The Health & Adult Social Care Select Committee of Buckinghamshire Council met on Thursday 2 July 2026 to discuss the Better Care Fund, the Integrated Community Equipment Service, and the Q4 performance of the Health & Wellbeing Portfolio. Key discussions included the allocation of £56.97 million for the Better Care Fund, the recovery of the Integrated Community Equipment Service following the insolvency of NRS Healthcare, and performance indicators across various health and social care areas.

Better Care Fund

The committee reviewed the Better Care Fund (BCF) Plan for 2026/27, which outlines how £56.97 million will be allocated to support hospital discharge, prevention services, intermediate care, reducing hospital admissions, and ensuring the sustainability of adult social care. This plan is the first year of a new three-year national framework and was developed jointly with health partners, including the Thames Valley Integrated Care Board (ICB) and Buckinghamshire Healthcare NHS Trust.

Key priorities for the BCF in 2026/27 include:

• Hospital discharge and Home First approaches.
• System flow and admission avoidance.
• Strengthening intermediate care capacity.
• Maintaining the sustainability of adult social care.
• Greater emphasis on prevention and integrated neighbourhood delivery.

The plan details a £1.25 million increase in funding compared to the previous year, with additional investment focused on managing demand and cost pressures within adult social care, including placement pressures, Deprivation of Liberty Safeguards (DoLS) assessments, and workforce cost uplifts. New allocations will support the development of Integrated Neighbourhood Teams and establish primary care-led dementia diagnosis clinics.

During the discussion, Councillor Thomas Hogg raised concerns about the target setting for emergency admissions and long-term admissions to residential and nursing care, questioning the ambition of the targets. Craig McArdle, Corporate Director for Adults and Health, explained that targets are set in continuous negotiation with NHS England and the ICB, and that current performance is strong when benchmarked against regional and national figures. He also highlighted the increasing demand and complexity of adult social care needs.

Councillor Larissa Townsend inquired about the allocation of funding to reduce dementia diagnostic waiting times. Conrad Eydmann, Head of Strategic Commissioning – Older People, outlined plans to establish primary care-led dementia diagnosis clinics, aiming to eradicate or significantly reduce the current waiting list of approximately one thousand individuals.

Integrated Community Equipment Service

The committee received an update on the Integrated Community Equipment Service (ICES), following the insolvency of the previous provider, NRS Healthcare. The service, which supports around 25,000 residents with essential equipment for hospital discharges and independent living, is jointly commissioned by Buckinghamshire Council and the Thames Valley ICB.

The report detailed the significant disruption caused by NRS Healthcare's insolvency, noting that they were one of only three national providers. Buckinghamshire Council, along with other affected local authorities, worked with national bodies to secure a replacement provider, Millbrook Healthcare, under urgency provisions. The transition involved a council-wide response, including the establishment of an in-house continence service and a crisis response team.

Despite initial challenges, including a backlog of equipment orders and data transfer issues, the service has largely returned to normal operational levels. Millbrook Healthcare is now providing community equipment, Essity is managing continence services, and Livity Life (via Millbrook) is providing technology-enabled care. The committee heard that the market for such services is limited, with only two national providers, raising concerns about future resilience. Councillor Julia Wassell and Councillor Alan Sherwell both highlighted the importance of robust contingency planning and the need to mitigate the risks associated with a limited supplier market.

Councillor Michael Collins raised questions about the distinction between free and chargeable equipment, and the process for recycling returned items. Conrad Eydmann clarified that while council-funded telecare services include installation, the equipment itself may be funded by the individual. He also confirmed that Millbrook is responsible for recycling equipment they have issued, and the council is exploring options for managing equipment from other sources.

Q4 Performance - Health & Wellbeing Portfolio

The committee reviewed the Q4 performance indicators for the Health & Wellbeing portfolio. Several indicators were highlighted as red or amber, prompting detailed discussion.

• Number of older people (65+) admitted to permanent residential or nursing care homes per 100,000 population: This indicator was reported as red, with an outturn of 503.9 per 100,000 population, exceeding the target of 466. Commentary noted increased case complexity as a contributing factor, but also highlighted that Buckinghamshire's performance remained better than the South East and national averages. Improvement actions focus on reinforcing the Home First approach.
• Number of Carer's Assessments: This indicator was reported as amber, with 749 assessments completed against a target of 801. The report suggested that good signposting and information provided by partner agencies might be contributing to fewer formal assessments being requested. Work is underway to review targets and promote awareness of support services.
• Percentage of births that receive a face-to-face New Birth Visit within 14 days by a health visitor: This indicator was also reported as red, with 71% of visits completed within 14 days, below the target of 85%. The primary reason cited was high sickness rates within the health visiting team, accounting for an estimated 80% of the shortfall. The provider, Buckinghamshire Healthcare NHS Trust, is working with the council to address staffing levels and well-being.
• Percentage of young people whose Adult Social Care Assessment was completed before they turned 18 years old: This amber indicator showed 80% of assessments completed before the age of 18, against a target of 82%. Capacity issues within the team and late referrals were identified as contributing factors. Improvement actions include setting clearer referral expectations and developing a comprehensive transition tracker.

Other indicators reported as green included the number of younger people (18-64) admitted to permanent residential or nursing care homes, the percentage of service users receiving annual reviews, the percentage of safeguarding enquiries with achieved outcomes, the percentage of people living independently after re-ablement, successful alcohol treatment completions, and successful smoking quit rates at four weeks.

Work Programme

The committee discussed the draft work programme for the upcoming council year. Proposed items for the next meeting on 1st October 2026 include an overview of the Thames Valley Integrated Care Board's commissioning intentions, the Director of Public Health's Annual Report, and the Access to Emergency Care Review report. The committee also agreed to consider the outcome of correspondence with the CEO of Buckinghamshire Healthcare NHS Trust regarding maternity services, which could be added to the October agenda if deemed critical.