Health and Wellbeing Board - Tuesday 3 March 2026, 2:00pm

Health and Wellbeing Board
Tuesday, 3rd March 2026 at 2:00pm

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Speaking:

Start of webcast

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Cllr Isobel Darby

1 Welcome

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Cllr Isobel Darby

2 Apologies

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Harry Thomas - Democratic Services
Cllr Isobel Darby
David Munday - Director of Public Health
Craig McArdle - Corporate Director, Adult Social Care
Tiffany Adonis-French - Service director, ASC Operations
Gemma Thomas - Director of Strategic Partnerships, BHT
Zoe McIntosh - Chief Executive, Healthwatch Bucks
Dr George Gavriel - Director, Bucks GPPA
Cllr Isobel Darby
Adam Howard
Mark Russell
Sarah Winchester - Consultant in Public Health
Cllr Carol Heap
Nicola Newstone - Assistant Director for Partnership Development
Cllr Steve Bowles
Harry Thomas - Democratic Services
Sanila Hussain - Partnership Support Officer
Cllr Isobel Darby
David Walker - Oxford Health NHS Trust
Cllr Carl Jackson
Cllr Isobel Darby

3 Announcements from the Chairman

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David Walker - Oxford Health NHS Trust
Cllr Isobel Darby

4 Declarations of Interest

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5 Minutes

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Minutes of Previous Meeting

6 Public Questions

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7 Health and Wellbeing Strategy Focus - Age Well

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Sarah Winchester - Consultant in Public Health
Cllr Isobel Darby
Adam Howard
Cllr Isobel Darby
Gemma Thomas - Director of Strategic Partnerships, BHT
Mark Russell
Cllr Isobel Darby
Craig McArdle - Corporate Director, Adult Social Care
Cllr Isobel Darby
Sarah Winchester - Consultant in Public Health
Cllr Isobel Darby
Mark Russell
Cllr Isobel Darby
Dr George Gavriel - Director, Bucks GPPA
Mark Russell
Cllr Isobel Darby
Dr George Gavriel - Director, Bucks GPPA
Sarah Winchester - Consultant in Public Health
Mark Russell
Cllr Isobel Darby
David Munday - Director of Public Health
Mark Russell
Adam Howard
David Munday - Director of Public Health
Gemma Thomas - Director of Strategic Partnerships, BHT
Cllr Isobel Darby
Adam Howard
Cllr Isobel Darby
Adam Howard
Cllr Isobel Darby

8 Neighbourhood Health

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Gemma Thomas - Director of Strategic Partnerships, BHT
Cllr Isobel Darby
Gemma Thomas - Director of Strategic Partnerships, BHT
Cllr Isobel Darby
David Munday - Director of Public Health
Gemma Thomas - Director of Strategic Partnerships, BHT
Cllr Isobel Darby
Craig McArdle - Corporate Director, Adult Social Care
Cllr Isobel Darby
Dr George Gavriel - Director, Bucks GPPA
Cllr Isobel Darby

9 Joint Strategic Needs Assessment

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Tiffany Burch - Public Health Consultant
Cllr Isobel Darby
Sarah Winchester - Consultant in Public Health
Cllr Isobel Darby
Craig McArdle - Corporate Director, Adult Social Care
David Munday - Director of Public Health
Craig McArdle - Corporate Director, Adult Social Care
David Munday - Director of Public Health
Cllr Isobel Darby
Tiffany Burch - Public Health Consultant
Cllr Isobel Darby

10 Buckinghamshire Executive Partnership

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BEP reportingFinal

Craig McArdle - Corporate Director, Adult Social Care
Cllr Isobel Darby

12 Integrated Care Board Update

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Nicola Newstone - Assistant Director for Partnership Development
Cllr Isobel Darby

13 Forward Plan

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14 Date of next meeting

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David Munday - Director of Public Health
Cllr Isobel Darby
Webcast Finished

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Disclaimer: This transcript was automatically generated, so it may contain errors. Please view the webcast to confirm whether the content is accurate.

1 Welcome

Cllr Isobel Darby - 0:00:00

Good afternoon everybody and welcome to this meeting of the Buckinghamshire Health and

Cllr Isobel Darby - 0:00:13

Well being Board on Tuesday 3rd March. I need to remind everybody that this meeting is also

being webcast so good afternoon to everybody who's joined online and let you know that

in the unlikely event there is a technical issue with the webcast we're going to have

to pause the meeting until that has been resolved.

Excuse me.

So first of all, I would just like to,

oh, perhaps we ought to do apologies and substitutes first,

please, Harry.

2 Apologies

Harry Thomas - Democratic Services - 0:00:40

Yes, we've had apologies from Kate Walker and Raghu Bessin.

And we also have Councillor Jackson and David Walker

attending on Teams, because they couldn't be here with us today.

So hopefully they should be able to hear us.

Cllr Isobel Darby - 0:00:50

Right.

Are we going to be able to see them?

And could somebody keep an eye on that

and let me know if somebody starts waving,

because I'm not very good at watching that

and watching everyone in the room at the same time.

Okay, so welcome again.

What I'd like to do is just quickly go around the table,

just so I know we probably all know who we are,

but just to go around.

So to my left.

David Munday - Director of Public Health - 0:01:17

David Munday, Director of Public Health for Buckinghamshire.

Craig McArdle - Corporate Director, Adult Social Care - 0:01:22

Craig McArdle, Corporate Director for Adults and Health

at Buckinghamshire Council.

Tiffany Adonis-French - Service director, ASC Operations - 0:01:27

I'm Tiffany Adonis -Fringe, I'm Service Director for Adult Social Care Operations.

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:01:32

Gemma Thomas, Director of CICI, the Buckinghamshire Healthcare Trust and Director for Integrated Care for the Facebook Partnership.

Zoe McIntosh - Chief Executive, Healthwatch Bucks - 0:01:38

Hi, I'm Zoe McIntosh, I'm Chief Executive of HealthWatchBucks.

Dr George Gavriel - Director, Bucks GPPA - 0:01:45

I'm George Gabriel, I'm the Director of BUCKS, Chief Chief Provider of IELTS.

Joanna Kemener, SD5 Public Health Registrar in the Public Health team Buckinghamshire

Council.

Cllr Isobel Darby - 0:01:56

Lovely, just like to welcome Joanna because she is here for a while shadowing David and

welcome and I hope you have a really interesting and informative time at Buckinghamshire.

Adam Howard - 0:02:11

Hi, I'm Adam Howard, I'm the Head of Physical Activity at Active in the Community.

Mark Russell - 0:02:18

Sarah Winchester - Consultant in Public Health - 0:02:23

I'm a consultant in public health here at the Council.

Cllr Carol Heap - 0:02:29

Afternoon, I'm Councillor Carol Heade, Deputy Cabinet Member for Health and Wellbeing.

Nicola Newstone - Assistant Director for Partnership Development - 0:02:35

Nicola Neustone, Assistant Director in Buckinghamshire for Bob ICB.

Cllr Steve Bowles - 0:02:41

I am the cabinet member for communities at Buckinghamshire Council.

Harry Thomas - Democratic Services - 0:02:47

I am Harry Thomas, I am here with Democratic Services.

Sanila Hussain - Partnership Support Officer - 0:02:51

Cllr Isobel Darby - 0:02:52

For those of you who do not know me, I am Isabel Darby, cabinet member for health and

wellbeing.

I should have said that at the start, my apologies.

Could the people online introduce themselves as well?

Who is going to go first?

David Walker - Oxford Health NHS Trust - 0:03:10

I'm David Walker and I'm chair of Oxford Health which provides mental health services in

Buckinghamshire. Sorry about the name and apologies for not being with you in person.

Cllr Carl Jackson - 0:03:19

Thank you very much David. Thanks Isabel. Karl Jackson,

Buckinghamshire Council's cabinet member for education and children's services.

Thank you.

Cllr Isobel Darby - 0:03:29

Oh sorry I'm getting very confused to see you up there and so Sarah is in the room as we said.

Right, lovely.

3 Announcements from the Chairman

So I've got welcome to Gemma, who is going from Bucks NHS Trust,

who is going to speak on item seven following Sarah Winchester

on the Proactive Frailty Clinic.

Mark Russell, who's also going to speak to item seven,

focusing on the Adult Social Care Prevention Service.

And Adam Howard, who will contribute to item seven

regarding Move Together.

and Tiffany is coming, Tiffany Birch is joining us later,

Public Health Consultant who will join us for Item 9.

And I also need to thank you, David, online,

there on the screen, for your valued contributions

to the Health and Well -being book,

because I believe this is your final meeting.

And I'd just like to say from all of us, thank you so much,

and I believe you might be confirming your replacement.

David Walker - Oxford Health NHS Trust - 0:04:29

My replacement has been selected and I've made it my business to tell her to if not join this committee then pay

fulsome attention to the county and make sure that our presence in it serves local purposes as

well as possible and again apologies that we do have a name which is adjacent county but rest

assure that our commitment to the county is is firm. I will ask her to get in touch if I may

Cllr Isobel Darby - 0:05:00

Councillor Darby in due course. That would be lovely if she perhaps contacts Sunila that would be

4 Declarations of Interest

wonderful you've got Sunila's contact details. Right so declaration of interest so I'll just

wander around everybody shaking their heads no interest to declare lovely thank you very much.

So review of the minutes and actions from the previous meeting.

So first of all, we need to agree the minutes.

5 Minutes

So can I just ask if everybody is content

that I signed these minutes as a correct record?

Lovely, thank you very much.

And I'm told there are no previous actions to go through,

so I will just sign them a little bit later.

That's fantastic.

6 Public Questions

So we are now on to public questions, item six.

We're rattling through this at the moment, aren't we?

And that is, we've got no public questions received.

7 Health and Wellbeing Strategy Focus - Age Well

So we're now on to item seven, which is where we,

I'm really pleased that we've probably got

a little bit extra time now to spend on that.

So this is looking at one strand

of our health and wellbeing strategy, the age well part.

So I think Sarah, are you going to start this?

I am indeed.

I'm just going to try and get these slides

I'll do a warm up after a minute while you get sorted.

Don't worry.

So obviously this is a really, really important part of our health and wellbeing strategy.

We are going to have more and more people ageing and it is our job here in our various organisations

to make sure that they can age well to actually be the best they can for as long as they can.

and that is a win -win for them.

It's also a win -win for all our organisations

because hopefully they won't require so much care from us.

So I'm now gonna hand over to Sarah.

Sarah Winchester - Consultant in Public Health - 0:06:54

Thank you very much, Councillor Darby.

So I'm delighted to be here this afternoon

to bring an update from the AgeWell board,

which is a multi -agency partnership.

I've only got two slides, if I may.

So just to give a little bit of an introduction to this work.

So what does it mean to age well?

So we're talking here about living

a healthy and fulfilling life, remaining independent,

participating in activities, and being

a part of thriving communities for as long as is possible.

So that's always been important.

I'd say it's ever more so with the demographic shifts

we're seeing at the moment.

we know that over the next 20 years we expect Buckinghamshire's older adult population to grow by a third.

That is quite a substantial change.

There is good news with that. Older adults bring a lot of economic and societal opportunities,

but they're only likely to be realised if they remain well and independent.

We are seeing some good news in some data hot off the press from within the last fortnight.

healthy life expectancy is starting to show some signs of recovery in

Buckinghamshire despite the national trend still being downhill and but it

does remain lower than pre -pandemic so there is still more to be done. So the

AIDWEL programme in particular so this is trying to capture and to drive work and

innovation across our organisations in the county to realise the ambitions of

the local health and well -being strategy.

It's structured on those same three priority areas and I'm really pleased to say I think

there are some, there is some significant progress captured in our action plan but there

is always more to be done.

So highlighting some of those challenges as well in the report that you'll see in the

paper pack.

So just to touch on these three areas and then leave some time for discussion, within

Within the prevention strand, there's a focus on reducing serious falls.

We know that those are important for individuals' health and well -being for themselves, but

also it's a risk factor for loss of independence and for admissions to our acute providers.

We know that those falls admissions are rising locally, so this is a really important topic

for us to grasp as a partnership.

We're working across the spectrum of prevention, and there is some really good news coming

So we've got some traction in some of those upstream initiatives.

So I'm delighted that Adam is here from active in the community to talk about the move together

project and hear a bit more there.

But we know that some of those projects can take a while to come to fruition into these

figures.

And so we're now starting to look at turning our attention to what we can deliver in that

shorter term with those more targeted initiatives for those at greatest risk in the short term.

Within the proactive care priority, this is about intervening early to prevent those needs

from escalating.

Again, good for individuals, good for services.

The theme here is mostly around mental health, but also about proactive care with the proactive

frailty clinics, which I'm delighted Gemma will be talking about.

And that's a really good example of innovative partnership work in Buckinghamshire.

And then the third priority is empowering our communities.

And this is really focused on building social connectedness as a means of reducing social

isolation and feelings of loneliness.

We know there are significant health impacts as well as wider societal impacts when this

doesn't work as well as it could.

And it's really important for us to be working closely with our VCSE sector.

And on that note, I'm delighted to have Mark Russell with me from Age UK, BUCKS, for the

launch of our adult social care prevention service.

Today is day two, so very new and hot off the press.

And that's a great example of a catalyst for bringing many of these brilliant offers we've

in Buckinghamshire together so that the right support

can reach the right people.

So, more detail in all of the reports,

but hopefully that's an introduction.

I'm happy to either hand over to the case studies

or to take questions at this stage,

whatever is your preference.

Cllr Isobel Darby - 0:11:31

Adam Howard - 0:11:48

Perfect. Well firstly, thank you so much for having me and giving me some of your

time to come today to talk to you about move to get the Buckinghamshire. Again,

I'm Adam Howard. I'm head of physical activity active in the community. I'm

I'm going to do a really brief overview of what the service is and all the services starting

to achieve.

I know I've only got a few minutes.

Mark has heard me talk about this for hours and hours and hours.

He knows I can go on.

So I will try and keep this brief and to the point and give you some of the really kind

of key highlights around the project.

So Move Together Buckinghamshire is a person -centred movement and physical activity pathway.

So, put simply, we're looking to try and identify individuals who currently aren't moving very

much.

We're looking to support them, understand what they can do, what they want to do, what

they need to do, and encourage them to embed movement into their lives.

So, we do that through targeted support to some of those who are most in need.

So, we've got our eligibility criteria up there.

So, age 50 plus.

So, we looked at the strategy of being 65 plus, so we're in that really early intervention

stage.

Living with a long -term health condition, currently inactive, so doing less than 150

minutes a week.

And then living in those opportunity box wards.

So, we've got people who are inactive, living in areas of deprivation, living with long -term

health conditions.

Some of the people that are probably the most likely to be not moving very much are the

exact people that we're targeting.

And we're looking to work with them to do a few things.

It's about understanding what are their current barriers

to being active.

There are lots and lots of barriers that people have

to be in active.

It might be transport, it might be cost,

it might be confidence.

But we need to understand what are those current barriers.

What are they actually able to do?

We see a lot of people, especially with some of these

long -term health conditions saying,

I'd like to be active, but I'm a bit nervous about this because

I've got this condition.

So it's about understanding what can I actually do and then giving them the confidence that they're okay to do it

And really importantly probably more important than both the first two

What do they want to do to be active and I think the fact we've got the word movement up there is really important

Traditionally sport and physical activity you can all imagine

It's asking people to put on lycra go to a spinning class or go and lift some heavy weights in a gym

That method is not going to work for people who are inherently inactive.

They've been inactive for a long time.

There's so many reasons why a gym can be an intimidating environment.

It could be the cost of going in there.

It could be being, you know, surrounded by people who are naturally physically active.

So, movement's really important here.

It might be linking them up with local provisions.

So, something that is local to them in a trusted setting like a community centre.

It might be actually saying, we don't need you to go to walking football, but there is a Simply Walks.

you can just go on a walk in your green space.

Gardening's up there.

Traditionally, that's not linked to being active.

Actually, 45 minutes of digging and planting.

I did that in my garden this summer.

It's definitely a strenuous activity.

But that might even include five minutes walking there

and five minutes walking home.

And all of a sudden we've got them walking for 10 minutes,

gardening for 45 minutes.

They might not see that as them being really active,

but actually that is moving the dial

on how much they're doing.

So once we've understood what they want to do, what can they do, what are the barriers,

we work with them to create a 12 -week person -centred plan.

So it's not off the shelf.

Just because they live in the same street and they're living

with the same condition doesn't mean they'll get the same programme.

Because of the bits I just mentioned, they might not want to do the same thing.

So we work with them to create that 12 -week plan.

And we support them throughout those 12 weeks.

So we cheque in again if we've sent them to a local community centre.

and they've gone to that first session and the community centre is too hot or

the community centre is too cold or they sat next to someone they don't like or

they didn't like the instructor or the tea was too weak or the tea was too

strong these are all genuine reasons I have heard why people will not go back

to a session if we give them the 12 -week plan and then cheque in at 12 weeks we've

probably lost that initial motivation so we make sure we cheque in three times in

that 12 -week point just to gently say did you manage to make that class what

What did you think? Will you go back?

And if not, we can pick them up at that point

and move that path to something they would like to do.

So we've been running about eight months now.

So we're coming up towards the end of our first year.

And on the next slide, you'll see some,

oh, that's really tiny writing, I'm sorry about that.

The top bit is kind of what I've just walked through.

So that is what the participants received.

So in terms of that 12 week plan,

the 12 week plan is put together

by level three exercise referral specialists.

So people who really know what they're talking about.

And then below you can see some of the impact

that we're starting to get from the early data.

So we are managing to increase physical activity levels.

We talked about falls prevention, which is really important.

And you can see there participants increasing

the number of strength exercises they can do,

which is really important on that falls prevention piece.

Confidence in their own ability

doesn't come through in those stats, but from the conversations that we're having,

it's I didn't think I could go to that class and do it and actually I was able

to do it and the confidence they get from that will lead them to do other

bits and pieces. But what I'd finish with is, is yes this is all about movement and

increasing physical activity but if we can get people moving more and increase

those levels, the benefits far outweigh just their physical well -being and I'm

sure you're all very aware that there are lots of other benefits but some of

things that we've seen is increased independence. So people who are living at

home who might not be confident enough that they can stand for five minutes and

wait for a bus. Actually at the end of a 12 -week programme if they've been used to

doing things that might not be such a barrier and that might mean they can go

into town and the shops and go for a coffee. Linked to that is social

connexion. A lot of the people we're seeing yes they're inactive but there's

a really high level of social isolation and loneliness. Getting them into a

community centre with people who are like them, similar to them, similar

challenges, living in the same area. Might mean that actually yes they're getting

more physically active but they might go for a cup of tea before or after with

someone and start to kind of connect with people locally. And reduced falls

and the impact that's going to have on the NHS in terms of reduced one -on -one

calls and reduced GP appointments, mental well -being, these are all

all benefits, but I think for me some of the things that kind of hit home are speaking to someone who

just wanted the confidence to be able to get on the floor to play with their grandkids knowing

they could actually get back up again. It sounds really silly but that's a really big thing for

people. We had a lady whose daughter was moving, she lived in a second storey flat and she didn't

think she could help because she couldn't get up and down the steps. So at the end of the 12 week

moved house and she was actually able to help her daughter out.

And then I think the last slide is a case study.

There we go.

So I'll give you a few seconds to read through it.

This just suggests and tells me there's more that we're doing

than just getting people moving and active.

So that's it in a nutshell.

I don't know how I did in the five minutes.

I might have gone slightly over.

But hopefully that made sense, and hopefully that

was interesting.

Thank you to our commissioners and our partners,

including AGK, Barts Public Health, and LEAP.

And thank you for your time.

Cllr Isobel Darby - 0:19:33

Thank you very much, Adam.

What a success storey.

I mean, that really brought it to life.

Thank you very much, Adam.

What a success storey.

That really brought it to life.

I think for me, it's when you hear

about the real people behind these population numbers

and the differences it makes.

And that's what it's all about really, isn't it?

So thank you.

So we're now going to move on to Mark.

Sorry.

Oh, sorry, Gemma, I beg your pardon.

No, for myself.

Hello, everybody.

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:20:03

So the proactive frailty clinics are something we've worked

up in partnership between acute

and community health services and primary care.

Sorry, if you can move on to the next slide.

Thank you.

And what they're about is inviting people who are moderately frail in proactively to

a service.

So they're not people that are experiencing a decline in their health at this moment in

time, that they've kind of not identified through general practise or ED for services

or emergency department through services.

But they're people that we know based on their data in the primary care record, but also

from the mental health record and the hospital record that are moderately

fail and could use this support. So we invite them into clinics, they're

multidisciplinary clinics so within that clinic they're seen by doctor, a nurse

and an AHP which could either be a physio or an OT and a

comprehensive geriatric assessment is undertaken and a CGA is a kind of tailored

patient person -centred whole person assessment that looks at your health,

for your wellbeing and social factors.

So it's not just looking at particular conditions

you might have, it's looking at you as an individual.

And it focuses on what you as an individual,

what matters most to you, what do you want to achieve.

So similar to kind of what Adam was talking about,

is what's going to drive you to focus

on improving your health and wellbeing.

Following that assessment, the patient then receives

advice, interventions and onward referrals

that can support them so that their frailty doesn't decline

and we can continue to keep them well for longer

and as long as possible. And when I say well we mean health but we also mean

independence and generally feeling they have meaningful impact on society. So

just moving on to the next slide it's still quite early days we started this

at very end of October last year but we've now seen 72 people and 154 have

been referred and we're getting really positive feedback and we're kind of taking

a continuous improvement approach to making changes all the time. They're

operating within the neighbourhoods.

So they're close to people so that they can access them.

We're not inviting people to the hospital

and asking them to travel for a long time.

There are some quotes on there that people have shared,

but we've seen some really significant impact.

So we invited somebody in and they have Parkinson's.

They didn't have the,

they didn't know and weren't aware

that they were having symptoms.

So we've been able to get them diagnosed really early

and get that support,

which will have significant impact on their outcomes

and really support them.

We've been able to get people equipment on the same day

and to support them to stay at home

and kind of remain independent.

We've had people referred through

to falls prevention services

and lots of people have been signposted

to social prescribing, health coaching,

and prevention services, particularly through JOY.

And most of these people aren't aware that they're declining.

So it's really that proactive support.

And we really do believe, and there's an evidence base, that it will reduce hospital admissions

through identifying that frailty earlier, but giving people a plan to support them to

stay well in their community.

As well as kind of from the health perspective, it's really about that independence, which

you can see in terms of providing that equipment.

And it's a new way of working, kind of using the digital and the rich data that we have

around our population to be able to proactively support them.

Thank you.

Lovely. Thank you very much.

Is it marked to turn now?

Thank you.

Mark Russell - 0:23:45

As I said earlier, I'm from AGK Buckinghamshire.

We're a local independent charity with about 120 volunteers,

44 staff, and we directly support about 6 ,000 older adults a year.

We're delighted to have been chosen as a partner

to deliver the adult social care prevention service.

And we see it as a big opportunity

to support more older people, to be proactive about that support

and also see it as a big responsibility too.

And I'm going to share with you some basic information

about the service which launched yesterday.

So we're right in the thick of it now.

So, this service is supporting older people in Buckinghamshire, primarily over 65.

There is some ability to support people younger than that, depending on their circumstances.

And core to it is identifying emerging upstream needs and challenges, recognising adverse

changes in someone's circumstances.

They might have become more isolated and lonely over time.

They may have had a bereavement or lost a loved one.

Their health or mobility might be declining.

They might have suffered from mood change or increased

anxiety.

Those are the sorts of qualifications for the service.

The service will be delivering holistic,

person -centred assessments, which are core to understanding

someone's circumstances, and are co -produced with that client

support plan which will focus on achievable goals and root causes for

their situation. Those will be personal goals set with the client. We want to

make sure they have better knowledge and understanding of the access they have to

support around them and we'll base those goals on personal strengths and local

assets so we're not trying to create a goal that is unachievable or too

difficult or they don't have motivation to deliver.

How it works in practise.

So we'll have up to nine community support connectors

who are embedded in the communities

and aligned to the new integrated neighbourhood team

structures across BUCKS.

So six of those.

They'll be delivering home assessments.

And we've based that, having worked with public health,

we've based that on five pillars of ageing well.

So, this is an open university structure and framework for looking at good practise in

ageing and includes hydration, nutrition, social, cognitive, and physical activity.

But we're also looking at someone's environment, their financial situation, digital exclusion,

another wider impact on their lives.

The service offers initially a six -week support plan.

So a support plan is developed with the home assessment and then there's six

weeks to activate that support plan and that will be developed and left with the

client.

And then we'll be referring to other partners,

local and bucks wide to give them the relevant support to meet their goals.

And we'll be doing that through the joy system. Um,

this software system that allows us to use the marketplace to access referrals

across the support network in bucks.

There will also be some volunteer support on the service which will be used to encourage

and provide practical help to a client to get that support plan activated.

There will be a little bit of hand holding with that client through the volunteer, but

it's mainly around giving them the understanding and the motivation to engage with the services

that they've been referred to.

And we'll be collecting baseline measures and outcomes at the home assessment, at a

six -week cheque -in and then a six -month interval to see how they've got on and what the impact

of the service has been.

In terms of access to the service, there'll be professional referrals and there'll be

self -referrals as well.

We've got accessible channels, so there's a live Monday to Friday public phone line

for anybody to access the service.

We're live on the Joy Marketplace.

We're also connected into Joy Connect through the GP PCN network so they can refer using

Joy Connect.

Our community support connectors will be in the communities doing outreach, working with

the INT structures to be present at local activities and events.

Referrals will come from a variety of areas.

GP social prescribers, adult social care, self -referrers, organic referrals from Age

UK Bucks.

We get a lot of calls from older people in these circumstances and also the wider voluntary sector.

And then we'll be employing offline and online comms because there are a lot of older people who are digitally excluded for different reasons.

So posters and leaflets.

There will be a new brand launch for this service that stands alone in its own right.

And I can reveal that we launched yesterday with the name of the service as Age Better Bucks,

which we hope and have learned from engaging with public health,

but also older people and professionals was the best iteration

of what this service really can provide for people.

There is a website that has gone live on our site

and there'll be a standalone landing page for the service.

Social media will then come through and obviously we're on Joy,

a marketplace and connect as of yesterday.

What does success look like for the service?

I can't go into the level of detail.

Adam did on Move Together because we're literally a second day in, but obviously this is about

person -centred holistic support that helps and supports older people facing challenges.

Our target in year one is 1 ,250 people supported through this programme, rising to 2 ,000 annually.

And it's about being able to demonstrate the value and impact of those interventions working

with clients.

And those hopefully will move or improve these things.

So improve social connexion and contact.

And loneliness and isolation is at the heart

of what we're trying to do with this service, improve that.

And improved health and well -being, better mood,

less anxiety, more sense of purpose.

Also better access to financial support, for example.

And then better knowledge and access

to the services and support that exist locally

around that individual.

And ultimately, as well, I think working in the INT structure

is to make a more connected, integrated local support system

that talks to each other and understands how

to support individuals together.

And then finally in summary, what's it supposed to do

if there's one thing to take away?

Older people feel more supported and resilient.

They're able to maintain and support their independence,

often hard -fought independence.

And ultimately we want people to obviously age better

and we can all age better no matter where we're starting from.

Thank you.

Cllr Isobel Darby - 0:30:59

Thank you very much.

A lot to think about.

I've just got one question.

So Adam, you said that your work was in the opportunity bucks wards,

but I think I'm hearing that the other work is more widespread

than just the opportunity bucks wards, is that correct?

Yes, county wide.

Okay.

Adam, Mark, and of course Gemma, who's always here. Thank you for attending today.

Craig McArdle - Corporate Director, Adult Social Care - 0:31:38

Just a couple of observations first. Adam, I didn't like your presentation because we always start at 50 and it makes me feel old.

I'm part of your cohort now.

Don't live in opportunity books, but otherwise I'll

admit your criteria.

But it is important that we do look after ourselves.

I still think in young middle age,

but it is an important call out in terms of that.

So that was one observation.

The other was the sense that in Buckinghamshire, we've

got great partners and a really strong VCS, Voluntary and

Community Sector Chair.

And I'm really proud that you're on our patch, really,

and making such a difference.

And I was really heartened as well that it's joining up really well with our neighbourhood

working.

That's what we need to really focus on going forward across this county in terms of that.

I just wanted to ask something, though, because I think reading the data, Sarah, falls, looks

like it has to be an area of focus.

And my question was, do you think we understand that focus well enough?

And following on from that, really, is the data telling us that we could do better in

our care homes in terms of that as well?

And I just wondered whether we should also, as a board, be thinking about ageing well in

our care homes and whether we need to do a further piece of work in there.

Because clearly, when you move into a care home, we still want you to live well.

And it's really important we do that.

And Mark, it's probably a question for you in that respect.

I think it's really powerful that we've got HUK really operating in a real priority service

area as well.

Do you think there's more that we could do around information advice for people who want

to move into care and maybe shouldn't be moving into care at that time in their life as well?

Those are my questions, Chair.

Cllr Isobel Darby - 0:33:25

Right, lots of questions.

Who's going to go first?

Sarah Winchester - Consultant in Public Health - 0:33:34

Should I pick up the falls point?

Should I start there with that?

Thank you Sarah.

So I completely agree that looking at the data

it is telling us we need to sort of sit up

and take notice and think about this more.

I think I would say two things.

So one, the initial data that we've got

is showing that widening inequality

in terms of where these people,

where these residents are living.

And that's why I think it's really important

that with initiatives like Move Together,

we're starting with our opportunities,

these bucks' awards and we're putting in more resource

where we can see that need is arising.

I think we could know more, so we have scheduled this

as a topic report for the JSNA,

and I know we'll be discussing the JSNA later,

so that links across nicely,

and those conversations are starting at the moment,

so we can really drill into who is falling,

what are the risk factors, what are the outcomes,

and how can we find the sort of the sweet spots

for more activity and more support

to try and bring that prevention more online.

So I think Care Homes are a key group that will come through

in that report that will be done over the next six months.

Cllr Isobel Darby - 0:34:43

Thanks for your questions.

Mark Russell - 0:34:46

So let's start with, I mean, I'm glad you said about the age

because I often quote that the average age

of a UK council is 60.

So I always like to start with that,

just to particularly around policy locally

to make people's ears prick up because it is about us.

It's not about them over there.

It is about all of us and how we're ageing.

And just on Gemma's point about the frailty clinics,

I think we've already been in touch with frailty clinics,

been in touch with us

about integrating the adult prevention service

with the frailty clinics

and even having our community connectors present

at the clinic so that there's almost a live hand

over where we can.

So I think that's something we'll be looking at doing.

In terms of information advice and care, we do get lots of

calls into our information advice service around onward

care, and we do that responsibly, always giving more

than one option and trying to explain the sort of decision

making process and the resources available.

I would say one of the things I'd like to see more of and

we're working on is more partnership working across the

sector from commercially or commercial organisations into the voluntary sector so that we're not

as afraid as sometimes the charity sector can be in engaging with commercial organisations

where the care sort of transition might happen.

So we do work with in -home care organisations as well as care homes, but we probably should

do more of that and we're looking to do more partnership in that space.

But in terms of other areas of support for older people, I should use this as a platform,

shouldn't I? Um, and this isn't a platform for us because we don't offer some of

these services,

but areas where we get asked a lot and we do a lot of onward referrals is

actually still in the space of people wanting to retain that independence and

not go on to a different environment and a different care situation.

So PA, personal assistance services, sitting services, um,

low level advocacy with a small a,

help me get stuff done because I just can't get it done.

digital exclusion, complex systems of getting in contact with the right people,

the right authorities and still a lot around social connexion which is what

we've done on Age -Friendly Bucks with public health and also just personal

mobility around town, around the village, around my garden and having the social

confidence to do that as well as the physical confidence and I think that's

where it links very much into the false piece.

As soon as you're in a position where you don't want to walk outside the front

door because you're worried about the next trip,

which you won't be able to get up from or might hurt you. And once you've had one,

if you haven't never had one, once you've had one,

it is an incredibly emotional confidence hit,

which, which begins the potential decline.

So preventing that fall or really supporting once the fall has taken place is

massively important.

Cllr Isobel Darby - 0:37:51

Thank you very much, Mark.

And I know I fell and broke my ankle, and I know how nervous I was afterwards about

it happening again, and touch wood it hasn't, but it is that.

And that's somebody who isn't, if you like, a person who's not confident generally, but

I can absolutely see, and I have seen for myself, how once somebody has had a fall or

a couple of tumbles or even just a near miss, if you like, it makes them lack the confidence

and think well I can't do that or I better not do that just in case and

they're missing out on so much of wonderful life because of that and to

enable people to get over that hurdle and be confident and be safer is so so

Dr George Gavriel - Director, Bucks GPPA - 0:38:36

important. George I think you were next. Thank you chair and thank you all for

great presentations I particularly appreciate how and personal focused they

were and Mark's already answered my first question which is how are we

integrating our chief services you know I think we talk a lot don't need

Gemma and and I and Craig about you know we need a programme rather than a

selection of pilots so you know it's important that they're kind of working

together. On that kind of slight pilot side of things I think I want to

kind of challenge us a little bit around scaling and essentially, you know, some of these projects,

I think, you know, especially yours, Adam, you know, they're fantastic for the people

who get to benefit for them.

But we're seeing an approach now, particularly from the ICB around strategic commissioning

and an opportunity with neighbourhoods and this potential delegation that we might have

a little bit more control over our budget.

So I guess my challenge for all of us and and lots of my colleagues who know me have heard this

I think we really need to now nail down on

demonstrating return on investment so that we can then

Redistribute and scale, you know your statistics that 23 %

Reduction in Falls is amazing because that's the real benefit for our residents

But actually when it comes to you know, you're you want your service over the whole County

I am sure, and I definitely do, we need to really demonstrate actually what the savings

that can be made to the system so that we can completely justify spreading this to everywhere.

And I'm thinking, you know, particularly the potential benefits

for our rural isolated communities.

I think there's a huge opportunity there, not just around falls, but also the social isolation,

which is also very heavy in this report.

So that's my kind of challenge to everyone, rather than the question.

But I suppose then my question comes back to Mark, just a little bit around your baseline

measures.

Maybe could you give us a little summary of what those are?

And I guess my challenge to you is will they, will we from those baseline measures be able

to get to a point where we can demonstrate return on investment so we can scale your

service to more people, which is, you know, obviously what we want to do if it, if it,

if it achieves the goals that you've laid down.

Mark Russell - 0:40:54

I'll give it a go.

And because there's people in my team who are closer to it

than others.

So the baseline measures are a combination of ONS

for well -being measures, which we'll be asking at assessment

stage and then the six -week, six -month,

but also by age well pillars.

So hydration and nutrition, cognitive, physical,

social activity and that environmental factor,

I -statements.

So I -statements, which we ask again at the point of

assessment, which is a relative score for somebody

about their state at that time.

We're also looking to embed into the baseline, well,

into six -week and six -month questions, the client's

perception of whether they've achieved their goal or not.

So, there's one having the framework around the ONS sort of well -being measures, which

in a six -week period will be hard to move, but in a six -month period with the support

that comes through the referrals, we might see some movement and some change.

But the perception of people's feeling of achievement of their personal goals, those

key priorities that are in the support plan, I think could be quite important.

So, we'll be measuring at those different levels.

ONS4 for the sort of, you know, benchmarking that's more integrated with other measures

and frameworks.

The I statement's based on particular needs in those areas of sort of ageing well pillars.

And then my perception of whether I'm achieving the goals that we've set out to achieve.

And that's how we're approaching it.

And we've been working with public health on how that works.

I'm sure that when we're in the field, the practise might be a little bit more difficult,

but we're used to that sort of thing happening.

And we'll be tracking that certainly in the first quarter

to see what's coming through because all those measures will

be inputted onto the joy system, hopefully, which means we can

data extract them and look for those changes in impact.

And hopefully that will be something that we can work with

the Commissioner and Public Health on to, you know, adapt

and work to and see where we are after the first quarter.

Cllr Isobel Darby - 0:43:06

Lovely.

Thank you, George.

Do you want to come back?

Dr George Gavriel - Director, Bucks GPPA - 0:43:08

Yeah, I just so I mean for me those are the important things

But I think realistically to kind of, you know, sustain and spread this, I suppose maybe

it's a question more for Sarah.

Do you think there's work?

First of all, do you think cohort's large enough for us to be able to then extract the

data that we need about impact on use of services, economic contribution, that side of things

which then can help Craig and I make decisions in the future about continuing and expanding

the service from resource reallocation and things like that?

I think we have to be realistic in terms of the size of this service.

Sarah Winchester - Consultant in Public Health - 0:43:47

It is focusing on reach rather than in depth for those clients because we know there are

other in depth services out there.

So the difference for each individual might be slight and we hope to scale that with the

volume.

I think this will give us an indication it's a very different service model to what we've

before and then once we've got those data then it becomes a question of do we

want more scale and more volume. I think to get a robust return on investment

we'd probably need more scale and more volume so you're probably looking at a

phase two of this type of service. This is very very early days but that's the

direction of travel that we'd like to see. I think impact on service use you'd

probably need more numbers to really get something robust. I think we'll be

looking at indications of that in conjunction with the sort of broad suite

Mark Russell - 0:44:44

of data. Two other things to say on that. One is we are in discussions about how

the data and anonymized level fits into other indicators so one of the

eligibility non criteria is someone who's already in adult social care sort

support, but we'll be able to look at this data anonymized to see if people have gone

into adult social care support, which I think is important.

And through JOY, there is a connexion with the GP e -miss system.

So certainly from referrals that come from PCNs and the GP practises, there's the opportunity

to see if there's, I mean, obviously there's wider determinants and all the rest of it,

but to see where someone who's been on this programme,

at least to be able to map that journey,

and if it's linked back to the GP system,

they can do some sort of assessment around the impact

of the wider services they've engaged with.

So there's more work to be done on that.

But the processes and procedures are possible to do that work.

Cllr Isobel Darby - 0:45:49

Lovely.

Thanks very much.

David.

David Munday - Director of Public Health - 0:45:53

Excellent.

One of the nice things about others going first

as they asked some of the questions that were in my mind.

So that's really helpful.

And I think I was going to ask about the falls part,

but understanding that point about that kind

of secondary prevention.

So after one fall, and what we do,

I think is really important.

And Sarah described the data really clearly.

So that's really helpful.

Picking up back on the kind of move together part,

and picking up, I think, George's right challenge to us

in terms of, OK, how do we prove return on investment?

How do we expand this?

Adam, I'd be really interested from your perspective, is it a question of, as commissioners, it's

like there's a funding question, full stop, is it a question of how referrals come into

your service at the moment and is there anything more we should be looking at in that space?

Is it about what is available in the community that you're then connecting people to, to

help them be physically active?

From your perspective, what would help with that kind of ambition that we've all got to

get the most out of this service.

And then maybe I've got just a question

about the fair health clinic as well.

But do you want to?

Can you go first?

Mark Russell - 0:47:03

Thank you very much.

Funding, yes please.

Adam Howard - 0:47:07

No, seriously, on the funding side of things,

I think what we've learned very early on is,

I mentioned that the people that are putting

our programmes together are level three trained exercise

on referral, they're trained in COMB,

they've done MEC training,

so making every connexion count.

We've given them a set number of hours they can spend with the kind of people they're

working with, but they've got so much experience, they're really passionate, and they're opening

up some really good conversations.

And part of my job has been to say, you've spent quite a lot of time with that person.

They've kind of had their go, you need to move on.

But actually, when we're starting to gain trust, it feels like a bit of a wasted opportunity

not to be able to extend how long we can have with people.

Um, the budget has to be set on, we've got a KPI that is the divvy up per,

per people,

but I suppose increased capacity would allow those conversations to go a bit

deeper than just movement. Right now we're moving.

Can we move you into Mark service and that kind of thing? Um,

in terms of going County wide funding is going to be key there because what

we've got in the opportunity bucks wards,

which kind of links to your third point,

it's quite a good understanding

of what's going on in Aylesbury,

what's going on in Chesham and Wickham.

If we were to expand to Buckingham,

we don't have as good an idea of what's happening

in those trusted places I mentioned,

village halls, community centres, churches.

So to do the asset mapping of those places

is gonna be really crucial,

which again opens a lot of other doors.

If we know there are community centres that are underused,

we could put more provision in there.

If there are really trusted churches, they're a really good source to get to other people.

So that opens up that because I think if we look at joy as the marketplace, I'm very fortunate.

I sit across several counties.

Every county is trying to create a marketplace.

I'd say every county in the country has tried it from sport and talking to Sport England.

Everyone's trying to do a marketplace and we haven't quite nailed it yet, but there

is so much going on.

There is so much opportunity out there.

And I mentioned earlier, for some of the people that come into our service, they're motivated

to be active.

They know they need to move more.

They just don't know what's going on and where to find it.

And that's where we fit in.

In terms of the gaps in that provision, that free access to sessions, there isn't lots

going on that's free anymore.

Simply Walks is a really good example of free volunteer -based.

But we're certainly seeing with funding, rightly so, if you're funding something for a year,

you want to see that it's going to be sustainable past funding.

But if we're looking to set up free provision,

it's always going to require funding.

Even if we look at community pricing going two pounds, three pounds a session,

venue hire costs more, instructors cost more. So that's something to consider.

And then in terms of referrals, yes, there's so many amazing services. It's, uh,

it's making sure that we get in front of the right people and get the right buy

in, but it comes back to proving what's being done.

and I think we're at a point now we can start going back to partners we engaged

with early and saying we said we were going to do this and here's some

evidence that we're actually achieving what we said we were going to do. I mean

that's a really important part moving forward so just making sure we're

connected up to to the other services that are on offer and working in

partnerships really important and then doing that piece of work that goes back

and says look we've had a few months now to find our feet these are the early

results and now we can start using the service a bit more widely.

I don't know if I've answered all your questions.

David Munday - Director of Public Health - 0:50:45

They are a bit more rambly, but hopefully you extracted some useful stuff from that.

No, that's really, that's really helpful.

And it feels like on that last bit then on those referrals, but it's, it kind of

builds a bit of momentum, doesn't it?

It sounds like what you're, what you're describing, but we can all play our part

in flying the flag for what is currently available as well as that question of

yeah, how is it, how is a place?

Can we look at the expansion and the resourcing for it?

Thank you.

And if it's okay, just a quick question, Gemma.

Just wanted to, the proactive frailty clinics feels

like intuitively like exactly the right thing to be doing.

How easy is it to measure six, 12 months down the line?

I know it's kind of early stages at the minute.

What those kind of outcomes for people in terms

of whether it's reducing hospital admission or other ways

in which we're measuring the kind

of avoiding frailty kind of piece.

Have we got, we may not have data yet, but a plan

as to how we'll best measure that?

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:51:35

Yeah, absolutely. We do have a plan. So we work with a system called Connected Care Insights,

which uses the shared care record, which we all put data into. So it will track our health

activity and social care activity. We're trying to expand the amount of social care activity

we can put into that. We're also asking for what we call PRIMs and PROMs, so patient reported

experience measures and patient reported outcome measures. So we can see that kind of person

approach as well and make sure people are achieving their goals.

Again, similar to Mark's services.

But yeah, we've got that so we can see how the individual has changed and we've also

got a comparison group for people that have either not been identified to go through or

may have chosen not to go through when they've been invited so we can also compare it to

a comparison cohort.

Cllr Isobel Darby - 0:52:20

Lovely, thank you very much.

Got any more questions or comments from anybody, Carol?

No?

Okay.

Can I just ask one more question of Adam? You talked about things like gardening.

Would that be gardening in somebody's, their own home or would that be

gardening together with somebody else? I mean is there any sort of social

connexion other places where people can go to actually enjoy gardening and

Adam Howard - 0:52:51

enjoy company? A bit of both. For some people it will be doing it on their own in their

garden if they're more happy doing home -based exercises. Perhaps they

got the confidence to go and join another group but we also have identified several groups that

have community gardens so it's trying to link them up there where possible because again you get the

movement and you get that social connexion and we also know the benefits of being active in green

space are pretty phenomenal so you're kind of ticking three boxes there so that's the preferred

option but equally if we can get them doing some gardening on their own garden that's still a win

Cllr Isobel Darby - 0:53:28

for us. I was just thinking the reason that I asked the question was following

on from you saying well a lot of these activities cost money whereas simply

walk doesn't because you're just walking out in the open air in a public open

space which is why I came to the garden thing it's you know what opportunities

there are I mean are they presumably at specific locations so not and obviously

you're only dealing with the Yacht Bucks places at the moment but it's you know

it's worth the thought and I think it's worth the thought from all of us to

think about what physical activities can people do

out in the open which are not gonna cost money

because apart from walking.

Maybe a couch to 5K is a little bit much

for some people who are at risk of falls,

but what else is there and what could be done

with a small bit of money maybe

to sort of start something like that off.

I just have one thing there.

Adam Howard - 0:54:26

Actually, it links back to, I think, Craig.

You were talking about the falls prevention earlier.

I think it's also finding those activities that, through gardening, if we can embed some

of that strength in falls prevention stuff through stealth.

Because again, I look at my dad's perfect example.

He's 74.

He's had a back operation.

His risk of fall is very high now.

But if I said to him, you need to go to a falls prevention class dad, he can't get close

enough to hit me at the moment, but he would definitely try.

But if I said to him, you're going to go to a men's shed and we can embed movement into

the men's shed, we're doing it without him realising, basically.

I think that is going to really change the dial on falls prevention, especially in men.

If I look at a lot of the older adult classes that we run, a lot of older women come.

Men do come, but most of the men that come, come with their partner.

Very few men come off their own back.

So I do think there's a lot of work to do with people like my dad.

Cllr Isobel Darby - 0:55:28

I wonder if he's watching this.

He won't be able to work the internet, don't worry.

But I think, I think that's, that's, that's really important.

But I think, you know, if that, whatever it is to help people keep,

keep well is, seem to be a fun activity, if you like, maybe they don't like it to

but it is something which afterwards you say actually that's quite good, I quite enjoyed that.

And rather than being where you've got to go to the clinic and be given exercises,

I think that perhaps is a bit of a key, but it is a very personalised thing

and it's how you persuade that person who's sitting in a chair all day

to actually move in the first place in a lot of cases.

And I can remember when I was on this board a long, long time ago

and one of our GP partners said, you know,

the biggest barrier for exercise for a lot of her elderly

clients, elderly and overweight clients, was, well,

I can't do any exercise because of my knees.

And it's, well, you know, what you do.

But I mean, now we've got chair -based exercise

and things like that.

But it is, we've got to get over all those barriers

to help people feel better about themselves.

So has anybody got anything else they

want to raise on item seven.

So we are being asked to, well, we've discussed,

but I think note the progress outlined within the report,

endorse the ongoing direction of travel,

and to continue support integrated system delivery

of the Age World programme.

And I hope everybody's happy to do that.

But before we do that,

I would just like to thank every, all partners,

and especially the unpaid volunteers who are part of this,

because without them we wouldn't be doing so much and it really is important

but we also should remember that those unpaid volunteers are actually getting a

mental health benefit from volunteering as well at the same time but it's

everybody happy to note the report and to and we look forward to a further

8 Neighbourhood Health

report in due course thank you so our next item is item 8 neighbourhood health

And we've got a verbal update from Gemma.

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:57:45

So, hand over to you now, Gemma.

Yeah, very quick update.

So, we are expecting national guidance about kind

of neighbourhood health.

We have not yet received it.

We are told we will receive it shortly.

But shortly does not have a date to it.

What we are expecting is that health

and well -being boards will have a focus around the delivery

of neighbourhood health because of their strong understanding

of their local populations.

We've also been told not to wait for that guidance to carry on

and do the right thing for our population.

So we're still waiting for that, but we're continuing to engage

with national teams

and the National Neighbourhood Health Implementation Programme,

which we're one of the 43 places that are part of that.

And as our health and well -being strategy talks about this

and neighbourhood health is a key delivery vehicle for our health and well -being strategy

in Buckinghamshire, and we have a plan around our neighbourhood health programme.

We feel we're going to be in good progress, and we just need to continue focusing on that

and link in with the national teams to share our learning

and get the learning from the other 43 places.

Cllr Isobel Darby - 0:58:57

Lovely. Thank you very much.

Can I just ask a question?

What are the sort of main barriers to making more progress?

I mean, you've been told to go off and do your own thing almost

in the absence of a DCTATs one high.

But what are the barriers?

Is it people's time or what is it?

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:59:16

So I think there's a mixture of things.

I think from a national perspective,

whilst there is a lot of push with the three left shifts

that you'll talk about and neighbourhood health.

There is still a lot of pressure to deliver.

Our statutory targets, whichever organisation that might be,

but for example from Beckinsure Healthcare Trust,

there's still a lot of focus on waiting time targets

which are quite acute.

So there's still that focus and it's trying to maintain

that focus on the kind of prevention proactive care

which we know will help us to support

and deliver those shorter waiting times in the future.

But there's a double running to it.

And some of the incentives and financial flows

that come nationally don't naturally support that.

So we're trying to work through that.

That said, we have great partnerships in Buckinghamshire,

so I think we are able to continue to move forward

and it's conversations about how we get the money

in the right places.

We've got a lot of great projects

and I think our next stage in Buckinghamshire

is how do we scale those.

So for example, because it's on my mind,

the PRAXI Feralty Clinic at the moment

has got capacity to see 600 patients.

We know there are twelve and a half thousand people in Buckinghamshire that are eligible for that service

So how do we scale it to an extent where everybody that wants to have that service and is eligible can access that?

So I think we will continue to work nationally but also to look at locally to see what we can do

I think that barriers is quite a strong word. I think there's obstacles to overcome

in the estates and

data and digital spaces and sharing that estate and sharing that information and

aligning teams that may be from different terms and conditions and

different contracts how we bring them together but I think we can do that

locally it's time energy and effort and that we need to push to it but we talk a

lot it's about holding our nav to deliver those things and holding those

kind of statutory requirements that we get from our regulators.

I don't know if anyone else wants to add to this.

Cllr Isobel Darby - 1:01:16

David Munday - Director of Public Health - 1:01:21

Thank you. Any questions about David? I've got Craig. David. It was more a

reflection I think but as the neighbourhood health kind of planning

comes through and as we are required to kind of build that up it strikes me that

just as you were saying Gemma we're in a really strong place here because this

doesn't seem to be like something different to what we've just heard

presented because all of those services were really clearly articulating that

kind of really neighbourhood level offer being very kind of place based and so

So I'm not saying we've done it, tick the box,

because I'm sure there's more work to be done.

But it feels like we're doing that,

which will be required of us.

And it's for us to shape it in a way that's

going to then be building on what we've got.

Does that feel about right in terms of our approach?

Yeah, I completely agree.

We're doing loads of neighbourhood working.

Gemma Thomas - Director of Strategic Partnerships, BHT - 1:02:05

Neighbourhood working is ultimately working together

with other partners around our populations

as close to them as possible.

So we're doing that.

I think it's that scaling up and doing it

that this is our way of working

and if we are choosing not to work in the neighbourhood way,

we've got a really strong reason why,

whereas I think currently it can be not consistent.

Craig.

Cllr Isobel Darby - 1:02:26

Craig McArdle - Corporate Director, Adult Social Care - 1:02:28

Yeah, it was just more of an observation really

to support what Gemma had outlined.

The first thing is we're very clear

this isn't a pilot that we're doing.

We might be on a national pilot scheme,

but we're doing this for the long term

and we knew this would be a long -term project chair,

so we said one to five years would be it.

And the first year was very much bedding in, in terms of that.

This year has to be a year of delivery,

and I think we've all been very clear on that.

I think that scaling up is going to be the real challenge

across the county in terms of that.

Getting a standardised approach,

but also recognising local differences is going

to come out in terms of that.

Gemma, Bobby, and Nicola also are really highlighting some

wicked issues which have been around the table for a long time.

Estates is an issue, you know, the lack of capital,

we're going to have to make use, best use of the public estate.

So we have to be really creative in that space in terms of that. But for me,

that cultural change is massive as well and investing in our workforce,

different ways of doing things, empowering people to take a risk as well,

is a big cultural leap forward in terms of that space.

And then that we're all equal partners around the table as well.

So the BCS are as respect to the statutory bodies. That's,

that is a big cultural shift as well.

So I think the next 12 months will be really pivotal for us

in terms of this space, but we're going to stick

with it regardless, regardless

of what the latest government guidance may

or may not say when it arrives.

Cllr Isobel Darby - 1:03:52

George.

Dr George Gavriel - Director, Bucks GPPA - 1:03:56

So I mean obviously from a primary care perspective,

the Department, you know, just very much reiterate everything

that's been said by Craig and Gemma.

I think there's one more potential obstacle that does concern me and I think it's more

just for awareness for the board and perhaps it might be something to just monitor which

is obviously we have an ICB that's in reorganisation and will become the Thames Valley ICB on the

1st of April and we also have another area in Slough that's on the National Neighbourhood

We're just starting to have a few concerns around being held back by the sort of slowest

developer in neighbourhoods in the ICB.

And so I guess, you know, I think at this stage we have to, you know, have some good

grace about the fact that the ICB is going through some reorganisation.

But, you know, I do have a genuine concern that will be held back to the pace of other

places which are not developing their neighbourhood programme at the speed that we are.

Cllr Isobel Darby - 1:05:12

and I think it's something that's really important for us to monitor and actually I think it's of significant interest for this board to I guess just be cognizant of that and at some stage maybe make comment on it if it ever feels appropriate.

Thank you very much.

Has anybody else got any questions or comments at all?

No? So, excuse me, are we happy to note the update?

Thank you very much, Gemma.

9 Joint Strategic Needs Assessment

On to item nine, which is the joint strategic needs assessment.

That's on page 63 of the pack.

And we have got Tiffany here.

Tiffany Burch - Public Health Consultant - 1:05:43

Welcome, Tiffany, to take us through that.

Excellent. Thank you, Chair.

It's just for the minutes and for anyone who's not familiar

with what the Joint Strategic Needs Assessment is.

It's a statutory responsibility of this board.

And the concept is to provide an evidence base

for all the work that we're doing,

especially around the health and wellbeing strategy

and reducing health inequalities.

So with that in mind, over the last 12 months,

we've made a lot of progress on it,

although there's always more to do.

So we now have some automated chapters

that allow us to generate content a lot faster than we might have done in the

past where kind of it was out of date as soon as it was published because it

would take a long time and there are quite a lot of chapters in the coming

year planned so those are in the appendix for this paper but just a few

I wanted to mention and they link to some of the things that colleagues are

just discussing so we have the automated chapters for mental health and the

building blocks of health that are due out soon but other things that we are

continuing to do as part of that process are supporting the integrated

neighbourhood teams with assessment of their population needs and we're also

working on just starting so that's working on is a bit of an overstatement

we're just starting the process of the SEND so the Special Educational Needs

and Disabilities, JS &A chapter and then I'm aware that Falls and Frailty is also

on that list and I think that was mentioned already so yes we will

continue to develop those and we're always happy to take feedback from

partners throughout the year on topics that they think are relevant or

important that helps us feed the process. So yeah happy to take questions.

Cllr Isobel Darby - 1:07:21

Sarah Winchester - Consultant in Public Health - 1:07:28

Have we got any questions for Tiffany at all? Sarah. Just one thing to tie the different

agenda items together that I forgot to mention in my update was that the older

adults chapter has now been published in that new updated version so you can go

in and find the data that you're looking for,

and that will periodically update.

So a really helpful tool for all of our partners to use

when trying to think about any work that they're doing.

I think it went live in February,

so that's rather hot off the press.

So thank you for that one in particular.

Cllr Isobel Darby - 1:07:56

Thank you very much.

Craig and then David.

Craig McArdle - Corporate Director, Adult Social Care - 1:08:00

Yeah. So thanks for your work on, Tiffany, on this.

I think it's really starting to come together in terms of that.

There is so much data in there, that's my observation,

there's so much work that has gone into it.

And it's probably a question for David and Tiffany is,

how do we bring this to life and pull it out so that the key bits

are coming out around this table?

And I just thought, Chair, reading some of the tables

in there, wouldn't it be great when we're discussing best

starting life as our theme to pull out the theme so that's

the starting point in terms of that?

Because when you read that chapter there,

that the richness of detail in there is absolutely great,

because I think it will say, is this still the priority?

Are we on the right course, et cetera?

But I think it's a great piece of work.

It's definitely come on.

It's starting to come to life.

But I just wondered, David, how we can really build

on that approach.

David Munday - Director of Public Health - 1:08:56

Dr. David

process and using some of our public health expertise, but we don't for a

moment feel that we have got the the monopoly on its insight and on kind of

what the population need is that's out there. So a strong JSNA requires that

work across kind of the partnership that's you know clearly represented by

the board here. So I think that's kind of the first thing is that it's very much

like a system effort.

I think secondly then, with our updates that are coming

through on the health and well -being strategy,

the strategy itself was informed by the data that was

within the JSMA, but I think we probably could do a bit more

with the updates that come through in terms of drawing

that line between, okay, so here's the data that we've seen

on, as you've highlighted, Startwell,

and there's really rich insight there,

and that's how it has an informed action and the plans

that we've got, but also how it, as that data changes,

how those actions are kind of being modified and so forth.

So I think there's a way we can describe that

within the updates that come here that can pull that out.

And I think that will kind of help bring it to life.

I think we're always kind of open -minded to that work

programme that's been presented.

like there is endless things we could do,

kind of bits of kind of data related work on.

And if partners look through that list

and think there's gaps,

think that there is other opportunities

that we could take to understand kind of a particular topic,

a particular theme, a particular stage in life better,

then I think we really want that conversation

because it's meant to, as you were describing, Cree,

it's meant to inform action.

It's meant to kind of be visible and useful.

So, it's there to be a tool to be used and let's maximise it.

Craig McArdle - Corporate Director, Adult Social Care - 1:11:03

Yeah, that's really helpful in terms of that.

I think you're right.

This is, you know, this is a strategic board looking

at improving the health and well -being of the population

over the next five years, 10 years, 15 years as well.

So, we've really got to use that data as well.

I'm really keen that we take a more focused view

about the wider determinants of health really.

David and team in terms of that.

And I just wondered what the building blocks of health summary report might look like going

forward and how would you utilise that around this board?

And yeah, thank you.

Thank you, Craig.

David Munday - Director of Public Health - 1:11:37

So, I think that building blocks of health bit is really important.

I think we sometimes fall into that mistake that we think that kind of our health and

then healthcare services are exactly the same thing.

And we know that they aren't.

So we all, and as we've been talking about the various services that we've kind of been

developing around the age -well space earlier, we clearly need all of that in play to be

supporting us to age well.

But we know that the data and the evidence shows us that the things that determine our

health more than anything are some of those wider building blocks and those wider determinants

on kind of health and well -being.

And that will include the quality of our housing.

That will include the air that we breathe.

That will include access to green space.

We heard quite a lot about kind of green space before.

It includes the quality of our job, our education, and so forth.

So I think the JSNA chapter will be really helpful in kind of just pulling out that data

and that insight for us around that whole theme, but also then the annual report that

I'll do in 2026 will also use that same data to help pull out what do we think the key

kind of next steps are for us in Buckinghamshire to build that

kind of insight into an action around those building blocks of

health because I think we've got a strong base here, but I also

think there's more that we can do.

So I'll use my annual report in 2026 to try and kind of shine a

spotlight on where I think those opportunities are to have a

greater focus on some of those key building blocks of health.

Cllr Isobel Darby - 1:13:10

Okay, anybody else got any questions or comments?

So we are asked to note the progress and to agree the proposed topics for this financial

year and commit and agree to delivery by all partners of new and updated JSNA content and

priorities.

So, sorry.

Sorry, can I just make one more comment to kind of link all that together?

Tiffany Burch - Public Health Consultant - 1:13:38

So picking up on Craig's point about how we bring it to life where partners are

doing big commissioning, not that we want to do your commissioning,

but that's always an important time to come to us to see what evidence we have

on need and how that can link to the commissioning that you're going to do.

No point in reinventing the wheel.

And then secondly,

just to pick up on another area of my portfolio that links together is leading

on sort of public health research in addition to my intelligence function.

And there's quite a lot there nationally from the national Institute of

health research for public health and social care.

In addition to all the funding that they standardly do

as you know, for the NHS,

but there's a lot of untapped resource there

and support that they can provide us.

So particularly in the council, it can be wider.

Please do come to our team

because we can help potentially access funding,

but also link to the right resource and expertise.

Cllr Isobel Darby - 1:14:31

Thank you very much.

So is everybody happy that we move on to the next item,

10 Buckinghamshire Executive Partnership

which is now we've got information items so we've got item 10 which is the Buckinghamshire

executive partnerships that's page 71 of the pack and that is over to Craig.

Craig McArdle - Corporate Director, Adult Social Care - 1:14:49

Thank you chair yeah this just brings in a summary of our last meeting the

Buckinghamshire executive partnership you will see as part of that as well we

we did actually have a focus on the joint health and well -being strategy the

as well area as well although we didn't have the excellent presentations of Adam

or Mark at that particular session although Sarah was very good I might add

here for the public record in terms of that but that that was a good discussion

but we also tried to take a wider lens at that meeting as well chair so you'll

see the Buckinghamshire work plan which was a real collaborative piece of work

between Buckinghamshire Council and our job centre plus and of course our ICB

colleagues as well, I know Nicholas certainly has helped in that sphere as

well for us and that was a good discussion because work and the

employment is such a key area for us it really is in terms of that as well so

and I think one of our reflections is discussing that earlier with some of our

other health partners would have been helpful in terms of that as well and

then how do we really get that sort of approach into you know job coaching it

into the neighbourhoods etc feels like one of the challenges as well so that

felt like a really good discussion. The other good discussion was around that

best start to life focus really and we had an overview of the Family First

Partnership Programme and the best start in life and again what we're trying to

do locally is trying to stitch together some of the national programmes of work

which don't quite seem as aligned as they could be as well so that's what

we're trying to do around as partners just to make best use of these as well

And we're all very pleased about the Best Start family hubs, for example, but we just

need to make sure that they really dovetail into the neighbourhood, neighbourhood workings,

et cetera.

And crucially for our populations, people know where to go.

That's really important.

So that information and advice piece felt quite important as well.

We had our user updates around joining up care.

It's been a really busy winter.

So it's now Tiffany might want to say something around that really quite busy winter.

But we've managed to sort of maintain flow throughout that period of time.

and some great work by the BHT Trust,

adult social care colleagues to manage that as well.

We're not out of winter.

It might be March, but it doesn't feel like we're out

of winter today, certainly from the amount of pressure

that the hospital's under as well.

So we'll keep that working.

And then we had a really helpful update

on the integrated neighbourhood teams as well,

and then finally on SCMD.

I should also say that we're in the process of reviewing

the partnerships terms of reference.

We want to bring in more partners to that as well,

VCS etc. So just feel more of a collaborative board going forwards as well. It's been a very

statutory partners focused meeting at the moment so that's going to be on

the agenda further. We're going to look at membership but also get some

development time just so that we really sort of develop our relationships more

going forwards. As we said certainly around the INT integrated neighbourhood

teams this year it feels like a really big year for delivery.

That's it, Jack.

Cllr Isobel Darby - 1:17:54

Lovely, thanks very much Craig.

Has anybody got any questions or comments

on what Craig's just presented?

I mean, we're just asked to note the contents of that.

So is everybody content to note the contents of the report?

Thank you very much.

12 Integrated Care Board Update

Just going to skip over item 11 because Zoe's had to nip out.

So we now go to item 12 if we may.

That's the integrated care board report on page 79 of the PAC.

And to go over to Nicola.

Thank you, Nicola.

Thank you, Chair.

Nicola Newstone - Assistant Director for Partnership Development - 1:18:25

I will just give an update on a couple of the items that are in this paper.

So as George referenced, the ICB is now in formal staff consultation from last week,

which will be for a period of 45 days to the 9th of April.

On the same timeline as that, there's also been an operating model published

and you should have received as chair of the Health and Wellbeing Board an opportunity

to comment on the operating model of the ICB.

and that sets out how the ICB will operate

as a strategic commissioner and also gives some detail

on the executive roles and how they contribute

into that strategic commissioning view.

So that's the first point.

And then another topic, which is of high interest

to quite a lot of people around the table

is the Thames Valley Innovation Fund.

So in the document, there's a high level summary

So just as an update to that,

so the pot started at around 52 million.

There's been some initial decisions made

and funding allocated, which was primarily focused

on the delivery of core services.

So looking at elective pathways and access

of community services and also

the mental health investment standard.

So we're now entering into phase two

of the Thames Valley Innovation Fund.

And people that have submitted expressions of interest

should be hearing today whether those expressions

of interest align to five priority areas.

And if they do, over the period of March,

there are some planned workshops

where alongside stakeholders,

we will look at how we develop those expressions

of interest against those priorities.

And it links to that scaling up

to how we look across the Thames Valley to make investments

to kind of deliver some transformation.

So that will be the first point.

And then people will also be formed at this point,

the expressions of interest don't align to those priorities

and that will be more about working with the ICB

in the longer term around our strategic intentions

and also commissioning in a BAU sense.

Cllr Isobel Darby - 1:20:42

Thank you very much.

We got any questions or comments at all for Nika?

So thank you very much.

And if we go then, do we have anybody to report

on the literature in Luton?

Do we have anybody?

We don't have anybody here to report.

Oh, no. So they only attend every meeting.

Yeah. So we just, we just are really happy to note the contents

of the, the Bedfordshire,

at Luton and Milton Keynes Integrated Care Board.

Yeah.

I think what we're going to do is we're going to

just go over the Health Watch one

13 Forward Plan

and we will move on to the forward plan and AOB.

If that's okay with everybody.

I would just,

unfortunately, I always had to leave this rather suddenly,

but what I would do is I would just say that on that item,

on item 11, the Health Watch,

there was we've had a written response from Kate Walker and is that going to be

circulated or is that just there to... We will include that into the minutes. Okay

it will be included in a minute so is everybody okay with that? Okay lovely

thank you very much and then if we're now moving swiftly on to the forward

14 Date of next meeting

plan and AOB so we're looking at the next meeting on the 14th of May when

hopefully the sun will be shining and all the flowers will be out and we'll

in the garden doing our gardening and getting close to nature. I'm actually

looking forward to it. I really am because I love gardening that's my happy

place. So we've got the health and well -being strategy focus of LiveWell,

Buckinghamshire Works plan and then the information items. So is everybody happy

David Munday - Director of Public Health - 1:22:27

with the forward plan for that? Yeah, David? We'll I think work with Gemma in the

on whether any guidance has come out on the National Neighbourhood Health work or not,

kind of dot, dot, dot, as to whether there's something that needs to come on or not.

Cllr Isobel Darby - 1:22:42

But I don't think at the minute it's quite clear.

Absolutely. Are you happy if we played that one by ear for the time being?

So, yeah, so I think we are now at the end of the meeting

and I would like to thank everybody both in the room and online for being here today

and for anybody who's tuned in to listen, thank you very much.

I hope you found it useful.

And I think it's fair to say that around the table all the organisations are all committed

to the health and well -being of every single person in Buckinghamshire.

So I'd like to thank you and formally close the meeting.

Cllr Steve Bowles

Conservative

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Cllr Isobel Darby

Conservative

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Cllr Carol Heap

Conservative

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Cllr Carl Jackson

Conservative

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Health and Wellbeing Board - Tuesday 3 March 2026, 2:00pm - Buckinghamshire Council Webcasting

Health and Wellbeing BoardTuesday, 3rd March 2026 at 2:00pm

Agenda

Slides

Transcript

Map

Resources

Twitter

Forums

Speakers

Feedback

Votes

1 Welcome

Cllr Isobel Darby - 0:00:00

Cllr Isobel Darby - 0:00:13

2 Apologies

Harry Thomas - Democratic Services - 0:00:40

Cllr Isobel Darby - 0:00:50

David Munday - Director of Public Health - 0:01:17

Craig McArdle - Corporate Director, Adult Social Care - 0:01:22

Tiffany Adonis-French - Service director, ASC Operations - 0:01:27

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:01:32

Zoe McIntosh - Chief Executive, Healthwatch Bucks - 0:01:38

Dr George Gavriel - Director, Bucks GPPA - 0:01:45

Cllr Isobel Darby - 0:01:56

Adam Howard - 0:02:11

Mark Russell - 0:02:18

Sarah Winchester - Consultant in Public Health - 0:02:23

Cllr Carol Heap - 0:02:29

Nicola Newstone - Assistant Director for Partnership Development - 0:02:35

Cllr Steve Bowles - 0:02:41

Harry Thomas - Democratic Services - 0:02:47

Sanila Hussain - Partnership Support Officer - 0:02:51

Cllr Isobel Darby - 0:02:52

David Walker - Oxford Health NHS Trust - 0:03:10

Cllr Carl Jackson - 0:03:19

Cllr Isobel Darby - 0:03:29

3 Announcements from the Chairman

David Walker - Oxford Health NHS Trust - 0:04:29

Cllr Isobel Darby - 0:05:00

4 Declarations of Interest

5 Minutes

6 Public Questions

7 Health and Wellbeing Strategy Focus - Age Well

Sarah Winchester - Consultant in Public Health - 0:06:54

Cllr Isobel Darby - 0:11:31

Adam Howard - 0:11:48

Cllr Isobel Darby - 0:19:33

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:20:03

Mark Russell - 0:23:45

Cllr Isobel Darby - 0:30:59

Craig McArdle - Corporate Director, Adult Social Care - 0:31:38

Cllr Isobel Darby - 0:33:25

Sarah Winchester - Consultant in Public Health - 0:33:34

Cllr Isobel Darby - 0:34:43

Mark Russell - 0:34:46

Cllr Isobel Darby - 0:37:51

Dr George Gavriel - Director, Bucks GPPA - 0:38:36

Mark Russell - 0:40:54

Cllr Isobel Darby - 0:43:06

Dr George Gavriel - Director, Bucks GPPA - 0:43:08

Sarah Winchester - Consultant in Public Health - 0:43:47

Mark Russell - 0:44:44

Cllr Isobel Darby - 0:45:49

David Munday - Director of Public Health - 0:45:53

Mark Russell - 0:47:03

Adam Howard - 0:47:07

David Munday - Director of Public Health - 0:50:45

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:51:35

Cllr Isobel Darby - 0:52:20

Adam Howard - 0:52:51

Cllr Isobel Darby - 0:53:28

Adam Howard - 0:54:26

Cllr Isobel Darby - 0:55:28

8 Neighbourhood Health

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:57:45

Cllr Isobel Darby - 0:58:57

Gemma Thomas - Director of Strategic Partnerships, BHT - 0:59:16

Cllr Isobel Darby - 1:01:16

David Munday - Director of Public Health - 1:01:21

Health and Wellbeing Board
Tuesday, 3rd March 2026 at 2:00pm