The Plymouth Health and Wellbeing Board met to discuss winter planning, the NHS 10-year plan, dental services, and drug strategy in Plymouth. The board endorsed the winter planning preparations, reviewed the findings of the Devon 10 Year Health Plan engagement, and requested quarterly briefings on the NHS Devon Integrated Care Board's (ICB) dental workplan. The board also endorsed the actions taken by the Plymouth Drugs Strategic Partnership in 2024-25.

Winter Planning 2025-26

The Health and Wellbeing Board reviewed and endorsed the winter planning preparations outlined in the report. The report outlined Plymouth's preparations for winter, with University Hospitals Plymouth (UHP), Plymouth City Council and NHS Devon ICB working together.

Key points from the UHP Winter Plan 2025/26 included:

• Winter pressures are a recurrent challenge, driven by seasonal illness, increased admissions, delayed discharges and workforce pressures.
• NHS England has mandated that all trusts and systems must deliver ambulance handovers within 30 minutes, improve Category 2 response performance, maximise vaccination uptake for frontline staff, enhance community-based flow and discharge pathways, increase the number of patients receiving urgent care in primary, community and mental health settings, improve flow through hospitals, improve patient discharge times and eliminate internal discharge delays of more than 48 hours in all settings.
• The unmitigated acute bed gap is 70-90, and the forecast delivery of 50% of the One Plan objectives leaves a 39-bed gap. The One Plan is a strategic improvement plan to reduce attendances to the Emergency Department.
• The objectives of the One Plan link to maintaining ambulance handover times of less than 45 minutes, maintaining length of stay reduction by a further 0.5 days, launching a robust vaccination programme, empowering, supporting and improving community management of patients, supporting community management of infectious patients, supporting and maintaining elective care and proactive management of respiratory illness and prevention of admission.
• Learning from the Southern Hemisphere, particularly Australia, was used to model demand for flu.
• Workstreams include community services care and admission avoidance, acute hospital and community surge and demand, protected elective capacity, vaccination program, infection prevention and control (IPC) community and acute prevention/response, workforce wellbeing and timely hospital discharge.
• Key actions include ICB demand management schemes, hospital discharge, spot purchase beds, additional funding for capacity, revised escalation and governance structure, IPC community prevention and admission avoidance, Devon system IPC and visiting time-controlled deployment, acute virtual ward, community frailty virtual ward, paediatric respiratory syncytial virus (RSV) surge increase management and navigation actions to reduce footfall to the Emergency Department.
• Actions to increase vaccination numbers include increasing the number of trained peer vaccinators, shared communications and a dedicated UHP communications plan.

The report also detailed commissioned capacity and the social care winter plan, including winter surge commissioned capacity for discharge, advice Plymouth integration, hospital discharge coordination, community support pathways, infection prevention and control measures and business continuity plans.

The vaccination offer for winter 2025/26 includes eligible cohorts for flu, Covid-19 and RSV vaccinations, with various delivery models including primary care networks (PCNs), community pharmacies, schools, trusts, vaccination centres and targeted outreach clinics.

NHS Devon 10 Year Plan and Integrated Neighbourhood Teams

The Health and Wellbeing Board received an update on the Devon 10 Year Plan and Integrated Neighbourhood Teams, and were invited to comment and debate the content of the report, its implications and next steps for board partners.

The Devon 10 Year Health Plan engagement findings captured the views of people and communities in Devon to inform local priorities and strategy development while supporting the national 10-year plan process. The engagement programme focused on exploring views in relation to the three big shifts in healthcare: hospital to community, analogue to digital, and sickness to prevention.

Key findings from the engagement included:

• People valued the NHS being free at the point of access.
• The NHS workforce is seen as the most valuable, but most vulnerable asset.
• People valued the wide range of services that were available and how they have personally helped.
• There is a need across Devon to address access to primary care and mental health services and reduce waiting times in accident and emergency (A&E) and for elective care.
• Satisfaction levels of how the NHS is run is low but is aligned to the national picture.
• Funding the NHS sufficiently should be a priority.

The report also provided an update on the development of Integrated Neighbourhood Teams (INTs) in Devon, in line with national guidance, the 10-year plan and the emerging Health and Care Strategy. Devon is coordinating work pan Devon through an INT steering group, but driving local discussions through Local Care Partnerships.

The report noted that a huge collaborative effort in Plymouth had been made to pull together a bid for the National Neighbourhood Health Implementation Programme, with 25 signatures of support received across key stakeholders. The bid aimed to reduce health inequalities and improve outcomes through integrated, neighbourhood-based care.

The next steps for 2025/26 include place maturity assessment/development plans, developing a clear 'place vision' for INT development, a clear development plan for each area, agreed neighbourhood footprints, pilots aligned to guidance ambitions around Long Term Conditions and ambitions to support community urgent care, a risk stratification tool in place and personalised Care & Support Planning next steps.

NHS Devon ICB Dental Services Update

The Health and Wellbeing Board received an update on the latest developments regarding the national dental care consultation and implications for Plymouth's residents. The board agreed to receive quarterly briefings on NHS Devon ICB's dental workplan and progress against the indicators included in the update.

The national consultation regarding NHS dental care was open for six weeks and closed on 19 August 2025, with changes anticipated for April 2026. Items being consulted on included mandating a proportion of dental contract capacity to be unscheduled (urgent) care, improved payments to support care for patients with significant dental decay and/or significant gum disease and creating a new course of treatment for the application of fluoride varnish on children.

NHS Devon's 2025/26 priorities include urgent dental care provision, commissioning of further stabilisation sessions, commissioning access for vulnerable groups and procurement of lost activity.

Achievements and progress in 2025/26 include a unit of dental activity (UDA) uplift, an improved rate of pay for urgent dental care, contract management and a joint lotted approach being worked up with Cornwall and Isles of Scilly ICB for procurement of new dental contracts around the counties.

Local updates on dental access included that Devon currently holds 150 NHS dentistry contracts and 13 orthodontic contracts, and that the ICB target in the 2025/26 planning indicators for Q1 was 241,819 appointments, with NHS Devon dental contracts delivering 211,977 in Q1 (87.7% of target).

Plymouth Drugs Strategic Partnership Annual Report

The Health and Wellbeing Board received the Plymouth Drugs Strategic Partnership Annual Report and endorsed the actions taken by the partnership in 2024-25. The board were also invited to provide comments on suggested areas of focus for the partnership going forward.

The report provided an annual progress update for the Plymouth Drugs Strategic Partnership for the year from 01 April 2024 to 31 March 2025. The harms associated with alcohol and drug use are wide-ranging, with profound effects on both individuals and society. In response to increasing drug deaths, the UK Government published their 10-year drugs strategy in 2021; From Harm to Hope.

In Plymouth, the Plymouth Drugs Strategy Partnership acts as the central body for reporting, oversight and accountability. Its role is to ensure transparency, shared responsibility and effective governance.

Local need data indicated that in Plymouth there are an estimated 2,042 people who use opiates and/or crack (OCU) and 3,496 people who are alcohol dependent. The estimated prevalence of drug use and alcohol dependency is higher in Plymouth compared to England.

Local provision includes drug and alcohol services for adults commissioned to The Plymouth Alliance for Complex Lives, and drug treatment service for children and young people commissioned to The Children's Society.

Local data indicated that between April 2024 and March 2025, there were 848 new presentations to adult treatment services, accounting for 38% of the total adult treatment population during this period. The total number of adults in treatment between April 2024 and March 2025 was 2,196, which is an increase from 2,039 from 2023-24.

From April 2024 to March 2025 47% of people in drug and alcohol treatment in Plymouth showed substantial treatment progress, the same as the national figure.

Continuity of care has significantly improved in Plymouth over the past year.

The rate per population of deaths due to drug misuse between 2021 and 2023 (three-year rolling average) is 7.5 per 100,000 in Plymouth and 5.5 per 100,000 for England.

Key priorities for the Plymouth Drugs Strategic Partnership in 2025/26 are to explore the feasibility of combining priority one (enforcement) elements of the drugs strategy with regional colleagues, refresh the Plymouth Drugs Strategic Partnership Delivery Plan, undertake a health needs assessment for substance use, continue to build the CYP drug and alcohol working group, ensure continued mitigation and preparedness for synthetic opioid incidents and prioritise co-production and engagement with communities and lived experience representatives.

Partner Updates

The Health and Wellbeing Board received partner updates from NHS Devon and University Hospitals Plymouth NHS Trust.

NHS Devon provided an update on ICB clustering and leadership, Devon's exit from the Recovery Support Programme and Health and Care Strategy development.

Key points from the NHS Devon update included:

• The new ICB 'cluster' – covering Devon, Cornwall and the Isles of Scilly – was formally approved and is now in place from 1 September 2025.
• John Govett, has been appointed as the Chair of the new NHS Cornwall and Isles of Scilly Integrated Care Board (ICB) and NHS Devon ICB Cluster.
• NHS Devon will be exiting from the Recovery Support Programme (RSP) following significant progress made to improve the quality of care for people in Devon in a sustainable way.
• NHS Devon is in the final stages of developing a Health and Care Strategy for Devon.

University Hospitals Plymouth NHS Trust provided an update on the National Oversight Framework and League Table, Community Diagnostic Centres, a vision for the future, working together in pathology services, a CQC rating for surgery services, stroke thrombectomy in the South West Peninsula, unscheduled care, planned care and maternity pilot shifts.

Key points from the University Hospitals Plymouth NHS Trust update included:

• University Hospitals Plymouth has been placed in Segment 4 and ranked 109 out of 134 acute hospital Trusts for performance in the National Oversight Framework.
• One of eight new Community Diagnostic Centres is being built in the heart of Plymouth, due to open in summer 2026.
• There is a vision to build a Plymouth Health Village in the centre of the city.
• Colleagues from each of the four acute trusts across the peninsula have been working together as part of the Peninsula Pathology Network to look at innovative solutions that support the sustainability of pathology services.
• The Care Quality Commission (CQC) has upgraded the rating of the Surgery Services at Derriford Hospital from 'Requires Improvement' to 'Good'.
• The South West Peninsula had the second highest thrombectomy rate in the UK, at 6.7%, representing 229 procedures, the vast majority of which were performed at Plymouth.
• A new Urgent Treatment Centre (UTC), located in the brand-new three-storey Dartmoor Building at Derriford Hospital opened this month.
• The maternity team has recently introduced a key change aimed at improving patient experience and the quality of early care by moving patients first antenatal booking appointments from over the phone to face-to-face.
• An appointment-only system is to be introduced for blood tests at the Phlebotomy Community Hub at Windsor House.

Tracking Decisions

The Board reviewed the progress of the Board's tracking decisions, as detailed in the Tracking Decisions Log 2025-26.

Work Programme

The Board reviewed the Work Programme 2025-6.