The Health Overview and Scrutiny Committee of Shropshire Council met on Monday 29 June 2026 to discuss the 0-19 Healthy Child Programme, the future of Healthwatch, and updates from various joint committees. The committee received an update on the recommissioning of the 0-19 Healthy Child Programme, which resulted in an 18-month contract extension for Shropshire Community Health Trust. Members also discussed concerns regarding proposed national legislative changes that could impact the independence of Healthwatch Shropshire.

0-19 Healthy Child Programme

The committee received an update on the Public Health Nursing Service, which encompasses health visiting, school nursing, and the Family Nurse Partnership. This service is a statutory public health function funded by the Public Health Grant, providing universal, targeted, and specialist support to children, young people, and families across Shropshire. The recommissioning process, following a strategic review and options appraisal, led to a direct award to Shropshire Community Health Trust for an 18-month contract due to updated procurement guidance.

During the discussion, members sought further information about the independent review conducted as part of the recommissioning process, requesting its availability to the Scrutiny committee. Officers explained that the review contained commercially sensitive information and could not be published, but agreed to provide a summary of its findings. Concerns were raised about market engagement and the limited number of organisations capable of delivering a county-wide integrated service, with potential barriers to market entry including workforce transfer requirements, funding pressures, rurality, and the availability of suitable premises. Members suggested exploring the use of Council assets in the recommissioning process.

The committee also discussed national and local workforce pressures affecting health visiting and school nursing services, requesting information on current staffing levels, vacancies, and recruitment. Officers confirmed that the service was fully recruited to its established posts and agreed to provide further details on workforce numbers. Concerns were also voiced regarding national challenges in recruiting specialist community public health nurses, with the Chair indicating these would be raised through the Joint Health Overview and Scrutiny Committee with a view to national escalation.

Emphasis was placed on how vulnerable children and families are identified and supported through developmental reviews, targeted pathways, and partnership working, highlighting the importance of early intervention and the role of nurseries, schools, and other services in identifying developmental concerns. The visibility of school nursing services and schools' understanding of available support were also discussed. Officers reported that recent engagement with schools as part of a service review would inform the future recommissioning process. In response to questions about service performance, officers outlined the national and local indicators used to monitor delivery and outcomes. Members requested greater visibility of performance information and were assured that relevant performance measures would be circulated, with signposting to available Public Health Outcomes Framework data. The committee welcomed the opportunity to contribute to the service's future development, stressing the importance of ensuring future commissioning arrangements reflect local needs and improve outcomes for children and families.

Update on the Future of Healthwatch

Members received an update from Healthwatch Shropshire regarding its future and the potential implications of proposed national legislative changes. Healthwatch provides an independent patient voice, information and signposting services, advocacy support, and volunteer-led Enter and View activity across health and social care settings. Concerns were raised about proposals that could lead to the loss of Healthwatch's independent role and the potential impact on patient representation, public engagement, and the scrutiny of health and care services. Healthwatch and partner organisations have communicated these concerns to the Government and are seeking amendments to the legislation.

The committee discussed the importance of maintaining an independent mechanism for residents to raise concerns and influence service improvement. It was noted that the Health and Wellbeing Board had established a working group to consider the implications of these proposals and identify any potential gaps if Healthwatch ceased to operate in its current form. The committee requested that the outcomes of the Health and Wellbeing Board's deliberations be reported to the Health Overview and Scrutiny Committee before any final arrangements are implemented. Members also requested access to information on themes emerging from Healthwatch activity and complaints advocacy work to aid future scrutiny.

Update from the Joint Health Overview and Scrutiny Committee (JHOSC)

Discussions within the Joint Health Overview and Scrutiny Committee had focused on winter planning across the health and care system, community health provision, and the performance of West Midlands Ambulance Service. Improvements in system-wide winter planning, including greater coordination between partners and additional capacity within the health system, were highlighted. Members also considered issues related to vaccination delivery, delayed discharges, infection control, and the role of community pharmacy, requesting more detailed performance information for effective scrutiny.

Ongoing work to develop a community health strategy, including neighbourhood teams, urgent community response services, and district nursing provision, was noted. Further information had been requested on community service modelling and hospital transformation proposals. Improvements in ambulance handover times and productivity were also observed, with a recognition of the need for continued monitoring. The Joint Committee had requested additional performance data to support future scrutiny.

Update from the Health and Wellbeing Board

No Health and Wellbeing Board meeting had taken place since the previous meeting of the Committee, as the scheduled meeting had been postponed and its agenda items rolled forward. The next Health and Wellbeing Board meeting was scheduled to include consideration of neighbourhood health and care arrangements, Healthwatch updates, Joint Strategic Needs Assessment chapters relating to maternity services and drug and alcohol services, the Better Care Fund year-end position, and the Integrated Care Board's five-year strategic commissioning plan.

During discussion, members noted ongoing work to consider the future of the independent patient voice following proposed changes affecting Healthwatch and requested that developments be reported back to the Committee. Reference was also made to correspondence received regarding alcohol dependency training and the importance of continued partnership working across health and care services.

Work Programme

Members focused on the importance of neighbourhood health and care arrangements, the future development of the Joint Health and Wellbeing Strategy, children and young people's mental health, the future of the independent patient voice, and community drug and alcohol services. The committee emphasised the importance of early involvement in policy development and commissioning activity and requested timely access to information to support effective scrutiny.

The need for clear action tracking arising from Committee discussions and the importance of ensuring scrutiny activity is focused on areas where it can add the greatest value were highlighted. The Committee agreed that a dedicated work programming session should be held to review priorities, consider capacity, and identify the most appropriate scrutiny approach for future topics. Members also supported joint working with the People Overview and Scrutiny Committee on matters relating to children and young people's mental health and wellbeing.