This report and its appendices provide information to support the Health, Care, and Wellbeing Scrutiny Committee’s scrutiny of the Herefordshire and Worcestershire Health and Care NHS Trust Strategy.

The committee received an overview of the Herefordshire and Worcestershire Health and Care NHS Trust Strategy from Sue Harris, Director of Strategy, People and Culture, and David Thomas, Associate Director, Primary Care and Community Mental Health Services.

The principal points of the discussion are summarized below:

1. The trust has made progress embedding cultural improvements including strengthened leadership, clearer governance, and revised approaches to staff support.

2. The reporting of the strategy will start in April 2026 which will embed it as part of the trust’s decision making so people will be able to track progress.

3. Talking therapy services are undergoing expansion, with local increases in capacity and workforce underway, though some lag exists due to training.

4. Individual placement services (IPS) are subcontracted with Landau. The trust’s key consideration is that there is a set of expectations and deliverables that Landau has agreed to meet. Overall, Landau consistently delivers against these requirements and maintains a strong overall performance record.

5. In response to a question around workforce, it was noted that staff turnover has declined over time. It was added that staff turnover in relation to IPS in Herefordshire is not so much a direct operational workforce question but rather a contracting question. It was noted that Landau has a good record in this area.

6. There has been a considerable focus on inappropriate out-of-area placements over the last year or so and has been very successful with a baseline of zero inappropriate out-of-area placements.

7. It was confirmed that inappropriate out-of-area placement patients may be sent either to another NHS trust offering commercial capacity or to a private provider, depending on available capacity at the time.

8. In response to a question about whether Herefordshire and Worcestershire provide services to other counties, it was confirmed that they do not.

9. Length of stay reduction for working-age adults and older adults is also a key objective, supported by a seven-day mental health bed-management function.

10. The older adult targets slightly trail the working age adult targets because there are some additional complexities related to caring for older adults in mental health settings.

11. Challenges around discharge were noted, particularly where social care or housing issues delay patient movement from inpatient settings.

12. In response to a question about partnerships, the trust noted ongoing collaboration with Talk Community, public health, education settings, and wider NHS partners to support proactive, community?based mental?health approaches.

13. In response to a question about where Talk Community sits within the trust’s strategy, it was noted that Talk Community forms part of the neighbourhood health agenda. It was also acknowledged that there are potential tensions in partnership working due to challenges around IT systems, data sharing, and governance, which need to be addressed to realise this ambition.

14. In relation to mental health support teams in schools, the target is to have two new teams stood up by the end of 2026/27 and then further expansion over the two successive years. New funding is confirmed for 2026/27 in support of this with commitments to continue that funding  ...  view the full minutes text for item 7