The Health Overview and Scrutiny Committee (HOSC) met on 10 October 2025 to discuss the Pharmaceutical Needs Assessment, winter planning, and to refresh the scrutiny work programme for 2025/26. Representatives from Worcestershire County Council's Public Health Team, NHS England (NHSE), NHS Herefordshire and Worcestershire Integrated Care Board (HWICB) and the Local Pharmaceutical Committee (LPC) were expected to be in attendance. Councillor Karen May, Chair of the Health Overview and Scrutiny Committee, was scheduled to chair the meeting.

Planning for Winter

The committee was scheduled to receive an update on the health and care system's plans to manage winter pressures in urgent and emergency care. Representatives from the NHS Herefordshire and Worcestershire Integrated Care Board (HWICB), Worcestershire Acute Hospitals NHS Trust (WAHT), Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT) and Worcestershire County Council were expected to be present.

The report pack included the Herefordshire and Worcestershire Winter Plan 2025-26, which outlines a multi-agency strategy to manage seasonal pressures across various services. According to regulators, the plan aligns with national UEC priorities and demonstrates a mature system-wide approach.

Key priorities for Winter 2025 included:

• Reducing ambulance handover delays, with a commitment to no waits over 45 minutes.
• Improving emergency department waiting times and emergency access standards (EAS) performance.
• Reducing corridor care.
• Improving the experience of frail and end-of-life patients needing urgent and emergency care.

The HWICB's priorities were reportedly supported by partner plans, including:

• Increasing virtual ward capacity from 9 to 45 beds, focusing on respiratory and frailty patients.
• Increasing Urgent Community Response (UCR) team capacity by 4% to treat more patients at home or in community settings.
• Further developing Worcestershire's Single Point of Access (SPA) to increase admission avoidance.
• Reconfiguring acute trust assessment areas.
• Developing models of care to promote earlier discharge into community rehabilitation beds.
• Ensuring all available capacity to support hospital discharges (domiciliary care and community beds) are open, with surge capacity available.

Other planned interventions included additional investment in primary care, aiming to provide over 130,000 additional appointments between October 2025 and March 2026, with 30,000 for same-day urgent care. The vaccination programme was set to expand, utilising more than 75 delivery sites and community venues to target vulnerable communities. The Pharmacy First service was also expected to expand, enabling pharmacies to manage more minor illnesses, and Herefordshire and Worcestershire were allocated 12,970 additional urgent dental care appointments.

The HWICB was also prioritising improved responsiveness to patients nearing the end of their lives, aiming to reduce unnecessary admissions. The Herefordshire & Worcestershire ICS was also planning to provide a 24/7 mental health helpline.

Public Health was working with primary care on a vaccination/self-care pilot to reduce admissions, targeting patients at risk of serious illness due to influenza. Practice nurses were scheduled to proactively visit clinically vulnerable patients to provide flu vaccinations and self-care advice.

The report pack noted that demand on EDs and Minor Injury Units (MIUs) increased by over 9% in August 2025 compared to the previous year, with more patients self-presenting. The system's SPA was expected to manage demand by directing patients to MIUs or other community services. There are five MIUs in Worcestershire: Bromsgrove MIU, Evesham MIU, Kidderminster MIU, Malvern MIU and Tenbury MIU.

The report pack stated that HWICB and WAHT would commit to the current opening hours of Kidderminster MIU, and that the system had finalised plans with the ambition to achieve 78% EAS by March 2026.

Pharmaceutical Needs Assessment

The committee was scheduled to review the 2025 Pharmaceutical Needs Assessment (PNA) for Worcestershire. The PNA details the current and future pharmaceutical services required to meet the health needs of the local population, aiming to identify gaps in service provision, assess the pharmacy landscape, and outline recommendations for improvement.

The PNA is a statutory document produced by the Worcestershire Health and Wellbeing Board (HWB) that reviews local pharmaceutical service needs and provision. The final PNA was published on 1 October 2025.

Key findings from the PNA included:

• No major access gaps, but rural areas like Malvern Hills have seen pharmacy closures.
• Fewer pharmacies open on weekends and evenings, with no late-night services.
• Worcestershire has fewer pharmacies per capita than the national average.
• Pharmacies are valued, but issues reported include limited hours, travel difficulties, and low service awareness.
• Vulnerable groups face barriers due to stigma, privacy concerns, and communication issues.
• Opportunities exist to expand services for chronic conditions and harm reduction.

As of 2025, there were 109 total contractors, including 88 community pharmacies and 21 dispensing GP practices, a 6% reduction since the last assessment in 2022. Pharmaceutical Regulations have changed to allow 100-hour pharmacies to reduce their core hours to 72 hours, with many facing financial difficulty and reducing supplementary hours.

Most residents in Worcestershire have good access to pharmacy services, with 100% of the population living within a 20-minute drive of a pharmacy. Public transport access is also adequate, with 86% of the population able to reach a pharmacy within 30 minutes. The PNA highlights higher rates of chronic conditions in Worcestershire, such as asthma and hypertension, and an ageing demographic.

Engagement efforts revealed high overall satisfaction with community pharmacies, but concerns were raised about limited opening hours, long waits, transport issues, and digital barriers, particularly in rural areas. Awareness of available pharmacy services, such as Pharmacy First, was low. Focus groups with lesser-heard populations identified key barriers such as communication difficulties and stigma.

The key recommendations from the PNA were:

• Raise public awareness and trust in pharmacy services.
• Align services with local health priorities and support staff wellbeing.
• Consider how to improve evening access and simplify commissioning processes.
• Enhance privacy, accessibility, and tailored communication.
• Ensure respectful, private care for supervised medicine users.

The report pack stated that the PNA considers the extent to which community pharmacies are meeting the needs of the local population and makes recommendations as to how services may develop or continue to meet these needs.

Refresh of the Scrutiny Work Programme 2025/26

The committee was scheduled to review its work programme and consider priority issues for investigation. Worcestershire County Council has a rolling annual Work Programme for Overview and Scrutiny, which is routinely reviewed and approved by the council on an annual basis.

Panel members were expected to suggest topics for future scrutiny, prioritising issues using agreed feasibility criteria. The Overview and Scrutiny Performance Board was scheduled to receive feedback on the discussions and agree the final Scrutiny Work Programme at its 16 October meeting, with Council asked to agree the Work Programme at its meeting on 6 November.

The feasibility criteria include whether the issue is a priority for the council and local people, whether improvements for local people are likely, and whether it relates to a poorly performing service or new government guidance.

The HOSC is responsible for scrutiny of local NHS bodies and health services, including public health and children's health.

The draft scrutiny work programme 2025/26 included the following items:

• Integrated Care Board Update (10 November 2025)
• Overview of Common Neurological Conditions (10 November 2025)
• Update on Access to GP Appointments and Services (9 January 2026)
• Annual Review of Public Health (9 January 2026)
• Update on Dental Services Access (9 February 2026)
• Annual Overview from West Midlands Ambulance Service (4 March 2026)

Possible future items included:

• Update on Improving Patient Flow including the Urgent Community Response Service
• Adult Mental Health Rehabilitation Redesign & Acute Inpatient Improvement – Update
• Routine Immunisation (July 2026)
• Maternity and Newborn Services
• Community Paediatric Services
• Update on Stroke Services
• End of Life Care
• Eye Services
• Frailty and Progress with Implementation of the New Strategy
• Update on Cancer Pathway
• Acute Dermatology Services Provision Update