The Health Scrutiny Committee was scheduled to discuss intermediate care services, hear an update from the East Midlands Ambulance Service (EMAS), and review its work programme. A main focus of the meeting was to be a discussion of the case for changing intermediate care services in Derby and Derbyshire. The committee was also scheduled to discuss ways to improve patient discharge and help people stay at home longer.

Intermediate Care

The committee was scheduled to consider a report from the Derbyshire Community Health Services NHS Foundation Trust (DCHS) and NHS Derby and Derbyshire Integrated Care Board (ICB) regarding intermediate care services. Intermediate care services are short-term services designed to rehabilitate and re-enable people, helping them regain independence. These services can be provided at home, in community beds, or in residential settings, and are used both to prevent hospital admissions and to support people returning home after a hospital stay.

The report outlined a case for change, driven by the need for a more consistent care offer, capacity issues, duplication of information, workforce challenges, the consolidation of bedded care settings, estate quality, and value for money. The report stated that there is a:

need for a more consistent care offer across Intermediate Care pathways, as variation in admissions, referral practices, and care models can lead to differences in experience and outcomes.

The report outlined a vision for intermediate care services based on a 'Home First' approach, aiming to enable more people to return home after hospital and to support them in staying at home longer. Key elements of this vision include person-centred care, integrated health and social care teams, increased capacity for care at home, specialist services, workforce development, and care transfer hubs.

A listening exercise was planned to gather public views on the vision for intermediate care services, with specific questions focusing on improvements and considerations for implementing changes. The listening exercise was scheduled to run from February to April 2026, and a summary of the findings was expected to be published in Spring 2026.

The committee was asked to note the rationale and vision for change, support the public engagement approach, and endorse the next steps outlined in the Case for Change.

A related Case for Change document provided more detail on the current intermediate care offer in Derby and Derbyshire, the drivers for change, and the proposed vision. It noted that Joined Up Care Derbyshire (JUCD) is the name of the Integrated Care System (ICS) that brings partner organisations together to improve health outcomes, tackle inequalities, enhance productivity, and support social and economic development. Integrated care aims to provide coordinated, person-centred care by bringing together different health and care providers.

The document also detailed the current intermediate care services in the area, including home-based short-term care services and bedded care settings. It identified several drivers for change, such as the need for a more consistent care offer, capacity issues due to an ageing population, duplication of information, workforce challenges, the consolidation of bedded care settings, estate improvements, and value for money.

The vision for intermediate care in Derby and Derbyshire was presented as aiming to ensure that as many people as possible can return home quickly and safely after a hospital stay, with the right support to remain independent for longer. This vision aligns with the national 'Home First' principles.

East Midlands Ambulance Service (EMAS)

The committee was scheduled to receive an update on the work done by the East Midlands Ambulance Service (EMAS) to improve response times, particularly for Category 2 (CAT2) calls¹. The update was to cover several areas, including:

• Communications to influence the public to 'choose wisely'.
• Prioritising patient safety and experience.
• Positive recruitment and being over establishment.
• The introduction of a Critical Care desk in the Emergency Operations Centre (EOC).
• Working with the national team as part of the Urgent and Emergency Care recovery plan, focusing on internal efficiency, hear & treat[^3], job cycle, and post handover. [^3]: 'Hear & Treat' refers to incidents where the ambulance service is able to resolve the issue over the phone, without needing to send an ambulance to the scene.
• ICB's focusing on reducing hours lost waiting at hospitals and reducing 999 incidents.
• Continued collaboration between EMAS and DHU (Derbyshire Health United) focusing on 111/999 opportunities.

The update also included information on 'Hear & Treat' initiatives, such as fully embedded NHS Pathways², national C2 segmentation work, increased clinicians in EOC, automated calls passed to Urgent Community Response, and manual pushing of further incidents to Central Navigation Hub. Regarding conveyance, EMAS had introduced/refreshed a new process to support on-scene decision-making, including clinician-to-clinician conversations and navigation of patients to the most appropriate pathway.

Hospital handover was identified as a continuing challenge, with difficulties in discharging patients from hospitals impacting patient flow and causing ambulances to wait to handover. EMAS was working with system partners to keep patients safe, and the University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) had redesigned its emergency department to increase capacity.

Total lost hours year-to-date (April 2025 - October 2025) were 13,025, which equates to 1,085 12-hour shifts. This was said to have a direct correlation to C2 performance and increased risk to patients waiting for an emergency ambulance.

Despite these challenges, EMAS reported that October 2025 performance had improved compared to the previous year by 13 minutes.

Work Programme

The committee was scheduled to consider its current work programme and identify items for future consideration.

The work programme included the following topics for January 2026:

• Learning Disabilities (adults) – short breaks
• Fertility Review Update
• Stroke Rehabilitation
• Healthwatch Derbyshire update

For March 2026, the work programme included:

• Sickle Cell Carrier Update

Later or possible items included:

• Dementia Strategy update
• Living Disabilities Derbyshire – short breaks
• Healthwatch Derbyshire update
• Asbestos
• Mental Health Crisis Support
• Screen time for children and young people's mental health
• Food Additives
• Long COVID
• End of Life Care
• Care and treatment of people with Dementia