The Worcestershire Health and Well-being Board met to discuss the Joint Local Health Well-being Board Strategy, the Health and Work Strategy, the Pharmaceutical Needs Assessment, the Health Protection Group, the Integrated Commissioning Executive Officers Group, and the Better Care Fund. The board noted the progress being made in delivering the Joint Local Health and Wellbeing Strategy (JLHWS) and supported the Herefordshire and Worcestershire Integrated Care Strategy (ICS) Health and Work Strategy. The board was asked to review the summary and recommendations of the Pharmaceutical Needs Assessment (PNA), and delegate final approval for publication to the PNA working group.

Joint Local Health and Wellbeing Strategy Annual Update

Dr Tanya Richardson, consultant in public health, presented the three-year update on the Joint Local Health and Wellbeing Strategy (JLHWS), a partnership strategy delivered by every member of the board. The strategy prioritises good mental health and well-being, supported by action on healthy living, safe communities, and quality jobs. The update confirmed that this remains the right priority for the people of Worcestershire, emphasising the power of community, connection, and partnership.

Successes highlighted in the report included:

• Healthy Worcestershire: This programme is now in place in 30 venues across the county, with 99% of participants reporting an improvement in their health and well-being.
• Priority Neighbourhood Development: Work in priority neighbourhoods, particularly in Westlands, has led to a 7% reduction in emergency admissions to hospital.
• WorkWell programme: This programme, delivered by the ICB, links good work and mental well-being.

Lisa McNally, Director of Public Health, reinforced that Worcestershire is not a homogeneous place, and that focused work is required in specific areas such as Redditch, which is experiencing some poorer outcomes than average. She also noted a reduction in childhood obesity in year sixes at the end of primary school, which is double the national and regional reduction.

Councillor Bowen, Cabinet Member with Responsibility for Children and Families, expressed excitement about the development of Family Hubs and their potential to be transformative. She also wondered how they might join in with the revolution in fostering, particularly around peer support, parenting support, and early access to services.

Councillor Shirley Webb from Bromsgrove noted that the Healthy Worcestershire Programme has worked well in Bromsgrove, helping with preventative programmes and reducing social isolation.

David Mehaffey, ICB Director of Strategy, welcomed the statistics on childhood obesity at year six, noting the importance of prevention and early intervention.

Health and Work Strategy

David Mehaffey, ICB Director of Strategy, and Judy Gibbs, Head of Service for Skills and Employability at the County Council, presented the Health and Work Strategy, developed in response to rising levels of sickness absence and gaps in inclusive employment practices. The strategy's vision is to have a dynamic workforce that drives a vibrant local economy, where everyone has access to meaningful employment and where health and well-being needs are prioritised.

The strategy focuses on four strategic ambitions:

1. Inclusive work environments
2. Supportive pathways into employment
3. Early intervention
4. Enhanced collaboration

The strategy aims to increase the number of disability-confident employers, reduce sickness absence, improve employment rates for disadvantaged groups, reduce the number of fit notes issued, and reduce health-related benefits claims.

Councillor Satinder Bell, CMR for Health and Well-Being, noted the importance of rehabilitation and facilitating access to employment for people coming out of prison. She also raised concerns about sick notes, suggesting that primary care and healthcare providers need to work more closely to ensure they are issued appropriately.

David Mehaffey noted that the fit note process needs to be tightened up, particularly in primary care, and that additional funding has been allocated to address this. He also noted that 40% of people accessing the WorkWell service are doing so because of a mental health-related barrier to work.

Lisa McNally noted the importance of creating workplaces that are conducive to better well-being, physical health, and mental health, as this can lead to improved staff retention and reduced sickness absence.

Worcestershire Pharmaceutical Needs Assessment 2025

Matthew Fung, consultant in public health, and Dr Heidi Bowering, public health registrar, presented the summary report of the Pharmaceutical Needs Assessment (PNA) 2025. The PNA is a statutory document that assesses the current provision of pharmaceutical services, identifies gaps in service provision, and makes recommendations to ensure services meet the health needs of the population.

Key findings included:

• There are 109 pharmaceutical providers in Worcestershire, including 88 community pharmacies and 21 dispensing GP practices, a 6% reduction since 2022.
• Access to pharmacies is generally good, with 100% of residents living within a 20-minute drive of a pharmacy.
• Advanced services are generally well covered.
• Engagement work indicated overall high satisfaction with community pharmacies, but also concerns about opening hours, long waits, and transport issues.

The document makes several key recommendations, including raising public awareness and trust in pharmacy services, aligning services with local health priorities, improving evening access to community pharmacies, and simplifying commissioning processes.

Councillor Bowen asked for clarification regarding driving times for urban and rural areas, expressing concern that rural communities may need closer access than urban areas.

Councillor Andrew Willmott noted a 6% service reduction since 2022, with four pharmacies in the Malvern Hills District Council area closing, and asked about the reasons for this and the outlook for the future.

Julie, chief clinical strategy officer at Worcestershire acute NHS trust, asked whether the survey looked at the provision of pharmacy services in evenings and weekends across the population to try to help to ensure that pharmacy services were doing their bit to help manage urgent and emergency demand.

Councillor Bell noted the challenges of accessing pharmacies on Sundays and the limitations of online prescriptions. She also suggested that there is potential for educating people about over-the-counter medications to reduce the need to visit pharmacies.

The board was asked to review the summary and recommendations and delegate final approval for publication to the PNA working group.

Health Protection Group Overview

Matthew Fung, consultant in public health, and Vicky Milston, senior public health practitioner, provided an overview of the Health Protection Group (HPG) and its work. The HPG was set up in November 2022 and meets quarterly to plan and strategise around health protection issues.

Key areas of work include:

• Infectious Disease Outbreaks: The HPG monitors and responds to outbreaks of infectious diseases, such as measles and Strep A.
• MMR Uptake: Worcestershire has excellent MMR uptake rates, but efforts are ongoing to reach the WHO target of 95% vaccination coverage.
• Air Quality: The HPG is working to improve air quality, including using real-time data to inform behaviour change.
• Sexual Health: Rates of HIV and syphilis are increasing, and circuit breaker testing is being rolled out to identify cases earlier.
• Health Protection in Prisons: The HPG works with local prisons to manage outbreaks and provide education and guidance.

Councillor Bowen asked how the 1% increase in vaccinations in children in care was achieved and how this could be repeated.

Lisa McNally noted that it is incredibly important to find a way to continue this work, as it is cost-effective.

Councillor Bell asked about winter planning and whether anything different is being done to reduce admissions to the hospital due to flu. She also asked about the reduction in engagement with sexual health services and the trends in HIV.

Lisa McNally emphasised the importance of early HIV testing and encouraged everyone to promote this in their networks.

Worcestershire Integrated Commissioning Executive Officers Group (ICEOG) Update

David Mehaffey provided an update on the Worcestershire Integrated Commissioning Executive Officers Group (ICEOG), a joint group overseeing joint commissioning between the NHS and local government. The report covered a wide range of issues, including adult services, discharge from hospital, community services, community equipment, and public health.

Councillor Bell touched base on the short-term enhanced domiciliary care service and asked if the spaces are always taken up.

Mark Fitton, Strategic Director - Adults and Communities, explained that the enhanced domiciliary care service was an attempt to put more support into people to avoid them having to go into long term residential or nursing care.

Councillor Bell asked about plans to keep the service with outsourced providers or bring it back to Worcestershire County Council.

Mark Fitton explained that a decision was made last year to pull back in house some of the external provision by the end of this financial year, and that they are building the workforce to enable them to do that.

Councillor Bell noted a challenge with the equipment service and asked if it would be possible to work with the acute trust to borrow equipment on a short-term basis.

Mark Fitton explained that the current contract on equipment is commissioned with Herefordshire and Worcestershire Health and Care Trust, and that they are looking at what is the offer in Worcestershire and in some circumstances may be revising the level and type of equipment that can be provided.

Better Care Fund Update

Mark Fitton provided an update on the Better Care Fund (BCF), explaining that the Health and Wellbeing Board delegated responsibility for the planning and reporting of the BCF to the Integrated Commissioning Executive Officers Group (ICEOG). He noted that the BCF 24-25 year-end report and the BCF quarter one reporting template had been submitted to NHS England.

He noted that all the BCF metric goals were achieved, but there was a £174,000 overspend on the 24-25 budget, mainly due to Pathway One, which was jointly funded by WCC and the ICB. He also noted that there are some carry-forward funds identified from the disabled facilities grant.

He noted that there was nothing particularly to note on the 25-26 quarter one report, that the metrics are being reviewed on a quarterly basis with NHS England, and that they are currently forecasting a break even at quarter one.

Other Business

Lisa McNally reminded everyone of the community stories event coming up on 22nd of October at the cricket club.

Councillor Bell thanked everyone for their time and hard work and noted that the next meeting is on 18th of November at 2pm.