The Lancashire Health and Wellbeing Board met on Tuesday, 18 November 2025, to discuss a range of important topics aimed at improving the health and well-being of residents across the county. Key decisions included endorsing a refreshed governance model for the Board, approving the Better Care Fund Quarter 2 report, and seeking endorsement to develop local neighbourhood health plans. The Board also received an update on the development of a county-wide prevention strategy.

Review of Health and Wellbeing Board Arrangements in Lancashire

The Board received the findings and recommendations from a review of the Lancashire Health and Wellbeing Board (HWB) conducted by the Local Government Association (LGA). The review aimed to strengthen the Board's role and effectiveness in the context of evolving health and care landscapes, including Local Government Reorganisation and Integrated Care System developments.

Key recommendations endorsed by the Board include:

• Developing a vice-chairing arrangement between Lancashire County Council and the NHS to foster shared ownership and system alignment.
• Enhancing representation from the voluntary, community, and faith sector, as well as provider organisations, to ensure broader input.
• Introducing an improved District Council attendance model to strengthen local engagement and connectivity with local health and wellbeing partnerships.
• Establishing four sub-groups focused on Joint Strategic Intelligence, Joint Commissioning, the Better Care Fund, and Neighbourhood Health to provide focused oversight and delivery.
• Moving towards shorter, decision-focused meetings supplemented by thematic workshop sessions for deeper discussion.

The Board agreed to develop detailed implementation proposals for these refreshed arrangements by early 2026. Priorities will be aligned with national policy frameworks, including the NHS 10-Year Plan for Health and the Neighbourhood Health Service agenda. A Neighbourhood Health and Wellbeing Delivery Framework is to be developed by April 2026, and the Board will maintain oversight of Better Care Fund performance metrics. The potential implications of the forthcoming English Devolution and Community Empowerment Bill will also be monitored.

Lancashire Better Care Fund November Update

The Board formally ratified the Quarter 2 submission for the Lancashire Better Care Fund (BCF) for the 2025/26 financial year. The report detailed progress against key metrics, including emergency admissions, discharge delays, and residential admissions, as well as financial spend.

Discussions highlighted the complexity of tracking BCF expenditure and its effectiveness. Helen Coombes, Executive Director of Adult Services, acknowledged the need for greater transparency and a clearer understanding of how investments translate into improved outcomes. She noted that the BCF is made up of various funding streams and that the next six months will focus on understanding where the money sits within individual organisations and how to track its impact on key metrics, such as promoting independence and reducing residential care admissions. The Board was assured that the BCF Board would report back with more detailed data to support investments.

Concerns were raised about Lancashire's higher rate of residential care admissions compared to national averages, with Councillor Margaret France highlighting the county's high levels of deprivation and ill health among its elderly population. While acknowledging these factors, it was noted that the rate is still double the benchmark, indicating a need for more capacity for complex needs and alternative housing options like extra care. The BCF Board is working with acute and community health providers to address these issues and improve outcomes.

Developing Neighbourhood Health Plans in Lancashire

The Board received information on the steps being taken by key partners to improve neighbourhood-level health outcomes and sought endorsement to proceed with developing local neighbourhood health plans. Dr Sakthi Karunanithi, Director of Public Health, Wellbeing and Communities, explained that this initiative is a crucial part of the national 10-year health plan, focusing on prevention, community care, and the use of technology.

The definition of a neighbourhood is to be agreed locally, considering community recognition, service organisation, and optimal resource allocation, likely focusing on areas of 30-50,000 population. The plans will encompass not just NHS services but also social care, public health, and wider determinants of health, involving communities, the voluntary sector, and public and private partnerships.

The development of these plans is a significant undertaking, with a strategic plan required nationally by April 2026. A working group has been established, and the Board will be briefed on progress. Chris Sinnott from the Lancashire Chief Executive Group emphasised the importance of neighbourhoods being based on recognised places and communities, rather than solely on primary care networks. He also stressed that neighbourhood working should leverage existing services and community assets, rather than commissioning new programmes that replicate existing provision.

Concerns were raised about the potential impact of Local Government Reform on the timing and coherence of these plans. The Board was assured that groundwork on neighbourhood working would provide a foundation regardless of future local authority structures. The importance of involving the voluntary sector early in the process was also highlighted.

Developing a Prevention Strategy for Lancashire

The Board received an overview of the work underway to develop a unified prevention strategy for Lancashire County Council. Dr Sakthi Karunanithi explained that the strategy aims to establish a coordinated approach across council services to achieve better outcomes, reduce inequalities, and manage demand more effectively, particularly within social care.

The strategy is in its early stages and will focus on understanding and managing demand, measuring and maximising impact, and making smarter use of funding. It will build on existing strengths and involve collaboration with partners, including district councils, the NHS, and the voluntary sector. The phased approach will see immediate decisions feeding into the 2026/27 budget setting, followed by shaping a whole-system strategy and ultimately establishing an integrated prevention and early intervention approach. The strategy will also inform the development of neighbourhood health plans.

Pharmaceutical Needs Assessment (PNA)

The Board was informed that the Pan Lancashire PNA 2025 has been published. This statutory responsibility for all health and wellbeing boards describes current pharmaceutical provision, health needs that could be mitigated by pharmaceutical services, and future population changes, informing decisions on future market entry. The PNA has been developed collaboratively by three health and wellbeing boards and managed by a steering group. A six-monthly review of pharmacy provision will continue until the PNA cycle in 2028.