Ed Garvey (Senior Locality Commissioning Manager, NHS Devon ICB) presented a verbal update on the development of the Neighbourhood Health Plan and discussed:

a)     That NHS England had published its Operational Planning Guidance late in the previous year, requiring Integrated Care Boards and NHS Trusts to produce and submit a Neighbourhood Health Plan as part of the national planning cycle;

b)    That the Neighbourhood Health Plan would need to set out how the NHS, local authority, social care providers and the voluntary and community sector would work together to design and deliver neighbourhood-level health services;

c)     That national guidance from the Department of Health and Social Care had not yet been published, and therefore the specific requirements for plan development were still unknown however, guidance was expected imminently;

d)    That the purpose of the update was to ensure the Health and Wellbeing Board (HWB) was aware of the upcoming requirement, and that support and approval would be sought once guidance was available;

e)     That Plymouth had recently been successful in securing enhanced support from the national Better Care Fund (BCF) Improvement Support Programme, following a bid submitted shortly before Christmas, and that this support would assist in preparing the Neighbourhood Health Plan;

f)      That contact from the BCF national team was expected shortly, with a call already scheduled at 1pm on the day of the meeting to confirm next steps, timeframes and expectations;

g)     That the ICB and Plymouth City Council intended to develop the plan jointly, and would ensure the Health and Wellbeing Board was fully engaged in its development and sign?off process as required;

h)    That previous work across health, social care and the voluntary and community sector, particularly around integrated neighbourhood teams, would sit beneath and feed into the emerging plan, and that national priorities placed significant focus on neighbourhood-based preventative and community care models;

i)      That a Local Care Partnership (LCP) meeting had taken place in December where partners had committed to continuing collaborative work. An action agreed at the meeting was to map all relevant workstreams and develop a joined-up strategy and governance framework to drive neighbourhood work forward;

j)      That although Plymouth had not been selected for the national Neighbourhood Health Implementation Programme earlier in the year, the bidding process had generated substantial enthusiasm and cross?sector engagement, with a series of workshops continuing to explore co-production and neighbourhood service redesign.

In response to questions, the Board discussed:

k)     That Local Government Reorganisation (LGR) would have implications for neighbourhood arrangements and should be considered early in the planning process, even while details remained uncertain;

l)      That the HWB may need to convene an extraordinary meeting if required to meet tight national timescales associated with the plan and BCF governance, noting that timely HWB approval was likely to be necessary;

m)   That Healthwatch had not yet received significant public interest or awareness around neighbourhood health work. Members noted the importance of public communication and ensuring people understood proposed changes, especially regarding integrated teams and local wellbeing services;

n)    That concerns existed regarding potential duplication or postcode inconsistencies unless community involvement, co-production and transparency were built into the planning process from the outset;

o)    That Plymouth already had strong community?based models and good practice, and that this should be evidenced clearly in the plan, with the neighbourhood model seen as an opportunity to reinforce existing strengths;

p)    That national guidance was needed to shape priorities and provide a framework, but in the meantime local partners should continue preparing foundations through the Local Care Partnership and other integrated governance structures;

q)    That children’s social care national reforms also emphasised local, multi?disciplinary, co?located models, and that alignment between adults’ and children’s neighbourhood work would be important to avoid fragmentation;

r)     That transitions between children’s and adults’ services, particularly regarding neurodiversity and mental health, should be considered within the neighbourhood model to improve continuity for young people;

s)     Voluntary and community sector partners emphasised the importance of bottom?up, person?centred, trauma?informed service redesign. Members cautioned against top?down rollout that risked embedding system?designed rather than people?designed pathways;

t)     That significant cultural change across all organisations would be required to deliver neighbourhood-based care successfully, including challenging long?standing professional silos, organisational protectionism and system?driven metrics that did not reflect people’s lived experiences;

u)    That the Changing Futures programme had demonstrated strong methodologies for deep community engagement and co?production which could be used to shape the neighbourhood approach;

v)     That neighbourhood models may need to develop at different speeds across the city, reflecting the varying needs, strengths and characteristics of individual communities.

The Board agreed:

1. To note the verbal update on the Neighbourhood Health Plan;

2. To note Plymouth H&WB’s successful bid for enhanced national BCF support;

3. To review national guidance once published and to consider the development timeline for the Plan at a future meeting.