Agenda item

The Board is asked to note the early plans and timetable of delivery for Neighbourhood Health services in Oxfordshire. 

In line with the government's 10 year health plan, which includes a priority for moving care from hospital to community, local areas are required to develop Neighbourhood Health services. The Health And Wellbeing Board will have leadership for local Neighbourhood Health plans jointly drawn up by local government, the NHS and its partners. 

-       Annex 1: ‘Fit for the Future’ – 10 Year Health Plan for England – Executive Summary

-       Annex 2: NHS England – Neighbourhood Health Guidelines 2025/26.

Further information, including the full 10 Year Health Plan, can be found on the government website, here: 10 Year Health Plan for England: fit for the future - GOV.UK

Michelle Brennan, GP Representative, and Professor Malcolm McCulloch gave a presentation on neighbourhood health services in Oxfordshire and raised the following points:

-       Important to understand that the neighbourhood model of health was much bigger than just the NHS with involvement needed by local authorities, ICB’s and community and voluntary organisations.

-       Thematic analysis of feedback from system partners showed that people felt systems were fragmented and siloed, with confusion of where people need to go.

-       The left shift ambition of moving towards preventative care was vitally important to avoid hospital-centric care.

-       It was likely that neighbourhood health areas in Oxfordshire would be in a range from 50,000 to 100,000 people.

-       The John Hopkins segmentation showed 473,978 people were in the lower need group, 147,710 people were in the moderate need group and 18,75 were in the higher need group.

-       The Acute Sector being involved is important for this model to work.

-       Rapid mapping of services was underway and it was emphasised that Oxfordshire have a high level of services already aligned to the community.

-       The need for a high-performance system framework with five key functions was shown: operations, coordination, resource allocation, future scanning, and identity/governance was emphasised.

-       Better shared data platforms would allow for better coordination, citing international examples of integrated patient systems.

-       It was emphasised that a shift was needed to receive best value across the system, rather than in individual organisations.

-       It was important to scan for future trends, such as AI or ageing populations, and to adapt resourcing allocations and governance structures accordingly.

-       The move from analogue to digital would be an enabler for this work.

-       The governance structures would come in the form of a Primary and Community Board, reporting into the Place Based Partnership and the Health & Wellbeing Board.

-       The importance of having shared data sets.

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Ansaf Azhar, Director of Public Health and Communities, stressed the need to focus on the other leftward shift (treatment to prevention) alongside moving care away from hospitals, as well as ensuring that neighbourhood health centres were not purely clinical and to embed social care elements.

The Chair asked how a single point of entry into the system would be managed and whether it would be conducted nationally, locally or at an integrated care system level. The NHS app was referenced as one example, but it was noted as very complex. Coordination would have to take place across organisations.

Dan Leveson, Director of Places and Communities (BOB ICB) commented on the need of the Health & Wellbeing Strategy to reflect the current journey of health and social care in Oxfordshire.

The Vice Chair asked how this framework would work for organizations which have to be a part of multiple systems. It was noted that it had to be an iterative process to work out what worked best for individual organizations, in consultation with their stakeholders. It was commented on that the neighbourhood health plans were an opportunity to move away from traditional organisational approaches to a population-wide approach.

Cllr Andy Graham (West Oxfordshire District Council) asked about the frameworks for evaluation of the systems & the framework outlined. Officers confirmed that it was important to work with residents and to co-produce a framework, noting that the challenges, such as funding, faced in this area should be clearly explained.

Grant MacDonald, Chief Executive (Oxford Health NHS Foundation Trust) highlighted the need to identify the challenges of particular neighbourhoods where there is greater need, to push on work currently underway across Oxfordshire through the Place Base Partnership, for example. Officers noted this and said it was important for the Health & Wellbeing strategy to shift towards prevention given the new 10 year NHS plan.

Cllr Jane Hanna, Chair of Joint Oxfordshire Health Overview and Scrutiny Committee (HOSC), highlighted the importance of managing anxiety within different health and social care organisations given changes that would be upcoming and noted that HOSC would looking at this going forward.

Cllr David Rouane (South Oxfordshire District Council) asked for a worked example of the governance framework and commented on the need to have trust throughout the system.

Cllr Bethia Thomas (Vale of White Horse District Council) stated that the current system was broken, but what need to be explained to the public and others was how this proposed system would improve the situation, as well as what constituted a neighbourhood, given the rural nature of Oxfordshire.

The Chair stated that these questions were good examples of what needed to worked through at the workshop, highlighting the importance of District perspectives in addressing local challenges, such as a lack of public transport in rural communities.

Barbara Shaw, Chair of Healthwatch Oxfordshire, stated the importance of having patient voice involved in co-designing these systems and their patient journey.

Cllr Jane Hanna reiterated the importance of town and parish councils, and local elected representatives at all levels in this process.

The Chair thanked everyone for attending and the Board noted the early plans and timetable of delivery for Neighbourhood Health services in Oxfordshire.

RESOLVED: The Board noted the early plans and timetable of delivery for Neighbourhood Health services in Oxfordshire.