Health and Wellbeing Board - Thursday 14 May 2026, 2:00pm - Buckinghamshire Council Webcasting

Health and Wellbeing Board
Thursday, 14th May 2026 at 2:00pm 

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  1. Cllr Isobel Darby
  2. Cllr Isobel Darby
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  1. Sanila Hussain - Partnership Support Officer
  2. Cllr Isobel Darby
  3. Andrea Young - Chair of Oxford Health
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  1. Cllr Isobel Darby
  2. Sanila Hussain - Partnership Support Officer
  3. Cllr Isobel Darby
  4. Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative
  5. Cllr Isobel Darby
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  1. David Munday - Director of Public Health
  2. Cllr Isobel Darby
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  1. Paula Jackson - Public Health Consultant
  2. Cllr Isobel Darby
  3. Katie DeJoux - Culture and Outreach Service Manager
  4. Cllr Isobel Darby
  5. Katie DeJoux - Culture and Outreach Service Manager
  6. Cllr Isobel Darby
  7. Sean Culter - One Recovery Bucks
  8. Cllr Isobel Darby
  9. Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative
  10. Cllr Isobel Darby
  11. David Munday - Director of Public Health
  12. Raghuv Bhasin - Chief Executive Officer, BHT
  13. Cllr Isobel Darby
  14. Raghuv Bhasin - Chief Executive Officer, BHT
  15. David Munday - Director of Public Health
  16. Craig McArdle - Corporate Director, Adult Social Care
  17. Errol Albert - Corporate Director for Children's Services
  18. Cllr Isobel Darby
  19. Bobby Pozzoni-Child - Director of Partnership and Transformation Bucks Primary Care & Director of Integrated Care Bucks Place
  20. Cllr Isobel Darby
  21. Craig McArdle - Corporate Director, Adult Social Care
  22. Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place
  23. Cllr Isobel Darby
  24. David Munday - Director of Public Health
  25. Cllr Isobel Darby
  26. Sarah Preston - Head of Public Health Strategy
  27. Teresa Meredith - Assistant Service Director for Skills and Employment
  28. Cllr Isobel Darby
  29. Craig McArdle - Corporate Director, Adult Social Care
  30. Cllr Isobel Darby
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  1. Sarah Preston - Head of Public Health Strategy
  2. David Munday - Director of Public Health
  3. Teresa Meredith - Assistant Service Director for Skills and Employment
  4. Sarah Preston - Head of Public Health Strategy
  5. Cllr Isobel Darby
  6. Raghuv Bhasin - Chief Executive Officer, BHT
  7. Sarah Preston - Head of Public Health Strategy
  8. David Munday - Director of Public Health
  9. Nicola Newstone - Assistant Director, Partnership & Development, BOB ICB
  10. Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place
  11. Cllr Isobel Darby
  12. Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative
  13. Cllr Isobel Darby
  14. Sean Culter - One Recovery Bucks
  15. Cllr Isobel Darby
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  1. Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place
  2. Cllr Isobel Darby
  3. David Munday - Director of Public Health
  4. Cllr Isobel Darby
  5. Craig McArdle - Corporate Director, Adult Social Care
  6. Cllr Isobel Darby
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  1. Craig McArdle - Corporate Director, Adult Social Care
  2. Cllr Isobel Darby
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  1. Bobby Pozzoni-Child - Director of Partnership and Transformation Bucks Primary Care & Director of Integrated Care Bucks Place
  2. Cllr Isobel Darby
  3. Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative
  4. Cllr Isobel Darby
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  1. David Munday - Director of Public Health
  2. Cllr Isobel Darby
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Cllr Isobel Darby - 0:00:00
Good afternoon everybody and welcome to this meeting of the Buckinghamshire Health and
Cllr Isobel Darby - 0:00:15
Wellbeing Board. My name is Isabel Darby and I am Cabinet Member at Buckinghamshire Council
for Health and Wellbeing and I am the Chairman of this board. I need to remind you that the
Our meeting is also being webcast,
and in the unlikely event that there is a technical issue,
we will have to pause and recommence.
And I would like to welcome,
we have two people joining us online.
We've got Ashley Waite, who is the deputy member
for communities substituting for Steve Bowles,
and we've got, is it?
Sorry.
Sorry.
Hugh Terry, who is joining us from Bucks Mind, so welcome.
What I was thinking of doing is we will have the apologies
and substitutes, so I've just done the substitutes,
some of them, and then we'll go around the table
and say who we all are.

1 Welcome

So Sunila, apologies please and substitutes.

2 Apologies

Thank you, Chairman.
Sanila Hussain - Partnership Support Officer - 0:01:21
So we have received apologies from Zoe McIntosh
from HealthWatchBucks and Kate Walker
from Community Impact Bucks.
And then we've got Councillor Ashley Waite substituting
for Steve Bowles.
Cllr Isobel Darby - 0:01:33
Thank you very much.
And we will go around the table.
But firstly, I would like to extend a very warm welcome
to Andrea Young, who is our new representative from Oxford
Health, who's replaced David Walker as the chair.
And obviously, we thank David for all his contributions
over the years.
I had the privilege of meeting Andrea online last week,
and I think it would be a really good introduction
to a new board member if she just was persuaded
to say a few words about herself and her background.
So over to you, Andrea.
Andrea Young - Chair of Oxford Health - 0:02:10
Thank you, Isabelle, and thanks for the very warm welcome.
Sorry, my voice is going.
So I've been with the Mental Health Trust since 2022,
but I'm not new to the NHS, I'm afraid, having spent most

1 Welcome

of my career in the NHS, having started life as a midwife.
And I've been the PCT Chief Exec in Oxfordshire
and cover the southeast of England for NHS England
when we set it up in 2012 and 13.
But I have to say places where I'm most happy.
So very happy to be back in Oxfordshire and Buckinghamshire
and hope we can continue to contribute
to all the good progress you're making.
Thank you.
Cllr Isobel Darby - 0:02:55
Thanks very much, Andrew, and we look forward to receiving your contributions.
We've also got welcomes to Paula Jackson, Public Health Consultant, who will be speaking
to Item 7.
And then the case study presenters, Katie DeJoux, Culture and Outreach Services Manager,
who's going to talk about Priority 1, Pressure Partners.
And do correct me if I've got any of this wrong.
Hugh Terry, who is on teams, and he will be speaking
about priority two, which is safety planning.
And then we have Sean Coulter from One Recovery,
Bux will be speaking
about priority three, individual placement support.
So I would just, now we quickly just go around the table
so that we all know who we are.
So over to you, Raghu.
Hi, sorry we've been a couple of minutes late.
Mark Maseen, Chief Exec of Bux Healthcare.
David Munday, Director of Public Health for Buckinghamshire.
Craig McArdle, Corporate Diet for Adults and Health at Buckinghamshire Council.
Councillor Carol Heap, Deputy Cabinet Member for Health and Wellbeing.
George Gavriel, Director for Buckinghamshire Primary Care Provider Collaborative.
Sarah Preston, Head of Public Health Strategy, Buckinghamshire Council.
Theresa Meredith, Assistant Director of Skills and Employment, Buckinghamshire Council.
Paula Jackson, Consultant in Public Health, Buckinghamshire Council.
Katie Dejoux, Culture and Outreach Services Manager for Buckinghamshire Libraries.
Sean Cutler, IPS Lead at One Recovery Bucks.
Yes, Bobby Potts, only child, Director of Partnerships and Transformation with Bucks
Primary Care with George Gabriel and Director for Integrated Care at Bucks Place -Based Partnership,
which is a joint role with Gemma Thomas.
Gemma Thomas, Director of Trust at Buckinghamshire Healthcare Trust and Director of Integrated Care.
Nicklin Euston, Assistant Director in Buckinghamshire for Thames Valley ICB.
Carl Jackson, Buckinghamshire Council's cabinet member for education and children's services.
Good afternoon everybody, Errol Albert, Interim Corporate Director for Children's Services, Buckinghamshire Council.
Sanila Hussain - Partnership Support Officer - 0:05:07
It's Neela Hussain, Partnership Support Officer.
Cllr Isobel Darby - 0:05:09
Thanks very much everybody and I think we just should go back to George for a minute just to say that his title has changed because he used to be the GPPA
and I was just about, just about got my head around what the GPPA was and now
it's changed but it's the same, the same isn't it? You're roughly in
the same role or do you want to expand? Yes, so very similar role and with
Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative - 0:05:33
Batching It Bucks Primary Care, although the ICB have suggested the title we have
in front of us, it's slightly different actually because my prior role was on
behalf of general practise alone, this role now is on behalf of the whole of
primary care which actually incorporates all community pharmacy, optometry and dentistry.
So we're looking at more like 700 or 800 organisations across Black
Cllr Isobel Darby - 0:06:00
My apologies, I have been told that and I've completely forgotten it, but I just knew it was George and we're in safe hands with George, so that's good. Thank you very much.
Okay, so moving swiftly on, we are looking, oh sorry, more welcomes.
Welcome to Sarah Preston, Head of Public Health Strategy, and Theresa Meredith, Assistant Director of Skills and Employment, who will be speaking to Item 8.
Gemma Thomas, Director of Strategy, Buckinghamshire Healthcare Trust, Director of Integrated Care,
Buckinghamshire Place, who will be speaking on item nine.
And then we need to have a note of thanks to Michelle Evans -Riches, Programme Manager
of Bedfordshire, Luton and Milton Keynes Integrated Care Board for her valued contributions to
the Health and Wellbeing Board.
Michelle is leaving the service and was due to attend via Teams but unable to.
Michelle's colleague Andrew will confirm replacement with Sunila for future board attendance.
And welcome to Bobby Pozzone -Child, Director of Partnership and Transformation,
Bux Primary Care and Director for Integrated Care, Buckinghamshire Place,
who will be speaking on Item 13, Buckinghamshire Primary Care Provider Collaborative.
Now we have come to declarations of interest.

4 Declarations of Interest

Do we have any declarations of interest?
Don't think so?
Excellent. So then we need to review the minutes and the actions from the previous meeting.

5 Minutes of the previous meeting

So hopefully everybody's had a chance to look at the minutes from the previous meeting.
And I don't know if firstly, are we happy that they are a correct record?
Is everybody happy with that? Excellent. Do I sign them?
So you're happy that I sign them as a correct record.
And then to I believe that David you wanted to come in on something then.
So I shall let you do that while I'm signing.
David Munday - Director of Public Health - 0:07:52
It was not any point on the accuracy, Chairman, but more just to point to our last meeting
we discussed the Move Together programme, which is a programme for over 50 -year -olds to improve
physical activity where they're facing long -term conditions to improve health outcomes, reduce
demand on services.
And it was really just to note that we've been able to secure the funding for an expansion
of that service.
So initially that started as for opportunity bucks wards only,
but we're now expanding that to cover the whole county.
So remaining focused on physical activity for over 50 -year -olds,
but also including people who are at risk of long -term conditions,
not necessarily just waiting for people that have those diagnosed.
So a really positive storey that we can expand that,
and I think just wanted to note that to the board this afternoon.
Cllr Isobel Darby - 0:08:44
Yes, thank you very much, David, and I think we all welcome that.
And whilst I think the work that's being done
and the opportunity bucks towards is really, really
exciting, there's always that thought, well,
if we could do it elsewhere, it's needed everywhere.
But I think we are having an effect on those most deprived
awards.
But it's great when we can expand something.
We can say, look, this is working.
And we found a way that we can expand it.
So that's really, really encouraging.
Thank you.

6 Public Questions

Item six, public questions, none received.
Excellent.

7 Health and Wellbeing Strategy Focus - Live Well

Item seven, the health and wellbeing strategy focus,
which is live well.
So we've got all the different strands
of our health and wellbeing strategy.
And we're looking today at live well.
And so we are going to, I'm going to hand over,
is it first to Paula to take us through that,
and then we will discuss.
So if we can all listen,
and then if we want to ask questions,
we can have a bit of debate.
Paula Jackson - Public Health Consultant - 0:09:41
Thank you, over to you, Paula.
Thank you, Chair.
Yes, so I'll give you a quick overview of the LiveWell update
and then hand over to some of my colleagues in the room
and online to talk through the case studies.
So just to recap, the health
and wellbeing strategy includes a life course approach
for health improvement.
So start well, live well, and age well.
And there's also a section on how we embed our ways
of working across the system.
So today we're focusing on LiveWell.
And this looks at improving the health of adults in our population through prevention
of ill health, proactive care, and empowering our local communities
so they can live a long and healthy life.
You'll see there's quite a few papers included today.
So it includes an update on the actual action plan that we developed last year.
There's also a paper summarising progress, key successes and challenges,
and a dashboard of lots of data, so key performance indicators
to give you an overview of where we're progressing both locally
and benchmark nationally.
So I'll just focus first on what the three outcomes are targeting.
So I mentioned that we look at preventing ill health,
and that's through initiatives such as increasing physical activity,
a system -wide approach to healthy weight management,
smoking cessation work and our approach to reducing alcohol -related harm within
Buckinghamshire. And when you bundled all these together it provides a really
comprehensive approach to particularly cardiovascular risk management within
Buckinghamshire. Our proactive care work that focus specifically within adults on
our mental health and well -being because we know that a huge burden of ill health
within the working population is mental health so a lot of the work we're
at there is on local service access.
And thirdly, in terms of what we're doing
to empower local communities,
the Live Well programme really focuses a lot
on workplace health.
So keeping people healthy in the workplace,
but also supporting those that need help
to return to employment.
So I'll give you a quick overview then of progress
of where we are at the moment.
And I hope you see from the papers there's quite a lot
to celebrate locally.
You can see in terms of prevention,
and we continue to perform well across a range of key indicators.
We've got positive trends in terms of physical activity,
smoking cessation, weight management, and cardiovascular prevention.
If you look at some of our key performance indicators,
you can see that our physical activity levels are increasing,
as is our usage of leisure centres, which is really good news.
Our weight management services are delivering above target
in terms of uptake and outcomes.
And we continue to improve the quality and accessibility of our smoking cessation services.
But it's important to point out that along with national trends, our trend locally for
overweight and obesity continues to increase, which is a real concern.
And that isn't a trend that we can reverse overnight.
That takes a lot of collective action from local partners to try and drive forward improvement
in that area.
I'm mindful that our healthy weight services are exceeding
target, that is placing a lot of additional demand locally.
So again, our partners are working at pace at the moment
to try and increase capacity to meet that local demand.
Also, it's important to note alongside national trends,
our hospital related admissions
for alcohol harm are also increasing at quite a
concerning rate.
And that's really galvanised the local response in many areas,
including partnership action within the council
and our alcohol licencing committee, alongside work
to establish an alcohol care team within the hospital trust.
So moving on then to proactive care, as I said,
a lot of this is focusing on improving access
to mental health services.
And you'll see from the data
that we've seen really good improvements in terms
of talking therapies and clinical outcomes.
And they're the services that we support for people
we've got common mental health disorders,
including anxiety and depression.
We've also seen an increase in access
to these talking therapies from our deprived communities.
And again, that's really good to see
because we know the burden of poor mental health
is much higher in those local communities.
We've also launched a digital peer support programme
called Qwell, and that's improving accessibility
to mental wellbeing support for those that are less likely
to access mainstream services.
And in addition, there's a needs assessment that's been completed
in the past year, which is looking
at the physical health service for those
with severe mental illness.
And again, this is really important because we know those
with severe mental illness have a much higher rate
of preventable health conditions.
They're entitled to an annual health cheque every year,
and you'll see from the data this year
that the target uptake has just reached 60%.
So that's meeting national target,
but it is a decline on previous years.
And that's quite a concern locally.
We think there's two drivers of that decline.
One is a national decision
to remove quality outcome framework incentives
from the primary care contract.
And secondly, we saw the end of the time limited
and outreach project, which improved uptake
and those less likely to take up the offer.
So that's noted as a priority for the ICP Mental Health Board.
It's going to be considered at a future meeting and it's also being, work is being led by our mental health commissioners to look locally at what we can do with mental health services and primary care to improve uptake and we can raise the rate of that offer again.
So moving on then to empowering local communities
and the workplace initiatives.
I think just to flag there's a lot of work going
on over the past year.
That includes a new work and health partnership,
a new connect to work scheme, and the launch
of Buckinghamshire work plans.
And I won't go into any detail on those.
I've got colleagues here today to discuss
on the next agenda item.
I think lastly though it's important to flag
that one of the key aims of the health and well -being strategies
to tackle health inequalities.
And although we're mindful that we deliver strongly in terms
of most of our key performance indicators for adults,
this really masks the local variation in local communities.
And if you look at our premature mortality rates,
we have a persistent gap in terms of the mortality rate
of those in our deprived communities compared to those
in our more affluent.
And that's been a persistent trend over the last decade.
And so that really emphasises the importance of our local partners continuing to work together
to tackle inequalities and we've got a lot of opportunities going forward, particularly
in terms of neighbourhood health and other work that we're doing within public health
to target those most in need.
So we'll provide another update on this programme in another year and just the recommendation
to board today is to note progress so far to endorse this continued direction of travel
and really to support the collective efforts of system partners to improve the health and lives
Cllr Isobel Darby - 0:17:18
of adults within Buckinghamshire. Thank you. Thanks very much Paula and I think you know when you sort
of give that presentation you just think my goodness so many things going on and so many
positive things going on, but so much more work still to be done.
And I can see the enthusiasm.
Did you want to go straight into your case studies now?
And then we can talk about things afterwards.
Thank you.
Yes, chair.
Good afternoon again.
Katie DeJoux - Culture and Outreach Service Manager - 0:17:47
Katie Dejoux from the libraries.
So I'm just going to give you a brief oversight
of being a pressure partner.
So libraries are pressure partners.
I can tell you a bit more about that, but also different community and faith settings
are pressure partners as well.
So that's where you can walk into the setting and you have convenient access to blood pressure
monitoring tools and advice.
So focus on areas facing high levels of deprivation, but all across the county.
Faithful community groups also host blood pressure stations and locations frequented
by residents across Bucks.
It's about detecting high blood pressure early on because we know this can lower risk of heart disease.
So it's part of the Love Your Heart Bucks campaign which promotes simple steps to help your heart healthy and keep your heart healthy and highlights where local support is available for lifestyle changes.
So I'm Faith in Community Centre. The concept was initially co -designed with WISE Mosque.
So it builds on community bonds and peer -to -peer relationships to support residents with their
health and to make them feel comfortable because it's in a setting that they're familiar with.
It allows for blood pressure checking and advice to be more available within diverse
communities, and it fosters a sense of trust and encourages participation.
It also demedicalizes checking your blood pressure so that simple steps can be taken
early to prove health and wellbeing, and for someone that's just been diagnosed with high
blood pressure going into a GP surgery sometimes just naturally reduces your blood pressure.
So again people are in settings that they feel familiar and comfortable with.
Just some stats as well that there were over 2 ,000 readings were completed at
pressure partner locations between April 2025 and March 2026 last year. So there are four faith
settings pressure partners, there are 16 community settings and there's more information available on
the Love Your Bucks website of where you can go.
Obviously I'm here today because I can give you
a bit more insight around libraries.
So libraries in Buckinghamshire offer blood pressure
monitors for members to loan for free.
So in most of our libraries you can walk in
and just like you loan a book, you can go in
and loan a blood pressure pitch for up to three weeks
and you can extend that.
And five of our libraries are pressure partners.
That's Aylesbury Library, Chesham Library,
Hazelmere Library, Princess -Risborough Library,
and Burnham Library.
So a nice spread across the county and we're hoping that we can get more libraries as pressure
partners.
And just some facts as well that I think help as well, that over 1200 blood pressure monitor
kits have been loaned since last year.
But actually on an average, three loans were per borrower.
So that's showing us that BP loan kit scheme is supporting ongoing health monitoring and
maintenance rather than one -off cheques.
So that's really, and we've got 129 kits in total across our library service.
And then just some feedback as well.
In Burnham Library we have a health kiosk, so that's more digitised version where you can go
in and get your blood pressure done, but you can also get your BMI.
But we also have a pressure station.
And what the librarians have found there is that for some people they like the technology.
They like to be able to go in and reuse it.
But for some people, they want to be able to sit down and just have a BP kit.
So there's the two options there.
And actually, the people that come in and use the pressure station
are then more comfortable to loan those kits out permanently.
And they know that they can go there and loan the kits out.
And then lots of libraries have connexions with their local GP practises.
So they're making connexions with their GP practises
to let people know that they can go into the library and loan them.
So like I said, recently diagnosed with high blood
pressure.
So when I go to my GP, they take my blood pressure.
But then following a period of a month,
they often like me to monitor every day for a week.
So rather than going into my GP surgery
or going into the pharmacy, I can conveniently
pop to my local library and loan out a VP kit.
Thank you.
Thank you very much.
Cllr Isobel Darby - 0:21:57
And I think you can't underestimate
the importance of people being aware of their blood pressure.
and I'm somebody who's always had low blood pressure
and I found out one day it was absolutely sky high,
but I had no idea.
I felt absolutely no different.
And it is really, really important
to be able to have those cheques
and then to monitor when necessary.
So thank you so much.
And I think, sorry, just to add on,
Katie DeJoux - Culture and Outreach Service Manager - 0:22:21
a part of this is training to library staff as well.
So that if people have questions,
you've got library staff that are on hand
to be able to provide advice and guidance.
And actually when you loan the kits out,
it comes in a bag and there's more information there as well.
So if people do have low blood pressure or high blood pressure,
they can see what happens and where they need to go to.
And there's also the booklet includes, they can keep that
and they can record their blood pressure readings in that kit.
Fantastic.
Cllr Isobel Darby - 0:22:49
Should we move on to the next presentation?
Hello.
Sean Culter - One Recovery Bucks - 0:22:56
So again, yes, Sean, One Recovery Books, IPS Lead.
So a little bit of an overview of the service.
So in November 2024, we launched our IPS service.
And that is to support clients who are wanting to get
into paid and competitive employment as part
of their recovery journeys.
And so, yeah, what is individual placement and support?
Helps people to find and retain work to aid their recovery.
It involves dedicated individual support in their job search.
It is followed by a position in paid employment and the employment specialist will also provide
ongoing support as they start their job so we don't just place them and leave them.
I think that's a critical part of the service.
So what does it do for our clients?
It helps to build confidence and skills, increases their social network or indeed change it away
from maybe more problematic social networks that they may have had before, improves their
financial position, gives a sense of purpose,
and provides more structure in their life.
So what is actually involved?
It's a one -to -one personal service
to suit their personal needs.
There's individualised rapid job searching,
focusing on their employment goals,
supporting with writing CVs, cover letters, job
applications.
And we have conversations around disclosure as well.
So there are real benefits.
And we're finding with employers that the stigma is definitely
being broken down.
And actually, giving these people a chance
can actually make them probably, in a lot of cases,
with feedback that we receive, is that actually they're
more loyal to those employers for giving them
that second chance.
We provide interview support.
That might be mock interviews.
We offer as well employment -related benefits
advice to make sure that they're not
We provide that in -work support for up to four months,
and we are integrated within the recovery team.
And again, that's a critical point in case there is lapse,
relapse, we're able to get them the support straight away
by referring them back in.
So yeah, to talk around, yeah, some individuals.
So we had one particular individual was working as a chef
in a public house in Owsbury.
Their substance use was alcohol, so that was a trigger for them working in that environment.
So they signed up to the programme.
Obviously their real skill was cooking as a chef, so they wanted to continue to do that.
And obviously we talked around moving away from public house settings.
What we actually did is looked at maybe high -end hotels.
As a result of that, he applied for a job in Wales.
He was accepted for a trial there.
The job came with free accommodation, free food.
It's literally the hotel is on a beach.
And he sent us photographs of him basically saying he's living his best life there.
And again, that change of social network was so pleasing to hear.
And he did give us some feedback as well.
He said, I'd like to give a big shout out and thank one of your employees.
He gave me an incredible amount of emotional support and put in a huge effort to motivate
me to get sober, find a job and get rid of depression.
Pasquale is a great man and you have him in the right place.
I've never met anyone in my life who cared so much about me and supported me even when
I was down.
So really great to get that recognition and see that we are making real changes to people.
And actually, we were providing the in -work support.
And he actually asked us to stop on the basis that he said,
I'm living my best life now, but you contacted me
as a reminder of my past.
So actually, we congratulated him,
and really, really pleased to hear that.
Another one was where a client, again, it was alcohol use,
was their issue.
And they wanted to disclose.
They wanted to give full disclosure about their treatment
because they wanted to have that ongoing support.
There was a supermarket, national supermarket branch
and a site in Ellesbury, and they made reasonable adjustments
as a result of that.
Those were things like allowing them time to be able to come
to appointments, to still attend their group sessions.
Unfortunately, he also suffered a physical injury just before.
And again, they made reasonable adjustments
in his induction to move away from the physical aspect
and do more online training as a result.
And we did send a letter to them recognising the exemplary
approach that they had shown and commitment.
And again, pleased to say that he's still there
and yeah, thoroughly enjoying it.
That's it for me.
Cllr Isobel Darby - 0:28:02
But I think that's a, those are two really uplifting accounts,
aren't they?
And although we are looking at whole populations,
It's really lovely to hear about individuals and how they have benefited.
And I'm sorry, because I have absolutely, because I'm looking at the room and I've skipped over
Hugh who was supposed to be the second one on safety planning. So can I now go to you,
Hugh. Welcome and over to you for your presentation. No problem. Thank you so much. Can you hear me?
Brilliant. My neighbour's chosen today to have a lot of work done on their house, so I've switched
over to the headset. My name is Hugh, I'm an operations manager at Buckingham Shear Mind.
Can you see the slides or do you want me to share them?
I can share them.
Yeah, so these slides have been put together by Melissa, the team leader of Safety Planning Bucks, who can't be here today, so I'm presenting on her behalf.
Safety Planning is a six -week short -term support service for adults in Buckinghamshire who've attended A &E with thoughts of ending their life and or self -harm.
It ties in with the work that we do at Safe Haven and provides more structured one -to -one support for people. Referrals come through the Psychiatric Liaison Service
or through our Bucks Safe Haven.
They will work with a support worker
who can help them identify coping strategies
and teach them new skills,
consign post them to community services and other services,
help them to reduce isolation,
and ultimately creating a safety plan
for them to stay safe in times of crisis.
We do this over the phone and via teams,
and we can also do it in person as well.
Between December 24 and December 25, we had 76 referrals. We're on track since January.
We've already done nearly that many, received nearly that many referrals since January.
So yeah, things are going well. SR presented to us after attending A &E was,
in October 25, they were referred to us. They had a long -term alcohol use disorder and a
history of child sexual abuse in the family. They were experiencing suicidal ideation and
impulsive behaviours and struggling with their daily activities and routine after losing
their job and their sense of purpose. So the team worked closely with One Recovery Butts,
who was also supporting this person,
ensuring joint working throughout,
really good communication.
A safety plan was developed to help them manage crisis.
They had regular meetings and calls
with the safety planning team
and also with Safe Haven in the evening,
providing some really important consistency for this person.
And even when service users aren't able to engage,
our teams still leave them messages and voicemails
to make sure that they know we're still here to support them, which proved really important
for this person in particular. We also, the team also provided a letter of support for
their application for inpatient rehabilitation, which they were accepted onto in December.
So they completed their detox in December and they remain at inpatient rehabilitation.
They're now clean and recovering in rehab. They're making plans for the
future and rebuilding relationships with their family. We received a really lovely
email from this person which you can see some quotes from at the bottom of this
slide. This is the first time in my life someone has turned up consistently for
me week after week. It made all the difference and for the first time in a
long time I feel like I'm alive again and they'll have the option of moving
into assisted housing within the rehabilitation grounds for the next
stage of their recovery.
Thank you very much.
Thank you.
That's really encouraging again.
And can I just ask, so obviously you've
been involved in the recovery so far.
What happens, let's assume that this person is
successful in going into assisted housing, what support
do they get in that transition?
Because that's quite a big change, isn't it?
And that's kind of a, to me, that I would flag that
as a crisis point where it could go one of two ways.
It can either continue to go really well
or it could could deteriorate.
So what support is given then please?
Yeah, well, I can say that our team are really engaged
with the multidisciplinary team working
and provide really good handovers where it's needed.
I can say that they're very dedicated
to the people that they're supporting.
And in this instance are still in contact with this person.
so this person is able to email in and reach out for further support.
And of course, Safe Haven is always there as that contact point.
So once they've finished that six weeks of support, Safe Haven is still there
if they go into crisis.
And actually, some of the people who work in safety planning
also work in Safe Haven, so there's those familiar faces too.
Right. Thank you very much for that, Hugh.
I'm going to open to questions and comments and discussion around the table now.
So does anybody want to kick off?
George, I see your hand up.
Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative - 0:33:48
Yeah, thank you for the presentations.
They're always really inspiring.
I think I just wanted to provide a bit of a clarification
on the SMI health cheque incentives in primary care.
I completely agree with you.
I think a lot of the changes have
been due to changes in incentivization primary care.
I probably want to give you, I think
there's a little bit more detail.
I think it's worth the board hearing.
So in, there were actually two incentive schemes
in primary care in 2024.
One was the co -op incentive scheme
around undertaking six in one comprehensive health cheques
in people with serious mental health illness.
And the other was a locally commissioned service
which were quite similar.
In December 2024, we had a letter
from BobICB essentially stating the withdrawal
of the locally commissioned service due
to a significant overlap with the commitments
and expectations of QOF.
Unfortunately, two months later in February 2024,
the six in one health cheque requirement was also removed
from QOF but the ICB didn't go back and reinstate the LCS.
So actually, the removal of two incentive schemes,
one national and one local
at the same time I think is probably quite a significant
factor on that.
Might be something for the board to consider with regards
contacting our new ICB, whether that's something they might want
to reconsider.
Cllr Isobel Darby - 0:35:23
David and then Raghu.
Thanks.
David Munday - Director of Public Health - 0:35:28
I just wanted to come back to the alcohol point that you had
raised, Paula, because you described, so it's kind of a
comment and then a question probably for Raghu, in regard
to the alcohol care team kind of initiative,
because you described a worrying trend in the alcohol kind
of admission part within that.
But it strikes me that the alcohol care team initiative is
one that feels like a really positive move,
because it is really trying to kind of capture people
in that teachable moment when people are coming to hospital
because of an alcohol -related kind of issue.
And it's trying to then kind of plug them
into the type of support that they need.
And I think the information I've seen from elsewhere,
though obviously it's something we'll need to gather locally,
is then the return on investment for that is really positive.
I suppose the question does kind of reflect the question,
Raghu, is will all the hundreds of things
that BHT have got to do and all the pressures they're under,
where does this fit in terms of the priority list of something
that the trust can deliver?
Raghuv Bhasin - Chief Executive Officer, BHT - 0:36:32
I don't know if you wanted to ask a question.
I can answer David's and then I'll ask a question.
So pretty high on the priority list.
So we sort of approved that this would be a priority
for us last week as our exec and the leadership team
in the care group, which in our really focus on this,
particularly our director of nursing Victoria,
like it's built these teams in previous trusts.
And so we've got a very strong clinical lead interest
as well and that's so very high and yet I suppose and it sort of links the question
and I think we'll fund it after your very nice funding uh next couple years but we'll just fund
it sort of it's really helpful presentation I suppose I'm I'm quite keen almost to take a bit
of a step back and understand what's our theory of change here to try and improve the health like are
Are we trying lots of little initiatives to meet individual needs, say people who have
got suicidal ideation, people who have got alcohol issues, people who have got obesity
issues, or are there some more fundamental issues that we need to address such as the
economic health and wellbeing of people and are they in work, etc.
And then how do we direct our focus and what then is the demands and capacity.
So do we have enough capacity to do weight management for the target population in this county? Do we have enough capacity to do alcohol?
support for the target population in this county because then I think we can have a conversation about how we move money around in a
slightly bigger way
Then we've been constrained perhaps by well, this is how much we've got in public health funding
etc because I eyes eyes
As the trust would be really keen to put money into all of this sort of stuff
and less money into dealing with the consequences of that.
But having a sort of our theory of change is we're going to go out and try and address people's needs
at this stage. We're going to focus on these three interventions which Everton's based and
we need to grow our capacity. Would be great going into next financial year because I think
this is sort of like, I think the request of the board is,
can you sort of, are you content to,
content with progress and we'll see you again next year?
Well, what I'd quite like to have is a series
of conversations about how we can help,
because there's some amazing stuff happening.
I don't know, and I don't think we know,
is like, is it of the scale that we need?
And the answer's no.
What would it take to turbocharge some of this?
and then how could we help as the organisation
that's got the most amount of money in the county?
So I think what I'm hearing is we need to,
from the trust point of view,
you would just like to be able for us collectively
to focus on a few things rather than many things.
Cllr Isobel Darby - 0:39:35
Well, it's almost, yes, sorry.
It's almost, so at the moment,
Raghuv Bhasin - Chief Executive Officer, BHT - 0:39:40
I don't think this is cited in the data
of the demand for these services and the capacity.
So it says weight management is coming up to capacity.
So I'm really concerned about that.
And so how can we help?
It sounds like the team are working,
but how can we help to address that?
Because it's a really positive programme.
So I think citing this a bit more in the,
what's the data saying, and maybe in your reports, David,
and then saying, this is how we're doing against it.
And this is the really, we're gonna back these horses,
because we've got the evidence, and just go
at them a bigger scale.
So I'm encouraging us to be bolder, and I'm very happy
to support that, however that would be useful.
Yeah, thank you.
David Munday - Director of Public Health - 0:40:26
And I welcome other comments around the table on this.
I think it's both a good challenge and also the kind
of support is really welcome.
Three quick things I'd say then regarding this,
and there's lots that we could say.
So firstly, I think the strategy that we've got
And the health -wise -waving strategy that we've got
is embedded in and kind of informed
by the joint strategic needs assessment that we've got.
So it does, it's clearly focused on where
we see the health need is kind of within Buckinghamshire.
That doesn't equate to, though, one of your points, Raghu,
which is, have we got all of the capacity we
need to do all of the action?
But it does tell us, I think, that we are
focusing on the right things.
On the point about, like, are we doing lots of different things
and kind of then the degree to which it's scaled,
I think particularly within the prevention part
of the Live Well plan, a focus of,
and we need to be really disciplined in keeping
a focus on tobacco harm, alcohol harm, physical inactivity,
and unhealthy weight as the four things that we can do lots
about as a local system, which are the modifiable risk
factors for premature mortality.
It's driving the morbidity.
It's driving demand on services.
and I think the strategy is trying to capture those things.
And then on that capacity point in terms of kind
of healthy weight particularly,
there are some constraints in terms of funding,
but what we've been doing with the Be Healthy Bucks service
is prioritising that healthy weight programme
and we will look to expand that
where there's kind of demand kind of needs it.
But we, and then my third point is there is lots to do
to get more, to get broader and more upstream than that,
Because what we don't really want to do
is just be doing the treating unhealthy weight,
to pick that as an example.
And so I think it will be at our next Health and Well -being
Board meeting, I'll present my Director of Public Health
Annual Report for this year, which does pull out
what those key building blocks of health
are that we need to ensure are in place in Buckinghamshire
to be taking that kind of collective and effective action
on health and wellbeing and being as upstream as possible.
So that will help us, but it absolutely shouldn't be,
well, there's just another report
and then we'll come back in a year and have another update.
Like we need to carry on that kind of conversation.
I completely agree.
And I'm sure we can use that and other kinds of forums
under the board itself to help.
So I guess probably really good provocation questions,
reflections from my part,
but other colleagues may have used.
So as ever a really big question.
Craig McArdle - Corporate Director, Adult Social Care - 0:43:14
I think what that demonstrates really is I think we
as a system really need to step up our integration plan
and take it to that next level.
That's what we need to do.
And I think there's a real appetite
around the system to do that.
Looking at total place -based budgets
across the public sector, not just healthcare as well.
So I certainly know our new chief executive is very
supportive of that approach.
And I think as a system, we just need to set out what is that
roadmap to really provide an integrated health across the
County of Buckinghamshire.
So I think that's the answer.
And a small group of us will, will absolutely be going away to
look at that subsequently as well.
I also think that needs to stretch into children's as well,
because that's, we know that's where the building blocks are
early on that best start to life as well.
So I think your, your questions are absolutely the right ones.
and just seeing those three or four big ticket items is what we'll need to focus on.
I would say we've got lots of evidence what works well.
We as a system put in an awful lot of information to the ICB's Innovation Fund,
which actually demonstrated really well what we wanted to scale up.
So I think we've got the evidence there to use Raghu as a really good start for TEN.
And I actually think we should revisit some of those Innovation Fund bids as part of this as well
and maybe make another call on our ICP colleagues as well around that.
So that's what I wanted to answer in part of that.
I had a question as well, but someone asked what I wanted to follow.
Thanks very much, Craig. Errol, did you want to come in?
Yeah, thank you, Chair.
Errol Albert - Corporate Director for Children's Services - 0:44:47
I'm grateful to Craig for raising that, because that was the point I was going to raise,
just because every opportunity I like to do the quick wins and the join -up
in relation to that whole system approach.
And when you think about, as mentioned by Craig,
around the Best Start in Life programme,
which involves our family hubs becoming those one -stop shops
within the community, if you think
about one of the most stressful things in life
is parenting young children, or it can be.
And on the basis of our preventative agenda,
wouldn't it be great, as Katie was describing,
to have some of those pressure stations
within those family hubs?
So that in the time that those children are doing whatever
that they're doing, that that parent has an opportunity
to pop next door and see a professional
to take blood pressure, et cetera.
Because in the event that there is a crisis
in relation to that parent's health,
we then have a crisis in relation
to the care of that child.
So if we think about that whole system approach,
herein lies another opportunity for us to do that join up.
So we'll be very much having that conversation
around doing that.
And indeed, picking up Raghu's point,
there is grant funding attached to Best Start in Life.
So there's nothing to say that we can't utilise that funding
in relation to the staff that could be in that centre.
Thank you.
That's fantastic.
Cllr Isobel Darby - 0:46:01
Yeah, thank you very much.
Has anybody else got Craig?
That's my best topic, then Bobby's got me.
Oh, sorry, Bobby.
Bobby Pozzoni-Child - Director of Partnership and Transformation Bucks Primary Care & Director of Integrated Care Bucks Place - 0:46:09
Hi, yeah, I think I was probably going to just reiterate Craig's point around stepping
up our integration agenda, because I think Errol's described exactly where we should
be getting with this.
But actually, what we need to really be doing is driving the enablers that are going to
make it slick, make it seamless, enable us to get ahead of the curve and not be, you
know, sort of constantly taking people's blood pressures and then never being able
to utilise that information and really effectively work with it.
So, I think things like the digital integration that sits and enables the work that we want
to be doing is absolutely pivotal and we need to be moving at pace in that way across all
the providers in our place.
Cllr Isobel Darby - 0:46:42
Thank you.
Great.
Craig McArdle - Corporate Director, Adult Social Care - 0:46:45
I know Katie's now left, but I was really interested in that approach certainly.
And I know the INTs have built strong links with the libraries as well.
But looking at Gemma and Bobby as well, the bit I took away from that was that sort of
touch points with faith in community settings.
And I wonder as part of our integrated neighbourhood approach whether we needed to think about
that a little bit more because it felt a really good basis for that and using those assets
within those communities already.
So I just wondered what your reflections were on that.
Yeah, I completely agree.
Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place - 0:47:19
So our integration leads are starting to engage with those areas.
It's taking time to develop trust with those communities.
But definitely something we need to do.
So an example of that is in Wickham with our community health and well -being workers.
And they've gone into some of those kind of mosques and base settings to do that.
So not only in terms of getting out and getting intervention messages,
but also engaging with communities to understand what they want and need to build into the wider programme.
Cllr Isobel Darby - 0:47:48
Right, any more for any more? Oh, David?
David Munday - Director of Public Health - 0:47:53
Just a brief point, if that's so, a couple of just very quick responses.
So I think Errol's point on the pressure partners and best starting life is a really good one.
And we can look at how that gets established. I think that's a great idea.
And to Gemma's point on that engagement that's happening,
I think where if my team have got any contacts or kind of experience of some of the public health engagement
That's happened in those communities then very happy to share that
Just to kind of help with that help with that journey of going craig's right to point to that and and chairman
I know you mentioned this cabinet on Tuesday
But I just wanted to point to the fact the members of the board about the tobacco and vape spill
They've got received royal assent and obviously we've now had the next King's speech
But just to note that, and we've got the tobacco data
within the pack.
It was one of the metrics that Paul had presented.
So, smoking in Buckinghamshire is at an all -time low,
both in terms of overall prevalence
and also critically smoking in pregnancy,
which obviously harms mum, harms baby as well.
And the HD have done significant work to address that.
So, we're in a good place in bugs.
But we still see that nationally 80 ,000 people a year die
from smoking -related illness.
And whilst we're seeing that downward trend,
And we need to kind of carry on that progress.
And what the Tobacco and Vapes Bill will do
is provide that world first smoke -free generation, which
I think is incredibly kind of positive.
It also does the thing I think we all worry about,
about that kind of ban on advertising and sponsorship
and the particular marketing to children.
And then that marketing of vapes and the marketing
of other tobacco products, which we've
seen an increase in usage among children and young people.
And we know that from the data that 80 % of people who smoke
started smoking under the age of 20.
So doing more legislatively, if I can say it,
to address that is really helpful.
And then it will also help with the smoke -free place agenda.
So people kind of, their right to be
in a smoke -free environment is increasingly protected,
which I think is also positive.
So my hope is that is a good bit of national work.
We then will need to work locally
for some of the implementation of that,
but will help us in that important trajectory.
Cllr Isobel Darby - 0:50:01
Thank you very much.
I just wanted to make one point about how important
Sarah Preston - Head of Public Health Strategy - 0:50:08
skills and employment plays in this as well.
When we're talking about integration,
Teresa Meredith - Assistant Service Director for Skills and Employment - 0:50:11
the pressure partners also work out of adult learning
centres and we have 3000, excess of 3000 residents
access those service annually.
So it's really about looking at other community venues
as well that we already have a good resident basin. Thanks very much Theresa and I think that
Cllr Isobel Darby - 0:50:28
is important you know and I was just sort of reflecting you know we've got sort of new things
well so we we've always had family centres but family hubs now we've got these new things we've
got integrated neighbourhood teams we've got people going out knocking on doors we've got
all these different things and it's okay you can see that things could almost duplicate or fall
between the cracks.
And I think it's our duty really to keep talking to each other
so that we absolutely know and understand what is going on.
And yes, the more places that we can get blood pressure
to read things taken, the absolutely better.
And we heard the libraries today.
But as you say, there are other places
where this is going on as well.
And we don't need to sort of forget that.
So thank you, Craig.
So I thought all the presentations were really interesting.
Craig McArdle - Corporate Director, Adult Social Care - 0:51:21
And, Sean, you're one in supporting people into work.
I just wondered what the segue is into the next agenda item.
Not wishing to move the agenda, aren't you?
But I just wondered what the learning was from that
to other similar work programmes as well.
And whether as a system we're actually communicating
and sharing best practise.
So you might want to ask that in the next part.
but it feels like a really good link up to the next item.
Okay, I'm going to move us on. Thank you for the nudge.
Cllr Isobel Darby - 0:51:50
Is the board happy to note the progress outlined
within the report and endorse the ongoing direction
of travel of the Livewell section?

8 Work and Health Programmes in Buckinghamshire

Yeah. So we'll move on to the Item 8,
Work and Health Programmes in Buckinghamshire.
I'm going to hand over to Sarah Preston,
Head of Public Health Strategy.
Sarah Preston - Head of Public Health Strategy - 0:52:07
Can I just do one quick thing?
I'm going to hand over to Dave.
No, what?
So what?
So sorry.
David Munday - Director of Public Health - 0:52:14
So Sarah and Theresa have got the detail on this,
and they'll talk you through.
I just wanted to do the brief introduction bit first,
if that's OK.
So because this ties in exactly from the live well
kind of part of the action plan, but we
wanted to have a specific agenda item around it,
because there's so much within that action plan.
So I just wanted to make sure we kind of see this,
and just as Craig's pointed out, as part
of that kind of overall approach in terms of the live well
space.
This area, in my view, is really important
because there isn't health without wealth,
and there isn't wealth without health.
So, what I mean by that is that having a good and stable job
that pays you a kind of a living wage
is one of the strongest determinants
of health and well -being.
We've heard a little bit about a couple of case studies
of how important that is for people
with specific addiction needs as well.
And then, but also, you don't create jobs that are stable
and that pay a decent wage without having
a thriving economy.
And you don't have that unless you have a healthy workforce.
So you have these two sides of the same coin.
There's a lot of activity and a lot of policy happening
nationally on this agenda.
And if I'm honest, it hasn't always
felt fully joined up as to what's come down locally
and what the asks and requirements are.
So as ever, it's our role in the system
to ensure that kind of join up and having that cohesive approach,
which is then why we brought this paper through to explain kind of what's happening in that space.
So sorry to jump in, I'll pass across to Theresa and then Sarah to kind of explain those programmes of work.
Thank you for that. So I was just going to give an update on Buckinghamshire Works Plan.
So Buckinghamshire Works Plan is Buckinghamshire's local Get Britain Working plan.
Teresa Meredith - Assistant Service Director for Skills and Employment - 0:54:06
It was a requirement from government for each area to have its own written working paper.
It's been co -designed by Buckinghamshire Council, Buckinghamshire Jobcentre Plus and Integrated Care Board.
The plan really recognises the high employment rate in Buckinghamshire compared to the government's national target.
but it also sets out how we can work together in partnership to help residents to move into
good work and achieve good employment outcomes.
One of the key drivers of the plan is our Connect to Work programme, which we launched
on April 1st in Buckinghamshire.
It's a DWP funded programme.
We have enough funding in that programme to support 1600 residents over a four -year programme.
We have commissioned delivery of that provider to a very experienced provider who also has several contracts with other local authorities to deliver their Connect to Work.
So that gives us some real confidence around the delivery of that programme.
I've got some statistics on where we are today.
So, bear in mind we're only on week six.
We've had 86 expressions of interest from residents,
so it shows that there is a high need for this programme in Buckinghamshire.
56 of those initial expressions of interest
have now moved to their first initial meeting with their employment advisor,
and that gives them an opportunity to really talk about what their goals are,
what other support and health needs they may have,
which other services they're already working with,
so we can try and triangulate the supporting place.
We have 21 people who have achieved milestone one.
So for technical terms, that means
that they've completed their vocational profiling.
They're now moving closer to the next step to employment.
And really good news, we have two people
who've been offered an interview.
So early days, and we're moving really well in the programme.
We met with the Department of Work and Pensions yesterday,
and they were really pleased with the progress
in a six -week period.
Just from the data that we've created so far, there's a high level of self -referrals from residents.
So the piece that we now need to do is what you've all been talking about,
is that integration much more with other services.
We've also recognised that we possibly need to do some work on our expression of interest form
because we weren't asking the question of have you been referred by a health professional.
So that's something we can take away and look at now.
From the residents that we have engaged with to date,
there is a high level of mental health support needed
and that is becoming very clear that that's the barrier
to employment for them.
That's my update.
Yeah, thank you.
Thanks very much.
Sarah, do you want to come in now?
Sarah Preston - Head of Public Health Strategy - 0:56:50
Yes. I'm going to do a quick update on WorkWell.
So WorkWell nationally started a few years ago
with some pilot sites.
Frimley was one of them.
and it's now being rolled out nationally and led by the ICB.
WorkWell is an early intervention health -led employment support programme.
So it helps people with physical and mental health conditions
to stay in work or return to work sooner.
It offers a personalised holistic approach
and it very much connects people to local services.
That might be physio, that might be counselling,
might be occupational health, might be return to work planning.
The next steps with WorkWell is co -designing what that offer's
going to look like for Buckinghamshire and for the ICB.
There's an event in June where people will be invited from
across Thames Valley to start co -designing that offer.
So that's where we are with WorkWell at the moment,
but it's coming very soon to Buckinghamshire.
And then on an update on what we've been doing,
particularly in public health.
So to support the system collaboration and actions
to move, improve the health -related employment
outcomes that we've just been talking about,
we've been working to establish a system partnership which
met for the second time earlier this week.
We had 35 people kind of coming to the meeting,
such a really wide range of different organisations
and partners, many kind of linked to the organisations
in this room, too.
Really good engagement and enthusiasm
and for the potential of this partnership
to bring together these different work
streams we're talking about and do things a bit differently.
As we're already hearing, it's a really complex picture.
But some key themes are emerging from those partnership
discussions already, particularly around what
we can do about reducing duplication and fragmentation,
how we can make the support offer as simple as possible
for residents, but also for employers who are accessing it.
So really our next steps around the partnership are
to decide the initial focus we want to take collectively
because there's a lot we could do but really focusing
on the few things to get some things moving.
And just the other that I was going to mention
about what we're doing in public health,
we've done an evidence review to understand what works so far
and what we know around work and health.
We've also been collecting a lot of insights from stakeholders,
other areas and at the moment we're collecting insight from local businesses
as well about what they need and want and from all of this information we're
exploring what additional support bucks employers need to help improve their
workforce and the health and well -being of their workforce and
helping to reduce sickness and so that we can offer something if it's needed
that adds value and complements but doesn't duplicate what already exists so
So that's a quick update on what's going on.
Cllr Isobel Darby - 0:59:56
Yeah, thanks very much, Sarah.
We got any comments around the table?
That's really helpful.
Thank you.
Raghuv Bhasin - Chief Executive Officer, BHT - 1:00:05
And you meant the paper mentions the complexity of all of these different programmes.
I just wondered, how much do we need to sort of stick with all separate programmes or how
much can we locally integrate and brand this?
Because it's all the same thing, isn't it?
And it'd be helpful.
Because I think we should yeah, we should try and make it as intelligible as possible to the local population
Even if the programmes and funding
Pots are separate
Absolutely and in our partnership meeting area in the week that message is coming loud and clear that that's what the big
Sarah Preston - Head of Public Health Strategy - 1:00:46
Partners that are delivering the big kind of employment support offers wants to explore and be able to do
because that is absolutely a key thing for the system
to work out how we can do.
There are challenges because everyone has their own targets
for their own funding, but there must be a way
that we can come together.
So we want to start those conversations.
David.
And that is all exactly right.
David Munday - Director of Public Health - 1:01:07
And I think one of the conversations we were having
just this week was to say that the Buckinghamshire Works
programme is kind of required to have this kind
of governance group.
And then, of course, the next thing is the next programme
is a car to have its own governance group and so forth.
And we were having the exact conversation,
let's have that as one thing.
And so that we do join it up in terms
of that oversight of the work.
Because it otherwise doesn't make sense
to do it in different parts.
And the forum that Sarah was describing
in terms of the WorkWell programme,
we deliberately wanted to draw in integrator leads
into that so that where we've got kind of work coaches
and that kind of offer, that's integrated in within our INTs
so that absolutely the point of kind of what the public
interact with and engage with feels kind of local
and joined up.
Thank you, Nicola.
So I was just gonna comment on WorkWell.
So WorkWell, we see that as a line
into the six neighbourhoods in Buckinghamshire.
Nicola Newstone - Assistant Director, Partnership & Development, BOB ICB - 1:02:08
So one of the integration leads will definitely be at that event alongside of the partners.
And the other thing to add is that Joy is the platform that supports the WorkWell.
So having that in Buckinghamshire well places us to help us roll out WorkWell.
And then I was just going to reflect on the conversation at the
health and work partnership meeting that absolutely it can't be an update of the
different programmes. And we were describing how it's quite confusing. Everyone doesn't know what's
So how do we make that more simple for both employers and the public?
Yep.
Lovely. Thank you very much.
And a point well made. Gemma.
Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place - 1:02:47
Thank you.
So it's just a point to say, so not only are we big employers in the county,
we're also the healthcare providers.
And often that's the first point of contact people are coming to,
to be off work.
So just make sure,
it's just a plea really to make sure that we're linking in with us as health
providers, so general practise, when people are at six notes, how do we signpost people
to the right places? If people are off work and on waiting lists within BHT, are there
conversations we can have to support these people differently to know that it's affecting
their work as well?
Cllr Isobel Darby - 1:03:21
George?
Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative - 1:03:23
Yeah, I think first just to say how welcome this is. So I will be the duty admin doctor
on Monday. I know I will have in the region of 30 requests for fit notes to fill in. That's about
a normal day for my surgery in one town in Buckinghamshire which is recreated 45 times
every day. So I think really really keen to work on this. It feels like the first really tangible
offer that we've kind of had outside of you know in terms of people who are on sick notes.
obviously we've always had lots of support from JobcentrePlus for the
the other cohort so really keen to work with you. I fear for a risk of being
inundated with if we're having referrals or sending so you know again just making
sure that we start off with the the right groups that are going to benefit
most and just essentially offering myself and our team to support that as
much as we can because I think I think this is could have huge impacts for
people and a big impact for the health service,
which is having huge demand around fit notes at the moment.
Cllr Isobel Darby - 1:04:29
Thank you, George.
Sean?
Yeah, so I just really want to speak back
around the Connect to Work.
Sean Culter - One Recovery Bucks - 1:04:36
We've formed a really, really positive working relationship
already.
So that's been really refreshing to see that.
I think one of the frustrations I always had
is that clients needed to be in structured treatment.
And what about those clients that are in recovery?
we felt like there's a real risk then that actually they do relapse and they come back
in and we had nowhere to signpost them to.
So it's really pleasing that we have been able to refer clients and equally we've had
clients referred from Connect to Work into us.
So I think one of the challenges that's been recognised as well is where we do need to
work together and that we're not all going out to the same employers, for example, and
creating that employer fatigue where they just close the door on us because we're the
Third one's have arrived there, so I think it's really pleasing
and reassuring that there's already that recognition
and collaboration starting to happen.
Fantastic.
Cllr Isobel Darby - 1:05:29
Thank you.
Any more for any more?
Okay. So are we happy to receive the update
and note the progress on that?
Yep. Okay.
So now we're on to item nine,

9 Neighbourhood Health Framework

which is the neighbourhood health framework.
It's on page 71 of the report.
Gemma Thomas - Director of Strategy BHT & Director of Intergrated Care Bucks Place - 1:05:48
And that's over to Gemma.
Thank you.
So this, so in March 2026 NHS England published the guidance
for the development of neighbourhoods as well
as guidance in the development of neighbourhood health centres.
And at the same time NHS England also sent out a list of asks
that we need to deliver in 26, 27 and 27, 28.
So this paper sets out at a high level what those asks were from NHS England and our progress
against them, which I think, as you can see, is really positive and we're moving in the right
direction in terms of having neighbourhood footprints set out, established plans for
priority focus areas in each neighbourhood, as well as kind of the wider offer, not just focusing
on that complex cohort, but the prevention work that we've just been talking about amongst other
things. There are a couple of areas where we're still working towards and I know
the Better Care Fund will be on the agenda later on. The paper also sets out
it provides the NAPC which we think as a programme is probably the best one -page
explanation of what it is. I think it's really positive in that it sets
neighbourhoods as a whole system -wide programme which is the approach we've
taken in Buckinghamshire and it sets out some of the kind of key asks. It
It particularly sets out a stronger role for health and wellbeing boards in the delivery
of this, which I think is really important.
And it also asks health and wellbeing boards to set out a plan for neighbourhood health,
which we have as part of the action plans for our health and wellbeing board.
And when we bring the ways of working update to health and wellbeing board later in the
year, we will kind of provide a more detailed version of that neighbourhood health plan
for your review and comment.
I think the area where it's perhaps slightly disappointing
is although it alludes to making that connexion
across other areas such as kind of education
and the other kind of areas within the council,
it leaves that up to local decision making
and local figuring it out.
So it's good that it's in there,
but I think it's perhaps not as detailed as we'd have liked,
but we're gonna continue to try and deliver on that.
just at a high level to kind of set out where we are against those areas.
We know what outcomes we want to improve.
They're set out in the health and wellbeing strategy
and we're already kind of seeing improvements in that.
So, for example, in 25 -26 we saw a reduction in unplanned admissions
to the hospital, which is really positive and shows that we're working.
But we've also seen things such as the increase in referrals.
So through the referrals that went through the Joy app,
we've seen reduction in GP contacts
as well as emergency admissions.
And we're also seeing increasing numbers going through
to the prevention services such as Be Healthy Bucks.
And we're hoping they will lead to population health outcomes
in the coming kind of months and years.
That's kind of the service delivery,
which you know about.
It also talks about kind of the enablers,
so the neighbourhood health centres.
So we're currently in the process of looking and mapping out where neighbourhood health centres might sit across our neighbourhoods in Buckinghamshire
and getting lots of input and engagement through the steering groups.
I know we've had councillors in all of those sessions.
We've had conversations with the best start elements and estates colleagues across the piece.
And then obviously, Buckinghamshire Healthcare Trust purchased Queen Victoria Road from the council in March,
which will look to be the neighbourhood hub in Wickem.
In terms of workforce as well, that's a key enabler
that I think we're really starting to focus on for this year
and starting to work with those professionals on the front line.
But what does neighbourhoods mean to them?
How can they work?
And leading to Bobby's point earlier,
those digital tools that will help them to kind of really be able
to access all the information they've got available
and make the right decisions for those patients and population
and not kind of hand people off between the systems.
but seamlessly moving through the care.
And then finances.
Better Care Fund last year had put money towards
the neighbourhood health centres,
sorry, neighbourhood working, and we're looking to expand that.
I think you can update that to you there later on.
There's the 10th Valley Innovation Fund, which is supporting kind of
neighbourhood working, waiting for the ICB to confirm some of that money.
But we're expecting that to support
with things such as community health and wellbeing workers and
The Buckinghamshire Healthcare Trust have also put money towards it.
So we're looking to fund it in terms of scaling up and that delivery there.
And then priorities for next year, which will bring the detail to when we
bring the full plan, we're looking to focus on expanding the proactive
frailty service, which we spoke about as a case study at the last
Health and Wellbeing Board and expanding that to about 4000 people a year,
Embedding community health and wellbeing worker service,
which is started in Wickham and Elsbury.
And we've already had some really positive engagement
from the local communities.
Increasing referrals and uptake
of the healthy lifestyle support services.
So that's Be Healthy Bucks,
one recovery bucks that we heard from earlier
and moved together predominantly.
Supporting the needs of the complex people
that live within the neighbourhood.
So how do we support them both from a care,
a health, but also the wider determinants perspective
and moving outpatient services into the community,
starting with gynaecology and dermatology.
Thank you.
Cllr Isobel Darby - 1:11:38
Thank you very much.
We've got any comments on that at all,
any questions for Gemma?
David.
David Munday - Director of Public Health - 1:11:48
Thanks Gemma, that's really a welcome update
and helpful to hear about how we see this overall work
fitting within the health and wellbeing strategy as well.
So I think that fit with it being under our kind of
of working feels good, so I think that's really positive.
And then I just wanted to kind of note,
I felt that that priorities slide that you had at the end,
I thought was really positive, because I read the reform agenda,
I think it's called, in one of the bits before,
and to be honest, not all of that makes me leap out of bed in the morning.
But I felt like how we're articulating the priorities that we want to deliver
in the next year are the things that make me leap out of bed in the morning.
So it was more just to kind of reflect back.
I think that looks really positive.
And on that point, and we touched on it earlier
with Raghu's kind of much broader comment,
I think having those kind of referrals
across into those healthy lifestyle support services.
And I know my team's linked up on what the actual targets will
look like.
And to get really focused on that
is a really positive action.
I'm not sure we ever really done that before.
So I think that feels like a step in the right direction.
So really, it's not so much a question, just more kind of a bit of a kind of endorsement.
It feels like a good way to be focusing.
Thank you very much.
Cllr Isobel Darby - 1:13:07
And Craig?
Craig McArdle - Corporate Director, Adult Social Care - 1:13:09
I mean, we've really got to say this is a fantastic report, and when I saw it the first time, I think it's absolutely amazing.
And the health journey and achievement slide is the best visualisation I've seen of our progress to date.
So I think we need to keep sight of that about how far we've come as a system during that period.
HASC, our scrutiny committee has asked in the past about what have we achieved and what progress has made.
This sort of evidence I think is fantastic.
So I really commend this report.
I would also reflect though when you look at the national asks and where we are against them.
The national asks I would say aren't quite as ambitious as we are as a system.
And I think that's really positive that we're actually much more ambitious in the national system here.
We've got lots of greens there, lots of blue, but Raghu isn't satisfied on any of those.
And that's absolutely right.
It's a bad population in terms of that as well.
I think your point around how we join up with children's is I think within our gift.
And I think we've clocked that.
We've got Errol here and others and his team's working with us.
But I think that's the big opportunity for us in terms of that.
but this is a fabulous report, much to commend.
Cllr Isobel Darby - 1:14:29
Praise indeed and absolutely well deserved.
So yeah, I mean, I think, you know, we were always striving for better, aren't we?
We're doing well, but we want better.
But, you know, I think and we're not.
I think certainly in Buckinghamshire Council, we never sit on our laurels.
We say, what's the next bit? What's the next challenge?
What can we we've done this? Well, how can we how can we do to even better?
So that's really good.
So we have to note again the journey so far.
And thank you very much.

10 Better Care Fund Plans 2026/ 2027

So now moving on, we've got item 10,
which is on page 81 of the pack, which is the Better Care Fund
plans.
And I'm about to crave, I believe.
Craig McArdle - Corporate Director, Adult Social Care - 1:15:07
So we're on a high now.
We're down to the Better Care Fund, aren't we?
Which is my favourite subject, as people know.
So the Better Care Fund is a national mandated programme
to provide greater integration and around a full budget
between the ICB and the local authorities.
It's been in place a number of years now.
I can't even remember how long ago, but a number of years.
And each year we, this Health
and Wellbeing Board must submit a plan to NHS England,
setting out our aims and objective.
And you will see within the report there about,
it's underpinned by quite a lot of national guidance
and where we should prioritise.
so we should absolutely prioritise hospital flow
in particular, system flow and admissions avoidance
and maintaining crucially for the director
of adult social services the sustainability
of adult social care in terms of that.
So that will absolutely focus our priorities.
And some of the metrics that we're tracking
and we do perform well against these
when we'll get the return back of last year's chair
and we get reduction of emergency admissions
and certainly as you all well know chair as well,
reduction in long -term admissions to residential care. Again that's another
strong area for for this bit of the world. This year we have identified some
additional funding. There's been a small working group between system partners to
see where that's most effective and it's in 1 .7 .1 of the report. Some of that will
be around some of the adult social care cost pressures that we've talked about
as being referenced earlier, an allocation to the neighbourhood core teams which feels really important.
We've got a, as we've...
Well, and a backlog around that as well, so there's a little bit of focus on that in terms of that.
And then we think we also need some additional capacity around our next phase of our integration journey.
So this has been to our books executive partnership. There's been a small task and finish group around it
Chair and vice chair you'll be asked to sign this off formally
Outside this meeting the full plan as it's coming forward over the next few days. That's all I want to say chair
Cllr Isobel Darby - 1:17:26
Thank you very much quick anybody got any comments before we go to the recommendations on that
so
The recommendations on this are we note the proposed approach to the Better Care Fund
for 26 -27 and that we continue to delegate the authority for the ongoing development
of the Better Care Fund plans, allocation of expenditure, proposed metric trajectories
and reporting requirements to the Buckinghamshire Council and Integrated Care Board Joint Commissioning
meeting.
That's a bit of a mouthful, isn't it?
I'll be happy with that.
Brilliant.
Thank you very much.
The next items are for information so these have obviously all been
there in the report I don't know if anybody wants to say anything extra on

11 Buckinghamshire Executive Partnership

their item but we've got the Buckinghamshire Executive Partnership and George or the
the lead officer on that is there anything you wish to say? No? Okay then

12 Integrated Care Board Update

integrated care board that's on page 89 Nicola is there anything you want to add
to that? No. And then we don't have anybody from Bucks and Muck teens do we? So I'm

13 Buckinghamshire Primary Care provider Collaborative

assuming we're all happy to note all of those items. Fantastic. Item 13 AOB the
Buckinghamshire, here we go, the Buckinghamshire primary care provider
collaborative. I've just got to learn new acronyms here. I'm glad it's out there in full.
Bobby Pozzoni-Child - Director of Partnership and Transformation Bucks Primary Care & Director of Integrated Care Bucks Place - 1:18:49
So, Bobby, did you want to say anything on that?
Yeah, I thought, I'm going to assume you've all read the comms
because I think it came out to a lot of you and it's obviously
in the agenda pack, so that's that bit.
And George has obviously kind of set
out the tone a little earlier.
I guess I just wanted to sort of share a few key things
about why we think this is important for primary care
and particularly for primary care in Buckinghamshire.
And the first is just to set the scene on the scale.
So, the primary care provider collaborative,
at Bucks Primary Care.
We are the representative voice facing into system partners
now for the 46 GP practises, the 13 soon to be 14 primary care
networks in Buckinghamshire, and the one GP federation
fed Bucks.
But we're also now here on behalf of the 82 community
pharmacy providers, the around 80 community optometrists,
and then also 100 dental workers.
And that workforce is estimated to be around 4 ,500 people.
Also, again, thinking about the healthcare workforce
and all of the things that we've heard about today,
a particularly important set of the workforce
that is providing significant proportions of contact
and around 50 % of that is general practise workforce.
And again, a few more numbers for you.
General practise provided nearly quarter
of a million appointments in December.
So I think that kind of sets out some of the scale
of what's going on out in the community in primary care.
Linking to some of the work that we've got going on
and some of the issues that we're sort of working
with provider groups on.
We know access obviously is a significant concern
for the patients, for the residents,
particularly general practise access and dental access.
So one of the key things that we've been working
with dental providers on is around sort of the evolution
of flexible commissioning from the ICB
and how that plays into the local work that's going on
with the homeless population particularly,
recognising dental access for homeless people,
people experiencing homelessness is a real challenge.
And also thinking about the contracting
particularly the changes in the dental commissioning,
dental contracts and the knock -on impact
for urgent care services in general practise providers as well.
So there's been quite a lot of change over the last few months on all of that.
And then I wanted to highlight community pharmacy as well
and the significant opportunity.
You know, community pharmacists are on the high streets.
They are where people are going.
They are dispensing, I don't know the numbers,
a lot of prescriptions every month
and patients are passing through those doors.
There are loads of services that could be better utilised
in community pharmacy, and I think on the integration agenda
there's a significant amount of work,
and I know if David Dean was sat here, he'd be saying,
yes, we'll do more, we'll do more,
we'll do more pharmacy first, we'll do more blood pressure,
we'll do more on contraceptives.
We are there for patients, and obviously the evolution
in the workforce there with pharmacists being prescribers
as they graduate in 2026 would be really significant
for the changing workforce as we look down the line.
But there are also challenges, so it would be remiss of me not
to mention some of the challenges
for community pharmacy that we're also working with them
to try and adjust, so thinking about the sort
of scale infrastructure.
So unfortunately, we've lost the PCN community pharmacy leads
that was funded through the ICB,
which had helped community pharmacy to integrate better
with general practise providers
to increase utilisation of pharmacy first.
That's now gone, so we're trying to work
through the integration agenda,
but also through Bucks Primary Care work to support the changes there.
And also some of the kind of nitty operational issues
that are going on with like digital solutions and integration and things.
So it was a whistle stop tour.
I haven't really said anything about general practise, particularly,
because I'm not sure that there's much more to say than what you probably already know.
Demand is like that.
And the access challenges still remain.
Bucks Primary Care are working very closely with practises on the sort of
access agenda.
and we spent the whole of yesterday afternoon going
through different things around access
with general practise providers and we will continue to do that.
And obviously that primary care access recovery directly links
to the neighbourhood health agenda
and that number one reform agenda in the framework.
So that was a bit of a whistle stop really on some of the stuff
to do with primary care that I think is relevant
for you to know.
Cllr Isobel Darby - 1:22:55
I don't know if you've got anything you want to add but.
I think probably other thing
Dr George Gavriel - Director, Buckinghamshire Primary Care Provider Collaborative - 1:23:02
just emphasise is just the approach we're taking much like the rest of the
partners we're trying to support the life course approach so we have in post
at the moment a live well and an age well need from primary care who
effectively will be available for appropriate committees and board and we
are we've just closed applications for a start well lead and we're hoping to
in the next few weeks really for that role.
So once that's in place, we'll obviously make connexions
from those leads and hopefully can integrate
within the hospital and local authority teams
and get to know the relevant people there.
Cllr Isobel Darby - 1:23:44
Brilliant.
Thank you very much and thank you Bobby
for that absolute whistle -stop tour.
And all those numbers, I was, you know, it was bombarded.
But, you know, it's quite sobering
when you see how many people are involved in this,
in providing primary health care to our population.
And we need to get this right,
because then we make Bregu very happy,
because he has less people walking through his door,
saying, I've got to come to A &E,
because I can't get a doctor's appointment.
And you certainly should not go to A &E,
if you can't get a doctor's appointment,
but I can understand the desperation
that some people are led to.
And we just need to get that right.
we need to get those messages out.
We absolutely need to get our wonderful community pharmacists
doing what they can because there's an awful lot they can do.
And if they can't manage somebody's symptoms,
they will signpost to the next stage up, which is the GP.
So we just need to get that message and that trust
in the population trust, I think,
that actually a pharmacist doesn't know an awful lot
and you don't always need to see a doctor
about every single thing.
And I think that is really, really important.
and not forgetting our dentists and our optometrists and everybody else because
it's all part of a whole system. So thank you very much for that update.

14 Forward Plan

So we're now on to the forward plan. So the next meeting is in September.
We have got the date haven't we which is the 3rd of September but it has to be
confirmed by Buckinghamshire Council's full council meeting but please have
that in your diaries.
And we're looking at, you can see on the agenda,
what we're looking at having at that meeting.
Oh, sorry.
David Munday - Director of Public Health - 1:25:36
And just on the forward plan point,
just very quickly if that's okay.
We've heard about the alcohol care team today.
We've heard from One Recovery Bucks
in terms of some of the drug and alcohol support
that happens here.
We've got a combatting drugs and alcohol partnership
in Buckinghamshire.
And so I co -chair that with, it has been Detective Chief
Inspector Sally Spencer from TVP.
She's actually just changing roles.
So it'll be her kind of replacement.
And that's a system partnership group
established as part of the government's kind of 10 -year
plan to reduce harm from drugs.
But in our approach, we've got that reducing harm.
We've got the reducing crime.
We've got the reducing death from drugs,
but include that alcohol part in it as well.
So it's a kind of a cohesive look.
We haven't yet been in the discipline
of providing any update or reporting into this board
on what happens there.
So if it's OK, I'd like to just work
with the team that kind of lead on the partnership,
just to look at maybe the next meeting or the one
after bringing in something that just makes
that connexion between what's happening there
and the broader health and well -being
and that integration work, which is
so much the theme of our board.
So, a suggestion in terms of a future agenda item
on the forward plan.
Yeah, absolutely.
Cllr Isobel Darby - 1:26:55
And, Cilla, we'll take that on board.
And I think, you know, it is just so important
that we know of all these bits of the system
that are operating.
And then it's down to all of us to,
incumbent on all of us to say,
what's my bit of the organisation doing about this?
And should I be doing more
or should I be talking to somebody else?
So, that's brilliant.
So I'd just like to thank everybody for their attendance and their participation today.

15 Date of next meeting

And I will now formally close the meeting and wish you a safe journey home. Thank you.