The Health and Wellbeing Board met on Thursday 15 October 2026 to discuss the Director of Public Health's annual report on mental health and wellbeing, feedback from neighbourhood engagement, and plans for future health and wellbeing strategies. The Board received the Director of Public Health's annual report, which focused on mental health and wellbeing. Dr Richard Sharpe, Consultant in Public Health, presented the report, highlighting that mental health is a continuum influenced by personal factors and life experiences, and that poor mental health is often driven by wider societal issues such as poverty, insecure employment, housing pressures, and social isolation. The report emphasised that the Isles of Scilly, like Cornwall, cannot treat its way out of poor mental health and that a whole-system approach prioritising prevention, early intervention, and addressing the wider determinants of health is crucial. Key themes emerging from engagement with local residents included the difficulty of accessing specialist support, particularly in person, the stigma associated with mental health in small communities, a strong desire for community mutual support, and a need for appropriate training for local people to offer support. Concerns were also raised about accessing services during a mental health crisis and the potential need for evacuation off-island.

The report made four key recommendations:

1. Embed Mental Health and Wellbeing within All Local Policies: This involves adopting a Health in All Policies approach across housing, transport, planning, regeneration, and economic development, and ensuring commissioning frameworks target communities with high rates of deprivation and undiagnosed mental distress.
2. Shift Investment Upstream into Prevention and Community Support: This includes moving from short-term grant cycles to long-term, sustainable commissioning of the voluntary, community, and social enterprise (VCSE) sector, expanding community capacity and social prescribing through neighbourhood approaches and micro-grant ecosystems.
3. Create a No Wrong Door System for Mental Health and Wellbeing: This involves implementing the Compassionate Cornwall All-Age Framework principles to ensure trauma-informed practice and seamless pathways across all care settings, aligning systems with NICE NG225 principles, and ensuring individuals with co-occurring mental health and substance use conditions are not excluded.
4. Use Intelligence, Evidence and Lived Experience to Drive Continuous Improvement: This includes optimising the Real-Time Suspected Suicide Surveillance system, utilising learning from VCSE collaboratives, and exploring emerging technologies to uncover drivers of distress.

Councillor Joel Williams, Lead Member for Children, welcomed the report and suggested a local version of Cornwall Council's mental health conference. He also inquired about the replacement for the social prescriber role and how mental health would be integrated into the council's corporate plan. Chris Reid, from the Isles of Scilly Health and Care Partnership, outlined workstreams focused on mental health and children's and young people's health. The Board voted to endorse the recommendations.

Isles of Scilly Neighbourhood Engagement Feedback Report

Chris Mitchell and Dr John Garman presented the findings from neighbourhood health and wellbeing engagement events held across the Isles of Scilly in May 2026. Over 150 residents participated, highlighting the strength of local communities and the high regard for local services and professionals. However, significant issues were raised regarding access to services beyond the islands, including travel requirements, weather disruption, transport costs, and a lack of coordination between services. Residents expressed a strong preference for more joined-up approaches and for more care to be delivered closer to home.

Mental health, children's, and family wellbeing were also identified as important themes, with a need for improved access to support and greater visibility of available services. Wider factors influencing health and wellbeing, such as housing affordability, cost-of-living pressures, and social isolation, were also discussed. The report identified five interconnected priorities: improving access and connectivity, strengthening care coordination, delivering more support closer to home, supporting mental health, children, and families, and addressing health and wellbeing inequalities. The Board noted the findings and endorsed continued partnership working to develop a local Neighbourhood Health and Wellbeing Plan.

Health and Wellbeing Support for Fishing Communities on the Isles of Scilly

Gareth Walsh, Advanced Public Health Practitioner, presented a report on developing health and wellbeing support for fishing communities. He explained that fishing communities face unique challenges in accessing healthcare due to their work patterns, geographical location, and time pressures. A multi-agency Steering Group has been established to coordinate outreach and reduce duplication. For the Isles of Scilly, the approach will focus on working with local partners and communities to identify needs and coordinate appropriate outreach, rather than establishing routine independent service visits. The emphasis will be on ensuring residents are aware of available support and that outreach is proportionate and responsive to local demand. The Board noted the formation of the Steering Group and supported the proposed approach.

Healthwatch Isles of Scilly First Service Update

Debbie Gilbert, Chief Executive of Healthwatch Cornwall CIC, provided the first service update since Healthwatch Cornwall assumed responsibility for Healthwatch Isles of Scilly in June 2026. She explained that the service is now operating with a significantly reduced annual budget of £11,000, necessitating a proportionate delivery model. Early themes emerging from resident feedback and stakeholder engagement include concerns about access to mainland healthcare, transport reliability, coordination of medical travel, and the impact of travel disruption on appointments. Ambulance services, urgent care pathways, and the integration of NHS 111, primary care, and transport arrangements were also highlighted. The Board noted the transition to the new provision, the activity completed in the first three months, and supported continued intelligence-sharing and promotion of Healthwatch contact routes.

The Neighbourhood Health and Wellbeing Plan: Developing the Strategy for Health and Wellbeing at Place

Katie Ash, Director of Public Health for the Isles of Scilly and Assistant Director of Public Health for Cornwall, presented a report on developing the Neighbourhood Health and Wellbeing Plan. This plan will replace the existing Cornwall and Isles of Scilly Health and Wellbeing Strategy and will act as the overarching strategic framework for health and wellbeing across both areas. The Plan will be organised around four outcomes: Start Well, Live Well, Age Well, and Healthy Neighbourhoods, and will be underpinned by the Marmot Principles, focusing on prevention and action on the wider determinants of health. A single Plan will be developed for both Cornwall and the Isles of Scilly, with specific recognition of the latter's distinct needs. The Board endorsed the proposed scope and purpose of the Plan and agreed that it would replace the existing strategy. They also approved Option 1, which involves developing the Plan and awaiting the final Health Bill before publication to ensure alignment with statutory requirements.