The Health and Adult Social Care Overview and Scrutiny Committee were scheduled to discuss proposed changes to Integrated Care Boards, and the co-option of a representative from Healthwatch Cornwall. The committee was also due to receive updates from the Portfolio Holder for Adult Social Care and Partnerships and the Portfolio Holder for Community Safety and Public Health. Finally, they were scheduled to answer questions from the public.

Integrated Care Board Changes

The committee was scheduled to receive an update on proposed changes to Integrated Care Boards (ICBs) ¹. NHS England (NHSE) informed ICBs that they would need to reduce running and programme costs by 50% during the 2025/26 financial year. NHS England published a letter entitled 'Working together in 2025/26 to lay the foundations for reform', clarifying that ICBs have a critical role to play in the future as strategic commissioners, to realise the ambitions that will be set out in the 10-year NHS Plan, but would need to deliver in-year cost savings.

The update on proposed changes to ICBs included the NHS South West response to national requirements. The proposal was made and agreed for the South West, for consideration nationally, reducing the existing 7 ICBs to 3 as follows:

• Cornwall and Isles of Scilly and Devon
• BNSSG and Gloucestershire
• BSW, Dorset and Somerset

The rationale for a Devon and Cornwall model is as follows:

• Very similar demographics and resultant challenges would provide greater resilience than at present whilst retaining co-terminosity with local authorities to aid co-commissioning agenda.
• Opportunity to have a more joined up view in respect of University Hospitals Plymouth NHS Trust.
• High degree (20%) of overlap of Cornwall patients go to Devon for their acute services, and the majority of patients leaving Cornwall for tertiary services receive these in Devon (UHP) too.

The committee was asked to note the ongoing engagement with the local authority about the way in which they continue to engage with the local authority as the future operating model is developed and further guidance is published nationally.

Healthwatch Cornwall Representative

The committee was scheduled to consider a report recommending that a representative from Healthwatch Cornwall be co-opted on to the Health and Adult Social Care Overview and Scrutiny Committee.

Healthwatch Cornwall is the consumer champion of health and social care in Cornwall. It listens to people's experiences of local, publicly funded care, whether good or bad, and uses them to help inform and influence the commissioners and providers of services.

The report stated that it is seen as best practice by the Department for Health and the Centre for Public Scrutiny that health scrutiny committees work closely with local Healthwatch organisations.

The committee was asked to consider whether the Healthwatch Cornwall representation should be one named representative in order to allow a further representative to be co-opted on to the Committee, or whether no representative of Healthwatch Cornwall should be co-opted on to the Committee.

Public Questions

The committee was scheduled to answer two questions from members of the public.

Mr R Rooney from Fowey asked whether the committee would urgently revisit the ICB's closure of Fowey Hospital, given concerns about flawed consultation, lack of options appraisal, and a legally inadequate Equality Impact Assessment, to ensure NHS guidance and equalities law were properly followed before endorsing irreversible decisions affecting vulnerable Fowey residents.

Mr N Morson from Ponsanooth asked whether the committee agreed that the paper before Scrutiny should set out and detail proposals for patient engagement in the cluster .

Updates from Cabinet Members

The committee was scheduled to receive updates from Councillor Jim Mckenna, Portfolio Holder for Adult Social Care and Partnerships, and Councillor Thalia Marrington, Portfolio Holder for Community Safety and Public Health.

Councillor Jim Mckenna's update included raising awareness of potential items and/or performance issues that the Overview and Scrutiny Committee may wish to consider for its work programme, including the CQC report once available, and the committee may want to consider the continuous improvement plan in response to this.

Councillor Jim Mckenna also noted that admission rates into long term care are down and the council are supporting more people to live at home with care and support.

Councillor Thalia Marrington's update noted that the SW Director of Public Health visited Cornwall on 24 June for an assurance visit.