The Committee in Common between the Cornwall Health and Wellbeing Board and the Cornwall and Isles of Scilly Integrated Care Partnership (IoS ICB) were scheduled to meet to discuss the Better Care Fund, the Healthwatch Cornwall Annual Report, and the Joint SEND Commissioning Strategy and SEND Strategic Plan. The meeting was also scheduled to include verbal updates on the Health and Wellbeing Board and Integrated Care Partnership Journey, and a stocktake on the Life Course Boards and Integrated Care Partnership Board.

Joint SEND Commissioning Strategy and SEND Strategic Plan

The Committee in Common were scheduled to discuss and provide feedback on the proposed adoption and implementation of the Cornwall Joint SEND Commissioning Strategy 2025 – 2030 and the Cornwall SEND Strategic Plan 2025 – 2028.

The commissioning strategy aims to improve outcomes for children and young people (CYP) with special educational needs and disabilities (SEND), including those with an Education Health and Care Plan (EHCP) up to the age of 25, through integrated commissioning and service delivery. The strategic plan addresses areas requiring improvement that were highlighted in the Local Area SEND Inspection 2023 and provides a framework for coordinated action across education, health and social care.

The report pack identified key challenges in Cornwall's SEND system:

• Rising Demand: EHC needs assessment requests have increased by over 150% in six years, and less than 45% of EHC plans are finalised within the statutory 20-week timeframe.
• Service Delays: Delays persist in Speech and Language Therapy and across the neurodiversity pathways.
• Early Intervention Gaps: Opportunities to address adversity and health inequalities early are being missed.
• Financial Pressures: The Designated Schools Grant (DSG) is insufficient, with an annual overspend exceeding £25M.
• Access to Provision: There is a shortage of specialist education places in appropriate locations, leading to long travel times and associated impacts.
• Exclusion Rates: CYP with SEND in Cornwall are excluded or suspended at twice the national average.
• Future Growth: By 2029, the number of CYP with disabilities is projected to increase by 1,000, with EHCPs expected to rise to 6,900.

The Joint SEND Commissioning Strategy identifies five strategic priorities:

1. Early Identification and Support
2. Sufficiency and Quality of Provision
3. Preparation for Adulthood
4. Inclusion and Belonging
5. Effective Joint Commissioning

The SEND Strategic Plan identifies five core priorities:

• Improving the Quality of EHCPs Across the Partnership
• Effective Communication to Ensure Positive Experiences
• Using Data to Evaluate Services and their Impact
• Improving Education Offer and Outcomes
• Addressing Long Waits for Health Services

The report pack also notes that in June 2025 there was a government announcement to extend the SEND Statutory Override until the end of the 2027–28 financial year. The decision is intended to allow councils to continue excluding SEND-related DSG deficits from their general balance sheets, providing temporary financial relief and avoiding potential insolvency for many local authorities.

Healthwatch Cornwall Annual Report

The Committee in Common were scheduled to review the Healthwatch Cornwall Annual Report 2024-25, which reviews Healthwatch activities for the year. The report includes information about the work that has been undertaken in supporting health and social care leaders to better understand the issues experienced by people using services in Cornwall and the actions taken to address these. It explains the strategies the service has taken to ensure there is a representative voice of Cornwall's residents and opportunities local people have had to get involved. The report sets out Healthwatch priorities for 2025-26.

The report pack notes that Healthwatch Cornwall produced three reports in 2024-25, with a focus on matters relating to a) Cost of Living, b) Dentistry and c) Mental Health. Healthwatch also undertook six 'impact reviews', which consider the progress made by the health and social care system against earlier issues identified, and 28 'enter and view' visits, where volunteers visit health and social care services to gather evidence to support their statutory function.

The priorities for 2025-26 are:

2.8.1 Building on existing work, reflecting on the impact of the work in areas such as Dentistry, Mental Health, and the Cost of Living.

2.8.2 Improving access to GP surgeries

2.8.3 Mental Health and Neurodiversity, specifically understanding the local issues around ADHD, Autism, and broader mental health needs.

2.8.4 Local Service Improvements, specifically exploring matters relating to minor injury units, care homes, and pharmacy services

2.8.5 Partnership Boards development by ensuring the voice of people with lived experience is represented with stakeholders.

2.8.6 Rural Health and Care Access specifically in respect of transport and digital exclusion.

2.8.7 Listening Hubs and Community Engagement by growing the network to reach more communities.

2.8.8 Prevention and the VCSE Sector and their role in early intervention and community wellbeing.

2.8.9 Digital presence and reach of Healthwatch Cornwall.

The report includes a message from Debbie Gilbert, CEO/Executive Director Healthwatch Cornwall, who said:

This year has been one of growth, collaboration and meaningful impact. Healthwatch Cornwall continues to play a pivotal role in amplifying the voices of people across the county.

The report also includes a message from Dr Keith Judkins, Board Chair, Healthwatch Cornwall, who said:

Despite the challenges facing services, we remain steadfast in our mission to ensure your voices are not just heard but drive real change. Together, we're shaping the future of health and social care across Cornwall.

Better Care Fund for Cornwall

The Committee in Common were scheduled to discuss the Better Care Fund (BCF) for Cornwall, and to consider delegating authority to Kate Kennally, CEO Cornwall Council, in consultation with Kate Shields, CEO – ICB, and Councillor Fran Grottick, Chair of the Council of the Isles of Scilly Health and Wellbeing Board, to approve the submission of Better Care Fund quarterly and End-of-Year returns during 2025-26 to NHS England in compliance with the National Conditions of the Better Care Fund.

The Better Care Fund is a national vehicle through which Integrated Care Boards and Local Authorities are required to pool funds to meet published policy objectives relating to the overlap between health and social care functions, particularly but not exclusively relating to hospital discharge.

The report pack notes that Cornwall and the Isles of Scilly's Better Care Fund for 2025-26 encompasses in excess of £100m of pooled funding:

The Better Care Fund for Cornwall and the Isles of Scilly for 2025-26 sets out the following domains:

• A Narrative Plan, describing the Cornwall and Isles of Scilly system, achievements and priorities,
• An expenditure plan describing planned expenditure against individual schemes,
• An analysis of capacity and demand for intermediate care services
• Target performance levels across three mandated metrics.

The priorities for 2025-26 are:

• Priority 1: Intermediate Care
• Priority 2: Community Equipment and Technology Enabled Care
• Priority 3: Carers
• Priority 4: Disabled Facilities Grant

The mandated performance metrics are:

• Emergency Admissions to hospital for people aged 65 and over per 100,000 Population
• Average length of discharge delay for all acute adult patients
• The rate of people aged 65 and over whose long-term support needs are met by admission to residential or nursing care homes per 100,000 population

Stocktake on the Life Course Boards and Integrated Care Partnership Board

The Committee in Common were scheduled to receive an update from Cornwall Council and ICB Chairs and Co Chairs on the following:

• Start Well
• Life Well
• Age Well
• Integrated Care Partnership Board.

The report pack includes highlight reports from the Start Well Steering Group, the Live Well Steering Group, and the Age Well Steering Group.

The Start Well Highlight Report Nov 24 - May 25 notes that the JSNA highlights significant impact of child poverty of SEND outcomes, and that there is a key need to align focus on more primary prevention and secondary prevention to reduce demand to address timeliness and waiting list.

The Live Well CiC Highlight Report notes that the Cornwall and Isles of Scilly Work and Health partnership secured national pilot funding for a 'work well' pilot. One of 15 pilots in the country to support people with health barriers to stay in or access work.

The AW LCSG Highlight Reporting for CiC July 2025 - Nov 24-May 25 notes recognition throughout period, linked to BCF Metric reporting in 2024-25 of areas robust performance relating to Admission Avoidance this period.

Committee in Common Terms of Reference

The Committee in Common were scheduled to note the terms of reference for the committee. The report pack includes a document outlining the Terms of Reference of the Committee in Common between the Cornwall Health and Wellbeing Board and the Cornwall and Isles of Scilly Integrated Care Partnership.

The document notes that the Cornwall Health and Wellbeing Board and the Cornwall and Isles of Scilly Integrated Care Partnership are legally distinct, but are meeting as a Committee in Common with aligned Terms of Reference.

The core purpose of the Health and Wellbeing Board is to integrate commissioning across the NHS, public health and social care services in order to improve efficiency, secure better care and, ultimately, health and wellbeing outcomes for the local community.

The Cornwall and Isles of Scilly Integrated Care Partnership is concerned with improving the care, health and wellbeing of the population.

The document also outlines the membership of the Committee in Common, including Councillor Leigh Frost, Leader of the Council & Group Leader - Liberal Democrat Group, Councillor Hilary Frank, Portfolio Holder for Children, Families and Schools, Councillor Jim McKenna, Portfolio Holder for Adult Social Care and Health Partnerships, Kate Kennally, CEO Cornwall Council, and John Govett (ICB), Joint Chair.