The Health Overview & Scrutiny Committee met to discuss plans for winter preparedness, updates on maternity services, and the integration of NHS services across Gloucestershire and neighbouring areas. The committee also reviewed performance reports and the committee's work plan.

Gloucestershire Urgent and Emergency Care (UEC) and System Flow: Winter Plan 2026/27

The committee was scheduled to consider the NHS Gloucestershire Urgent and Emergency Care (UEC) and System Flow Winter Plan for 2026-27. This plan details proposals aimed at ensuring resilient winter planning and preparedness for Gloucestershire. The approach outlined in the plan is a whole-system, place-based approach, working collaboratively across health, social care, primary care, local authority, and Voluntary, Community, and Social Enterprise (VCSE) sector partners. It aligns with NHS England's Winter Planning Guidance 2026/27 and focuses on prevention, resilience, and maintaining safe access, flow, and outcomes throughout the winter months. Key elements include strengthening assurance through regional and local stress testing, refreshed escalation arrangements, and clear system governance, supported by the 2026/27 System Escalation Policy and the System Coordination Centre (SCC).

The plan details a move towards proactive assurance by using predictive data alongside real-time operational intelligence to identify emerging pressures earlier. This includes forecasting future Operational Pressures Escalation Level (OPEL) levels and areas requiring proactive assurance. The SHREWD reporting and forecasting system is being developed to strengthen visibility of emerging risks.

A strengthened whole-system approach to Integrated OPEL was also scheduled for discussion, building on learning from the previous winter. This framework integrates national and local frameworks, including a new Gloucestershire Primary Care OPEL and a Regional Maternity OPEL. The policy aims for proportionate escalation based on pressure, with clear action frameworks at each OPEL level and an early intervention approach before crisis thresholds are reached.

Communications for Winter 2026/27 were also to be reviewed, focusing on the Stay Well This Winter campaign for prevention and vulnerable groups, priority vaccination programmes, and the Choose Well – Right Care, Right Place campaign to guide individuals to the most appropriate urgent care services.

Infection prevention and management strategies were also on the agenda, including vaccination planning for flu, Covid-19, and Respiratory Syncytial Virus (RSV), with targeted outreach for communities with lower uptake. Infection Prevention and Control (IPC) measures were to be strengthened, building on lessons learned from the previous winter.

Community care plans included strengthening admission avoidance through additional Rapid Response/Urgent Community Response capacity, aiming to provide rapid assessment and care at home. Additional winter capacity was planned, with increased daily caseloads for community teams.

The Gloucester Health Access Centre (GHAC) was to provide planned additional urgent primary care capacity, with 36 additional GP appointments per day during predicted winter pressure periods. This aims to increase urgent care capacity outside of hospital settings.

Sustained improvements in ambulance handover performance were to be discussed, with the Timely Handover Process (THP) and Handover Standard Operating Procedure (SOP) remaining embedded. The focus for winter was on maintaining these gains despite increasing demand.

The Gloucestershire Mental Health Liaison Team (MHLT) was to provide an update on extended provision for children and young people, co-streaming embedded across services, and improved timeliness of assessments within the Emergency Department.

The committee was also to consider how the winter plan aligns with the system transformation portfolio, focusing on reducing the risk of delay-related harm, improving outcomes, reducing duplication, and ensuring value for money. This includes priorities such as coordination for urgent care, development of the urgent care offer, coordination of the discharge process, and ensuring efficiency in hospital flow.

Finally, the committee was to review plans for regional and local stress tests in September and November 2026, respectively, to test system preparedness against challenging winter scenarios and refine plans before peak winter pressures.

Maternity Update

The committee was scheduled to receive an update on current maternity issues. This included:

• The outcomes of the Care Quality Commission (CQC) inspection of maternity services.
• Information regarding the Baroness Amos National Maternity and Neonatal Investigation.
• The Thirlwall Inquiry Report, including its recommendations.
• An update on the Gloucestershire Maternity Community Transformation Programme, focusing on developing a case for change.

Introduction to the Cluster

An update was scheduled on the cluster arrangement between NHS Gloucestershire ICB and NHS Bristol, North Somerset and South Gloucestershire ICB, prior to their formal merger on 1 April 2027. This update was to cover the operational aspects of the cluster, its combined population and workforce, and the leadership structure. The report highlighted that the two organisations are operating as one in practice while remaining two statutory bodies during the transition period. The ambition for the cluster is to be a leading strategic commissioner for approximately 1.7 million people.

Gloucestershire Integrated Care System (GICS) Performance Report

The committee was to receive an update on the performance of the Gloucestershire Integrated Care System Partners against NHS constitutional and other agreed standards. This report provides an overview of how the system is performing against key targets and benchmarks.

Gloucestershire Integrated Care System Partner Update

This section of the report provided updates on health and care services delivered by NHS Integrated Care System (ICS) Partners. It included:

• An update from NHS Gloucestershire Integrated Care Board (ICB) on its commissioner activities. This included information on the ICB's organisational change in preparation for its merger with NHS Bristol, North Somerset and South Gloucestershire ICB, and an update on the Neighbourhood Health Framework, published in March 2026, which sets national ambitions for neighbourhood health. The ICB's Community Health and Wellbeing Grant 2026 was also to be discussed, providing £1 million annually for local VCSE organisations. Information on easier access to flu and Covid-19 vaccinations was also to be provided.
• NHS Provider Updates from Gloucestershire Health and Care NHS Foundation Trust (GHC), Gloucestershire Hospitals NHS Foundation Trust (GHT), and South Western Ambulance Service NHS Foundation Trust (SWAST).
  • Gloucestershire Hospitals NHS Foundation Trust (GHT) was to provide updates on CQC Well-Led Assessment and Inspection Reports, including ratings for maternity, urgent and emergency care, and medical care. The results of the CQC Adult Inpatient Survey 2025 were also to be presented, highlighting areas of positive patient experience and areas for improvement. The Trust was also to report on the Thirlwall Inquiry, elective spinal surgery plans, the development of an Urgent Treatment Centre at Gloucestershire Royal Hospital, the impact of heatwaves on operational performance, planning approval for the new Gloucestershire Cancer Centre, and a performance and activity update comparing August 2025 with the current period, noting improvements in some areas but challenges in cancer performance and patient discharge.
  • Gloucestershire Health and Care NHS Foundation Trust (GHC) was to provide an update on Wotton Lawn Hospital, following the closure of a Large-Scale Safeguarding Enquiry. Updates on Know Your Numbers blood pressure checks, a Musculoskeletal (MSK) Community Education Day, and awards success for its Complex Emotional Needs service were also scheduled. The National Audit of Care at the End of Life (NACEL) 2025 audit results were to be presented, alongside a performance and activity update, highlighting key performance challenges such as length of stay and waiting times in some services.
  • South Western Ambulance Service NHS Foundation Trust (SWAST) was to report on its 'good' rating for five services by the CQC, including outstanding ratings for caring in Emergency Operations Centres and Emergency and Urgent Care. The documentary 999: On The Front Line was to be mentioned. A performance and activity update was to be provided, noting high demand during summer heatwaves and a significant uplift in activity in Gloucestershire compared to the previous year. Response times for August 2026 and the effectiveness of Hear and Treat/See and Treat initiatives were also to be discussed.

Work Plan

The committee was scheduled to review its work plan, noting the dates of future meetings and suggesting items to be included. Members were asked to consider the reasons for and expected benefits of the scrutiny committee's involvement when proposing items, and to categorise them as 'Overview', 'Scrutiny', or 'Information'.