The Health Overview and Scrutiny Committee met on Wednesday, 4 March 2026, to discuss access to GP appointments and NHS primary care dental services. Key discussions included the challenges and successes in improving GP appointment availability, the impact of housing growth on GP services, and the ongoing efforts to enhance NHS dental provision across the county. The committee also reviewed and proposed updates to its work programme for the upcoming year.

Access to GP Appointments

The committee received an update on access to GP appointments, including out-of-hours services, from representatives of NHS Herefordshire and Worcestershire Integrated Care Board (HWICB). Charmaine Hawker, Director of Primary Care for HWICB, and Dr Roy Williams, a local GP and Clinical Director for the Wild Forest Health Partnership, presented information highlighting that Herefordshire and Worcestershire consistently rank among the top performers nationally for ease of access to general practice services. Despite this overall positive picture, the report acknowledged variations in access between individual practices, which remains a key priority for HWICB.

Discussions focused on the impact of housing growth on GP services, with councillors raising concerns about whether existing infrastructure could cope with increased demand. HWICB representatives explained that they are actively planning for housing growth through a five-year capital investment plan and working closely with council colleagues. A significant point of discussion was the recruitment and retention of GPs. Dr Williams highlighted efforts to engage with students from the three counties medical school and encourage them to train and remain in the local area. However, the challenge of retaining GPs was acknowledged, with more GPs leaving than joining nationally, although local attrition rates were reported as lower than the national average.

The financial pressures on general practices were also a key theme. Dr Williams explained that while more GPs are being trained, the ability of practices to employ them has not kept pace with demand due to increased running costs and a reduction in real-terms income. The formula for allocating funding to general practices, known as the Car Hill formula, was also discussed, with acknowledgement that it is due for a national review to address issues, particularly concerning deprived practices.

The committee explored the increasing use of online consultations and digital tools for accessing GP services. While these methods have helped to reduce telephone waiting times and offer greater convenience for many, concerns were raised about digital inclusion and ensuring that vulnerable and hard-to-reach groups are not left behind. HWICB representatives assured the committee that multiple access routes, including telephone and in-person appointments, remain available and that efforts are being made to improve digital inclusion.

The provision of out-of-hours GP services was also discussed, with a focus on the upcoming contract changes due to commence in July 2026. The new model aims to deliver improved integration and coordination through a single point of access. Councillors from Bromsgrove and Redditch highlighted the particular challenges faced by their areas regarding access to out-of-hours care and the need for local provision.

Update on Access to NHS Primary Care Dental Services

Charmaine Hawker also provided an update on access to NHS primary care dental services. She reported that since HWICB took on commissioning responsibilities in April 2023, there has been a steady increase in access to dental services, with improvements towards pre-pandemic levels. The report highlighted that Herefordshire and Worcestershire are performing above the national average for both child and adult access rates to NHS dentistry.

Discussions centred on the challenges within the national dental contract, which has remained largely unchanged since 2006 and does not adequately compensate for complex care or incentivise preventative work. Reforms to the contract, due to be implemented from April 2026, were discussed, which aim to improve access, focus on quality and prevention, support the workforce, and reduce oral health inequalities. These reforms include changes to urgent care provision, new complex care pathways, and improved remuneration for preventative treatments.

The committee heard about efforts to address workforce challenges, including an increase in Foundation Training Practices in Worcestershire. The independent contractor status of dental practices was also discussed, with an acknowledgement that practices balance NHS and private provision to maintain financial viability.

Progress against the Local Dental Recovery Plan was detailed, including the opening of two new dental practices in Hereford and the commissioning of additional activity through initiatives like the Inequity Premium Practice scheme, which targets areas of high deprivation. The committee also discussed the national target for urgent dental appointments and the local efforts to increase capacity.

Concerns were raised about the cost of dental treatment for patients and the potential for unnecessary work. HWICB representatives explained the NHS banding structure for treatment costs and the existence of a process for monitoring and investigating potential fraudulent claims. The importance of prevention was strongly emphasised, with discussions on supervised toothbrushing schemes and the role of fluoride varnish. The committee also discussed the geographical distribution of dental need and the ongoing efforts to reinvest funds into areas with the highest priority.

Refresh of the Scrutiny Work Programme 2026/27

The committee reviewed suggestions for its work programme for the upcoming year. Members were invited to propose topics for future scrutiny, with a focus on issues that are priorities for the council, key for local people, and likely to lead to practical improvements. The current work programme for 2025/26 was presented, and the committee discussed potential additions and amendments for the 2026/27 programme, with a view to finalising it for approval by the Overview and Scrutiny Performance Board and then Full Council. Key upcoming topics for scrutiny include Maternity and Newborn Services, the Cancer Pathway, Urgent Care Patient Flow, and End of Life Care.