===== PAGE 1 ===== You can view the agenda and livestream link on the website or use a smart phone camera and scan the code To: The Chair and Members of the Health and Wellbeing Board County Hall Topsham Road Exeter Devon EX2 4QD Date: 7 October 2026 Contact: committee-mailbox@devon.gov.uk ## HEALTH AND WELLBEING BOARD Thursday, 15th October, 2026 A meeting of the Health and Wellbeing Board is to be held on the above date at 2.00 pm at Stover Country Park, Newton Abbot, Devon TQ12 6QG to consider the following matters. Donna Manson Chief Executive ## AGENDA ## PART I - OPEN COMMITTEE 1 Apologies for Absence 2 Declarations of interest Members of the Council will declare any interests they may have in any item to be considered at this meeting, prior to any discussion taking place on that item. The other registrable interests of Councillors of Devon County Council, arising from membership of City, Town or Parish Councils and other Local Authorities will automatically be recorded in the minutes. For details of District and or Town and Parish Twin Hatters please see here - County councillors who are also district, borough, city, parish or town councillors ===== PAGE 2 =====

Minutes of the meeting held on 2nd July 2026 (previously circulated). For reference these are available here: Health and Wellbeing Board - Democracy in Devon
Items Requiring Urgent Attention
Items which in the opinion of the Chair should be considered at the meeting as matters of urgency.
Chair's Announcements
Devon Joint Health and Wellbeing Strategy: Rural Areas and Access to Services (Pages 1 - 38)
Presentation from Devon Rural Deprivation Group exploring the priority theme of rural areas and access to services in Devon followed by consideration of next steps as part of the Devon Joint Health and Wellbeing Strategy, attached.
Developing Devon's Neighbourhood Health Plan: Timeline and Principles (Pages 39 - 44)
Report of the Chair of the Health and Wellbeing Board (PH/26/09): Developing Devon's Neighbourhood Health Plan: Timeline and Principles, attached.
Growing up in Devon: Annual Public Health Report 2026 (Pages 45 - 46)
The Report of the Director of Public Health: Growing Up in Devon, Annual Public Health Report 2026 (PH/26/10), attached.
Electoral Divisions(s): All Divisions
NHS Devon Update
Verbal update from NHS Devon.
OTHER MATTERS
Scrutiny Work Programme
In order to prevent duplication, the Board will review the Council's Scrutiny Work Programme.

## 3 Minutes ===== PAGE 3 ===== ## 11 Forward Plan (Pages 47 - 48) To review and agree the Board's Forward Plan, attached. ## 12 Dates of Future Meetings Future meeting dates are included in the Council's Meetings Calendar. Next meeting: 7 January 2026 (venue to be confirmed) ## PART II ITEMS WHICH MAY BE TAKEN IN THE ABSENCE OF THE PRESS AND PUBLIC None Members are reminded that Part II Reports contain exempt information and should therefore be treated accordingly. They should not be disclosed or passed on to any other person(s). They need to be disposed of carefully and should be returned to the Democratic Services Officer at the conclusion of the meeting for disposal. ===== PAGE 4 ===== # MEETINGS INFORMATION AND NOTES FOR VISITORS ## Getting to County Hall and Notes for Visitors For SatNav purposes, the postcode for County Hall is EX2 4QD Further information about how to get to County Hall gives information on visitor parking at County Hall and bus routes. Exeter has an excellent network of dedicated cycle routes. For further information see the Travel Devon webpages. The nearest mainline railway stations are Exeter Central (5 minutes from the High Street), St David's and St Thomas. All have regular bus services to the High Street. Visitors to County Hall are asked to report to Main Reception on arrival. If visitors have any specific requirements, please contact reception on 01392 382504 beforehand. ## Membership of a Committee For full details of the Membership of a Committee, please visit the Committee pages on the website and click on the name of the Committee you wish to see. ## Committee Terms of Reference For the terms of reference for any Committee, please visit the Committee page on the website and click on the name of the Committee. Under purpose of Committee, the terms of reference will be listed. Terms of reference for all Committees are also detailed within Section 3b of the Council's Constitution. ## Access to Information Any person wishing to inspect any minutes, reports or background papers relating to an item on the agenda should contact the Clerk of the Meeting. To find this, visit the Committee page on the website and find the Committee. Under contact information (at the bottom of the page) the Clerk's contact details will be present. All agenda, reports and minutes of any Committee are published on the Website. ## Public Participation The Council operates a Public Participation Scheme. For full details of whether and how you can participate in a meeting, please see the Public Participation Scheme or contact the Clerk for the meeting. Please also note the maximum available seating in the Council's meeting rooms and Chamber outlined in that guidance. In relation to Highways and Traffic Orders Committees, any member of the District Council or a Town or Parish Councillor for the area covered by the HATOC who is not a member of the Committee, may attend and speak to any item on the Agenda with the consent of the Committee, having given 24 hours' notice. ## Webcasting, Recording or Reporting of Meetings and Proceedings The proceedings of any meeting may be recorded and / or broadcasted live, apart from any confidential items which may need to be considered in the absence of the press and public. For more information How to get involved - Democracy in Devon ===== PAGE 5 ===== Anyone wishing to film part or all of the proceedings may do so unless the press and public are excluded for that part of the meeting or there is good reason not to do so, as directed by the Chair. 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A reminder will be on every Committee agenda. ## WiFi An open, publicly available Wi-Fi network (i.e Gov WiFi) is normally available for meetings held in the Committee Suite at County Hall (instructions for signing up to Gov WiFi are available at this link). ## Fire In the event of the fire alarm sounding, leave the building immediately by the nearest available exit following the fire exit signs. If doors fail to unlock press the Green break glass next to the door. Do not stop to collect personal belongings; do not use the lifts; and do not re-enter the building until told to do so. Assemble either on the cobbled car parking area adjacent to the administrative buildings or in the car park behind Bellair. ## First Aid Contact Main Reception (Extension 2504) for a trained first aider. ## Mobile Phones Please switch off or silence all mobile phones before entering the Committee Room or Council Chamber. ## Alternative Formats If anyone needs a copy of an Agenda and/or a Report in another format (e.g. large print, audio tape, Braille or other languages), please contact the Customer Service Centre on 0345 155 1015 or email: committee@devon.gov.uk or write to the Democratic and Scrutiny Secretariat in Room 142, County Hall, Exeter, EX2 4QD. Induction Loop available Induction Loop available

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## Proposition: Rurality should not be a reason for poorer access, poorer housing, weaker connectivity or worse health outcomes Nora Corkery, Janie Devoreard ard October 15th 2026 Partnership Devon Health and Wellbeing Board October 15th 2026 Nora Corkery, Janie Moor, Ian Flett, Darin Halifax Devon Rural Deprivation Partnership

===== PAGE 8 ===== ## Introducing the Devon Rural Deprivation Partnership ## Looking Through the Rural Lens

Devon Rural Deprivation Partnership established in June 2024 - Independent cross-sector collaborative partnership Group working together to better understand & address pockets of nested rural deprivation in Devon • Designated as the Health and Wellbeing Board Rural Areas and Access to Services Sub-Group 2026 ## THE PROPOSITION: Rurality should not be a reason for poorer access, poorer housing, weaker connectivity or worse health outcomes. ===== PAGE 9 ===== ## What have we done so far? - Influenced the Devon County Council Equality Impact Assessment requirement for consideration of rural isolation, access to services and transport, digital access & social connectivity. Also the NHS Devon Quality & Equality Impact assessment inclusion of “Rural or Coastal Deprivation” Initiated and influenced the development of the Devon Public Health Rural Composite Exclusion Risk Indices Dashboard (CERI) - Contributed to the Devon County Council Full Council Decision Feb 2026: One Door for Devon to support the Cost of Living within Rural and Coastal Communities including the recommendation to consider opportunities to ‘rural proof’ future & opportunities to consider rural impacts within future decision-making and policy development ===== PAGE 10 =====

## 1 | The case – Why this matters What rural deprivation & disadvantage looks like in Devon – How many H & WB Board members live in a rural/ coastal community? ===== PAGE 11 ===== ## Devon is relatively affluent – but rural deprivation is often hidden

Central llfracombe (75 years) Devon Life Expectancy Gap 15 years

Exton (90 years) • 41,145 people (4.9%) of people in Devon live in neighbourhoods in the most deprived 20% nationally, with 104,474 people (12.4%) in the most deprived 30% nationally. • Rural disadvantage is particularly visible in Barriers to Housing & Services and the Indoor Living Environment domains. • Long distances, infrequent public transport, poor connectivity and older housing can create deprivation that is not captured by income alone. Small, dispersed pockets can sit inside otherwise affluent places – making place averages an unreliable guide to lived experience. ===== PAGE 12 ===== Low income / insecure work - Less financial resilience

Distance + transport barriers - Harder to reach work, care & services ## The rural deprivation pathway Distance and low density amplify the impact of poverty Poor housing / fuel costs - Higher bills, colder homes, poorer health Digital exclusion - Fewer routes to information & support Isolation - Reduced social connection & prevention ## Health & wellbeing implication: If services are designed around population density and digital access alone, the people facing the greatest barriers can be the least likely to benefit. ===== PAGE 13 =====

## Stories from our communities ===== PAGE 14 =====

## Case study 1 | Sheena's experience ===== PAGE 15 ===== ## Case study 2 | Shirley's story • Retired, low income, no savings - Over-crowded, cold and draughty home, bills spiralling out of control Abusive partner - but unable to leave

Traditional preference for cash over digital payments - Remote village with poor transport links - Deteriorating health conditions, frequent no shows at hospital • Digital exclusion prevents access to the GP surgery ===== PAGE 16 ===== ## Case study 3 | Brian's story No local family - rural isolation - Witnessing but unable to prevent drug and alcohol abuse in his teenage son O - Unmanageable and escalating household bills - Deteriorating physical health Low paid, seasonal work

===== PAGE 17 ===== ## Key issues we are trying to address • IMD disguising pockets of rural deprivation leading to unmet need - Failure to embed rural considerations into policy and service design & delivery • Wicked problem = Lack of a public sector rural connection & intersectionality approach (eg: Combined County Authority Health in All Policies HiAP commitment)

===== PAGE 18 =====

Resilient Resilience to climate change Environmental resilience Social resilience

EU Rural Commission Vision for Rural Areas 2025

===== PAGE 19 ===== ## What can be achieved in the next 100 days? 1. All Health & Wellbeing Board members to commit to championing systemic rural proofing within their own organisations (example NI Rural Needs Act 2016) 2. Development and shared use of a shared Devon Rural Intelligence System (CERI) to build a much better understanding of place, needs & barriers & to improve health & wellbeing outcomes 3. Approve investment in a Devon Rural Deprivation Group Place – based Rural Proofing Pilot (cost c. £30k) Board Partners to commission Devon Rural Deprivation Partnership to provide Rural Proofing workshops for Key staff First 100 days:

===== PAGE 20 =====

## 2 | Three asks A practical programme the Health & Wellbeing Board can sponsor ===== PAGE 21 =====

===== PAGE 22 ===== ## ASK 1 | Make rural proofing routine - Systemic embedding of rural proofing of all strategies, commissioning, service delivery redesign & investment decisions - All partners commit to a requirement for rural impact to be visible & evidenced in business cases and equality/health impact assessments. Report exceptions and mitigations to the Board to monitor progress Page 16 Approve the Action with Communities in Rural England (ACRE) Rural Proofing checklist • test it on 3 live decisions/ policies/places refine & make it standard in all policy development & service design & delivery aiming to provide a service for people living in a rural community • Always Ask: Who is furthest from the service? Is there public transport? What does the journey cost? What happens without a car? First 100 days: What happens for people who need What happens without broadband? face-to-face support? Approve 1 or 2 place-based rural proofing pilots

Approve training for key public sector staff ===== PAGE 23 ===== ## UK RURAL PROOFING | CURRENT POLICY & GOVERNMENT ACTIVITY (NI Rural Needs Act 2016) THE POLICY SHIFT From “end-of-pipe” review → proactive rural proofing at policy design stage ## GOVERNANCE

Defra leads; all departments assess real-world rural impacts ACCOUNTABILITY 2025 → 2026: GOVERNMENT ACTIVITY New cross-government board + annual public reporting + new rural metrics Page 17 APR 2025 Rural Taskforce established Cross-Whitehall + rural stakeholders Growth • housing • skills • health • resilience • connectivity Future of Rural England Report Strategic recommendations and action across government ## Implementation Board, metrics, annual reporting; rural proofing embedded in major decisions SIX PRIORITIES FOR RURAL ENGLAND - Defra/ MHCLG Strategic Authority Rural Proofing Working Group 2026 Economic growth & productivity Infrastructure & housing Skills & education Health & wellbeing Safety & community resilience Connectivity ===== PAGE 24 ===== ## Rural Proofing of Devon Policies & Services Devon County Council Adult Social Care Service - Devon Communities Together was commissioned to carry out an inspection of Adult Social Care core policies to check for unconscious bias in terms of rurality and deprivation. Devon Communities Together submitted a detailed Rural Proofing Review Report with recommendations in June 2024. As a result of your work, and guided by it, we are now building into the business as usual review schedule of our operational guidance, the lens of ensuring equality of access, experience and outcomes for those people living in rural communities". James Martin, Policy and Executive Support Manager, Office of the Director of Integrated Adult Social Care Devon County Council Devon & Torbay Combined County Authority– Through the Combined County Authority (CCA) Business Advisory Group, Devon Communities Together conducted a light touch rural proofing review of the Local Growth Delivery Plan 2025 – 2030 ACRE National Rural Proofing Network – Devon Communities Together collaborated on the development of a Rural Proofing Toolkit 2026 which is an available resource to Health & Wellbeing Board partners. ===== PAGE 25 ===== ## ASK 2 | Approve a shared rural intelligence approach Ask: Rural Disadvantage cannot be fully understood through any single dataset. The Board should approve a shared approach that combines quantitative data, local intelligence and lived experience to identify communities experiencing hidden disadvantage and prioritise areas for action? - Approve the development, testing & adoption of the Composite Exclusion Risk Index (CERI) as part of a wider rural intelligence framework to identify hidden disadvantage. Page Approve a shared rural intelligence approach that brings together CERI, IMD, service intelligence, local insight and lived experience to provide a more complete understanding of rural disadvantage at a very local level. Approve partnership mapping to identify existing activity, community assets, service provision, gaps and opportunities for collaboration. Support the selection of pilot place(s) to test the approach, align partners around shared priorities and evaluate impact. First 100 days: Nominate a senior lead

Select test places through a shared rural intelligence approach Agree a shared baseline Identify existing funding pots Establish baseline measures and success indicators ===== PAGE 26 =====

## Why Develop a Devon Rural Intelligence System? - No single dataset or methodology fully captures rural deprivation, exclusion, resilience, opportunity or local context. Page 20 • A Devon Rural Intelligence System brings together multiple sources of quantitative and qualitative evidence to support better understanding, decision-making and place-based action. - This directly supports the Rural Strategic Framework's ambition to strengthen the evidence base for understanding and responding to rural need.

===== PAGE 27 ===== ## Devon Composite Risk Exclusion Index Looking beyond Deprivation Key Message: CERI provides an additional lens to identify communities that may be at greater risk of exclusion and less resilient to economic, social or service-related shocks. Question answered: Which rural communities may face greater exclusion risk and have fewer routes to recovery? - CERI combines measures relating to Digital Exclusion, Transport Exclusion, Social Exclusion, Employment Exclusion, alongside wider factors relating to health, housing, skills and access to healthy assets • Explores Hidden Rural Disadvantage • Provides an additional lens beyond deprivation • Many identify communities not highlighted through traditional deprivation measures alone • Generating national interest and emerging academic partnerships Composite Exclusion Risk Index Deciles Devon

===== PAGE 28 ===== ## How the Intelligence is used in practice ## Developing and Testing the Devon Rural Intelligence System Priority Places Where are the most deprived communities? CERI Are there additional communities at risk? Community Insight What are people telling us?

JSNA What does all the evidence tell us? Devon Rural Intelligence System A shared evidence base for stronger places and healthshier communities Better evidence. Stronger places. Healthier communities.

## Action Services, investment, policy and partnership response

Services

Investment

Policy

Partnership response ===== PAGE 29 ===== ## ASK 3 | Collaborative place-based NHS & Public sector rural neighbourhood plans & service design in partnership with rural communities - Partners to approve the creation & use of a shared Rural Deprivation Partnership Innovation Fund, with shared outcome measures & aligned to existing budgets rather than creating a new bureaucracy. • Prioritise locally designed and co-produced action on warm homes, digital inclusion, social connection, transport and access to prevention. • Give rural communities a route from 'good local project' to 'system partner' – invest in relationships & pool resources so everyone has a stake in procurement & building value First 100 days:

Address system question: how do the Board members work together to commission joined up place-based neighbourhood services & budgets in partnership with rural communities & VCSE sector? ===== PAGE 30 ===== ## Devon Rural NHS Neighbourhood Footprint – The Challenge • The Key Challenge is the commissioning of neighbourhood healthcare plans using the requirement of 30-50,000 residents. Devon has over 842,000 residents (split into 25-30 neighbourhood health plans to deliver health based services over 8000 km squared) https://www.england.nhs.uk/long-read/next-steps-on-neighbourhood-health-and-new-delivery-models/ Page 24 These geographies may well work in an urban setting but will not work so well in a rural setting where trusted organisations are geographically dispersed and very much village/town location based and there will be the complexity of multiple healthcare providers. • NHS England - Neighbourhood footprints should follow “natural communities”, not simply administrative boundaries. The national model envisages neighbourhoods of around 50,000 people, but explicitly recognises the need for local flexibility. This is particularly relevant where rural populations are dispersed and settlements are smaller. • A rural partnership approach between VCSE's and healthcare care providers such as the NHS Trusts, Adult and Children's services and Mental Health services is vital ===== PAGE 31 ===== ## Rurality and the VCSE Over 6,000 VCSE organisations in the county. • Many of them specifically serve rural communities. - Substantial long term funding received from the ICB for VCSE infrastructure. • Much of this funding will support small VCSE networks in rural locations. VCSE provide key access points for rural communities (village halls etc). ===== PAGE 32 ===== ## Rurality and the NHS (Key concerns) • In a neighbourhood of 30,000 to 50,000, how do we ensure rural communities are not overlooked? Transport, particularly when linked to “Did Not Attends.” • Rural loneliness and isolation. Digital Exclusion (around 20% of people aged 65 or over in rural communities feel unconfident using online services). ===== PAGE 33 ===== ## Case study 4 | Digital Confidence in Communities • One-to-one support in familiar places can build confidence as well as technical skills. - Digital inclusion should include devices/data, skills, trust and accessible service design. Rural barriers include patchy broadband/mobile coverage, device and data costs, and limited confidence. Embedding digital support in community settings can reach people who do not respond to centralised or online offers (ICB Digital Inclusion investment in VCSE community grant fund £85k 2026/27) • Transferable lesson: treat digital inclusion as a determinant of health – not an IT project. System response: retain phone and face-to-face routes, fund assisted digital support, and co-design services with excluded residents. Public Health identifies Forever Connected and Digital Skills Devon as community-based examples described by residents as highly impactful.

===== PAGE 34 ===== ## Digital exclusion can turn 'digital first' into 'no access'

pag Rural barriers include patchy broadband/mobile coverage, device and data costs, and limited confidence. • People can be digitally excluded even when they have a smartphone: confidence, trust, accessibility and service design matter. • Devon’s overall Digital Exclusion Risk Index is 3.9/10 • Online-only access can compound existing inequalities in healthcare, benefits, education and employment. Mid Devon and East Devon are 4.3, with some small areas reaching 6.6. Source: Devon Public Health: Digital Exclusion JSNA (May/July 2026) Peggy is an older woman. Starting from being completely digitally excluded received multiple VCSE Digital Inclusion sessions over months in to help her feel more confident and to understand how best her iPad and phone could help her in her everyday life. Focusing on key skills to help her to connect with friends and family better, particularly her children who did not live close by greatly improved her wellbeing. These skills also enabled her to be more independent, and she was even able to contact bill providers over email when needed, as well as search the internet for information her with a new sense of independence. ===== PAGE 35 =====

## What have we learnt-A Devon example? Case study: practical approach already visible in Devon ===== PAGE 36 ===== # Case study 4 | Rural-proofing support around family life Multiple access routes bring early help closer to families, rather than expecting families to travel to services. ## THE RURAL CHALLENGE ## A building-only model cannot reach every community equitably

Poor digital connectivity Long travel distances Higher travel costs Harder access to early help, health and SEND advice Limited public transport Rural isolation ## THE DEVON MODEL 5 Family Hub buildings Central phone Online form FAMILY SUPPORT Proactive outreach in trusted local venues Simplified front door Single Session Network Sites in community settings Digital and telephone access routes ===== PAGE 37 ===== # A countywide network, not a collection of buildings Outreach, community partnerships and digital routes extend support across urban, coastal and rural Devon.

Family Hub and outreach activity across Devon ## WHAT THIS MODEL ENABLES

## Earlier access Timely advice through outreach, phone, online and Single Session support.

## 2 ## Broader reach Trusted venues and EasyPeasy extend help into communities and homes.

## 3 ## Better inclusion Support for pregnancy, early development, school readiness and emerging SEND needs. ## NEXT PRIORITIES Expand Network Sites • reach isolated communities • tackle digital exclusion • strengthen local SEND support • use family feedback and local intelligence ===== PAGE 38 =====

## 4 | Practical Actions for Approval for the Health & Wellbeing Board A practical programme the Health & Wellbeing Board can sponsor ===== PAGE 39 ===== ## We are asking the Devon Health and Wellbeing Board to approve: Making rural proofing routine - Systemic embedding of rural proofing in service design & delivery A shared rural intelligence approach A Collaborative place-based NHS & Public sector rural neighbourhood plan service design in partnership with rural communities ===== PAGE 40 ===== ## What can be achieved in the next 100 days? 1. All Health & Wellbeing Board members to commit to championing systemic rural proofing within their own organisations (example NI Rural Needs Act 2016) 2. Development of a shared Devon Rural Intelligence System (CERI) to build a much better understanding of place, needs & barriers & to improve health & wellbeing outcomes 3. Approve investment in a Devon Rural Deprivation Group Place-based Rural Proofing Pilot (cost c. £30k) 4. Board Partners to commission Devon Rural Deprivation Partnership to provide Rural Proofing workshops for Key staff ===== PAGE 41 ===== ## Discussion ## What will we do differently? Which current decision, service or commissioning process should be rural-proofed first? ## Where should we test? Which rural places offer the clearest opportunity to demonstrate joined-up action? ## Who will own delivery? Which partner can convene the first 100 days and bring the right resources together? ## CLOSING PROPOSITION: ### Rural deprivation is not a niche issue. It is a test of whether our health and wellbeing system works for everyone, wherever they live ===== PAGE 42 ===== ## Supporting Papers 1. Devon Rural Deprivation Partnership Strategic Framework 2026 2. Citizens Advice Devon Illustrative Case Studies 3D DCT Adult Social Care Rural Proofing Report May 2024 4. Case Study Rural Proofing Family Hubs 5. DCT Rural Fuel Crisis Snapshot Survey 2026 6. Defra Rural Taskforce Report, ACRE Briefing Note July 2026 7. Evidence Base & Suggested Reading 8. Rural Papers List H&WB Board 151026 ===== PAGE 43 ===== ## Evidence base & suggested further reading - Devon Nested Rural Deprivation Partnership Group - Strategic Framework (2026) • Devon Communities Together - Breaking Barriers: Access to Drug & Alcohol Treatment & Support Services in Rural Devon (2025) • Devon Communities Together – Rural Proofing Desktop Review of Devon Adult Social Care Policies (2024) • Devon Communities Together - GP Services – Testing the Deep End Rural Model: A Practical Case study (2023) • Devon Communities Together - Devon Core 20 Plus 5 Community Connectors Programme: People living with rural and coastal deprivation North Dartmoor & Ifracombe Evaluation (2023) • Devon Communities Together - Rural Digital Health Inequalities (2022) Ω O D • Devon Public Health – Indices of Multiple Deprivation 2025 (published 2025/updated 2026). • Devon Public Health – Deprivation JSNA (2026). • Devon's Joint Health and Wellbeing Strategy 2026–2035. • Devon Public Health – Digital Exclusion JSNA (2026). • Devon Public Health – Living and Working Well JSNA (2026). • Devon Public Health – Poverty in Devon 2024. • Devon Public Health Annual Public Health Report 2022/23 – Energy Saving Devon. • Devon County Council – Community Transport / Cost of Living: Transport. • Devon Public Health – Population Summary, including Breaking Barriers insights (2025). ===== PAGE 44 ===== ===== PAGE 45 ===== Developing Devon's Neighbourhood Health Plan: Timeline and Principles Please note that the following recommendations are subject to consideration and determination by the Committee before taking effect. ## 1 ) Recommendation The Board is asked to: 1. Approve the timeline and principles set out in this paper, including focusing the January 2027 board meeting on achieving the foundation preparations for Neighbourhood Health. ## 2 ) Background This paper sets out what neighbourhood health and neighbourhood health plans are and the role of the Health and Wellbeing Board within these, establishes a broad timeline for their preparation during 2026/27 and 2027/28, and defines guiding principles for the Health and Wellbeing Board to guide their production. ## 3 ) What are Neighbourhood Health Plans? In 2026, the Department of Health and Social Care published the Neighbourhood Health Framework, setting out the next steps for the NHS, local government and wider partners to develop neighbourhood health services as part of the 10-year health plan. This relates directly to 'hospital to community' strategic shift in the plan, and also links strongly with the strategic shifts from 'treatment to prevention' and from 'analogue to digital' National guidance has also defined three system levels at which neighbourhood health activities take place. These are: • Neighbourhoods (covering populations of around 30,000 to 50,000 people): where groups of GP practices, NHS community services, social care and other providers to deliver more co-ordinated and proactive care through multi-agency neighbourhood teams. At present these align to Primary Care Networks across Devon - Places (covering populations of around 150,000 to 350,000 people): where partnerships of health and care organisations on a wider footprint including local government, NHS providers, VCSE organisations, social care providers and others come together to join up the planning and delivery of services, redesign care pathways, engage with local communities and address health inequalities and the social and economic determinants of health. At present these align to Local Care Partnerships in Devon, with further alignment to local authority boundaries desirable. ===== PAGE 46 ===== ## Agenda Item 7 • Systems (covering populations of around 500,000 to 3 million people): where health and care partners come together at scale to set overall system strategy, manage resources and performance, plan specialist services, and drive strategic improvements in areas such as workforce planning, digital infrastructure and estates. This aligns to the Integrated Care Board. Neighbourhood health plans are local strategic frameworks developed by local government, the NHS, and community partners to integrate health, social care, and public health services around local populations. Working through Health and Wellbeing Boards, the ICB and local authorities are jointly responsible for producing a statutory Neighbourhood Health Plan for the local authority area and have a statutory duty to have regard to the Plan in exercising their functions. During 2026/27 Health and Wellbeing Boards must complete foundational preparations to transition into full implementation of locally owned Neighbourhood Health Plans for the 2027/28 commissioning cycle under the national Neighbourhood Health Framework. Specifically the requirements are to: • Agree neighbourhood footprints and governance arrangements for neighbourhood health, including reviewing board membership and reporting processes to align to new neighbourhood health duties, and establishing governance arrangements which facilitate coordination across the Integrated Care System and engagement with locality partners - Establish outcomes measures (focusing on local monitoring of core national outcome measures during 2026/27 before defining local outcome measures and objectives during 2027/28) and agree operational delivery targets as required - Alignment with the Joint Strategic Needs Assessment so neighbourhood health priorities respond to local needs and health inequalities - Confirmation of how pooled funding arrangements such as the Better Care Fund will be used to align care delivery at a neighbourhood level. During 2027/28, each Health and Wellbeing Board will develop a locally owned neighbourhood health plan. This will: - Describe how the three national ‘strategic shifts’ (hospital to community, treatment to prevention and analogue to digital) will be delivered locally - Explain how neighbourhood health will support wider local goals, including reducing health inequalities and contributing to broader public service reform - Show how local objectives are informed by the JSNA and other relevant assessments Confirm final neighbourhood geographies for delivery • Set out organisational responsibilities, including who delivers what - Define governance and operational partnership arrangements - Show how neighbourhood health aligns with other local initiatives (e.g. Best Start Family Hubs, mental health hubs, housing, Pride in Place, employment support). ===== PAGE 47 ===== ## 4 ) Timeline for Devon Health and Wellbeing Board Based on the requirements of Neighbourhood Health Plans outlined in section 2 above, the following table sets a broad timeline, aligned to Devon Health and Wellbeing Board meeting dates, when relevant actions will be undertaken.

Board Meeting	Activity
October 2026	Approval of timeline and principles paper
January 2027	Board Meeting focused on achieving foundational preparations for Neighbourhood Health Plans setting actions to be achieved by March 2026
April 2027	Establishment of regular ICB and Locality reports to Health and Wellbeing Board on neighbourhood health developments
July 2027	Initiation of detailed work on production of Neighbourhood Health Plan
October 2027	Progress update on development of Neighbourhood Health Plan
January 2028	Presentation and discussion of draft Neighbourhood Health Plan for Devon
March 2028	Publication of Final 2027/28 Neighbourhood Health Plan for Devon

## 5 ) Principles The following guiding principles are recommended to guide the development of the Neighbourhood Health Plan for Devon: Wider Partnership and Prevention Focus: rather than being an NHS-specific plan, neighbourhood health plans should set out how the NHS, local authorities and wider community partners can work together to improve the health of the population. As such they should focus on the shift from treatment to prevention, reducing health inequalities, and partnership work on the building blocks of health such as transport, housing, skills and regeneration. Establishing mechanisms for the Health and Wellbeing Board to engage with wider community partners and involve them in the co-design of neighbourhood health will be vital - Multi-Levelled: Neighbourhood health objectives may be defined by or be specific to different geographic 'levels' across the wider system. Certain priorities and outcome measures and high priority groups (such as those experiencing frailty, end of life, or specific long-term conditions), will be defined nationally. More locally, priorities may also emerge at ICB, place (locality or local authority) or neighbourhood levels, consistent with local priorities, populations and need. Finally within the 30-50,000 'neighbourhoods' used for neighbourhood health plannings, health inequalities will exist between communities and population groups, requiring the identification of priority areas and groups within the broader neighbourhood. For neighbourhood health plans to work effectively they will need to be consistent work at these multiple levels ===== PAGE 48 ===== Evidence and Intelligence Led: Neighbourhood Health plans should be informed by evidence and intelligence, to ensure they target local need, reduce health inequalities and support evidence-based interventions. The JSNA should inform this, making use of recent developments to JSNA tools to support neighbourhood health planning (see appendix 1) and ongoing development to address emerging priorities and reporting requirements. Both qualitative and quantitative data and evidence should inform the establishment of local priorities and interventions. Ensuring robust and effective data sharing exist between the NHS, local authorities and wider community partners to support new statutory duties around neighbourhood health will also be critical - Establishing Critical Success Factors: Critical success factors are the essential elements, conditions and activities required to achieve defined objectives. This includes the use of project management principles to establish specific and measurable goals, clarify the roles and responsibilities of different organisations and partners, and ongoing monitoring and refinement. Establishing critical success factors within the neighbourhood health plan will be vital and aligns with an evidence and intelligence led approach - Integration in the Commissioning Cycle: The commissioning cycle refers to the process by which local services are commissioned and planned through the assessment of need, setting of priorities, planning and procuring of services and the monitoring of quality and outcomes, on an ongoing, cyclical basis as set out in figure 1 below. It is vital that the neighbourhood health plan are embedded in the commissioning cycle of health and care organisations and for that the Board is assured that this direct alignment is in place.

Figure 1, The Commissioning Cycle

===== PAGE 49 ===== ## 6 ) Conclusion and Next Steps The Health and Wellbeing Board will play a critical role in the design and delivery of neighbourhood health plans, directing the local strategic shifts from hospital to neighbourhood, from treatment to prevention, and from analogue to digital. This paper has outlined neighbourhood health plans and related requirements, set out a timeline for Board activities through to March 2028, and proposed principles to guide the development of a neighbourhood health plan for Devon. Recommendation: The Board is asked to approve the timeline and principles set out in this paper, including focusing the January 2027 board meeting on achieving the foundation preparations for Neighbourhood Health. 7) Options / Alternatives Nil 8) Consultations / Representations / Technical Data Nil 9) Strategic Plan Neighbourhood Health Plans and the identification of priorities relating to three strategic shifts (from hospital to community, from treatment to prevention, and from analogue to digital) and addressing health inequalities and the wider determinants of health will support the ongoing development and delivery of the Devon County Council Strategic Plan. 10) Financial Considerations Nil 11) Legal Considerations Nil 12) Environmental Impact Considerations (Including Climate Change, Sustainability and Socio-economic) The development of neighbourhood health in Devon and particularly the shifts to community settings and prevention has scope to positively contribute to climate change targets. ===== PAGE 50 ===== ## 13 ) Equality Considerations A focus on health inequalities is at the core of Neighbourhood Health planning along with the identification of higher risk groups in the population in relation to protected characteristics, geography, inclusion health and socio-economic status. ## 14 ) Risk Management Considerations The approach described is seeking to address and number of risks that will emerge through consideration of properties and populations. Contact(s) for enquiries: Name: Simon Chant, Consultant in Public Health Telephone: 01392 383000 Email: simon.chant@devon.gov.uk ===== PAGE 51 ===== Growing Up in Devon, Annual Public Health Report 2026 Please note that the following recommendations are subject to consideration and determination by the Committee before taking effect. ## 1 ) Recommendation The Board is asked to: 1. Note the publication and recommendations of the new Annual Public Health Report. ## 2 ) Background One of the statutory duties of the Director of Public Health is production of an independent annual report which provides an overview of the health status of the local population, highlights key health issues, and outlines public health priorities and actions for the year ahead. Each annual report in Devon is themed around an important health and wellbeing topic. Current and previous Annual Public Health Reports for Devon can be found here: https://devon.cc/APHR ## 3 ) Growing up in Devon, the Annual Public Health Report for 2026 The Annual Public Health Report for 2026 was published in October 2026 and is entitled 'Growing up in Devon in 2026: the opportunities and challenges'. It explores the experiences and voices of children and young people in Devon, their aspirations for the future, how different their experiences can be, and how this shapes their health and wellbeing. The report makes a number of recommendations to improve these experiences and ensure that young voices are heard. The current report can be accessed here: https://devon.cc/APHR2026 ## 4 ) Options / Alternatives Nil ## 5 ) Consultations / Representations / Technical Data Nil ===== PAGE 52 ===== ## 6 ) Strategic Plan Neighbourhood Health Plans and the identification of priorities relating to three strategic shifts (from hospital to community, from treatment to prevention, and from analogue to digital) and addressing health inequalities and the wider determinants of health will support the ongoing development and delivery of the Devon County Council Strategic Plan. ## 7 ) Financial Considerations Nil 8) Legal Considerations Nil 9) Environmental Impact Considerations (Including Climate Change, Sustainability and Socio-economic) The development of neighbourhood health in Devon and particularly the shifts to community settings and prevention has scope to positively contribute to climate change targets. ## 10 ) Equality Considerations A focus on health inequalities is at the core of Neighbourhood Health planning along with the identification of higher risk groups in the population in relation to protected characteristics, geography, inclusion health and socio-economic status. ## 11 ) Risk Management Considerations The approach described is seeking to address and number of risks that will emerge through consideration of properties and populations. Contact(s) for enquiries: Name: Simon Chant, Consultant in Public Health Telephone: 01392 383000 Email: simon.chant@devon.gov.uk ===== PAGE 53 =====

Health & Wellbeing Board - Forward Plan

Items / Committee Date	Frequency
Standing items
Themed items (tbc)
Health & Wellbeing Strategy Priorities and Outcomes Monitoring/updates
Better Care Fund update/sign off
NHS Devon update
Adults Safeguarding Annual Report	Annual
Joint Commissioning Strategies – Action Plans	Annual
Health Protection Committee Annual Assurance Report	Annual (Jan/March)
Healthwatch Annual Report	Annual (June/July)
One Devon Suicide Prevention Action Plan Update	Annual (June/July)

Future Items
Early Years Strategy – progress updates
Equality (future meeting tbc)

15 October 2026
Rural Areas and Access to Services
Standing items
Terms of Reference	Carried forward
BCF – no update due to national reporting timelines

7 January 2027
Start Well Live Well
Standing items BCF and NHS Devon update
Terms of Reference
Standing Item: Health Protection Committee Annual Assurance Report	Annual (Jan/March)

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