The Health Select Committee of Wiltshire Council met on Tuesday 2 June 2026 to discuss several key health-related issues. Scheduled topics included an update on the Integrated Community Based Care contract, an overview of NHS dentistry in Wiltshire, and the implementation of a joint temporary staffing service by the BSW Hospitals Group. The committee also reviewed the cluster Integrated Care Board operating model and received an update on adult social care performance.

BSW Hospitals Group - Joint Temporary Staffing Service Implementation

The committee was scheduled to consider concerns raised regarding the BSW Hospitals Group's decision to outsource its NHS bank staffing function to a private provider, Pulse (Bank Partners), part of the Acacium Group. This change, due to go live on 1 August 2026, would move NHS bank workers from direct engagement by NHS organisations to being managed by a private company. A written submission from UNISON Salisbury Health outlined concerns that this decision removes a significant workforce group from direct NHS engagement, transfers a core NHS function to a private, profit-driven provider, and potentially reduces terms of engagement and pension provision for NHS bank workers. The submission highlighted that TUPE protections do not apply to these zero-hours bank arrangements and that the Equality Impact Assessment identified a disproportionate detrimental impact on employees from ethnic minorities, predominantly affecting women. The union requested that the committee call Salisbury NHS Trust executives to account, write to the Secretary of State for Health and Social Care, and formally note concerns regarding the adequacy of consultation.

In response, the BSW Hospitals Group stated that the new arrangement relates specifically to the administration and management of temporary staffing services, not the privatisation of NHS clinical services. They maintained that NHS services would continue to be delivered within NHS organisations under NHS leadership and clinical standards. The group indicated that existing bank workers would be supported through a transition process, with opportunities to register with the new provider. They acknowledged that TUPE protections do not apply to bank worker arrangements but stated that they have sought to minimise disruption. Regarding pension arrangements, the BSW Hospitals Group noted that eligibility for the NHS Pension Scheme is subject to its rules and that bank workers are only eligible for NHS pension accrual up to 37.5 hours per week. They also highlighted that 72% of bank workers at Salisbury NHS Foundation Trust also hold substantive NHS contracts, allowing them to continue accessing NHS pension benefits through that employment. The group stated that the proposed alternative pension arrangements reflect contractual and employment structures within the wider labour market. The Equality Impact Assessment was updated to reflect the impact of the change in pension arrangements, and the Trusts remain committed to supporting bank-only workers to access substantive employment opportunities.

Update on the Integrated Community Based Care Contract

The committee was scheduled to receive an update on the contract with HCRG Care Group Ltd for Integrated Community Based Care (ICBC) services across Bath and North East Somerset (BaNES), Swindon, and Wiltshire. The report detailed progress on the transformation of services, including the establishment of Integrated Neighbourhood Teams (INTs) and the launch of a BSW-wide Single Point of Access (SPA) on 1 April 2026. The SPA aims to provide a single front door to community services, bringing together referral management, clinical triage, and care navigation. The report noted that while a multi-channel communications strategy was delivered, some residents reported difficulties in getting through to the SPA. The report also provided an update on the Quality Dashboard, highlighting areas such as infection prevention and control, pressure injuries, and the Hospital@Home service. Plans for Year 2 of the contract were outlined, focusing on consolidating delivery, scaling successful models, and demonstrating measurable improvements in outcomes and system flow.

Overview of NHS Dentistry in Wiltshire

The committee was scheduled to receive an overview of NHS dentistry in Wiltshire. The report presented data on dental contract performance, including emergency department attendances for tooth extractions and hospital admissions for tooth extractions. It also detailed changes to the dental contract for 2026, which include mandatory unscheduled and urgent care, complex care pathways, and preventative changes allowing dental nurses to apply fluoride varnish. The report highlighted the introduction of a voluntary 3-year quality improvement scheme aimed at improving quality and adopting best practice through shared learning, with Year One focusing on patient recalls. The overview also referenced NICE guidance on dental checks for adults and children, emphasising patient-specific, evidence-based clinical judgement for recall intervals. The summary of the contract changes indicated an improvement in oral health inequalities, more consistent delivery of evidence-based care, an increase in unscheduled care provision, and proactive preventative actions for children's oral health.

Cluster Integrated Care Board (ICB) Operating Model

An update was scheduled on the changes to the Integrated Care Board (ICB) operating model, following the announcement of a reduction in the number of ICBs from 42 to 26. The new cluster ICB, covering Dorset, Somerset, Bournemouth, Christchurch and Poole, Wiltshire, Swindon, and BaNES, was set to operate from April 2026. The report outlined the ICB's priorities, including delivering future-ready health services, improving local outcomes, and strengthening engagement with communities and local authorities. It detailed the shift towards a more strategic commissioning role with a stronger focus on place and neighbourhoods, with some functions, such as key workers for people with learning disabilities, autism, and neurodiversity, planned to transfer to local provider organisations. The report also discussed the creation of a dedicated Wiltshire place commissioning team, led by Caroline Holmes, which would oversee primary care transformation and partnership development. The committee was also to receive a report on the Neighbourhood Health Plan in the autumn of 2026.

Adult Social Care Performance Overview to Quarter 3 2025-26

The committee was scheduled to receive an overview of Adult Social Care performance. The report highlighted a rising demand for services, with an 6.1% increase compared to the previous year, though approximately 88-89% of contacts were resolved at the first point of contact. A transformation project was underway to review the front door operations and strengthen first-point-of-contact resolution. The report detailed an increase in the number of people receiving ongoing support, leading to a gradual increase in caseloads. It also noted a steady rise in the average weekly cost of a care package, attributed to price uplifts, increases in the national living wage, and inflationary pressures, as well as increasing complexity within the caseload. The results of the National Service User Survey were shared, indicating high satisfaction with care received, good overall quality of life, and an increased sense of safety. However, feelings of loneliness and insufficient social contact were identified as areas of concern. The committee was to receive corporate key performance indicators annually in the autumn and an annual report from Adult Social Care, including case studies, also in autumn 2026.

General Practitioner (GP) Registration

A brief was prepared to inform the committee about the process of registering with a GP, in response to a query from a committee member. The document explained that the process is straightforward and can be done in person or online, with all GP Practices in Wiltshire having open lists for patients living within their boundary areas. It also referenced the new NHS patient charter, You and Your General Practice, which outlines rights and responsibilities. The brief assured the committee of the ICB's statutory duty to commission and maintain sufficient primary medical services, outlining the methods used to assess GP sufficiency, including the General Practice Dashboard and national workforce reporting. A case study on Lyneham was included, showing that all residents can register with local practices, and the ICB's position was to support existing, well-performing GP Practices and their Primary Care Networks rather than fragmenting services into smaller, potentially unsustainable sites.

Cabinet Member Update

Councillor Clare Cape, Cabinet Member for Public Health and NHS Liaison, was scheduled to provide a verbal update. This was expected to include information on No Smoking Day, recent data on norovirus and respiratory viruses from the UK Health Security Agency, and the rollout of the 'Healthy Man' programme. She was also to provide an update on additions to the Council's response to the consultation on the NPPF, reflecting the need to consider health and wellbeing in planning policy, and her attendance at a Youth Council event. Councillor Gordon King, Cabinet Member for Adult Social Care, was also expected to provide an update, thanking operational teams for their contribution during a challenging winter and highlighting their efforts in maintaining patient flow and ensuring timely discharges.

Forward Work Programme

The committee was scheduled to review and approve its forward work programme. The attached document outlined planned agenda items for future meetings, including reports on Wiltshire's Whole System Approach to Healthy Weight, Oral Health Initiatives, Prevention, Discharge from hospital, Smoke Free Generation, the NHS 10 Year Plan, Thematic Review into Self Neglect, A&E Healthwatch Survey, ASC Performance, Adult Social Care Complaints, Neighbourhood Health Plan, Safeguarding, Urgent Care Reports, Older Person's Accommodation Strategy, and Dementia Strategy. Pre-meeting briefings on how Adult Social Care manages demand and a briefing from Beyond Dementia were also noted.