The Health Select Committee of Wiltshire Council met on 14 January 2026 to discuss the Wiltshire Health and Wellbeing Joint Strategic Needs Assessment (JSNA) 2025, review the findings of a rapid scrutiny exercise on urgent care services, and receive updates on the Unpaid Carers contract and the Trowbridge Integrated Care Centre. Key decisions included noting the JSNA and requesting further information from the Integrated Care Board (ICB) on how it informs their work, agreeing to receive three separate reports on urgent care, discharge delays, and preventative work, and noting the positive performance of the Unpaid Carers contract.

Wiltshire Health and Wellbeing Joint Strategic Needs Assessment 2025

The committee received a comprehensive overview of the 2025 Wiltshire Health and Wellbeing Joint Strategic Needs Assessment (JSNA) from Mike Rose, Public Health Principal for Intelligence and Wider Determinants, and Nicky Murch, Manager of the Public Health Intelligence Team. The JSNA is a statutory document that provides a detailed breakdown of the health of Wiltshire residents, informing policy and strategic planning.

Key findings from the JSNA highlighted an ageing population, with a projected 40% increase in those aged 65 and over by 2045. While life expectancy in Wiltshire is higher than the regional and national average, significant health inequalities persist, with life expectancy markedly lower in more deprived areas. Prevalent health conditions like hypertension and diabetes are heavily influenced by lifestyle behaviours, with 10% of adults in Wiltshire estimated to smoke, 60% being overweight or obese, and a quarter not undertaking recommended levels of physical activity. Housing issues, including fuel poverty and homelessness, were also identified as significant concerns. The assessment also noted growing numbers of pupils with diverse educational needs.

The presentation also linked the JSNA findings to the NHS 10-year health plan, emphasizing a shift towards community-based care, prevention, and digital integration. Concerns were raised about ensuring vulnerable groups, including older people, Gypsy, Roma, and Traveller communities, those with learning disabilities, and individuals in rural areas, are not left behind by technological advancements. The challenges faced by those in the justice system, military communities, and the impact of deprivation on health outcomes were also discussed.

Following the presentation, councillors engaged in a detailed discussion about the JSNA's implications. Councillor Jane Davies, Chair of the committee, highlighted the value of the data in understanding local demographics and its connection to the NHS 10-year plan. Councillor Ed Rimmer raised questions about the sustainability of the current system in light of the ageing population and the definition of fuel poverty. Councillor Christopher Williams emphasised the need to translate this data into accessible information for the general public. Professor Kate Blackburn, Director of Public Health, stressed that the JSNA is a shared resource, owned by all partners, and its data should inform strategic planning and operational delivery. The committee resolved to note the JSNA and requested that the ICB include reference to how the JSNA informs their work in their forthcoming report on the local response to the NHS 10-year plan.

Report of the Rapid Scrutiny Exercise: Reporting on Urgent Care in Wiltshire

Councillor Phil Chamberlain, Lead Member for the Rapid Scrutiny exercise, presented the findings of the group's review into urgent care services in Wiltshire. The exercise aimed to identify the most pertinent data to scrutinise urgent care provision, focusing on front-door services. The report highlighted the complexity of the urgent care system, emphasizing that it operates as a whole, with issues in one area impacting others.

The committee discussed the need to disaggregate the report into separate areas to better understand the system from a resident's perspective. It was agreed to request three separate reports: one on urgent care services, focusing on performance data, how residents access these services, and how health inequalities are managed; a second on discharge delays; and a third on preventative work, encompassing both NHS and Wiltshire Council initiatives. The first report on urgent care services will include detailed performance data on GP access, Minor Injury Units (MIUs), A&E attendances, and ambulance response times, alongside information on how residents are accessing these services and how health inequalities are addressed. The committee also requested that definitions of urgent care provision be included to ensure clarity for non-health professionals.

Councillor Lainey Barker highlighted the interconnectedness of the system, using the example of falls clinics and their impact on hospital admissions. Councillor Christopher Williams raised concerns about the accessibility of MIUs and urgent treatment centres for residents in East Wiltshire, leading to increased A&E attendances. Caroline Holmes, Interim Executive Director of Place for Wiltshire for the ICB, suggested that the reports could be structured around avoiding admission and discharges, with an overarching piece linking the two. The committee agreed to this approach, with the first report on urgent care services to be presented in March 2026.

Unpaid Carers (Adults) Contract Overview

Councillor Gordon King, Cabinet Member for Adult Social Care, presented an overview of the Adults Unpaid Carers contract, commissioned by Wiltshire Council and the Wiltshire ICB, and awarded to Carers Together Wiltshire (CTW). The report highlighted the significant progress made by CTW in reducing waiting times for carer assessments and reviews, with average wait times for assessments dropping to 19 days.

Kirsten Kerr, Service Delivery Manager for CTW, presented the organisation's annual report, detailing their work in providing information, advice, and support to unpaid carers across Wiltshire. CTW, a consortium led by Age UK Wiltshire, offers a range of services including carer assessments, support plans, and peer support groups. The report highlighted a significant reduction in overdue reviews and waiting lists, with a new model implemented in January to ensure carer assessments are booked within two weeks. Feedback from carers indicated that the support received had made them feel human again and less isolated.

The committee discussed the effectiveness of the service, with Councillor Ed Rimmer inquiring about national waiting times for assessments and the potential for sharing best practices. Councillor Trevor Carbin asked about the administrative relationship between CTW and its partner organisations. Councillor Dr Monica Devendran, a Wiltshire Carers Champion, raised concerns about the visibility of CTW's services, particularly in GP surgeries and rural areas, and inquired about the recruitment of more Carers Champions. Councillor Williams shared a positive example of a local carers' cafe supported by an area board. The committee resolved to note the contract overview and annual report, and requested that information on carer support and how to access it be communicated more widely, including inviting CTW to present at all area boards.

Trowbridge Integrated Care Centre Update

Caroline Holmes, Interim Executive Director of Place for Wiltshire for the ICB, provided an update on the Trowbridge Integrated Care Centre (TICC), which is due to open in April 2026. The TICC is a £16 million initiative designed to replace the outdated Trowbridge Community Hospital and will offer a wider range of services closer to home, aiming to reduce travel to acute hospitals and improve access to urgent care.

The report detailed extensive engagement with local people and staff, with key themes emerging including the desire to reduce travel to the Royal United Hospital (RUH) and other centres, and requests for extended opening hours for the Minor Injury Unit (MIU). The TICC will offer increased outpatient appointment capacity, with an additional 262 appointments per week, and is expected to avoid 132 hospital admissions per year. The MIU opening hours have been extended to 8:30 am to 8 pm, seven days a week. The centre is also designed to be Net Zero in use, incorporating solar panels and air source heat pumps, projected to save approximately £45,000 per year in energy costs and reduce carbon emissions by 120 tonnes annually.

Councillor Sam Blackwell congratulated the ICB on the development, highlighting its regenerative impact on Trowbridge. Councillor Ed Rimmer inquired about the projected utilisation of the building and the environmental payback period for the Net Zero features. Councillor Trevor Carbin asked about the timescale for redeveloping the old hospital site. Ms. Holmes confirmed that there would be future opportunities to add services and that the old site would be sold on the open market. The committee resolved to note the update and requested a further report on how the centre is operating once it has opened.

Cabinet Member Updates

Councillor Gordon King, Cabinet Member for Adult Social Care, reported on the success of the Healthy Man programme, with a second cohort starting in Corsham and Trowbridge following a successful first cohort in Chippenham. He also shared positive news about Bradbury House Respite Centre and Wiltshire Support at Home, both of which received good ratings in their Care Quality Commission inspections. Councillor Clare Cape, Cabinet Member for Public Health and NHS Liaison, provided an update on the reduction in smoking prevalence in Wiltshire and highlighted the positive impact of the Hospital at Home service on A&E attendances. She also shared her thoughts on the NHS 10-year plan impact statement, noting omissions regarding the role of local authorities, the digitally excluded, mental health, and wider determinants of health.

Forward Work Programme

The committee reviewed and approved its forward work programme. It was agreed that separate reports on urgent care, discharge from hospital, and preventative work would be added to the programme. An update on the community integrated care contract will be added for June or July, and the committee will receive an update on urgent care services in March 2026.

Urgent Items

There were no urgent items raised at the meeting.

Date of Next Meeting

The date of the next meeting was confirmed as Wednesday, 11 March 2026, at 10:30 am. An online budget meeting for Health Select members was also scheduled for 23 January 2026.