The Overview and Scrutiny Performance Board (OSPB) met to discuss local government reform in Worcestershire, progress on child and adolescent mental health services, and the board's future work programme. The board agreed to write to the Leader of the Council and the Chief Executive to ask for the administration's position on local government reorganisation as soon as possible, and to conduct the consultation as early as possible in September.

Devolution and Local Government Reform in Worcestershire

The board received an update on devolution and local government reform (LGR) in Worcestershire from officers and representatives from Pricewaterhouse Coopers (PwC). Worcestershire County Council is under pressure to reorganise local government due to the English Devolution White Paper, which requires areas with two-tier local government to submit plans to create a single tier. The government wants to move more resources and decision-making to combined authorities¹. The government has given Worcestershire Council until 28 November 2025 to submit its final proposal to the Ministry of Housing, Communities and Local Government (MHCLG).

The presentation for members on 15 July 2025 outlined the work done so far, including an options appraisal. The initial options appraisal considered two options:

• a single unitary council for the whole area
• two unitary councils based on a north/south divide

The appraisal found that a single unitary authority was more sustainable, effective and efficient than creating two new councils. The financial model indicated that disaggregating county services into two authorities would incur considerable one-off implementation costs, ongoing costs and reduced ongoing benefits, with a considerably longer period required to recoup the costs of transition.

The board heard that the council is developing a strategic business case for a single Worcestershire unitary authority, detailing the practical and financial benefits. The presentation noted that while there are similarities across Worcestershire, there are marked differences between the proposed North and South areas, which would introduce unintentional disadvantage.

The presentation stated that the financial landscape for newly formed unitary councils will be daunting, with significant inherited debt levels and the imminent integration of Dedicated Schools Grant (DSG) deficits into balance sheets in April 2028², coupled with high operating expenditures per capita. The board discussed the following issues:

• Survey Methodology: The board discussed the methodology used for the district council's consultation process. Some members felt that the survey was confusing and did not provide enough information on the potential options or the impact on services or finances.
• Democratic Deficit: Some members raised concerns about the lack of democratic accountability in the decision-making process, with one councillor stating that the decision to respond to the letter to say that we'll go to one Worcestershire was made on the eve of a full council meeting, instead of coming to full council to have a decision.
• Council Tax Harmonisation: The board discussed the potential for council tax increases, particularly in the south of Worcestershire, as a result of local government reorganisation.
• Economic Geography: The board discussed whether the PwC report had done enough to identify a sense of economic base in the north and a sensible economic area.
• Staff Morale: The board discussed the impact of local government reorganisation on staff morale, with some members expressing concern that the uncertainty surrounding the process could lead to staff leaving the council.
• Consultation: The board discussed the need for meaningful consultation with residents and stakeholders, with some members expressing concern that the consultation process was not neutral.
• Timeline: The board discussed the timeline for local government reorganisation, with some members expressing concern that the timescale was too tight to allow for meaningful consultation and decision-making.
• Decision Making: The board discussed the decision-making process for local government reorganisation, with some members expressing concern that the decision was being driven by central government rather than local needs.
• Financial Aspects: The board discussed the financial aspects of local government reorganisation, with some members expressing concern about the potential for increased costs and reduced services.
• Indices of Deprivation: The board discussed the indices of deprivation in Worcestershire, with some members expressing concern that the indices were more prevalent in the north than in the south.
• Economic Area: The board discussed whether the PwC report had done enough to identify a sense of economic base in the north and a sensible economic area.
• New School Build: The board discussed the potential for a new school build in Worcestershire, with some members expressing concern about the unintended consequences of not building the school.

The board agreed to write to the Leader of the Council and the Chief Executive to:

• ask that the administration set out their position as soon as is possible
• urge that the consultation is done quickly and as early as possible in September, not October
• explore all practical ways of ensuring all members receive a copy of that consultation proposal before it goes out, and if it's so timed that the board can discuss it at the next meeting, they will
• highlight that it's a government decision and not one that the council is pushing

Child and Adolescent Mental Health Services (CAMHS)

The board received an update on the progress being made on the recommendations agreed by Cabinet in March 2023 in respect of the Child and Adolescent Mental Health Services (CAMHS) Scrutiny Report.

The board heard that a roadmap of services has been developed with a focus on creating an interactive directory of mental health and wellbeing services. A new search tool has been procured for integration into the Herefordshire and Worcestershire Health and Care NHS Trust website, and information collated for population of the new roadmap. The planned go-live date for the search function on the Trust website is 18 August 2025.

The board also heard that the Integrated Care Board (ICB) has commissioned a new service, named 'Melo', which went live on 1 April 2025. The vision for the new Melo service is to offer an innovative, flexible, timely and integrated outcome-focused service that is available to all children and young people aged 0-25 years and their families, to support early mental health issues, promote well-being and build emotional resilience. The new service includes additional funding of £836,000 per annum across Herefordshire and Worcestershire, taking the total annual contract value to £1,425,520 per annum.

The board heard that CAMHS referral criteria has been reviewed alongside clinical case reviews, and processes are now in place between the CAMHS service and children's social care services to review, escalate and resolve any concerns in relation to the care or care plans for individual children in care if they arise.

The board also heard that data collection and reporting of performance has been reviewed by the Herefordshire and Worcestershire Health and Care NHS Trust and following a procurement process, a new electronic patient record system is now in use. This system will provide enhanced functionality and deliver improvements in data reporting going forward.

The board discussed the following issues:

• Disaggregation of Data: The board discussed the possibility of disaggregating the data for Herefordshire and Worcestershire to see how the two counties compare.
• Increased Diagnosis: The board discussed whether the improvements in waiting times were due to a decrease in referrals or an increase in capacity.
• Peaks and Troughs: The board discussed the reasons for the peaks and troughs in referrals throughout the year.
• Waiting Times: The board discussed the waiting times for CAMHS assessments and treatment.
• Vacancies: The board discussed the high vacancy rates in CAMHS and the steps being taken to mitigate this.
• SEND School Transport Budget: The board discussed whether there was a correlation between the increasing SEND school transport budget and quicker diagnoses.

Overview and Scrutiny Role and Remits, Scrutiny Chairs (and Lead Member) Update, Work Programme and Cabinet Forward Plan

The board considered the aims of overview and scrutiny and noted its remits. The board also considered and commented on the Scrutiny Chairmen (and Lead Member) updates and the OSPB Work Programme. Finally, the board considered the Cabinet's latest Forward Plan to identify any items it would wish to consider further at a future meeting, and any items it would wish to refer to the relevant Overview and Scrutiny Panel for further consideration.

The board heard updates from the chairs of the following scrutiny panels:

• Environment Overview and Scrutiny Panel
• Children and Families Overview and Scrutiny Panel
• Corporate and Communities Overview and Scrutiny Panel
• Economy Overview and Scrutiny Panel
• Adult Care and Well-being Overview and Scrutiny Panel

The board discussed the need for more detail in the Cabinet Forward Plan, and agreed to write to the Leader of the Council to request this. The board also agreed to consider potential topics for a discrete piece of work for a task group in scrutiny at its next meeting.