Agenda item

Dr Michelle Brennan and Dan Leveson have been invited to present a report providing an update on the ongoing work to develop a Neighbourhood Health Plan for Oxfordshire.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make before this plan is presented to the Oxfordshire Health and Wellbeing Board for approval on 4 December 2025.

With the agreement of the Committee, the Chair varied the agenda and took item 10 before item 9.

Oxfordshire’s system partners were invited to present a report providing an update on the ongoing work to develop a Neighbourhood Health Plan for Oxfordshire. The Committee invited the following Officers to answer questions:

• Ansaf Azhar, Director of Public Health & Communities
• Chris wright, Associate Director of Place – Oxfordshire BOB ICB
• Ian Bottomley, Deputy Director, Integrated Commissioning – HESC
• Kate Holburn, Deputy Director of Public Health
• Lily O’Connor, Programme Director Urgent and Emergency Care for Oxfordshire BOB ICB
• Dr Michelle Brennan, Chair Oxfordshire GP Leadership Group
• Sue Butt, Oxford Health NHS Foundation Trust?Transformation Director
• Victoria Baran, Deputy Director of Adult Social Care

The Committee received an update on the development of Oxfordshire’s neighbourhood health plan. The deadline for submitting the final plan had been extended beyond December 2025, allowing more time for partners to refine the plan. The Chair emphasised that this extension would help avoid a rushed process and enable a more robust outcome. The meeting provided an opportunity for scrutiny and recommendations.

Discussion began with concerns about implementing strategic changes, such as shifting care from hospitals to the community, prioritising prevention, and increasing digitalisation, without additional funding. The Head of Joint Commissioning -Age Well explained that aligning the neighbourhood health plan with the Better Care Fund (BCF) would be essential, as many services supported by the BCF would underpin the neighbourhood agenda. Despite financial challenges, partners were expected to coordinate creatively and maximise the impact of existing resources.

Efficient use of the BCF was identified as a key lever for cross-sector collaboration and resource allocation. The adoption of population health management approaches was also emphasised, enabling collective use of data for targeted prevention and addressing unmet needs. Integrating services at the neighbourhood level and building strong relationships were considered vital. The Committee expressed confidence that partnership working and resource alignment could drive the required changes.

The value of community projects and lessons from co-production and voluntary sector involvement were discussed, with the Wantage Community Hospital project cited as an example of transformation from a hospital-based to a community-focused initiative. The importance of engaging the voluntary sector and leveraging local assets was highlighted, alongside the need to map community activity and integrate voluntary sector knowledge. Co-production and voluntary sector engagement were deemed essential for effective prevention and holistic neighbourhood planning.

The governance structure for the neighbourhood health plan was examined, particularly regarding the involvement of voluntary, community, faith, and social enterprise sectors. A dedicated stakeholder event had been held to discuss engagement methods, with approaches tailored to suit different organisations’ capacities. Ongoing collaboration with infrastructure organisations, regular meetings with the voluntary sector, and offers for representation on key boards were noted, aiming for both information sharing and genuine influence over decision-making.

The role of overarching organisations in representing the voluntary sector within the plan’s governance was considered. While organisations such as Healthwatch sat on the Place-Based Partnership Board, it was acknowledged that no single organisation could represent the entire voluntary sector due to its diversity and limited resources. Regular interactions and flexible participation, allowing topic-specific groups to join relevant board discussions, were suggested to ensure broader representation. Patient Participation Groups were also identified as a means to enhance engagement.

Cllr Garnett left the meeting at this stage.

The Committee explored whether the construction of neighbourhood geographies for the health plan took into account potential local government reorganisation (LGR), particularly to ensure alignment with broader determinants of health such as housing, planning, and transport. It was confirmed that discussions had taken place with district councils and that the planning process was mindful of possible LGR changes. The current neighbourhood plan would serve as a transition plan, with a more formal version to follow once LGR details were clearer, to avoid creating neighbourhoods that might later conflict with new boundaries.

The role of the Health and Wellbeing Board in the neighbourhood health plan, mechanisms for public accountability, and governance sign-off were discussed. The Board would have overall accountability and leadership for the plan, with regular updates provided to the Joint HOSC. The plan would be developed with input from a wide range of stakeholders, including lived experience representatives and district councillors, and would be socialised with all relevant organisations for sign-off. The Board’s membership might be reviewed to ensure broad stakeholder involvement.

Parish council involvement in the development of neighbourhood health plans was raised. Parish councils had not yet been engaged but would be included as the process moved to the individual neighbourhood level, recognising their valuable local insight. Collaboration would likely be coordinated with guidance from County and District Councils, and it was recommended that the Oxfordshire Association of Local Councils be used as a key communication channel.

The Committee sought clarification on the practical advantages the neighbourhood health plan would offer to ordinary residents, particularly those in rural villages with limited access to transport and healthcare. The plan aimed to provide more care closer to home, reducing the need for hospital visits unless absolutely necessary. It was acknowledged that rural neighbourhood plans would differ from urban ones, but the overall goal was to address local needs within communities and build on existing assets.

Mechanisms for influencing the neighbourhood health plan, especially regarding the involvement of local members and parish councils, were outlined. Engagement could occur through relevant officers, the Health and Wellbeing Board, local authority members, the HOSC committee, and the place-based partnership. Local members played a key role as frontline representatives in their communities and at parish meetings, ensuring that local voices could influence the development and implementation of the plan.

The criteria for determining what constituted a neighbourhood within the plan, and ensuring coherence across Oxfordshire, especially with possible future changes to local government boundaries, were clarified. Four planning units: North, City, South, and West, had been established to facilitate local stakeholder engagement, not to set fixed boundaries. Neighbourhoods would likely range from 30,000 to 50,000 people, with further and continuous evaluation to ensure boundaries reflected natural community movements and local service use.

Concerns regarding upcoming contracts for neighbourhood health, particularly the impact on general practice and the definition of a “core offer” at different population levels, were acknowledged. Significant anxiety existed among GPs due to uncertainty about new provider contracts, which had not yet been detailed. It was explained that most people would continue to receive care through existing primary and community services, with neighbourhoods initially focusing on those with complex needs. Further information and engagement would follow once contract details became available.

Lessons learnt from previous neighbourhood and integrated care projects were discussed. Oxfordshire had already implemented several successful programmes, such as hospital at home, virtual wards, and integrated neighbourhood teams, with ongoing evaluation in specific areas. The neighbourhood health plan aimed to coordinate and scale up effective approaches across the county, balancing both service reorganisation and preventative work tailored to local needs.

The Committee AGREED to issue the following recommendations, subject to any necessary minor amendments offline:

1. For clear governance arrangements to be developed for the Oxfordshire Neighbourhood Health Plan, including defined roles for the Health and Wellbeing Board, Place-Based Partnership, and Primary and Community Care Board. It is recommended that there is openness and transparency, as well as regular reporting to the JHOSC on the plan’s development and delivery milestones.?

2. To ensure that the Neighbourhood Health Plan aligns with other strategic initiatives (such as the Better Care Fund and the Health & Wellbeing Strategy, and the Oxfordshire Way), and to avoid duplication and fragmentation.

3. To prioritise investment in digital infrastructure, interoperability, and usability to enable data sharing and Population Health Management at neighbourhood level. It is recommended that system partners report on progress in implementing Population Health Management tools and Health Evaluation Units. ?

4. To ensure that the local patient voice and local voluntary sector input is at the heart of the development and delivery of the neighbourhood health plan for Oxfordshire. It is recommended that the role of the local member is also integral to this.

5. To ensure the collective gathering of data by all key system partners as part of shaping and delivering the neighbourhood health plan. 

D/Cllr Poskitt left the meeting at this stage.