The Health and Wellbeing Board of Wiltshire Council met on Thursday 21 May 2026 to discuss the Better Care Fund Plan for 2026/27, progress on the Neighbourhood Health programme, and proposals to strengthen the Board's governance. Key decisions included endorsing the Better Care Fund Plan and adopting a new approach to strengthen the Board's governance and accountability.

Better Care Fund Plan 2026/27

The Board endorsed the Wiltshire Better Care Fund (BCF) Plan for 2026/27. This plan represents a bridging year focused on consolidating critical integrated services while strengthening neighbourhood delivery, prevention, and discharge and recovery pathways. The funding, which remains broadly stable, supports the BSW Integrated Care Strategy and the ICB's five-year commissioning plan. The focus has shifted from service development to optimisation, with priorities including strengthening therapy capacity in Home First pathways, reducing variation in multidisciplinary team (MDT) practices, and shifting care away from bed-based services towards home-based recovery. A significant portion of the BCF funding is allocated to Integrated Neighbourhood Teams (INTs) to support older people with frailty, those with complex long-term conditions, and those at risk of hospital admission or delayed discharge.

The plan details goals for key metrics, including non-elective admissions for those aged 65 and over, and delayed discharges. These goals are informed by trend analysis, peer benchmarking, and alignment with NHS provider and ICB medium-term plans. The Board noted that while Wiltshire performs strongly in some areas, such as care home admissions, there are areas for improvement, particularly in the average length of discharge delay and the proportion of patients discharged on their discharge ready date. Continuous improvement will be driven through robust joint governance, including monthly operational oversight, commissioning and performance reviews, and quarterly strategic oversight. The BCF dashboard will be strengthened to support in-year monitoring of spend, performance, and impact.

Neighbourhood Health Update

The Board received an update on the progress of Wiltshire's neighbourhood health programme, which has been described as a strong strategic system, moving into delivery phase by the Health Integration Partnership. Key milestones achieved since February 2026 include the finalisation of the Wiltshire Neighbourhood Health Vision and the go-live of Community Health INTs on 1 April 2026. The Board was asked to approve proposed neighbourhood footprints for Wiltshire, divided into three geographic areas: Wiltshire South, Wiltshire West, and Wiltshire North and East. These footprints are aligned with HCRG community services operational footprints and Primary Care Network (PCN) geographies. The Board also noted the outputs of the first Neighbourhood Health workshop, which focused on People and Prevention, and endorsed the proposed BSW locality plan development methodology. An update on Neighbourhood Health Centre planning was also provided, with a pipeline submission to NHS England due in late May 2026.

Strengthening Governance, Membership Engagement and Statutory Delivery for Wiltshire Health and Wellbeing Board

The Board considered proposals to strengthen its governance, membership engagement, and system leadership to more effectively discharge its statutory duties. The Health Integration Partners' maturity assessment highlighted the need for clearer ownership of the Joint Local Health and Wellbeing Strategy, stronger accountability for neighbourhood outcomes, and more explicit leadership on the wider determinants of health. The Board discussed two options for strengthening its arrangements, ultimately recommending and adopting Option 2: Strengthened governance and accountability model. This approach repositions the Board as the authoritative place-based strategic steward for neighbourhood health, involving revised Terms of Reference, explicit membership responsibilities, a clear separation between statutory and system leadership roles, and agreed assurance of neighbourhood health plans and wider determinants activity. The Board resolved to commission revised Terms of Reference and a System Governance Framework to clarify meeting structures and facilitate discussion and challenge in the delivery of duties.

Other Matters

The Board also received updates on the Best Start in Life Plan and the Families First Partnership Programme. The date of the next meeting was confirmed as 16 July 2026.