The Health and Wellbeing Board of Shropshire Council met on Thursday 22 January 2026 to discuss a range of critical issues impacting the health and wellbeing of residents. Key decisions included endorsing the Cardiovascular, Renal, and Metabolic (CVRM) strategy and approving the Better Care Fund 2025–26 quarter three template. The Board also noted updates on the ShIPP (Shropshire Integrated Place Partnership) and pharmacy services.

Special Educational Needs and Disabilities (SEND) and Alternative Provision (AP) Board Update

The Board received an update on the Special Educational Needs and Disabilities (SEND) and Alternative Provision (AP) Board. Significant improvements have been made over the past year, including enhanced co-production with parents and carers, improved health wait times for children and young people, and a substantial reduction in permanent exclusions from schools. A speech and language risk matrix tool has been introduced, and therapy sessions are now more accessible within mainstream schools. The EHC (Education, Health and Care) plan team has focused on improving the quality and accuracy of plans, with additional resources allocated to an annual review recovery plan to ensure all plans are up-to-date by Easter 2026. Specialist places and SEN hubs have also been expanded, improving access to support.

However, challenges remain, including long waits for EHC plans and neurodiverse assessments due to rising demand, although steps are being taken to outsource services and commission new providers. Sufficiency of provision is a priority, as is addressing the national trend of an increasing proportion of children being Electively Home Educated. The Parent and Carer Council (PACC) has highlighted the need for further improvements in co-production and strategic involvement, particularly in hub development. Financial pressures and geographical challenges continue to affect service delivery, requiring further work to ensure equitable access and high-quality practice across Shropshire. The partnership remains committed to addressing these areas through ongoing monitoring and quality assurance.

Children's Services Reforms & Families First

An overview of national reforms impacting Children's Services was presented, focusing on the National Youth Strategy, Families First Partnership, and Best Start in Life Family Hubs. These reforms aim to rebalance the system towards early help and support for children and young people within inclusive communities. The report highlighted that these reforms represent the largest changes in Children's Services in decades and are critical for achieving better outcomes and ensuring value for money. The reforms necessitate a more holistic approach across the organisation, requiring collaboration with adult services, housing, and domestic abuse services, as these are often contributory factors to children needing help. The changes are expected to have a wider impact beyond children's services, potentially informing broader organisational changes and improving efficiency through digital means. The reforms are being delivered in partnership with statutory safeguarding partners, including the police, health services, local authorities, and crucially, with children and families themselves.

The report detailed specific requirements for key programmes:

• Best Start in Life Family Hubs: This includes preparing a readiness survey for the Department for Education, identifying a local Family Hub site based on deprivation criteria, reviewing parenting programmes, and publishing a 'Best Start in Life Plan' outlining partnership actions to achieve the good level of development target for 3-4 year olds.
• Families First Partnership: This requires delivering a seamless system of support across 'Family Help' (previously 'Early Help and Children in Need'), developing a Multi-Agency Child Protection Team (MACPT) to provide a 'second look' and high challenge/high support, and embedding Family Group Decision Making (FGDM) to build upon family strengths.
• Youth Strategy: This aims to develop trusted adults, strengthen the youth workforce, foster positive social connections, provide enriching activities, improve education and training for employment, enhance safety, support physical and mental health, and engage young people in decisions, including lowering the voting age.
• Private Law Proceedings: This reform aims to identify families' needs earlier and foster improved multi-agency working between HMCTS, Cafcass, local authorities, domestic abuse support providers, and the police to reduce court time and hearings.
• SEND Reforms: While formal papers are awaited, local partnerships are being asked to assess their maturity against seven key pillars: co-production, effective systems leadership and governance, accurate understanding of needs through data, high-quality delivery, effective partnerships across health, education, and social care, a skilled partnership workforce, and targeted, judicious, and sustainable use of resources.

Shropshire's local context was highlighted, noting a high number of children in care (second highest regionally) despite relatively low levels of poverty. The council spends approximately 80% of its Children's Services budget on Children's Social Care, compared to a national average of 47%, indicating a significant reduction in spend on earlier intervention and prevention services. The report also noted the pressure on the SEND system, with a cumulative deficit of approximately £41 million in Shropshire's High Needs Block. The proposed changes represent an opportunity to rebalance the system by reinvesting resources into earlier help and support to prevent rising demand and reduce the number of children in care.

Housing & Health Action Plan Update

An update on the Housing and Health Action Plan detailed significant progress in integrating housing delivery with health and care commissioning. Shropshire Council is preparing for inspections under the Regulator of Social Housing's consumer standards, which encompass safety, quality, transparency, tenant engagement, and neighbourhood management. The Social Housing (Regulation) Act 2023, including Awaab's Law, mandates strict response times for investigating damp and mould concerns and requires landlords to provide written updates and audit their processes. The Renters' Rights Act has enhanced investigatory powers for local councils and introduced higher penalties for rogue landlords, with revenues to be reinvested in enforcement.

The homeless service has implemented four in-house temporary housing schemes, providing over 100 units and reducing reliance on Bed and Breakfast accommodation. These schemes aim to offer more intensive support and improved engagement from partner agencies such as mental health, substance misuse, and Adult Social Care. Residents are reporting feeling better supported and more able to address issues like mental health or substance misuse.

The revised Housing and Health Action Plan has been developed, combining actions where relevant for a simpler approach. Key priorities for the next 12 months include robust monitoring of the revised plan, embedding impact and outcome measures, and continuing work on recommendations from the Housing LIN report. A progress report will be provided to the Board in six months, including headline outcomes, best practice examples, and an appraisal of the impact on population health and housing quality.

Healthwatch Shropshire – Recent Activity & Forward Plan 2026-27

Healthwatch Shropshire provided an update on its recent activities and its forward plan, highlighting its role as an independent voice for people using health and social care services. Since its establishment in 2013, Healthwatch Shropshire has published over 120 reports on people's experiences and over 80 Enter & View reports following visits to care homes, hospital wards, clinics, and GP practices. Since 2016, it has also provided the Independent Health Complaints Advocacy Service for Shropshire residents.

The report drew attention to significant changes facing the Healthwatch network in 2026, following the publication of the Dash Review and the NHS 10 Year Plan, which includes the decision to abolish Healthwatch. The Board was asked to consider the implications of this decision on the independent voice of people using health and social care services in Shropshire, particularly at a time when building public trust and confidence in services is crucial. Key questions were raised regarding the ability of Local Authorities and ICBs to commission independent organisations to deliver Healthwatch functions, mechanisms for managing conflicts of interest, requirements for public reporting of findings and recommendations, and how transparency will be ensured when patient voice functions are integrated within LAs or ICBs.

Health & Wellbeing Strategy Delivery Progress

An update was provided on the progress of the Health and Wellbeing Board Strategy for 2022-2027. The report detailed progress against overall outcome metrics, showing a reduction in outcomes significantly worse than national performance, from 52% to 44%. However, the proportion of metrics significantly better than the England average has fallen, with more metrics now similar to national rates. Areas showing improvement since baseline include excess under 75 mortality rate in adults with severe mental illness, personalisation in NHS GP Patient Survey responses, hospital admissions caused by unintentional and deliberate injuries in children, emergency hospital admissions for pneumonia, hospital admissions as a result of self-harm, coronary heart disease hospital admissions, average weekly earnings, 16-17 year olds not in education, employment or training (NEET), school pupils with social, emotional and mental health needs, and smoking status at time of delivery.

Areas worsening since baseline include healthy life expectancy for males and females, improving access to health and care services (Barriers to housing and services domain IMD score), suicide rate, school pupils with social, emotional and mental health needs, children in care, adults overweight/obese, and diabetes prevalence aged 17+.

The report detailed progress against key strategic priorities: Workforce, Mental Health and Suicide Prevention, Children and Young People (including Mental Health), Healthy Weight and Physical Activity, and other identified priorities such as Social Prescribing, Drugs and Alcohol, Domestic Abuse, County Lines, Smoking in Pregnancy, Food Insecurity, Housing, Air Quality, and Killed and Seriously Injured on roads. The Board was asked to acknowledge the delivery progress made and make comments and recommendations for future reporting format and content to ensure robust oversight of progress.

ICB Update

NHS Shropshire, Telford and Wrekin (ICB) provided an update on current activities and next steps. The NHS Government Reset Programme is underway, with a voluntary redundancy scheme launched and a formal Management of Change consultation planned for early 2026. The system is working to mitigate winter pressures, focusing on improving patient flow, enhancing community care, and preventative measures such as vaccinations. A new Lung Cancer Screening (LCS) Programme was launched on 1 December, aiming to identify lung cancer early. NHS STW is also reviewing Locally Commissioned Services (LCS) in General Practice to ensure funding is fair, sustainable, and better aligned with local population needs. Next steps for the Reset Programme include informing staff of voluntary redundancy decisions and conducting a selection process for a Senior Leadership Team. The LCS Review is being conducted with GP leaders and the Local Medical Committee, with a new service model planned for April 2026. Public Health and NHS leaders are urging simple steps to prevent the spread of winter illness.

ShIPP Update

Members noted the update from the Shropshire Integrated Place Partnership (ShIPP). The ShIPP Accelerator Group reviewed its terms of reference and group roles, and agreed to merge with the Healthy Lives Steering Group. Proposals for a new plan for the Voluntary Community Sector Assembly (VCSA) to lead the prevention funding process were approved, with a focus on fairness and transparency. The outcomes of community engagement and mapping work for the Healthy Ageing Strategy were noted. The draft SEND for 0–25-year-olds Joint Strategic Needs Assessment (JSNA) was presented, and committee members were asked to review recommendations for finalisation. The Urgent & Emergency Care Winter Plan progress was noted, with a meeting arranged to align the National Neighbourhood Health Implementation Programme with UEC and other system programmes.

Better Care Fund (BCF) – Q3 Template

The Better Care Fund (BCF) quarter three template was retrospectively approved. Shropshire remains on track to meet all national BCF headline metrics, including emergency admissions, delayed discharges, and long-term residential admissions. Future integration of BCF planning will align with neighbourhood health planning, with further detail awaited from the NHS for 2027–28. The BCF settlement value for 2026–27 remains unchanged from 2025–26, which may present inflationary pressures.

Cardiovascular, Renal, and Metabolic (CVRM) Strategy

The Cardiovascular, Renal, and Metabolic (CVRM) strategy was endorsed, outlining a shift towards a multimorbidity approach by aligning strategies for cardiovascular disease, diabetes, hypertension, heart failure, and renal disease. The strategy is approaching the end of its first year, with a detailed report on outcomes and implementation progress to be presented at a future meeting. Dashboards to monitor key performance indicators are in development, focusing on prevention activity and measuring impacts on kidney disease, hypertension, and hospital outcomes. The Board emphasised the importance of monitoring both health outcomes and impacts on urgent and unplanned care, and approved the associated governance arrangements and year one milestones.

Pharmacy Updates

Members noted the pharmacy updates.

Health Overview & Scrutiny Committee Information

Members noted information regarding the Health Overview & Scrutiny Committee.

Any Other Business

The Director of Strategy and Development at NHS STW highlighted the launch of the Neighbourhood Health Framework, with a summary to be circulated to Board Members.