The Health, Housing & Adults Scrutiny Committee was scheduled to convene to discuss performance data from the Bedfordshire, Luton and Milton Keynes Integrated Care Board (BLMK ICB), supported living services in Milton Keynes, and the committee's work programme for the coming year. The committee was also scheduled to receive updates on structural changes within the BLMK ICB.

BLMK ICB Performance and Structural Changes

The committee was scheduled to receive a report from the BLMK ICB detailing performance in Milton Keynes against key NHS metrics during 2024/25. The report also included an update on the work of the BLMK Integrated Care partners to improve health outcomes for residents.

The report was intended to address questions previously posed by the scrutiny committee, including requests for Milton Keynes specific performance data, details of money spent in Milton Keynes over the last year, and progress made on the ICB's key initiatives since its inception.

The report included performance data relating to:

• Planned care, including delivery of planned treatment within 18 weeks, and waiting times for patients waiting 52+ weeks
• Diagnostics, including waiting times and the implementation of community diagnostic centres (CDCs) across BLMK
• Cancer care, including the 28-Day Faster Diagnosis Standard (FDS), the 31-day decision to treat standard, and the 62-day referral to treatment standard
• Urgent and emergency care, including the A&E 4-hour target
• Primary care, including the implementation of modern general practice access and the delivery of same day appointments
• Mental health, learning disabilities and autism, including the percentage of people on severe mental illness (SMI) registers receiving a full annual physical health check
• Dementia diagnosis, including work programmes to improve the level of diagnosis for patients with dementia
• Talking therapies, including targets for reliable recovery and reliable improvement
• LD&A health checks, including training with primary care to support identification of patients who have missed checks
• Use of the NHS App, with Milton Keynes reported as the leading Place in BLMK for use of the app
• Dentistry in MK, including the delivery of NHS dental activity across the contracted practices
• Primary Care Estates in Milton Keynes, including the development of Elverby Health & Community Centre in the Eastern MK expansion area

The report also detailed Milton Keynes funding and expenditure, noting that NHS England does not publish funding allocations for Integrated Care Boards at the Place level, and that BLMK ICB does not report expenditure at Place level.

Progress made on key initiatives in Milton Keynes delivered through the MK Deal¹ was also scheduled to be discussed, including the establishment of an Integrated Discharge Hub at Milton Keynes Hospital, the launch of a new Care Academy, and efforts to tackle obesity.

The committee was also scheduled to receive an update on proposals for ICB clustering and to receive the BLMK Integrated Care Board Update. The BLMK ICB Update summarised key items of business from the Board of the BLMK ICB arising from recent meetings, including a question from the Leighton Linslade Health Matters Group.

The update also mentioned a visit from The Rt.Hon. Wes Streeting MP, Secretary of State for Health and Social Care to Leighton Buzzard to officially open new clinical rooms at Leighton Buzzard Health Centre, and that the second round of ICB organisational change to reduce running costs by 30% was nearing completion.

The Board had agreed to commission independent, external support to undertake a Hospital Opportunities Assessment, and approved the infrastructure strategy for BLMK. They also approved the Green Plan 2025 - 2032, and noted that the Delivering the Financial and Operational Plan 2025/26 met the national targets in relation to 18-week Referral to Treatment (RTT) performance target.

The Board had also reviewed the decision-making arrangements for the Bedfordshire Care Alliance (BCA) and Bedfordshire Places Review and agreed to dissolve the Bedfordshire Care Alliance Committee and support development of an interim plan to allow collaborative arrangements to proceed and for place-based priorities. The Board agreed that once greater clarity exists surrounding the form, structure and responsibilities of the new ICB (BLMK, Cambridgeshire & Peterborough and Hertfordshire & West Essex), the findings of the BCA report should be used to inform an agreed action plan for collaboration throughout BLMK. Members also approved the next level of the MK Deal to begin on 1 July 2025.

Supported Living in Milton Keynes

The committee was scheduled to consider a report on Supported Living services provided by the Council. The report provided an overview of supported living, how the council commissions support, and how much the council spends. It also examined issues including demand, performance, new commissioning arrangements and gaps in provision.

Supported living combines accommodation and care for people that need help with daily living, including personal care, preparing meals, managing finances, accessing employment and the wider community, and developing life skills.

Milton Keynes City Council commissions supported living for people with learning disabilities, those with mental health conditions, people with autism and other support needs that can include physical disabilities and acquired brain injuries.

The council commissions care and support services through a framework agreement with 78 different supported living providers, although the council is only actively working with 52. The care and support provider is responsible for providing the accommodation, normally through a landlord. People in supported living are responsible for paying rent directly to their landlord, which may be covered in part by Housing Benefit.

Adults receiving supported living services are subject to financial contributions for their care and support based on national legislation and local policy, as determined by a financial assessment. People receiving mental health aftercare under Section 117 of the Mental Health Act 1983 are exempt from charges for services provided as part of their aftercare plan.

In 2025/26, the total anticipated spend in terms of supported living is £31.3m, compared to an actual spend of £27.8m in 2024/25.

The report noted an increase in demand for supported living services, with the number of people receiving supported living services expected to more than double from 2021/22 through to 2029/30.

Key outcomes for people who use supported living are measured by the council, and the council is ranked in terms of the Adult Social Care Outcomes Framework (ASCOF). The council's Quality and Compliance Team (QCT) are responsible for ensuring that supported living providers comply with their contract and that care is of sufficient quality, utilising a digital tool called Provider Assessment and Market Management Solution (PAMMS).

The report identified gaps in provision, including a lack of accessible properties and a lack of specialist providers with the skills to be able to meet the needs of people with complex autism diagnoses.

The current framework agreement is coming to the end of the contractual period, and a new framework is in the process of being established. The new supported living framework, which is due to go live in December 2025, will consist of four individual lots based on the person's main support need:

• Lot 1 Learning Disability
• Lot 2 Mental Health
• Lot 3 Autism
• Lot 4 Other (to include Physical Disability and Acquired Brain Injury)

Each lot will be limited to 10 providers, resulting in a maximum of 40 providers on the framework.

Supported living is regulated by the Care Quality Commission (CQC), and the council only uses providers registered with CQC to deliver supported living services. The council requires that providers are rated as Good or higher.

National measures to improve the standard of supported housing were introduced in the Supported Housing (Regulatory Oversight) Act 2023².

2025/26 Work Programme

The committee's 2025/26 Work Programme was attached for information. The work programme remains flexible and may be subject to change at short notice depending on circumstances.