeling unheard, poor transitions between children's and adult services, and difficulties in transitioning between adult care settings. The Case for Change summary points to aligning with national policy such as the 2025 Mental Health Bill, which aims to prevent long-term detention solely on the basis of learning disability or autism, and the Transforming Care for Learning Disabilities initiative, which focuses on Homes not Hospitals . It also notes the increasing demand for services due to an ageing population and the need to address service quality and safety concerns, referencing the Care Quality Commission (CQC) restrictions at Berkeley House. The agreed enhancements to the model of care include additional investment in community therapists and support workers, investment in VCSE partners for key working and navigation, a more proactive crisis response approach, and the development of crash pads and respite accommodation. The decision has been made not to commission a standalone Learning Disability unit, such as Berkeley House, due to low predicted demand and related risks to quality and safety. The full business case for the revised pathway is expected to be presented for sign-off in 2026.

NHS Gloucestershire 5 Year Strategy: Online, Digital and Technology

The committee is set to receive the second of three presentations on issues included in the NHS Gloucestershire 5 Year Strategic Plan, focusing on the Online, Digital and Technology theme. This presentation aligns with the national 10 Year Health Plan's key shifts from hospital to community, analogue to digital, and sickness to prevention. Gloucestershire is noted as being well-placed to deliver the digital shift due to strong partnerships and a clear strategic direction, with digital technology underpinning neighbourhood care and prevention. The presentation will highlight how digital and technology can support safer, joined-up care, faster access and decision-making, and a more efficient use of clinical time, emphasising that digital is an enabler of better care and sustainability. Engagement with the public has indicated interest in shared records, virtual care, apps and online access, and digital inclusion. Good practices such as Joining Up Your Information (JUYI) for shared care records and the use of Cinapsis for digital advice and guidance will be discussed. The Electronic Prescription Service (EPS) and the growing use of the NHS App for ordering prescriptions and booking appointments will also be covered. The presentation will address digital inclusion, acknowledging barriers such as cost, skills, and disability, and will highlight the role of community-based DigiHubs in providing practical help and building digital confidence. The aim for online, digital, and technology is to make care more joined-up, accessible, and efficient, while preserving choice, supporting inclusion, and enabling people to manage their health in ways that work for them.

Gloucestershire Integrated Care System (GICS) Performance Report

An update on the performance of the Gloucestershire Integrated Care System (GICS) against NHS constitutional and other agreed standards will be presented. This report includes a briefing note on performance against national cancer waiting time standards and associated targets for Gloucestershire, as well as an update on the Cancer Services Improvement Plan. Key performance indicators such as ambulance handover delays, ambulance response times, and cancer wait time performance will be covered. The report notes improvements in ambulance handover times, with Gloucestershire having the lowest average handover time in the South-West. However, Category 2 ambulance response times have deteriorated. Cancer wait time performance has seen a slight decline in August 2025, though Urological Prostate performance has reached a local record high. The report also mentions the commencement of the Autumn COVID-19 booster programme.

NHS Gloucestershire Integrated Care Board (ICB) Report

The committee will receive a report from the NHS Gloucestershire Integrated Care Board (ICB), providing updates from Integrated Care System (ICS) partners responsible for the commissioning and provision of NHS services in Gloucestershire. This report includes a detailed overview of maternity services in Gloucestershire, covering temporary service changes, neonatal and maternal mortality reports, the national maternity and neonatal investigation, and the maternity health needs assessment. The report highlights the temporary suspension of the home birth service due to safety concerns raised by staff, noting that this suspension has been extended for at least six months to allow for the co-design and implementation of a new model of care. The report also details the findings of independent reviews into maternal and neonatal deaths, the progress of the national maternity and neonatal investigation, and positive results from the Care Quality Commission's (CQC) National Maternity survey, where Gloucestershire was rated as 'better than expected' in several areas. The Maternity Health Needs Assessment is underway and is expected to be completed by March 2026, aiming to identify health and care needs to support equitable, safe, and personalised services. Updates on the Strategic Commissioning Framework and the Medium Term Plan will also be provided, outlining a shift towards a more locally led, medium-term approach to planning. A new NHS dental access centre in Gloucester City is also mentioned, with building work underway and an anticipated opening in summer 2026.

Work Plan

The committee will review its work plan, noting the dates of future meetings and suggesting items for inclusion. An invitation to a joint meeting with the Adult Social Care and Communities Scrutiny Committee on 3 March 2026 will be confirmed. The work plan will also include items such as the NHS 5 Year Strategy: Gloucestershire NOW (Online, Digital and Technology) for the January meeting, and Wellbeing, Prevention and Maintaining Health Independence for the March meeting. A review of the NHS Winter Assurance Plan Proposals 2025-26 and an update on the Maternity Needs Assessment are also scheduled for the March meeting.