The Health & Adult Social Care Select Committee met to discuss the Thames Valley Integrated Care Board's (ICB) operational delivery and commissioning intentions, the Buckinghamshire System Winter Plan for 2026/27, and a draft review report on access to emergency care. The committee also reviewed its work programme for future meetings.

Thames Valley Integrated Care Board: Operational Delivery and Commissioning Intentions

Representatives from the Thames Valley Integrated Care Board (TV ICB), Dan Leveson and Rob Bowen, provided an overview of the ICB's achievements over the past six months and its priorities for the next twelve months. The TV ICB, formed on 1 April 2026, brings together populations across Buckinghamshire, Oxfordshire, and Berkshire West, serving approximately 2.5 million people with an NHS budget of £5.8 billion.

Key foundational work over the last six months has included developing an integrated needs assessment across the Thames Valley and clarifying commissioning priorities. The ICB has published its commissioning intentions for 2027-28 and beyond, focusing on three population priorities: children, young people, and their families; people living with frailty and complex needs; and individuals experiencing long-term conditions. The approach will shift towards commissioning for whole pathways of care, from prevention to acute needs, and accelerating the development of neighbourhood working as a core delivery model. A commitment has been made to allocate at least 1% of the ICB's financial allocation to support these changes and the transition to proactive and preventative care.

Dan Leveson elaborated on the neighbourhood working agenda, highlighting its importance in addressing complex health needs, particularly for those with multiple long-term conditions, the elderly with frailty, and children and young people. The ambition is for neighbourhood working to become the primary delivery model for integrated health and care, with a focus on reducing health inequalities. The ICB is reducing its capacity by 50% to focus on being a strategic commissioner across a larger geography.

During the discussion, concerns were raised about staff support during organisational changes, with assurances given about wellbeing initiatives, career coaching, and a planned event to bring staff together. Questions were also raised about delayed discharges, with the committee being informed of ongoing efforts to improve patient flow and the discharge to assess home first initiative. The referral process for emergency eye clinics was also discussed, with a commitment to investigate potential improvements.

Councillor Thomas Hogg raised concerns about the quality of care if pharmacies are relied upon more heavily without adequate training, to which the ICB representatives responded by affirming their faith in the training and contractual monitoring of pharmacists.

Councillor Frances Kneller highlighted the importance of collaboration between the ICB and local government, noting the inclusion of public health teams in the integrated needs assessment and the presence of local government representatives on the ICB board.

Councillor Bickney questioned the ICB's commitment to prevention and the strategic use of volunteering. It was confirmed that prevention is a core priority, with a commitment to resourcing these initiatives. The value of volunteers and the voluntary sector was acknowledged, with a recognition that more can be done to partner effectively with these organisations.

Councillor Naila raised questions about the commissioning of neighbourhood models, considering variations in local needs and the development of neighbourhood hubs. It was explained that neighbourhood working will be determined by local population needs, using data to identify cohorts with similar needs and coordinating care accordingly. The development of hubs will be determined by the services required, with a focus on co-locating services and utilising existing public estates.

Councillor Ghosn raised concerns about the lack of dental care for children and the need for a report on how this will be addressed. It was acknowledged as a real concern, and the committee expressed a desire to delve into the details of this issue.

Councillor Opsley highlighted the challenges faced by an ageing and increasingly isolated population, particularly those who are not digitally connected. The importance of neighbourhood working, community assets, and supporting carers was stressed.

Councillor Schaefer asked for an update on the potential development of a neighbourhood health hub in Buckingham, with