The Health Select Committee of Wiltshire Council met on Wednesday 09 July 2025 to discuss the Integrated Community Based Care Contract update, the Home First and Reablement service, Adult Social Care performance indicators, and the Trowbridge Integrated Care Centre. Key decisions included noting the progress of the Integrated Community Based Care contract, endorsing the Home First and Reablement service priorities, and reviewing the Adult Social Care performance indicators.

Integrated Community Based Care Contract Update

The committee received an update on the mobilisation of the Integrated Community Based Care (ICBC) contract with HCRG Care Group Ltd, which commenced on 1 April 2025. Caroline Holmes, Interim Executive Director of Place for Wiltshire and Interim Executive Lead for Community Planned Care and Cancer for the ICB, explained that the contract brings together a range of health and community services across Bath and North East Somerset, Swindon, and Wiltshire. The aim is to provide more integrated, person-centred care closer to people's homes. Val Scrace, Regional Director for HCRG Care Group, detailed the mobilisation process, including the transfer of approximately 1,950 staff and the implementation of a 100-day plan to ensure a smooth transition. Concerns were raised by Councillor Chuck Berry regarding the financial implications and governance of outsourcing these services, with assurances given about the robust oversight mechanisms in place, including joint contract oversight groups and senior leadership forums. The committee was also informed that a call-in request to the Secretary of State regarding the procurement process was still pending.

Home First and Reablement Update

Emma Townsend, Interim Director for Adult Social Care, presented an update on the Home First and Reablement discharge pathway service. This service, which fully transferred to Wiltshire Council as an in-house service on 1 April 2025, aims to enable patients to return home from hospital with appropriate health and social care support, thereby reducing hospital stays and promoting independence. The report highlighted a 15% increase in activity since April, with an average of 225 people supported each month. In May, 76% of individuals remained at home following rehabilitation. Councillor Ed Rimmer raised questions about potential cost savings from the dual provider situation and strategies to reduce discharge cancellations, while Councillor Chuck Berry inquired about the financial benefits and the separation of services between HCRG and the council's reablement team. Councillor Sam Blackwell sought clarification on the implications of staff transferring to different organisations. The committee was assured that the service delivers significant long-term financial benefits through its focus on rehabilitation and reablement, and that efforts are being made to recruit qualified therapists.

Adult Social Care Performance Indicators

Catherine Wiesenbridge, Service Manager for Performance and Insights, presented the Adult Social Care Key Performance Indicators (KPIs) for Quarter 4 (January to March 2025). The report indicated strong performance across several areas, including reablement 91-day outcomes, Section 42 safeguarding outcomes, and a reduction in the number of inadequate care providers. There was also a positive reduction in the number of households on the housing register and in temporary accommodation, which was noted as a significant achievement compared to the national picture. The only KPI rated amber was the long-term support needs of younger adults, with a focus on reducing admissions to residential and nursing care homes. Councillor Chuck Berry requested comparative data and budget figures for future reports, while Councillor Dr Monica Devendran asked for an overview of the Section 42 safeguarding process. The committee resolved to receive the annual report of Adult Social Care KPIs in November, with a request for enhanced comparative information, budget figures, and longer-term trends.

Update on Trowbridge Integrated Care Centre

Caroline Holmes provided an update on the Trowbridge Integrated Care Centre, due to open in early 2026. This new facility will replace the Trowbridge Community Hospital and will house a range of health and care services under one roof, aligning with the NHS's 10-year plan for neighbourhood health services and a shift towards preventative care. The centre will be a 100% net-zero building, utilising state-of-the-art green technology. Councillor Ed Rimmer questioned the cost implications and payback period of the green technology, while Councillor Trevor Carbin and Councillor Christopher Williams raised concerns about the lack of new inpatient services and the need for similar facilities in other areas of Wiltshire. Councillor Chuck Berry sought clarity on the financial arrangements between HCRG, Wiltshire Council, and NHS Property Services regarding the use of the building. It was clarified that the building is owned by NHS Property Services, and HCRG, as the provider of community NHS services, will pay rent as part of their contract. The committee resolved to note the progress of the Trowbridge Integrated Care Centre.

Forward Work Programme

The committee reviewed its forward work programme, with a discussion on the rapid scrutiny of urgent care reporting, which will be broken down into four areas: access to GPs, access to community-based urgent care, access to A&E, and discharge from hospital. Volunteers were sought to lead on each of these areas. The committee endorsed the forward work programme and noted the revenue budget outturn report, including the overspend on adult social care.

The next meeting is scheduled for 09 September 2025.