The Health Scrutiny Committee was scheduled to convene to discuss updates on community mental health services, the NHS 10-Year Plan, and the committee's future work programme. The meeting was also scheduled to include a period for public questions, and to confirm the minutes of their previous meeting.

NHS 10-Year Plan and Reform

The committee was scheduled to receive an update from the Derby and Derbyshire Integrated Care Board (ICB) on the NHS 10-Year Plan and subsequent cost reductions.

The NHS 10-Year Plan, published on 3 July 2025, was described in the report pack as part of the government's mission to build a health service fit for the future. It was designed as a response to the 2024 review of the NHS undertaken by Lord Darzi¹, and it outlines how the government intends to reinvent the NHS through three shifts:

• hospital to community
• analogue to digital
• sickness to prevention

The plan also sets out a new operating model for the NHS, with the aim of delivering a more diverse and devolved health service. Key structural changes mentioned in the report pack include:

• Combining the headquarters of the NHS and the Department of Health and Social Care, reducing central headcount by 50%.
• Making ICBs the strategic commissioners of local healthcare services, building ICB capability, and closing commissioning support units.
• Introducing a new patient choice charter, starting in the areas of highest health need.

Instructions issued to all ICBs on 13 March 2025 outlined the requirement to make 50% corporate cost reductions across the ICB sector by the end of December 2025. The report pack notes that NHS England published a Model ICB Blueprint in April 2025 to outline the core roles of ICBs, and that they have also published a Model Region Blueprint in recent weeks, which supports greater understanding of the interface between future ICBs and regulators.

Significant developments arising from this policy include:

• The agreement that most existing ICBs are not sustainable with a 50% reduction in costs and that 'clustering' of ICBs is required in many cases. The number of ICBs in England will reduce from 42 to 25.
• Under the existing legal framework, clustering will enable the appointment of a single Board and Executive Team, and a restructuring programme to reduce headcount to achieve the cost reduction targets.
• NHS England has agreed to a proposal that NHS Derby and Derbyshire ICB will cluster with NHS Lincolnshire ICB and NHS Nottingham and Nottinghamshire ICB, with a view to potential merger in 2027 subject to legislative change.
• Using benchmarking information, the ICB cluster will be required to make cost reductions of around 45%. These reductions relate to corporate costs and do not include savings relating to the commissioning of patient care.
• Dr Kathy Mclean OBE, the current Chair of NHS Derby and Derbyshire ICB and NHS Nottingham and Nottinghamshire ICB, has been appointed as the chair of the cluster organisation.

The report pack stated that the ICB cluster does not believe a fair and compliant process to meeting the cost reduction targets can be fully met by the original December 2025 implementation deadline and a phased approach will be taken, which will extend the process into 2026/27 financial year.

The report author, Sean Thornton, Director of Communications and Engagement, noted that cost reduction targets will necessitate the move to cluster ICB arrangements during 2025/26, but that this process will not impact on the finances available for the delivery of frontline healthcare.

The committee was asked to receive the update of the NHS 10-Year Plan and NHS Reform for information, and to note the continued commitment to engage with the Committee on any future service redesign.

Update on The Community Mental Health Framework/Living Well Derbyshire

The committee was scheduled to receive an update on the Community Mental Health Framework² and Living Well Derbyshire.

Living Well Derbyshire provides services for people experiencing symptoms of mental ill health that are significantly impacting their daily functioning, causing disruption to their lives and risk to their wellbeing. The service focuses on supporting people who may be too unwell to be supported by existing primary care teams or IAPT (Improving Access to Psychological Therapies), but do not meet the threshold for current Community Mental Health Team (CMHT) intervention. Living Well offers a range of multidisciplinary interventions and treatment to support people aged 18 and over.

The report pack included a presentation which noted that:

• There is substantial evidence that the aims of the Community Mental Health Framework, which underpin Living Well Derbyshire, are being met.
• National NHSE outcomes designed to measure outcomes locally consistently demonstrate the positive impact of Living Well Derbyshire.
• Evidence gathered demonstrates that the caseloads of long-term services provided by social care, health and VCSEs for people with mental ill health are reducing, whilst the use of short-term services is increasing. There are also early indications of reducing referrals to Mental Health Liaison Teams which frees up capacity to provide greater support to complex cases in the community and therefore to reduce presentations at A&E.

The presentation also included feedback from people who have accessed the service, including one person who said:

This service has helped me realise that I can go at my own pace in life and to not rush progress. I find it hard to trust people because of what I've been through and I've been able to trust Jack which has helped me with my progress.

The report noted that Derbyshire County Council (DCC) contributes £0.295m to the Recovery and Peer Support Service, which is a key part of the Living Well Derbyshire VCSE offer and is led by Rethink³. Funding of £0.295m from the Better Care Fund (BCF) supports the DCC contribution.

The service is a 2+1+1+1 year contract, commencing 1 April 2023 and includes an annual ICB contribution of £1.357m which covers their contribution for the core service offer and for the entirety of the VCSE staffing structure for Living Well across Derbyshire.

For Living Well Social Care staffing employed by DCC, the ICB has committed to providing full funding (£0.766m was provided in 2024/25) from 1 April 2025 until 31 March 2026.

The report noted concerns around sustainability should commitment for further funding not be agreed from 1 April 2026.

The committee was asked to note the progress made on the key outcomes delivered by Living Well Derbyshire.

Work Programme

The committee was scheduled to consider the proposed work programme and make suggestions for future items.

The work programme included the following items for future meetings:

• 24 November 2025: East Midlands Ambulance Service and Fertility Review Update
• January 2026: Healthwatch Derbyshire
• March 2026: Sickle Cell Update

Possible later items included:

• Dementia Strategy – update
• Asbestos
• Obesity jabs
• Long/Post COVID
• Mental Health Crisis Support
• Living Well Derbyshire – short breaks
• Stroke Rehabilitation
• Healthwatch Derbyshire
• Screen time for children