The Warwickshire Health and Wellbeing Board met to discuss Healthwatch Warwickshire's annual report, the Orchard Centre update, the Pharmaceutical Needs Assessment, and the Children and Young People Partnership. The board approved the publication of the Pharmaceutical Needs Assessment and the appointment of the Executive Director for Children and Young People as the Chair of the Children and Young People Partnership.

Here's a breakdown of the key discussion points:

• Healthwatch Warwickshire Annual Report 2024-25
  • Chris Bain presented the Healthwatch Warwickshire Annual Report 2024-25 on behalf of Liz Hancock, the chair of Healthwatch Warwickshire.
  • The report highlighted that Healthwatch Warwickshire had engaged with almost 53,000 people in the last year, and produced 13 reports, including one on veteran's health.
  • Bain drew attention to the pending closure of local Healthwatch bodies, and the importance of ensuring that patient voice and lived experience of patients continues to be heard in all decisions relating to the provision and commissioning of services.
  • Bain requested that the board consider establishing a working group to look at the causes and solutions around digital exclusion.
  • Councillor Jerry Roodhouse thanked Bain and the rest of the board and staff, noting that Veena, a member of staff, had been brilliant on the young people stuff.
  • Sue Noyes offered her commitment that as long as Healthwatch Warwickshire is operating, she would work closely with them.
  • Krishni Waring emphasised the importance of patient and public voice in developing services.
• Pharmaceutical Needs Assessment
  • Tim Sachs and Duncan Vernon presented the Coventry and Warwickshire Pharmaceutical Needs Assessment (PNA).
  • The PNA is a statutory duty of the Health and Wellbeing Board, and is required to be produced every three years.
  • The PNA assesses the needs and identifies gaps in the local pharmaceutical provision.
  • The PNA concluded that there is currently a sufficient provision of pharmacies across Coventry and Warwickshire.
  • The PNA makes 19 recommendations for partners based on the findings.
  • Sue Noyes raised concerns about the fragility in the community pharmacy market at the moment, recounting her experience of receiving notice by a major pharmacy supplier of six months, and then receiving no commercial entrants at all.
  • Eamonn Kelly praised the document, and raised the issue of workforce, asking what the workforce possibilities are in terms of being able to recruit more staff into pharmacy.
  • Councillor Jerry Roodhouse stated that the housing growth is going to add more pressure to the fragile market.
  • Councillor Jerry Roodhouse noted that the technology within the pharmacies is not responding back, and that it doesn't always tell people when their prescription's ready.
  • Nigel Minns asked about the 20 minute drive time, and whether that's a consistent thing across Pharmaceutical Needs Assessments.
  • Pete Sidgwick added to Nigel Minns' point, noting that 29% of disabled adults live in households without access to a car.
  • Councillor Jim Sinnott asked if the board looks at not prescribing, and diverting people into other directions.
  • The board approved the publication of the Pharmaceutical Needs Assessment.
• Children and Young People Partnership Update Report
  • Nigel Minns presented an update on behalf of the Children and Young People Partnership.
  • The work of the partnership is driven by subgroups, including the Early Years Integrated Delivery Plan, the Healthy Child Programme, Mental Health and Wellbeing, and the SEND and Inclusion Partnership.
  • Minns noted that he appeared to have stepped into the role of Chair on the basis that the partnership has continued.
  • The board approved the appointment of the Executive Director for Children and Young People as the Chair of the Children and Young People Partnership.
• Health on the High Street - Rugby UHCW
  • This item was postponed at the request of UHCW.
• Rugby - Orchard Centre Update
  • Sophie Gilkes provided an update on the plans for the Orchard Centre, the community hub for Rugby.
  • The trust secured £375,000 to redevelop the Orchard Centre.
  • The 0-5 contract has been awarded to a different provider who will no longer use the Orchard Centre as a delivery point, meaning that there is additional space.
  • The trust are working with UHCW to relocate their physio services across into the Orchard Centre.
  • Emma Daniell asked if the location of the Orchard Centre is going to be open to community providers.
  • Laura Nelson supported the plans and linked it into the neighbourhood health model.
• July HWBB Joint Development Session
  • The board received and considered a summary from the Joint Development Session held on 24 July 2025.
• Other Business
  • Sue Noyes stated that she would like to give a presentation at a future Health and Wellbeing Board to explain more detail of where the NHS League tables ratings have come from.
  • Eamonn Kelly made a similar offer.
  • Kelly mentioned that he would be going to the next iteration of a musical, which is being produced by the street triage team, called Will and All Warwick Street Triage the Musical.
  • Kelly stated that he would be at Coventry City Football Club with members of the Talking Therapies team and a campaign, a collaboration called It Takes Balls to Talk, talking about suicide prevention.

Healthwatch Warwickshire Annual Report 2024-25

Chris Bain presented the Healthwatch Warwickshire - Annual Report 2024-2025 on behalf of Liz Hancock, the chair of Healthwatch Warwickshire. The report included examples of how Healthwatch Warwickshire have made a difference to the community, and how their activities will benefit people living in Warwickshire.

The report highlighted that between 2024-25:

• Healthwatch Warwickshire have shared clear advice and information on topics such as mental health support and finding and NHS dentist, in total speaking to 49,370 people during the year.
• 3,567 people shared their experiences of health and social care services with Healthwatch Warwickshire, helping to raise awareness of issues, and improve care.
• Healthwatch Warwickshire have published 13 reports about the improvements people would like to see in areas likes veteran's health, pharmacy and dentistry. The most popular reports were on pharmacy across Warwickshire North, Rugby and South Warwickshire, highlighting people's concerns around accessing services where and when they are needed.

Bain drew attention to the latest developments that local Healthwatch are to be abolished, quoting the Secretary of State as saying,

the work of local Health Watch bodies relating to health care will be brought together with ICB and provider engagement functions. And the other part, the social care functions to be with local authorities from this point on.

Bain stated that Healthwatch had made the point that if you're having an integrated care system, separating the functions out in this way might not be the best way of generating that integration.

Bain stated that the staff have taken the pending closure of Healthwatch as a bit of a challenge, and they are working extremely hard. Bain stated that he did not sign a letter that went out from chief executives of local Healthwatch complaining about the closure of Healthwatch, because for him it missed the point.

The point is that there have to be concrete and clear mechanisms for patient voice and the lived experience of patients to be heard in all decisions relating to the provision and commissioning of services. I happen to believe in Warwickshire that the best way of doing that is through Healthwatch Warwickshire. I could not be clear that it was the same everywhere else. So for me it was not about Healthwatch. It was about patient voice and lived experience of patients.

Bain stated that Healthwatch will continue as they are now to ensure patient voice continues to be heard throughout this care system.

Bain stated that Healthwatch has a Young People's Project which is now about four months old, and that they have an interim report which is out. Bain stated that they have gathered young people's experiences of trying to access both primary and secondary care.

Bain stated that Healthwatch also has a significant piece of work on menopause and women's health, and that they are in the process of rolling out a pelvic health survey to see if they can reach an understanding about women's views on pelvic health and access to services for that.

Bain stated that their report on the boating community is out and on their website as is the one on the Gypsy Roma Traveller community, and the challenges that both of those communities have in accessing particularly care.

Bain stated that they are working closely with the county council on matters relating to the community integrator and the services that sit underneath it, including the community recovery service and discharge to assess.

Bain stated that digital exclusion is now appearing in almost every area of work, and requested that the board considers establishing a working group to look at the causes and solutions around digital exclusion.

Bain stated that they've sent around a briefing on prostate cancer and PSA testing to the Ovi and Scrutiny committee, and that they're now doing a joint project with Healthwatch in Worcestershire around prostate cancer and PSA testing to see whether there are experiences across both counties which are of relevance.

Bain stated that online triage is also interesting and relates to digital exclusion and it's about people's experiences with triage online.

Bain stated that feedback that they get most commonly is about hospitals and general practice, and that some of it is positive and some of it is negative.

Bain stated that the reports they've issued in the last quarter are:

• Young people's experiences of GP and mental health services
• Our annual report
• Ensuring healthcare access for canal boat residents
• GP online triage patient feedback
• Our enter-in-view report for the Castlebrook Care Centre

Bain highlighted some things that they have not yet identified as clear problems, but they are hearing noises across the system about them, including:

• The impacts of the local government review and NHS cuts will be on patient experience and outcomes
• The future for patient and public engagement when Healthwatch is no longer here
• The challenges for community pharmacy and BSL interpreters for people who are hearing impaired and attempting to access services
• Digital exclusion
• Pelvic health
• Access and delays

Bain stated that what they've been doing for the last 12 years, is collecting patient and public feedback about what would make things better, including:

• Assumptions and bias
• Communication
• The ability to create safe spaces for people
• Trusted relationships
• Simple acts of kindness

Councillor Jerry Roodhouse thanked Bain and the rest of the board and staff, noting that Veena, a member of staff, had been brilliant on the young people stuff.

Sue Noyes offered her commitment that as long as Healthwatch Warwickshire is operating, she would work closely with them.

Krishni Waring emphasised the importance of patient and public voice in developing services.

Pharmaceutical Needs Assessment

Tim Sachs and Duncan Vernon presented the Pharmaceutical Needs Assessment (PNA).

The PNA is a statutory duty of the Health and Wellbeing Board, and is required to be produced every three years to assess needs and identify gaps in the local pharmaceutical provision. It is a tool used to inform the current and future commissioning of services from pharmaceutical service providers.

The Warwickshire Health and Wellbeing Board and the Coventry Health and Wellbeing Board have approached the development of the 2025 PNA collaboratively, in line with the process followed in 2022. One report has been produced for both areas as agreed by the Health and Wellbeing Board on 11th September 2024, with this report replacing the 2022 PNA for both Coventry and Warwickshire. It is a requirement of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (the NHS 2013 regulations) that the report is published by 1st October 2025.

The development of the PNA has been overseen by the Coventry and Warwickshire Community Pharmacy Steering Group, a multi-disciplinary group that includes representation from Warwickshire County Council, Coventry City Council, Coventry and Warwickshire ICB, Local Pharmaceutical Committee and Healthwatch.

Two engagement activities have been undertaken to support the development of the PNA, a public survey which was live from December 2024 to February 2025 and received 1,622 responses, and a 60-day formal consultation as required by the NHS 2013 regulations and the PNA guidance, which was live.

The PNA makes the following statements as a minimum, as set out in schedule 1 of the NHS 2013 Regulations:

• Necessary Services - The PNA provides an understanding of essential services which are required to be provided by all pharmacies. Access to pharmacies is examined to help determine the current provision of necessary services.
• Relevant Services - The PNA includes a section on each relevant advanced service, including consideration into the distribution of providers and uptake of the service. Service recommendations have been made where appropriate.
• Other NHS Services - In addition to the section on advanced services, the PNA includes a section on each Enhanced and Locally Commissioned Service, including consideration into the distribution of providers and uptake of the service. Service recommendations have been made where appropriate.
• Map of pharmaceutical services - Maps have been provided for:
  • Pharmacies within the Health and Wellbeing Board area. These maps have been further broken down into the PNA defined localities.
  • Pharmacies against travel time. Maps for travel by car and public transport have been produced.
  • Pharmacies that are open outside of core opening hours (Monday – Friday 9pm – 5pm).
  • Maps for services where an understanding of location is necessary for the analysis.
• Explanation of assessment - The PNA contains an introduction chapter which explains the background and requirements, and a chapter on the approach to the PNA which goes through the production process.

The PNA has concluded that there is currently a sufficient provision of pharmacies across Coventry and Warwickshire. The Coventry and Warwickshire Community Pharmacy Steering Group will monitor any changes to pharmaceutical provision and will advise the Health and Wellbeing Board on the need for a supplementary statement or a new PNA. The PNA makes 19 recommendations on the current pharmaceutical service provision which can be seen on page 7 of Appendix 1 for Pharmaceutical Needs Assessment.

Sachs stated that they reviewed what the PNA guidance said, and what other local policy areas, sort of health and well-being boards were doing, in order to understand how people are developing a set of criteria by which they can judge pharmaceutical access against.

Sachs stated that they drew on best practice so that they were able to definitively say, we've set these criteria and we've assessed them against that, some standards there.

Sachs stated that the key areas that they looked into were:

• Most residents should be within a 20 minute drive of a pharmacy, that's open during, usually five hours on a week.
• Most residents in urban areas should be within a 20 minute walk distance of a pharmacy in urban areas.
• There should be pharmacies open out of hours, accessible to each of the urban areas in Coventry and Warwickshire.
• Most residents in rural areas should be within a 30 minute drive of a pharmacy that is open out of hours.
• Housing developments expected to be completed in the lifetime of the PNA should be reviewed against the above principles.

Sachs stated that in order to understand good quality access to pharmacies, they also said there should be reasonable access to some of the advanced and locally commissioned services.

Sachs stated that the conclusion was there is sufficient provision of the services, but caveated that it's not perfect.

Sachs stated that they recognise there have been some closures, and that the hours have changed, and that it is a very difficult time to be a pharmacist, and that the business model is only just breaking even.

Sachs stated that they are really hopeful that going forward with the development of the integrated medical teams, and also with our working with pharmacies within those, that actually we can improve the services from pharmacies, and again, supporting them with the income that comes with that.

Sachs stated that Pharmacy First has been significantly expanded, and that they're in the near future going to have a digital solution for that, whereby people can directly book rather than having to walk in or wait or hope that there will be appointments available, which he thinks will really, really help.

Vernon stated that the PNA makes 90 recommendations for partners based on their findings, and that some are broad and general for everyone to pick up and run with, and some are quite service specific.

Vernon stated that the PNA has highlighted some of the opportunities there to sort of further improve what residents of Warwickshire can get out of pharmacies, and in particular some of the helpful thinking around neighbourhood teams there.

Vernon stated that significant new housing developments should be monitored, and that if there are significant changes, then that would prompt any supplementary statements or further analyses to understand what the impact of that would be.

Vernon stated that there should be clear information on opening time services that offered, alternative provision, and opportunities to promote those group meetings as well.

Vernon stated that the Warrich Community Policy Serial Group can oversee progress and recommendations on the PNA and integrate it with other activities and conversations around community pharmacy.

Sue Noyes raised concerns about the fragility in the community pharmacy market at the moment, recounting her experience of receiving notice by a major pharmacy supplier of six months, and then receiving no commercial entrants at all.

Sachs responded that it is precarious, and that if it wasn't the pharmacy first and the money that comes with that, he thinks we might be losing some pharmacies.

Eamonn Kelly praised the document, and raised the issue of workforce, asking what the workforce possibilities are in terms of being able to recruit more staff into pharmacy.

Councillor Jerry Roodhouse stated that the housing growth is going to add more pressure to the fragile market.

Councillor Jerry Roodhouse noted that the technology within the pharmacies is not responding back, and that it doesn't always tell people when their prescription's ready.

Nigel Minns asked about the 20 minute drive time, and whether that's a consistent thing across Pharmaceutical Needs Assessments.

Pete Sidgwick added to Nigel Minns' point, noting that 29% of disabled adults live in households without access to a car.

Councillor Jim Sinnott asked if the board looks at not prescribing, and diverting people into other directions.

The board approved the publication of the Pharmaceutical Needs Assessment.

Children and Young People Partnership Update Report

Nigel Minns presented an update on behalf of the Children and Young People Partnership.

Minns stated that the Children and Young People Partnership (CYPP) was established in October 2022 as a subgroup of the Health and Wellbeing Board to give space for focus work around children and young people.

Minns stated that over the last year, it has really strengthened its role in coordinating and driving forward those key priorities for children and young people across Warwickshire.

Minns stated that the work of the partnership is driven by subgroups, and so the focus is focused on those groups, and they are very strongly linked to some of the work around the GSMA that's been produced, including:

• Early Years Integrated Delivery Plan
• Healthy Child Programme
• Mental Health and Wellbeing
• Special Educational Needs and Disabilities (SEND) & Inclusion Partnership

Minns stated that in addition to these, the CYPP has also fed into discussions on the Families First pathfinder programme; around Reforms for Children's Social Care, and some work about the School Attendance Charter.

Minns flagged up a few highlights, including:

• Improved maternity access for Black and minority ethnic women by Maternal Circles Pilot
• Enhanced early years foundation support, workforce training for over 600 practitioners, a deep dive into self-pointing data, which led to a targeted communication campaign
• Continuation of strategic work on the impact of education and healthcare plans, particularly related to speech and language therapy
• Work building on the Empowering Futures GSMA dashboard, which can be used to identify particular children who can SEND impact on them

Minns stated that in addition to the subgroups, there have been two Health and Wellbeing Board Development Days in the last year, which have been led by Journal and Young People's Partnership, including one on Child Healthy Weight and Alcohol Harm, and another on CAMS redesign.

Minns stated that the Family Wraparound Service Pilot is underway, and that they are in the process of redesigning children and family centres.

Minns stated that the school attendance work is really interesting, with children and young people and partnership members looking at the impact of waiting lists for mental health services on emotionally-based school avoidance, and the impact of emotionally-based school avoidance on the waiting lists for mental health services.

Minns stated that he appeared to have stepped into the role of Chair on the basis that the partnership has continued, and that as the terms of reference required the Chair to be a member of the Health and Wellbeing War, and he was the only member of the Health and Wellbeing War who was a regular attendee, there weren't many other options.

The board approved the appointment of the Executive Director for Children and Young People as the Chair of the Children and Young People Partnership.

Health on the High Street - Rugby UHCW

This item was postponed at the request of UHCW.

Rugby - Orchard Centre Update

Sophie Gilkes provided an update on the plans for the Orchard Centre, the community hub for Rugby.

Gilkes stated that the Orchard Centre is actually the community hub for Rugby in terms of community services provision, and that it's a really important part of the health infrastructure.

Gilkes stated that the trust secured £375,000 to redevelop the Orchard Centre.

Gilkes stated that the 0-5 contract has been awarded to a different provider who will no longer use the Orchard Centre as a delivery point, meaning that there is additional space.

Gilkes stated that the trust are working with UHCW to relocate their physio services across into the Orchard Centre.

Gilkes stated that they will also be realigning the facilities, and providing some generic clinical space there.

Gilkes stated that there is a sustainability element on this as well, and that they will be installing electric chargers there.

Emma Daniell asked if the location of the Orchard Centre is going to be open to community providers.

Laura Nelson supported the plans and linked it into the neighbourhood health model.

July HWBB Joint Development Session

The board received and considered a summary from the July HWBB Joint Development Session held on 24 July 2025.

Other Business

Sue Noyes stated that she would like to give a presentation at a future Health and Wellbeing Board to explain more detail of where the NHS League tables ratings have come from.

Eamonn Kelly made a similar offer.

Kelly mentioned that he would be going to the next iteration of a musical, which is being produced by the street triage team, called Will and All Warwick Street Triage the Musical, which tells the story with people with lived experience.

Kelly stated that he would be at Coventry City Football Club with members of the Talking Therapies team and a campaign, a collaboration called It Takes Balls to Talk, talking about suicide prevention.