Agenda item

Representatives from West Yorkshire Integrated Care Board will provide a summary of its operational planning.

Contact: Yolande Myers, Principal Governance Officer

The Joint Health Overview and Scrutiny Committee (JHOSC) received a presentation on the 2025/26 operational planning framework for the West Yorkshire Integrated Care Board (ICB). The presentation outlined a whole-system approach to planning, integrating finance, workforce, activity, and performance considerations. The ICB’s final plan, submitted in March 2025 and updated in April, aimed for a break-even position, supported by £49.2 million in deficit funding and £432.6 million in planned efficiencies which was equivalent to 6.7% of the ICB’s total allocation. A system risk of £33.2 million was held centrally for planning purposes.

The presentation outlined that the approach to resource utilisation was underpinned by transformation initiatives, collaborative service reviews, and integrated neighbourhood health models. Key focus areas included elective recovery, productivity improvements, and the full implementation of recommendations from a Price Waterhouse Cooper external review. The ICB acknowledged there would be difficult decisions to ensure financial sustainability while maintaining service quality and access.

The Committee advised that workforce planning remained a priority, with the region seeing continued growth in the substantive healthcare workforce and a reduction in reliance on bank and agency staff. Notably, there had been a significant increase in Hospital and Community Health Service doctors and General Practitioners, largely due to the expansion of Resident Doctor posts. The Committee was advised that the ICB would continue to focus on managing vacancies, reducing temporary staffing further, and improving efficiency in the non-clinical workforce over the coming year.

It was noted that performance metrics were reviewed across several domains, including elective care, cancer, diagnostics, mental health, and learning disabilities. The ICB had set ambitious targets to reduce long waits and improve access, with planned improvements in Referral to Treatment times, cancer diagnosis standards, and diagnostic waiting times. Mental health metrics also showed progress, including reductions in out-of-area placements and improved access to talking therapies and perinatal services.

The Yorkshire Ambulance Service (YAS) operational plan was also presented, highlighting a projected 3.9% increase in demand. Despite this, deployed hours on the road were planned to be maintained, contingent on £11 million in growth funding. Improvements were expected in “hear and treat” and “see and treat” rates, with increased staffing in Emergency Operations Centres. YAS was broadly compliant with national commissioning guidance, although some areas required further system-wide support.

The presentation outlined key risks to delivery and the governance structures in place to mitigate them. These included financial pressures, national reforms, workforce challenges, and rising non-elective demand. Mitigation strategies involved cross-system collaboration, targeted programmes, and strengthened oversight through established committees such as the Finance, Investment and Performance Committee and the System Oversight and Assurance Group. Each place within West Yorkshire would contribute to the final operational plan sign-off, ensuring local accountability and alignment with regional priorities.

During discussions, the Committee commented on the following issues: -

• The six key diagnostics monitored were MRI, CT scan, non-obstetric ultrasound, echocardiogram, endoscopy, and electrophysiology tests.
• Concerns raised about long waits for treatments like cataracts and the disparity between NHS and private sector waiting times.
• Clarification sought on whether patients who re-refer themselves are counted twice in Referral to Treatment statistics.
• In relation to Performance and Transparency, Members stressed the importance of clear, accessible reporting for public understanding.

• Emphasis placed on including detailed breakdowns of performance challenges in reports.
• Community Diagnostic Centres were discussed, with concerns about staffing shortages (e.g. radiographers) affecting their effectiveness despite investment in equipment.
• Out-of-area placements for mental health patients remained a challenge with a target to reduce from 51 to 14 by March next year.

• Talking therapies were performing well, with recovery rates above national targets.
• Annual health checks for people with learning disabilities were consistently above the 75% target.
• Inpatient care for people with learning disabilities and/or autism was still above the target of 53 at 71.
• Concerns were raised about missing or unclear data in reports, particularly around inpatient care for adults and children with learning disabilities or autism.

• Clarification provided that national reporting combined some metrics, which may obscure local detail.
• Calls for better integration of GP-level data into ICB reporting to reflect community-level needs more accurately.
• Regarding Governance and Reporting, Members requested more granular and locally relevant data to support scrutiny and decision-making.

• A Request to receive data on the use of restraint in mental health units, including breakdowns by protected characteristics.
• Demand for ambulance services had risen by 3.6% over the past year.

• Staff numbers and deployed hours were being maintained, with increased use of clinicians in control centres, from 85 to 112.
• Category 2 response times were improved at 21–24 minutes.
• Ongoing work with NHS England and ICBs to reduce conveyance rates and improve “hear and treat” and “see and treat” outcomes.

RESOLVED –

1)      That representatives of the ICB be thanked for their report and attendance at the meeting.

2)      That the Committee be provided with the following additional information: -

(i)      details of the NHSE commissioned piece of work to understand how each ICB handle financial support (concurrent / non-concurrent) to ensure all ICB’s are applying same criteria / assumptions.

(ii)    data regarding workforce, specifically the reliance on bank and agency staff.

(iii)   information relating to the increase in resident doctors, specifically the split in those who are in training places vs those on locally employed contracts, and to provide the number or percentage of vacancies.

(iv)   confirmation as to the 6 main diagnostic tests for cancer treatment, and whether patients are being ‘double counted’ if they have been discharged but then return for further treatment.

(v)    further information be provided on the statistics in the WY area relating to reliance on mental health inpatient care for autistic adult

(vi)   data on the number of restraints taking place in Mental Health Units for WY patients, compared to national data.