To receive apologies for absence.

Apologies for absence were received from Cllr Kevin Tillett, and Cllr Mark Dykes.

To receive details of any councillor nominated to attend the meeting in place of a member of the committee.

Cllr Polly Andrews was present as the named substitute for Cllr Kevin Tillett.

To receive declarations of interest in respect of items on the agenda.

No declarations of interest were made.

To receive the minutes of the meeting held on Monday 27 April 2026.

The minutes of the meeting held on 27 April 2026 were confirmed as a correct record.

Resolved: That the minutes of the meeting held on 27 April 2026 be confirmed as a correct record.

To receive any written questions from members of the public.

No questions were received from members of the public.

To receive any written questions from members of the council.

No questions were received from councillors.

To provide an update on Herefordshire and Worcestershire Health and Care NHS Trust’s adult mental health rehabilitation services redesign.

The committee considered a report on the Adult Mental Health Rehabilitation Redesign – Update item.

The principal points of the subsequent discussion are summarised below:

1. The Herefordshire and Worcestershire Health and Care NHS Trust provided an update on its adult mental health rehabilitation service redesign programme. It was noted that the programme had been developed over a two-year period and sought to ensure that people received the right care, in the right place and at the right time.

2. The committee heard that the trust currently operated three inpatient mental health rehabilitation units across Herefordshire and Worcestershire, providing 33 beds in total. Rehabilitation services are intended to support people to develop the skills required to live as independently as possible, with level one rehabilitation focused on daily living and functional skills and level two rehabilitation providing more intensive clinical stabilisation.

3. It was reported that the preferred option is to establish a community rehabilitation team for level one rehabilitation, reduce the number of rehabilitation beds from 33 to 18, and procure level two rehabilitation beds from external providers. The trust considered that this would enable it to support a greater number of people in their own homes and communities, with the proposed community service expected to support up to 135 people.

4. The committee was advised that the option appraisal had involved clinical modelling, expert panels and engagement with staff, local authority and integrated care system colleagues, the voluntary and community sector, public health, and people with lived experience. It was noted that the process had been paused during 2025 to consider new potential providers of bedded facilities, although this had not changed the preferred option.

5. In response to questions about the planned closure of Oak House, the trust clarified that Oak House is a rehabilitation unit rather than a secure unit. It was confirmed that the proposals would not affect the secure mental health bed provision at Stonebow. The trust stated that the resources currently used for Oak House would instead support a community rehabilitation offer, although bedded rehabilitation capacity would remain available in Bromsgrove where required.

6. The committee noted the trust’s view that public-health modelling indicated that the proposed model should reduce the need for out-of-area rehabilitation placements. However, concerns were raised regarding access for Herefordshire residents required to attend a Worcestershire-based unit, particularly for people without access to a car and for their families and support networks. The trust acknowledged that detailed transport arrangements had not yet been developed and would require further work.

7. Members also raised concerns about the practical delivery and affordability of community provision in a rural county, including the availability of housing to support discharge and recovery. The trust advised that the proposal is intended to be cost-neutral, with staff from units proposed for closure offered opportunities within the community rehabilitation team. It was added that the trust had experience of a similar model through its hospital-at-home service.

8. The trust explained that a detailed implementation and transition plan would be developed only if the proposal passes  ...  view the full minutes text for item 27.

To review Herefordshire’s Joint Strategic Needs Assessment (JSNA) and neighbourhood health profiles.

The committee considered a report on Herefordshire’s Joint Strategic Needs Assessment and Neighbourhood Profiles.

The principal points of the subsequent discussion are summarised below:

1. The Director of Public Health introduced the item and explained that the Joint Strategic Needs Assessment (JSNA) is a statutory, ongoing assessment of the health, care and wellbeing needs of Herefordshire’s population. It was noted that, alongside the countywide summary published on a three-year cycle, the JSNA included themed needs assessments, dashboards and other products to inform strategic planning, commissioning, monitoring and evaluation.

2. The committee heard that the JSNA considers the wider determinants of health and wellbeing, including housing, employment, transport, social connections and the local environment, rather than health services alone. It was noted that health services accounted for only part of the factors influencing health outcomes.

3. The Lead Public Health Intelligence Analyst reported that the neighbourhood profiles had been developed to provide an area-based understanding of need, complementing the countywide and topic-based JSNA products. The profiles are intended to support the national neighbourhood health agenda, with Herefordshire identified as one of the first-wave neighbourhood health sites.

4. The committee was advised that the profiles were designed to be accessible to a wide range of users, including primary care networks, commissioners, council and partnership services, voluntary-sector organisations and other stakeholders. Their purpose is to identify opportunities for prevention and reducing inequalities.

5. It was explained that four neighbourhood areas had been defined using existing localities and primary care network footprints: Hereford City, East, South and West, and North and West. The two Hereford City primary care networks had been combined because their registered populations overlapped, while the profiles would also enable analysis of differences within each wider neighbourhood area.

6. The committee heard that the profiles had been developed as narrative and graphic products, interpreting and triangulating available evidence rather than presenting a comprehensive list of data points. A full North and West profile and draft summary profiles for all four areas had been included in the agenda papers, with members invited to comment on whether the profiles accurately reflected the story of each area.

7. In relation to Hereford City, it was noted that the area has the highest population density and contains both some of the most and least deprived areas in the county. Significant inequalities exist within the city, including a difference of around five years in male life expectancy between some areas, alongside higher smoking rates and avoidable mortality than elsewhere in Herefordshire.

8. The East neighbourhood was reported to have generally positive outcomes, including higher life expectancy, healthier lifestyles and strong communities. However, members heard that area-wide outcomes could mask local need, with Bromyard Central and Ledbury Central identified as areas experiencing deprivation and higher emergency hospital admissions.

9. It was noted that South and West is geographically diverse, encompassing better-connected locations such as Ross-on-Wye as well as remote rural areas including the Golden Valley and the Black Mountains. While health outcomes were generally positive, the profile identified barriers to physical and digital access to services,  ...  view the full minutes text for item 28.

To receive a verbal update on adult social care budget outturn.

The committee received a verbal update on the Adult Social Care budget outturn item.

The principal points of the subsequent discussion are summarised below:

1. The Corporate Director Community Wellbeing reported that the 2025/26 revenue budget outturn for Community Wellbeing was a net overspend of £3.7 million, after applying a contribution from the budget resilience reserve. This included £0.9 million of undelivered savings, while the principal amount of the overspend was increased demand across domiciliary care, residential care and nursing care, including increased need among people leaving hospital.

2. It was noted that demand for formal care and support had increased significantly during the first half of 2025/26 and had only partly reduced during the second half of the year. The committee heard that early indications for 2026/27 were more positive, with weekly demand broadly in line with the budget provision and below the levels experienced during the previous year.

3. The Corporate Director Community Wellbeing advised that there is an increased focus on supporting people at home and through supported living, where appropriate, rather than relying on residential and nursing care. It was also reported that delivery of the 2026/27 savings programme was underway, with first-quarter savings profiled for delivery having been achieved, and the value of undelivered savings from the previous year reduced by £300,000.

4. The committee was advised that the directorate has established structured process for budget oversight, savings delivery and challenge. These included dedicated workstreams and monthly meetings involving the directorate leadership team, finance colleagues and the Cabinet Member.

5. In response to a question about whether expenditure is achieving better outcomes, the Corporate Director Community Wellbeing stated that the service sought to support people in their own homes or supported living settings where this best met their needs. It was noted that feedback was collected through the People’s Voice survey following assessment and support-planning interactions, and that this information was used to identify both improvement opportunities and positive outcomes.

6. In response to a question on the quality of domiciliary care, the committee heard that feedback was sought from people receiving care and that the council’s quality and review team undertook spot checks and spoke to providers and residents. Where safeguarding concerns arose, work was undertaken by safeguarding and quality teams to address concerns relating to individuals and providers in a timely manner.

7. The committee discussed the cost of people who had previously funded their own care falling below the capital threshold and becoming eligible for council support. The Corporate Director Community Wellbeing advised that this normally created a cost pressure of around £0.5 million, which was considered during budget-setting. It was reported that work was underway to improve the offer to self-funders, enabling earlier engagement, more timely assessment and better planning for continuity of care.

8. The Cabinet Member Adults, Health and Wellbeing noted work to increase awareness of technology-enabled care through stands at community hospitals. It was reported that events had been held at Leominster and Bromyard, with further events planned. The purpose was to help residents, families and  ...  view the full minutes text for item 29.

To consider the draft work programme for Herefordshire Council’s scrutiny committees.

The Statutory Scrutiny Officer presented the draft work programme for the Health, Care and Wellbeing Scrutiny Committee.

It was agreed that the arrangements for completing the task and finish group report would be discussed further in a separate meeting.

Date of the next scheduled meeting: Monday 14 September 2026, 2.00 pm.

The date of the next meeting is Monday 14 September 2026, 2.00 pm.