The Oxfordshire Health & Wellbeing Board met to discuss a range of issues including the Oxfordshire Winter Plan, the Joint Strategic Needs Assessment, and the Pharmaceutical Needs Assessment. The board was also scheduled to receive updates on the Marmot Place programme, the Health & Wellbeing Strategy, and reports from Healthwatch Oxfordshire and various partnership boards. In addition, the meeting included discussion of plans for an upcoming Health and Wellbeing Board workshop.

Joint Strategic Needs Assessment 2025

The board was scheduled to consider the Joint Strategic Needs Assessment (JSNA) for 2025. The JSNA is described as a statutory annual report that provides an evidence base for the Health and Wellbeing Strategy. It is published in full on the Oxfordshire Data Hub.

The report was produced with contributions from analysts and sector specialists from Oxfordshire's local authorities, the NHS, Thames Valley Police, Healthwatch Oxfordshire and voluntary sector organisations.

The report uses data from NHS Digital, the Office for National Statistics, the Office for Health Improvement & Disparities, and the Department for Education, as well as local data. The 2025 update includes information from the 2021 census, as well as more recent data from 2023 and 2024.

The report pack included a recommendation for the board to: Approve the content of the Joint Strategic Needs Assessment (JSNA) for 2025; encourage widespread use of the JSNA in planning, developing and evaluating services across the county; and contribute information and intelligence to the JSNA Steering Group to further the development of the JSNA in future years.

Pharmaceutical Needs Assessment 2025

The agenda included an item to consider the Pharmaceutical Needs Assessment (PNA) 2025. Every Health and Wellbeing Board has a statutory duty to carry out a PNA every three years, with the last one for Oxfordshire having been published in 2022. The 2025 PNA was due for publication in October 2025.

The report pack included a recommendation for the board to: Receive an update on the production of the 2025 Oxfordshire Pharmaceutical Needs Assessment (PNA); note that the 2025 Oxfordshire PNA has been out to formal 60-day consultation and is ready for publication; and approve the publication of the completed 2025 Oxfordshire PNA.

The 222-page annex to the Pharmaceutical Needs Assessment 2025 report contained a draft of the PNA, which stated that there were 124 pharmacy contractors in Oxfordshire, operating from 129 sites. It said that the ICB is responsible for administering opening hours for pharmacies, which is handled locally by ICBs through delegated responsibility.

The draft PNA stated that a pharmacy normally has 40 core contractual hours, or 72+ for those that opened under the former exemption from the control of entry test. These hours cannot be amended without the consent of the ICB.

The draft PNA stated that a Distance Selling Pharmacy (DSP) is a pharmacy contractor that works exclusively at a distance from patients, and that as part of the terms of service for DSPs, provision of all services offered must be offered throughout England.

The draft PNA stated that the Pharmacy Access Scheme (PhAS) has been designed to capture the pharmacies that are most important for patient access, specifically those pharmacies where patient and public access would be materially affected should they close.

The draft PNA stated that the Community Pharmacy Contractual Framework (CPCF) is made up of three types of services: Essential Services, Advanced Services, and Enhanced Services.

The draft PNA stated that the Essential Services of the community pharmacy contract must be provided by all contractors, and listed them as:

• Dispensing medicines
• Repeat dispensing/electronic repeat dispensing (eRD)
• Disposal of unwanted medicines
• Public health (promotion of healthy lifestyles)
• Signposting
• Support for self-care
• Discharge Medicines Service (DMS)
• Healthy Living Pharmacy (HLP)
• Dispensing appliances

The draft PNA stated that there are nine Advanced Services within the CPCF, and that Advanced Services are not mandatory for providers to provide.

The draft PNA stated that Enhanced Services are those directly commissioned by NHS England as part of a nationally coordinated programme, and that Local Enhanced Services (LES) are developed and designed locally by NHS England, in consultation with Local Pharmaceutical Committees (LPCs), to meet local health needs.

The draft PNA stated that for the purpose of the PNA, 'pharmaceutical services' have been defined as those which are or may be commissioned under the provider's contract with NHSE.

The draft PNA stated that the council Public Health team has a duty to complete this document on behalf of the Oxfordshire HWB, and that a BOB-wide steering group was established to oversee the process and progress of the five PNAs in the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System footprint which includes Oxfordshire.

The draft PNA stated that the PNA local subgroup considered how the localities within the Oxfordshire geography should be defined for the purpose of the PNA, and agreed that the same locality boundaries used in the previous PNA (published in 2022) would be retained for the 2025 PNA. The localities used for the PNA for Oxfordshire are:

• Cherwell
• Oxford City
• South Oxfordshire
• Vale of White Horse
• West Oxfordshire

The draft PNA stated that the PNA is undertaken in the context of the health, care and wellbeing needs of the local population, and that the strategies for meeting the needs identified in JSNAs are contained in the Joint Health and Wellbeing Strategy.

The draft PNA stated that the NHS Long Term Plan identifies that community pharmacists have a role to play in the provision of opportunities for the public to check on their health, and that they will be supported to identify and treat those with high risk conditions, to offer preventative care in a timely manner.

The draft PNA stated that the Integrated Care Strategy set out by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Partnership has the following five priority areas:

• Start well helping all children and young people achieve the best start in life.
• Live well supporting people and communities to live healthily and happier lives.
• Age well staying healthy and independent for longer.
• Improving quality and access Accessing the right care in the best place.
• Promoting and protecting health keeping people healthy and well.

The draft PNA stated that Oxfordshire, as a whole, is a mix of rural and urban areas, however the individual districts vary widely: Oxford is classified as urban, Cherwell is classed as urban (although has significant rural areas), Vale of White Horse is classified as rural and both South and West Oxfordshire are classified as rural as well.

The draft PNA stated that the ONS estimates the current Oxfordshire population to be 750,200.

The draft PNA stated that the projections for the 2025 age structure of Oxfordshire are shown to generally be slightly lower than that of England in 2023. An expected but notable difference is the higher proportion of persons in the 18-24 age group (0.9% higher than England). This is expected because of the larger student population in Oxford City.

The draft PNA stated that in 2043, the projected number of households in Oxfordshire is expected to be 315,751, a 12.7% increase from April 2022. One person households will account for 27.4% and households with dependent children will account for 24.6%.

The draft PNA stated that planned housing developments across Oxfordshire from 2025 to 2030 indicate growth, with nearly 27,000 new homes expected countywide. The highest volumes are in Cherwell and Vale of White Horse, which also show the greatest predicted population increases over the same period.

The draft PNA stated that using the March 2021 Census data, 86.9% of usual residents in Oxfordshire identified as White and 12.0% identified as being from an ethnic minority group. In Oxfordshire, excluding those who identify as White, the most common ethnic groups were Asian (6.4%) or mixed/multiple ethnic groups (3.1%).

The draft PNA stated that the largest religious group in Oxfordshire is Christianity (47.3%), with 40.0% marking no religion.

The draft PNA stated that the overall percentage of households who have access to at least one car or van is 83.8% in Oxfordshire, compared to 83.1% in South East of England and 76.5% in England.

The draft PNA stated that healthy life expectancy at birth for Oxfordshire residents was higher for females (68.3 years) than males (67.1 years). The Oxfordshire averages are higher than both the England, 61.9 years for females and 61.5 for males, and regional of 64.4 years for females and 63.5 for males.

The draft PNA stated that Oxfordshire shows varying smoking rates, from 9.5% in Vale of White Horse to 16.4% in Oxford City. The average rate is in line with the regional figure, and all districts apart from Oxford City have smoking rates below the England average (13.6%).

The draft PNA stated that the Obesity prevalence within Oxfordshire range widely, however none surpass the England value (26.5%). The district with the highest prevalence was Cherwell (26.4%), followed by Vale of White Horse (22.0%) and West Oxfordshire (21.2%). South Oxfordshire (17.3%) and Oxford City (16.2%) report the lowest obesity prevalence and are significantly lower than the England average.

The draft PNA stated that hospital admission rates for alcohol-attributable conditions range from the highest in Oxford City (524 per 100,000) to the lowest in South Oxfordshire (382 per 100,000). All districts are lower than the England average (612 per 100,000) and nearly all are lower than the South East average (521 per 100,000). Only Oxford City is higher than the regional value.

The draft PNA stated that in Oxfordshire, between 2021-2023, the number of deaths from drug use per 100,000 was 2.5. This is lower than both the regional value (4.3) and the national value (5.5).

The draft PNA stated that Oxfordshire as a whole had lower chlamydia detection rates (1,271 per 100,000) compared to England (1,546 per 100,000). Only one district, Oxford City, had detection rates above 1,000.

The draft PNA stated that Oxfordshire Human Immunodeficiency Virus (HIV) diagnosed prevalence rate (0.93 per 1,000) is lower than the England's average (2.33 per 1,000). Only Oxford City and Cherwell had rates above 1.0 per 1,000.

The draft PNA stated that Sexually transmitted infection (STIs) diagnosis in Oxfordshire (327 per 100,000) were also below the England level (520 per 100,000). Oxford City (594 per 100,000) is the only district with a rate above the England average.

The draft PNA stated that the rate of Long-Acting Reversible Contraception (LARC) prescribing in Oxfordshire (60 per 1,000) per 1,000 was higher than the England value (44 per 1,000) in all districts, especially in West Oxfordshire (66 per 1,000) and Cherwell (65). Oxford City had the lowest rate at 49 per 1,000.

The draft PNA stated that Under-18 conception rate per 100,000 was 8.9, lower than the national (13.1) and regional (10.7) rates. West Oxfordshire and Oxford City are the only two districts above the county average, with 9.4 and 9.1 respectively.

The draft PNA stated that in general, long-term conditions are more prevalent in people over the age of 60 (58%) compared with people under the age of 40 (14%), and in people in more deprived groups, with those in the poorest social class having a 60% higher prevalence and 30% more severity of disease than those in the richest social class.

The draft PNA stated that overall Oxfordshire is a relatively healthy place to live however the experience is unequal.

The draft PNA stated that the prevalence of long-term health conditions across Oxfordshire's districts generally aligns with or falls below national averages, and that Oxford City consistently reports the lowest prevalence across multiple conditions, including heart failure (0.6%), atrial fibrillation (1.3%), diabetes (4.3%), Chronic Obstructive Pulmonary Disease (COPD) (1.0%), and rheumatoid arthritis (0.4%), often well below the England average.

The draft PNA stated that West Oxfordshire tends to report the highest prevalence for several conditions, including heart failure (1.3%), atrial fibrillation (3.0%), cancer (5.3%), stroke (2.1%), hypertension (17.2%), and asthma (7.1%), all exceeding national averages.

Oxfordshire Winter Plan

The board was scheduled to receive an update on and note the Oxfordshire Winter Plan. The plan outlines the programme of work in Oxfordshire to achieve improvements that will have the biggest impact on urgent and emergency care services.

The plan focuses on assessing and treating people in their own home, minimising emergency admissions where possible, and supporting people to return home from bed-based care.

The plan includes the following NHS high priority areas:

• Develop neighbourhood model of care
• Improve flow through mental health crisis and acute pathways and access to children and young people's services
• Improve and standardise care for those who require it on the same day
• Improve ambulance response times
• Improve waiting time in the Emergency Departments (EDs)
• Reduce length of stay in hospital and ensure that people are cared for in the most appropriate setting

The plan notes lessons learned from the previous winter, including:

• Build workforce capability & confidence in delivering community-based care
• Consolidate and coordinate resources, focusing on visiting and urgent services
• Interventions to build capacity elsewhere in system
• Build care home resilience to increase staff confidence & reduce conveyances, falls & safeguarding referrals
• Supporting people to navigate the urgent care system

The plan refers to national guidance including the NHS England guidance on the development of neighbourhoods, the government's Urgent and Emergency Care Plan 2025/26, and the 10-year health plan.

The Oxfordshire plan is based on all publications, with the focus on those who can be assessed and treated in their own home.

The plan includes the following key components:

• Shift from Hospital to Community
• Development of a neighbourhood model of care
• Vaccination programme
• Falls prevention and management
• Single Point of Access
• Improve and standardise care for those who require it on the same day
• Development of Urgent Treatment Centres
• Improve ambulance response times
• Improve waiting time in the Emergency Departments
• Improve flow through mental health crisis and acute pathways and access to children and young people's services
• Reducing length of stay in inpatient mental health beds and reduction of Out of Area Placements
• Reduce length of stay in hospital and ensure that people are cared for in the most appropriate setting

The report pack included a recommendation that the winter plan be approved.

Health & Wellbeing Strategy Update - Building Blocks of Health

The board was scheduled to note the Health & Wellbeing Strategy - Building Blocks of Health update. The Health & Wellbeing Strategy - Building Blocks of Health Update refers to the Oxfordshire Health and Wellbeing Strategy 2024-2030, which sets out a collaborative, system-wide approach to improving health outcomes and reducing inequalities across the county. The strategy is built around a life course approach of Start Well, Live Well, and Age Well, and addresses the broad social, economic, and environmental determinants of health, extending beyond healthcare provision.

The strategy identifies key building blocks of health , including quality housing, stable employment, strong communities, access to green space, and support for mental wellbeing. A clear focus is placed on reducing the life expectancy gap, addressing rural health access, and promoting inclusive and equitable economic development.

Get Oxfordshire Working Plan

The board was scheduled to discuss the Get Oxfordshire Working Plan. The plan outlines the government's proposals to address economic inactivity and unemployment, and notes that every place in England will produce a Local Get Britain Working Plan, aimed at tackling economic inactivity and promoting in-work progression.

The plan notes that in Oxfordshire, this will be known as the Get Oxfordshire Working Plan (GOWP), and that local areas are expected to take a whole-system approach, engaging with partners across government, health, education, and employers.

The plan notes that the GOWP is an opportunity to bring together partners and key stakeholders to understand and tackle the root causes of economic inactivity across the county, and to take a uniquely Oxfordshire approach.

The plan identifies the following key issues:

• Too many people are excluded from the labour market
• Too many young people leave school without essential skills or access to further learning
• Too many people are stuck in insecure, poor quality and low-paying work
• Too many women who care for their families experience challenges staying in and progressing through work
• Too many employers cannot fill their vacancies due to labour and skills shortages
• There is too great a disparity in labour market outcomes between different places and for different groups of people

The plan identifies the following disparities:

• Banbury: relatively high chronic illness and low life expectancy
• Oxford: deprived wards face unemployment, poor housing, mental health issues
• Rural areas: lack of public transport and high cost of car ownership create social isolation and limit job access

The plan identifies the following cohorts:

• Young people: Poor transport and high cost of housing near to economic opportunity. Disparities in school readiness and educational attainment, compounded by limited vocational pathways
• Carers and disabled people: Health-related inactivity is compounded by the lack of support
• Homeless, care leavers and substance misuse: Overlapping barriers requiring integrated support across partners

The plan identifies the following drivers and causes:

• Recruitment & retention: Sector-specific shortages, skills mismatch and barriers, geographic and economic constraints, and workforce retention issues
• Education and work readiness: Educational disparities, vocational and technical gaps, structural barriers in rural areas, and lack of support for SEND youth
• Health: Health barriers to employment, mental health challenges, work and mental health cycle, and geographic health inequalities
• Demographics: Migrants and older worker challenges
• Structural barriers: Housing costs, transport limitations, caregiving responsibilities, and social and economic factors

The plan identifies the following levers and systems changes:

• Utilise joint commissioning potential
• Joining up with Connect to Work
• Public health funding for inclusion
• Extend place-based working
• Local Government Reorganisation and Devolution
• VCSE strength
• OxRail and East-West Rail
• Potential of Place of Sanctuary
• OIEP Oxford Growth Commission
• Marmot Place

The plan recommends the following systems changes:

• Encourage more engagement with local anchors to make the most of employment opportunities, social value and local spending power.
• Develop provision and additional pathways in a way which reduces disadvantage and barriers for local communities, e.g. expanding ESOL provision.
• Improve and better coordinate outreach across multi-agencies to target individual groups ie those with long-term health issues, neuro-diverse, refugees etc.
• Drive a whole system approach to reducing disadvantage and disparities in life outcomes such as housing, environment and transport access.
• Evaluate what data is available at a local level to ensure individual cohorts with particular challenges are supported into sustainable employment.
• Embrace changes in national and regional policy and delivery in a way which brings together support to drive devolution and better outcomes locally

Report from Healthwatch Oxfordshire

The board was scheduled to receive a report from Healthwatch Oxfordshire. The report included a showcase of Healthwatch Oxfordshire's work in 2024-25, and noted that a public open forum meeting with Healthwatch Oxfordshire Board and team was held for members of the public to attend in Bicester Garth Centre on 10 September, combined with the team being 'out and about' during the day to speak to residents on the street in Bicester about their experiences of health and social care.

The report noted that since the last Health and Wellbeing Board meeting in June, Healthwatch Oxfordshire attended:

• Health Improvement Board (lay ambassador)
• HWBB extraordinary meeting on the Ten Year Health Plan for England
• Oxfordshire Joint Health Overview and Scrutiny Committee (Sept 2025)
• Full Council meeting on 9th September, where Chair Barbara Shaw spoke on implications of Dash Review.
• Oxfordshire Safeguarding Adults Board and Oxfordshire Children's Trust Board.
• Oxfordshire Place Based Partnership monthly (Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board - BOB ICB) among additional BOB ICB committees, including the Quality Committee.

The report noted that Healthwatch Oxfordshire has been actively involved in workshops by health and care system to scope and develop towards Neighbourhood Health, including at BOB ICB level, and Oxfordshire, and voicing need for pathways to engagement and shaping with local communities as this moves forward.

The report noted that since the last meeting in June, Healthwatch Oxfordshire published the following reports: Using Women's Health services in Oxfordshire – July 2025, based on what we heard from 684 women and people who use women's health services.

The report noted that Healthwatch Oxfordshire is leading an additional funded piece of work (funded by and in support of next steps in Oxfordshire Community Research Network) to develop a practical 'how to' resource for community members to take part in community research.

The report noted that Healthwatch Oxfordshire staff and lay volunteer representatives make Enter and View visits to healthcare settings to collect evidence of what works well and what could be improved to make people's experiences better, and that since the last meeting they have published Enter and View reports based on visits to Connect Health (now Cora Health) based on three visits to sites in Botley, Bicester and Henley.

The report noted that Healthwatch Oxfordshire closed a survey about using the NHS App (report in Oct) report due soon, on what we heard from over 800 people across the county, and that they have a current survey to hear about end of life care.

The report noted that Healthwatch Oxfordshire published formal responses to the Local Government reorganisation proposals, and to BOB ICB transformation plans, and fed in their evidence to BOB ICB Women's Health strategy, and the Government Men's Health strategy.

The report noted that Healthwatch Oxfordshire carry out active and ongoing outreach to community groups and other settings across the county, and gain insights into experiences and views on health and care along with via phone and their online feedback centre, and that they have a rolling programme of hospital visits to speak to the public.

The report noted that Healthwatch Oxfordshire have been actively working with Patient Participation Groups (PPGs) across the county, attending meetings to support them in their work, and to link them to information more widely.

The report included an appendix on the future of Healthwatch and independent scrutiny, and noted that the Dash Report on patient safety published for the government in July 2025 outlines the future landscape for patient safety including rationalising pathways for patient voice, action, accountability and response.

The report noted that the Dash Report includes proposed dissolution of Healthwatch England and all local Healthwatch, and that a Patient Experience Unit will be established in the Department of Health and Social Care into which Healthwatch England functions will be transferred.

The report noted that the Dash Report states that the statutory functions of Local Healthwatch relating to social care should be transferred to local authorities in order to improve the commissioning of social care, and that the work of Local Healthwatch, and the engagement functions of Integrated Care Boards (ICBs) and providers, should be brought together to ensure patient and wider community input into the planning and design of services.

The report noted that it is envisaged that changes proposed in the Dash Report will be implemented through new Health and Social Care Act legislation, with timelines uncertain, but potentially not until Autumn 2026 or beyond, and that until the legislations happens, Oxfordshire County Council remains responsible for ensuring the Healthwatch functions are carried out.

The report stated that Healthwatch Oxfordshire are committed to constructive engagement with health and care system partners both at place in Oxfordshire and more widely with the Integrated Care Board, and will actively work collaboratively to explore and contribute to the design of future approaches.

The report stated that it is important that key principles for independent voice are taken into account by the health and care system in planning this transition, and that any new model or approach must retain the following core characteristics if public voice is to remain credible and effective:

• Independence from service providers and commissioners building trust
• Built on local presence, relationship and understanding at neighbourhood level, bringing in the voices of everyone including seldom heard communities – to create meaningful change
• Informed by public need, not solely by system priorities
• Focused on integration, and recognising the patient experience which cuts across health and social care boundaries, and wider determinants
• Influential and confident voice acting as a critical friend

Place Based Partnership Update

The board was scheduled to receive an update on the Oxfordshire Place Based Partnership (PBP). The update noted that the PBP continues to meet on a monthly basis, and has been considering the role(s) that it may play going forwards to support wider system partners in health and social care throughout Oxfordshire.

The update noted that Oxfordshire PBP has offered to:

• Become an accountable board for delivering neighbourhood health and care and improving outcomes for agreed priority populations in Oxfordshire.
• Take on increased delegation of functions and budgets via Section 75 arrangements, growing pooled budgets and maximising benefits of joint commissioning.
• Host and contribute to funding a small place-based team that the ICB can transfer to retain commissioning expertise to support delivery of neighbourhood working and better outcomes for priority populations.

The update noted that members of Oxfordshire PBP recently supported a proposal to implement a reciprocal mentoring programme with members of the community from priority neighbourhoods in the county, and that the Oxfordshire Local Area Partnership (LAP) SEND Strategic Improvement and Assurance Board continues to meet monthly.

The update noted that on Monday 8 September, an extraordinary health and Wellbeing Board meeting took place to focus on the development of Neighbourhood Health and Care in Oxfordshire, and that the Oxfordshire Primary and Community Board met for the first time on 11 September, and will oversee the design and delivery of neighbourhood health and care, reporting to Oxfordshire PBP.

The update noted that Oxfordshire is also engaged with the Enabling Neighbourhood programme taking place throughout BOB, to ensure alignment as appropriate, and that an Oxfordshire integrated plan for winter has been developed, outlining how system partners expect to mitigate additional pressures and challenges that are particularly present throughout winter months.

The update noted that partners are now working on developing the next evolution of Well Together, and how it could be framed as a whole system approach to community development, and that BOB ICB and Public Health in OCC are jointly developing an Oxfordshire Health Impact Evaluation Unit.

The update noted that to further support the delivery of Neighbourhood Health and Care, a project has been jointly agreed by BOB ICB and Public Health to improve Oxfordshire's approach to Population Health Management.

Forward Work Programme

The board was asked to note the forward work programme, which included the following items:

4 December 2025

• Prevention of Homelessness Director's Group Update
• Marmot Place Update
• Health and Wellbeing Strategy Update Live Well
• Oxfordshire Safeguarding Adults Annual Report
• Oxfordshire Safeguarding Children's Annual Report
• Autism Strategy
• Report from Healthwatch Oxfordshire & Partnership Boards

12 March 2026

• Marmot Place Update
• Health and Wellbeing Strategy Age Well
• Director of Public Health Annual Report
• Report from Healthwatch Oxfordshire & Partnership Boards

Other Matters

The agenda also included standard items such as:

• Welcome by Chair, Councillor Liz Leffman, Leader of the Council
• Apologies for Absence
• Declarations of Interest
• Petitions and Public Address
• Note of Decisions of Last Meeting
• Workshop Discussion
• Marmot Place Update
• Reports from Partnership Boards
• Councillors declaring interests