The Herefordshire Health and Wellbeing Board met on 15 September 2025, to discuss a range of issues including the government's new 10-year health plan, progress on neighbourhood health, the relationship between work and health, and the county's pharmaceutical needs. The board approved the publication of the 2025 Herefordshire Pharmaceutical Needs Assessment, delegating final approval to the PNA working group, and also approved the Better Care Fund quarter 1 report 2025-2026. The board also agreed to recommend changes to Herefordshire Council's constitution regarding board membership and the appointment of the vice-chairperson.

Board Membership and Vice-Chair Appointment

The board agreed to recommend changes to Herefordshire Council's constitution regarding the number of seats allocated to the NHS Herefordshire and Worcestershire Integrated Care Board (ICB) and the arrangements for appointing the vice-chairperson.

The recommendations to full council are:

• Amend paragraph 2.8.9, bullet point 8 to read 'Two nominated representatives from the Integrated Care Board'.
• Amend paragraph 2.8.10 to read 'The vice-chairperson of the board shall be the chairperson of the One Herefordshire Partnership¹. Should this person be from an organisation that has the right to nominate to the Board, then that person shall also represent their respective organisation.'

The report noted that the current constitution identified 'A nominated representatives from the Integrated Care Board' but that it was uncertain whether the board intended this to read 'Two nominated representatives' or 'A nominated representative'. It was also noted that paragraph 2.8.10 stated that a vice chairperson was to be appointed from '…one of the board members representing NHS Herefordshire and Worcestershire Integrated Care Board…'.

The report clarified that the intention was to ensure that the chair of the One Herefordshire Partnership was appointed as the representative of the relevant nominating organisation, avoiding any additional appointees.

Fit For The Future: 10 Year Health Plan

The board received a briefing on the key features of the government's new 10 Year Plan for Health, which sets out ambitions to transform healthcare services by 2035. The plan addresses challenges such as long waiting lists, workforce pressures, and variable outcomes, and proposes radical shifts in how services are organised and accessed.

Key ambitions outlined in the plan include:

• Ending the 8am scramble for GP appointments
• Restoring the NHS constitutional standard of people beginning elective treatment within 18 weeks of referral
• Making personal health budgets a universal offer
• Putting a neighbourhood health centre in every community
• Raising the healthiest generation of children ever
• Ending the obesity epidemic
• Creating a smoke-free future
• Creating a new genomics population health service
• Putting the power back in the hands of the people and professionals
• Creating the most digitally-enabled health service in the world
• Giving patients real control over a single secure and authoritative account of their own health record
• Making the NHS App a world leading tool for patient access.

The plan focuses on three radical shifts: from hospital to community, from analogue to digital, and from sickness to prevention. It also outlines a new operating model for the NHS, workforce reforms, and plans for funding and finance.

The board was asked to note the contents of the report and the requirements to review and approve the development of Neighbourhood Health Plans later in the year.

Neighbourhood Health Programme 2025/26

The board received an update on the Neighbourhood Health Programme, which is fundamental to delivering the 10 Year Health Plan. The programme aims to deliver multi-organisational care closer to home for targeted cohorts, providing proactive, planned, and responsive care based on population needs.

The national plan allows for tailoring the approach to local needs while being clear about expected outcomes. Herefordshire is in a strong position to implement the plan, building on existing work around Integrated Neighbourhood Teams. The local programme aims to establish a new model of care closer to home for targeted cohorts before winter 2025.

Progress to date includes learning from other areas, focusing on six core components (Population Health Management, Modern General Practice, Standardising Community Health Services, Multidisciplinary Neighbourhood Teams, Integrated Intermediate Care, and Urgent Neighbourhood Services), and identifying initial cohorts.

Herefordshire has submitted an Expression of Interest to join the National Neighbourhood Health Implementation Programme.

The board was asked to note the contents of the report for assurance.

Good Work For Everyone: The Relationship Between Work and Health

The board received an update on the supporting priority of 'Good work for everyone' within the Herefordshire Health and Wellbeing Strategy. The report highlighted the bi-directional relationship between work and health, with good health enabling work and good work contributing to good health.

The report noted that Herefordshire has a higher dependency ratio between working and non-working age residents compared to the national average. While the county's employment rate exceeds 80%, there is a relatively high level of long-term sickness-related economic inactivity.

The board was informed of the national policy context, including the 'Get Britain Working' White Paper, and the sub-regional strategic context, the 'Get Marches Working Plan'. The Herefordshire and Worcestershire ICS Health and Work Strategy 2025-2030, built around four key strategic ambitions: fostering inclusive workplaces, creating supportive pathways into employment, providing early support for those in work, and enhancing collaboration across the system.

Examples of local programmes include WorkWell, a Department for Work and Pensions (DWP) pilot to support people struggling to enter or stay in employment due to health conditions, and Workplace Health Checks, providing free cardiovascular health checks directly to workplaces.

The board was asked to note the progress towards achieving good work for everyone, support the Herefordshire & Worcestershire ICS Health and Work Strategy, and consider how all members can contribute further to this priority.

Herefordshire Pharmaceutical Needs Assessment 2025

The board considered the Herefordshire Pharmaceutical Needs Assessment (PNA) 2025, which assesses the provision of pharmaceutical services and identifies any gaps in service delivery. The PNA is a statutory requirement for Health and Wellbeing Boards, with the last assessment published in October 2022.

The 2025 PNA found that there is sufficient provision of pharmacies and dispensing GP practices in Herefordshire, with good access to services by car. However, weekday evening provision after 1900hrs is reliant on a single pharmacy in Hereford. The PNA also identified variations in the provision of advanced services, such as smoking cessation, across different areas.

The PNA made several recommendations, including:

• Increasing public awareness and uptake of pharmacy services
• Increasing strategic oversight and alignment of services with health priority areas
• Ensuring sustainability of current services and staff morale
• Improving joint working between the local authority, NHS, and primary care networks
• Considering commissioning a rota to increase out-of-hours provision
• Ensuring hypertension case finding and smoking cessation services are provided in areas of greatest need
• Considering commissioning a new sharps disposal service

The board approved the PNA for publication on 1 October 2025, delegating final approval to the PNA working group.

Better Care Fund (BCF) Quarter 1 Report 2025-2026

The board received an update on Herefordshire's Better Care Fund (BCF) quarter 1 performance template 2025-26. The BCF provides a mechanism for joint health and social care planning and commissioning, bringing together budgets from the ICB and local government.

The report highlighted that Herefordshire's BCF Plan 2025/26 was classified as 'approved with local conditions' in June 2025, requiring a delivery plan on achieving metric goals to be shared with the West Midlands Better Care Manager. A delivery plan has been drafted and submitted.

Key performance data from the report included:

• Emergency admissions to hospital for people aged over 65 were not on track to meet the goal.
• National data was not available at the time of submission to provide up to date information in the template regarding average length of discharge delay for all acute adult patients.
• Long-term admissions to residential care homes and nursing homes for people aged 65 and over continued to reduce.

The BCF is currently underspent, mainly due to underspending on the Disabled Facilities Grant². High levels of demand in other funding streams, particularly in hospital discharge services, represent a significant risk to maintaining financial balance.

The board approved the BCF quarter 1 report and noted the ongoing work to support integrated health and care provision funded via the BCF.