Our monthly brief is designed to give you a overview of the latest partnership updates, some facts and figures, interesting reads and information about things that are coming up. 

Neighbourhood Teams

Neighbourhood Teams (NTs) bring together professionals from different organisations to share information and support people jointly to provide personalised and holistic care to prevent people from needing urgent/crisis support. Walsall has seven NTs, aligned to Primacy Care Network boundaries.

A facilitated face-to-face session for each of the seven neighbourhood teams took place during March to strengthen understanding and delivery of Integrated Neighbourhood Teams (INTs). The session focused on building a shared vision of integration, exploring “care by conversation” in practice, and developing clarity around team purpose, roles, and ways of working. Through a series of interactive and reflective activities, partners defined what effective integrated working looks like locally and how this translates into day-to-day practice. The session also provided space for teams to align on expectations of one another and identified what is needed from each partner to deliver joined-up care. A key outcome was the agreement of clear, collective commitments and actions to take forward in the next 3–6 months.

Following Walsall’s selection as one of eight areas in a national programme to improve digital neighbourhood health services, the work is now moving into the co-design phase. After mapping how services currently operate, the focus is on developing practical solutions that help teams better share information and coordinate care.

Co-designing digital neighbourhood health follows a step-by-step co-design approach, meaning local health and care teams help design solutions together rather than having them imposed centrally. It starts with a 1-to-1 session at each site, where teams map out how they currently work, what services they provide, who they partner with, and what digital tools they use. They also explore real-life scenarios to identify where things work well and where there are challenges.

Next, sites are paired with others facing similar issues to explore solutions with national product teams and develop ideas. These are shared in larger groups for feedback and to agree next steps, before a final session to review findings and shape a plan for testing solutions.

Expected Outcomes

  • A clearer picture of how neighbourhood services currently operate

  • Identification of key challenges in working together and sharing information

  • Practical, user-informed ideas for improving digital tools and ways of working

  • Shared priorities across different areas

  • Early designs for solutions that can be tested and developed further

The next Neighbourhood Health and Care Stakeholder Forum event is taking place Monday 27 April from 1pm-2pm. The theme will be digital. You can book your place here. If you have any suggestions for future themes please contact michelle.beddow1@nhs.net

Intermediate Care

Pathway 1: Workforce: The staffing investment continues to deliver measurable benefits.

Pathway 2: Bedded Rehabilitation Unit: The pilot is showing positive results, including reduced length of stay. Work is underway to quantify potential adult social care savings, and a proposal is being developed to secure recurrent investment for a dedicated bedded rehabilitation unit. A recent event at Swan House highlighted the facility’s impact, with stakeholders and residents attending to see the benefits of a specialised rehab service firsthand.

WM5G Pilot: The  pilot is on track to launch in March 2026, focusing on direct hospital  engagement and proactive monitoring to support early intervention and  independence. The model aims to install monitoring equipment on the day of  discharge whenever possible or provide a mobile kit for use at home. Routine  check-ins will monitor daily living activities, helping identify risks early  and promoting safe, independent living.

ICS Pathway 1 Reablement: The new integrated model, scheduled for August 2026, will bring together Community Reablement and ICS Pathway 1 Reablement services. It will provide coordinated support for people recovering after hospital stays or short-term interventions, with a clear focus on restoring independence. The redesigned approach will standardise reablement services across the borough, ensure consistent strengths-based practice, and reduce reliance on long-term care packages. Digital tools will be used to tailor support, track progress, and improve outcomes. A business case is expected to be submitted for approval in April 2026.

Feel Good Friday Clinic

The Feel-Good Friday clinic pilot has now successfully concluded. An evaluation is currently underway to review outcomes and inform next steps. The clinic and is now accepting referrals from the East Locality.

The lower-level falls prevention physical activity programme has now been finalised. While it was originally planned to begin on 1 April 2026, there has been a slight delay and the programme is now expected to commence between May and June. This programme will support people at risk of falls to stay active, learn practical strategies to prevent injuries, and maintain their independence through community-based support.

The service specification for the Specialist Falls programme, which is designed for individuals with more complex needs or a higher risk of falling, has been drafted and will be shared with key stakeholders to gather feedback and ensure the service meets local needs effectively

These developments are strengthening falls prevention and community-based support across local services, with a shared focus on helping people remain independent in their own homes. Staying active supports better health, independence, and the ability to continue with the everyday activities that matter most.

Putting Children First - Best Start in Life

Walsall is dedicated to improving early childhood development, so more children are ready to learn when they start school. The target is for 74.7% of all children to reach a good level of development by the end of their reception year. For children eligible for free school meals, the goal is 62.9%, with a strong focus on supporting those who need the most help to catch up and thrive.

To achieve these goals, a plan was collaboratively developed with operational teams and presented to the senior leadership across the partnership for approval and to agree on key priorities to drive success by 2028.

The four focus areas are:

  1. Integrated Early Years Team: Developing a small, collaborative team model that clarifies roles, working methods, and measures impact.

  2. Collective Workforce Development: Strengthening workforce skills, capacity, and partnership collaboration.

  3. Use of Trusted Community Spaces: Making the most of local, accessible spaces to better engage children and families.

  4. Upscaling Community Champions: Expanding the community champion program to build stronger family connections and reach more people.

These priorities lay the groundwork for coordinated support that helps every child in Walsall get the best possible start in life.

National Creative Health Programme

Walsall has been selected as one of six systems in England to join the first cohort of the Creative Health Leads Programme, led by the National Centre for Creative Health and funded by Arts Council England and The Baring Foundation.

Walsall Together, including partners from Black Country Healthcare NHS Foundation Trust and Walsall Council’s Public Health team, will work alongside the Walsall Cultural Compact, to lead the programme locally.

The initiative will support the integration of creative and cultural approaches into Walsall’s health and care system, helping to strengthen prevention, improve wellbeing and support neighbourhood health models.

A dedicated Creative Health Lead will help build stronger partnerships between the NHS, local authority, voluntary and community organisations, and the cultural sector. The programme will also build on existing work across the borough that uses creativity, arts and culture to improve wellbeing, reduce health inequalities and strengthen community connections.

In other news...

A fond farewell and a warm welcome: After four years as Independent Chair of Walsall Together, Professor Patrick Vernon MBE stepped down on 1 April 2026. He is succeeded by Greg Bloom, Managing Partner at Umbrella Medical and a member of the Board since its establishment.

During his tenure, Patrick played an important role in strengthening the partnership, advancing neighbourhood health initiatives and championing action to tackle health inequalities. Under his leadership, Walsall Together achieved significant milestones, gained national recognition and strengthened collaboration across health, local authority, housing and voluntary sector partners.

Greg brings extensive experience in primary care and a strong understanding of the partnership. As Chair, he will continue to support the delivery of Walsall Together’s strategy, focusing on closer community-based care, integrated neighbourhood teams and improved outcomes for residents.

The Board expressed its thanks to Patrick for his leadership and welcomed Greg as he takes on the role and leads the partnership into its next chapter.

Neighbourhood Health Framework: The Neighbourhood Health Framework, published on 17 March 2026, sets out plans to reorganise healthcare in England around local communities. It proposes creating multidisciplinary “neighbourhood teams” that bring together GPs, community services, mental health, and social care to deliver more joined-up care closer to home. The framework focuses on prevention, improving access, and reducing pressure on hospitals, with phased implementation expected through to 2029.

The framework reflects the same direction of travel already being taken by the partnership, recognising the strength of the collaborative, community-based work underway. Over the coming months, partners will review the existing Walsall Together strategy and current programme of work against the framework to ensure alignment and identify any opportunities to strengthen and build on established foundations. For a copy of the framework visit: Neighbourhood health framework - GOV.UK

Women’s Health Walsall: Representatives from the partnership recently attended Hear Her Now: Women’s Health in Walsall, a powerful theatre production shaped by the voices of over 300 women who shared their experiences through our involvement work over the past year.

Through storytelling and creativity, the performance brought to life experiences of menstrual health, menopause, not being listened to, and gaps in quality information, offering a moving insight into the challenges many women face every day. A panel discussion followed, with Dr Ravi Sandhu emphasising the need to bring women’s voices to the forefront of health and care. The discussion asked how we can make women’s health and care “business as usual,” not reliant on short-term funding.

Potential ways forward included:

➡️ Neighbourhood working

➡️ Peer support groups

➡️ Education programmes

➡️ Better integration of existing services

Taking Walsall Together national and international: Michelle McManus, Director of Place Development and Transformation for Walsall Together, has recently shared the Walsall Together approach on national and international stages, including:

  • World Health Organisation webinar (Portugal): Showcased how Walsall Together builds partnerships between health, local government, and communities, highlighting the WWOF and practical initiatives like Feel Good Fridays.
  • NHS Confederation Care Closer to Home Conference: Reflected on aligning neighbourhood health with wider public sector reform, delivering services in trusted community spaces, and connecting health with local economies.
  • Stronger Together roundtables (Innovation Unit): Explored tackling health inequalities with the VCSE sector, growing collaborative place-based leadership, and supporting sustainable neighbourhood health models shaped with communities.

Across all sessions, Michelle emphasised:

  • The importance of community-led, collaborative approaches.
  • Building trust and strong partnerships across NHS, local authorities, and VCSE organisations.
  • Using practical examples like Feel Good Fridays to reduce social isolation and improve wellbeing.
  • The WWOF as a shared framework to align priorities and focus on wider determinants of health.

These presentations have generated strong interest and shared learning, highlighting how Walsall’s approach can inspire practical, sustainable neighbourhood health improvements nationally and internationally.

Health and Wealth: Two Sides of the Same Coin: The Director of Public Health Walsall’s annual report, Health and Wealth: Two Sides of the Same Coin, was recently presented to the Health and Wellbeing Board. The report focuses on two key themes: strengthening the local economy and understanding the relationship between work and health. It highlights key challenges including economic inactivity, youth unemployment, and rising long-term health conditions, emphasising the need for coordinated action to improve health and support employment. The report calls for a ‘Health in All Policies’ approach, closer working with businesses, and greater use of social value to benefit communities. The full report can be read here. 

Goscote House, Walsall Services moving: From Summer 2026, a number of services based at Kingshill, Dorothy Pattison Hospital and Orchard Hills in Walsall will be moving to Goscote House. The new address will be: Goscote House, Goscote Lane, Walsall, WS3 1SJ. For more information including the services moving visit: https://staffzone.blackcountryhealthcare.nhs.uk/get-involved/services-moving-kingshill-and-orchard-hills-goscote-house-walsall

Neighbourhood Teams

 

Neighbourhood Teams (NTs) bring together professionals from different organisations to share information and support people jointly to provide personalised and holistic care to prevent people from needing urgent/crisis support. Walsall has seven NTs, aligned to Primacy Care Network boundaries.

Partners from across the region attended the second National Neighbourhood Implementation Programme learning event, further building momentum for neighbourhood working in Walsall. Reflections highlighted strong engagement across all seven neighbourhood teams, valued partnerships with housing and VCFS partners, and the positive impact of Feel Good Friday clinics on professional relationships and patient journeys. Priorities now centre on broadening ownership of the agenda, embedding lived experience in design, strengthening shared data and care planning, enabling data-driven commissioning, and securing timely investment.

A senior strategic group is now in place to lead delivery and shape the long-term direction of neighbourhood health. The model is shifting towards a “teams of teams” approach, promoting multidisciplinary working, reducing reliance on formal referrals, and strengthening collaboration across health, social care, pharmacy and the voluntary sector. All seven neighbourhood teams are developing new models of support for identified cohorts.

There is no national definition of a health hub, local work focuses on aligning estates planning and making use of shared spaces e.g Neighbourhood Hubs, Community Diagnostic Centres and Family Hubs. Planning needs to consider wider developments and digital/tech infrastructure. A ‘teams of teams’ model may involve multiple buildings working together.

Walsall’s established Integrated Commissioning Committee between the ICB and Council provides a strong foundation for neighbourhood health development. A Neighbourhood Health Plan is being developed alongside the refreshed Health & Wellbeing Strategy, with draft proposals going to the Health & Wellbeing Board in March and consultation planned over the summer. National guidance is expected to complement existing arrangements rather than significantly change them.

The national measurement framework has been embedded into local delivery plans, aligning with the existing wellbeing outcomes framework. Work continues on risk stratification, with ambitions to better integrate health, social care and wider partner data.

Walsall also successfully been selected as one of the  eight local areas and national teams to improve how digital neighbourhood health services work for people. The focus is on making services more joined-up, particularly how digital systems support teams to share information and coordinate care. After mapping how neighbourhood services currently operate, the next phase is to co-design practical digital solutions together. Using a structured workshop approach, sites will work in pairs, small groups and larger sessions to share challenges, test ideas and agree next steps. Running from February to April 2026, the programme aims to make care more connected, easier to navigate and better coordinated through digital support.

Citizen engagement is supported by a well-established infrastructure, strengthened by the appointment of a dedicated citizen voice lead. There is a clear focus on reaching marginalised and seldom-heard groups and embedding co-design and co-production into service development.

An active communications group is developing clear internal messaging and accessible public-facing materials to support understanding of neighbourhood health. Stakeholder engagement continues to grow, with increasing participation in forums and a strong emphasis on ongoing feedback and transparency.

The third stakeholder forum was held on 25 February giving an update on Walsall’s progress in developing neighbourhood health. The session ended with discussion, partner contributions, and plans to focus future forums on specific themes such as digital transformation. Q&As were recorded with copies available on request. The next event is taking place Monday 23 March from 1pm-2pm. The theme will be digital. You can book your place here. If you have any suggestions for future themes please contact michelle.beddow1@nhs.net

Intermediate Care

Pathway 1: Workforce: Non-recurrent workforce funding approved in September has already delivered measurable benefits, with Pathway 1 reducing length of stay, care calls, and dependency, contributing to overall budget savings. Due to this success, the funding is now recurrent, with ongoing monitoring to inform workforce planning and support the next phase of Intermediate Care development.

Pathway 2: Bedded Rehabilitation Unit: The pilot continues to demonstrate positive outcomes, particularly in reducing length of stay for patients who require rehabilitation. Initial data indicates that the model is contributing to shorter stays and a reduced need for ongoing care packages post-discharge, generating potential cost savings. Further detailed analysis is underway to evidence these financial and system-wide benefits.

An open house event is being planned at Swan House in March to showcase the benefits of having a dedicated rehabilitation unit within a care home setting and to highlight its impact to key stakeholders. A further round of soft market testing will be undertaken as part of the business case development to ensure market robustness and compliance. Financial modelling is progressing to clearly demonstrate cost avoidance and savings within Adult Social Care. The full business case is in development and is scheduled for submission for approval in March 2026.

WM5G Pilot: The WM5G pilot is scheduled to commence in March 2026. The pilot will prioritise direct engagement with hospital teams, rather than referrals via intermediate care services. A dedicated discharge coordinator will be based within the hospital to identify individuals who meet the eligibility criteria. The model is designed to ensure that equipment is installed on the day of discharge wherever possible, or that individuals return home with a mobile monitoring kit. The pilot will include routine check-ins and monitoring of daily living activities, such as eating and bathroom use, to support early identification of risk and promote safe independence at home.

ICS Pathway 1 Reablement: The new model is scheduled for implementation in August 2026 and will bring together Community Reablement and ICS Pathway 1 Reablement services into a single, integrated approach. This will strengthen support for individuals recovering after hospital discharge or short-term intervention, with a clear focus on restoring independence.

The redesigned model will standardise and coordinate reablement services across the borough, ensuring consistent, strengths-based practice while reducing dependency on long-term care packages. Digital solutions will be embedded to tailor support, track progress, and enhance overall outcomes.

A business case is currently being developed and is expected to be submitted for approval in March 2026.

Feel Good Friday Clinic

 

A full evaluation of Feel Goof Friday is now underway having collected data over the initial 12 weeks of the service. Early results show that the clinic provided a wide range of effective support, helping people improve their confidence, mobility, and overall wellbeing. Feedback from those who used the service, as well as staff, has been overwhelmingly positive.Funding has been secured to continue the clinic until the end of June 2026. This extension ensures people can continue to access support while the full business case is developed and approved. It also allows the team to refine services and continue monitoring the impact on participants.

In addition, the lower-level falls prevention physical activity programme has been finalised and is set to begin on 1 April 2026. This programme will help people at risk of falls stay active, learn practical strategies to prevent injuries, and maintain their independence through community-based support.

Work is also ongoing to develop a specialist falls programme for individuals with more complex needs or a higher risk of falling. Together, these initiatives will create a comprehensive pathway to prevent falls and support people to live safely and independently in the community.

Putting Children First - Best Start in Life

 

Walsall aims to improve early childhood outcomes by supporting 75% of five-year-olds to reach a Good Level of Development (GLD) and be ready to start school. The goal is to raise the current GLD rate from 63% to 72% by 2027/28, with a focus on reducing inequalities and helping disadvantaged children, including those with SEND and eligible for free school meals.

The Family Hubs programme is now part of the Best Start in Life programme.

The Best Start in Life programme supports children from pregnancy to age 19, including those with special educational needs and disabilities (SEND). It provides timely, personalised help to improve early learning, address the effects of COVID-19, and ensure access to effective health and support services. This includes help with healthy weight, immunisations, speech and language, and disability support all delivered locally through coordinated, joined-up, neighbourhood-based services, giving every child the best possible start in life.

Work is ongoing to create a shared vision and develop a Multi-Agency Plan. To support this, a multi-agency workshop will be held on 4 March, followed by a Development Day with strategic leaders on 16 March to plan next steps.

Dementia

 

The dementia project forms part of the wider programme of work on falls and frailty. Three task and finish groups have been agreed and will commence shortly: one focused on clinical pathways across the partnership, one on community engagement and prevention, and one on data and evidence.

If you would like to contribute to any of these groups, please contact helen.billings@nhs.net

 

In other news...

 

Women’s Health Walsall: You are invited to a unique theatre production bringing to life the voices of over 300 women and girls from across Walsall, whose stories were gathered last year, as part of our women’s health programme. The production takes place on Thursday 26 March 2026, 1pm-4pm, The Local Hub Bloxwich, 88 Sneyd Lane, WS3 2NA. Register your place: www.onewalsall.org/events/womens-health-theatre-production

Men’s Health Survey: The NHS Black Country Integrated Care Board (ICB) is seeking the views of local men on general health issues, with a particular focus on vasectomy. Your insights are vital in helping the NHS understand what works well, where things could be improved, and how services can better support men’s health and wellbeing.  The public conversation is now open, this survey will close on Sunday 15 March 2026. To take part in the survey, please click here: https://re-url.uk/W71H

Free Stop Smoking: Walsall frontline and patient-facing staff can join free 1-hour online Stop Smoking Very Brief Advice (VBA) training. Learn how to have quick, effective conversations that help people quit smoking, evidence-based, NICE-recommended, and CPD-certified.For more information visit:

Stop Smoking Very Brief Advice Training

 

Fair Futures for Young Carers Week: Throughout the week, young carers and their families are invited to take part in a range of exciting activities for young people, alongside professional training events and support opportunities for parents and carers.

Monday 9 March, 10.30am, Village Hotel: Drop in parent and family coffee morning - drinks  and refreshments provided.

Tuesday 10 March, 4.15pm-6.30pm, Ninja Warrior Walsall: Young carers can test their Ninja skills through obstacle courses and soft play. Email:  WalsallYoungCarers@walsall.gov.uk

Wednesday 11 March, 11.00 am-2.00pm, Manor Farm: Fair Futures for Young Carers professional event - training event sharing young carers awareness. Book your place here.

Thursday 12 March, 4.30pm-6.30pm, Retro Realm: Young carers can take part in retro gaming and arcade games. Email:  WalsallYoungCarers@walsall.gov.uk

Friday 13 March, 11.00am-2.00pm, Walsall Town Hall: Celebrating the achievements of our young carers with a celebration lunch and awards.

Vaccination Campaign: A national campaign is underway encouraging parents to get their child vaccinated. This comes in light of recent increases in cases in particular of measles. For more information visit: Parents urged to protect children through vaccination campaign - GOV.UK Resources for display can be downloaded from the campaign resource centre and the childhood immunisations postcard can also be downloaded and ordered for free from the public health resources website.

Gambling Harm: The harms caused by gambling can negatively impact both the person gambling and those around them. With your help, by proactively asking and identifying people experiencing gambling harms, we can begin to reduce any stigma and help residents get the support they need.

We have created a gambling harms directory for professionals, which has information on support services, advice and further resources: https://go.walsall.gov.uk/publications/gambling-harms-directory-professionals

Intermediate Care

The review of Intermediate Care continues to ensure the service delivers timely, person-centred support, enabling faster recovery, reducing avoidable hospital admissions, and improving independence, while maintaining a financially sustainable model through a skilled, multidisciplinary workforce.

The review is focusing on the following areas:

Intermediate Care Staffing Investment

The service is showing real improvements. People receiving therapy within 72 hours of leaving hospital are recovering faster, with shorter lengths of stay and fewer care calls. Pathway 1 service users receiving therapy within 72 hours post-discharge had a 7-day shorter length of stay and fewer care calls, with some able to exit at the 72-hour review, avoiding unnecessary stays and reducing dependency. The home pathway also saw a 3.29-day reduction in length of stay, and these improvements are contributing to overall budget savings.

Dedicated Rehab Unit

A two-year review of rehabilitation services highlighted opportunities to enhance recovery and independence. Since June 2025, a pilot programme has been testing a dedicated rehabilitation approach designed to improve outcomes and efficiency. The pilot offers purpose-built, multidisciplinary support, including dedicated Pathway 2 rehabilitation beds, on-site therapy from day one, and ongoing collaboration with care home staff. Early results show faster, more coordinated recovery helps people to regain independence sooner. Feedback from staff and service users has been very positive, highlighting the benefits of this collaborative approach. A dedicated unit makes better use of the workforce and improves continuity of care. It demonstrates how structured, collaborative rehabilitation can support high-quality care closer to home. The unit is expected to open in the Summer, and outcomes from the pilot will continue to be monitored to guide the future model of service delivery.

West Midlands 5G (WM5G) Pilot

The Intermediate Care Discharge Team at Walsall Healthcare Trust is taking part in a Digital Discharge pilot to help medically optimised patients return home safely and quickly, supported by a simple, home-based technology solution. The pilot which is expected to commence in March-26 is supported by WM5G, a subsidiary of the West Midlands Combined Authority, and is being run alongside University Hospitals Coventry and Warwickshire. Patients taking part can use sensors to monitor movement at home and a tablet or app for video calls, check-ins, and medication reminders. Data from the sensors is sent to a secure dashboard, where a dedicated clinical team monitors progress for up to six weeks. The same clinical team manages discharge planning, ensures GP’s or other care providers are updated, and provides support throughout recovery. Around 200 patients across the two sites will be able to benefit from this digital approach, helping them stay safe, independent, and well-supported at home.

ICS Community Reablement

A new project is bringing together Community Reablement and ICS Pathway 1 Reablement services to help people recover and regain independence after hospital or short-term support. The new model will consolidate reablement services across the borough, providing more consistent, strengths-based support and reducing the need for ongoing care. Technology will also be used to personalise care, monitor progress, and support better outcomes. The project is designed to deliver high-quality care closer to home, helping people live independently for longer. The new model is expected to launch in July 2026. 

Neighbourhood Teams

Neighbourhood Teams (NTs) are multidisciplinary teams (MDT) that can share information and support people jointly to provide personalised and holistic care to prevent people from needing urgent/crisis support. 

In Walsall, seven Neighbourhood Teams (NTs) aligned to PCN boundaries have been established. Five have agreed an initial cohort to be managed through weekly MDT meetings. The North NT runs Feel Good Friday clinics; West 1 and West 2 have active MDT meetings; East 2’s MDT starts on Monday 2nd February and will focus on frailty and dementia; South 2 is focusing on high-intensity users; and East 2 and South 2 are supporting the adult social care Live Well pilot.

The service specifications for the Live Well pilot have been finalised and they have received five tenders back from homecare providers. The University of Wolverhampton has also been confirmed as the Pilot Evaluation University Partner.

The second stakeholder forum was held on 21 January and was well attended. Q&As were recorded with copies available on request. The next event is taking place Wednesday 25 February from 3pm-4pm. You can book your place here.

We were delighted to welcome Dr Minal Bakhai MBE, Senior Responsible Officer for the National Neighbourhood Health Implementation Programme (NNHIP), to Walsall, where she spent time seeing first-hand how neighbourhood-based working is making a difference for local people.

Dr Bakhai visited the Feel Good Friday Clinics at the Stan Ball Centre and met with South and West 2 Integrated Neighbourhood Teams to see how coordinated, multidisciplinary approaches are supporting frail, housebound and high-need citizens through proactive, preventative care.

Reflecting on the atmosphere and sense of purpose created through this neighbourhood approach, she said: “This is what we are trying to bottle – you walk in and you feel it. What you’re doing is what communities respond better to, because it’s what actually matters to them, and that is really at the heart of neighbourhood health and wellbeing. So it was amazing to see.” Read the full story here.

The next Regional Learning Event is taking place on Tuesday 10 February in Edgbaston where we will be sharing best practice, learning from others and hearing more around the national direction.

Feel Good Friday Clinics

The Feel Good Friday Clinics were developed to proactivaly support older people living with frailty through early, holestic intervention, imporving outcomes and independance while reducing avoidable emergency department attendances, pressures on intermediate care and longer term care costs.

Just 11 weeks after launching they are already proving to be making a difference. So far, 39 out of 46 older people invited have attended a clinic. Each person received a Comprehensive Geriatric Assessment (CGA), which looks at physical health, medicines, mobility, home safety, and overall wellbeing. This holistic approach helps identify issues early and ensures the right support is put in place.

As a result:

  • 48% of people had medications safely stopped

  • 69% had changes made to their medicines

  • 36% received home safety assessments to reduce the risk of falls

  • 49% were connected to community services such as smoking cessation, weight management, and strength and balance activities

The clinics are also helping to reduce pressure on health services, with hospital admissions avoided and people supported through the Care Navigation Centre, preventing the need to contact their GP or emergency services.

Feedback from people using the service and from staff has been extremely positive. The clinic has now been extended until March 2026, and a new falls-prevention activity programme is planned to begin in April 2026, with further specialist support currently in development.

Family Hubs

Family Hubs are part of a national programme supported by the Department for Education and Department of Health and Social Care, running  from 2022 to 2028. They focus on six key areas of action outlined in the Best Start in Life vision of 2021. They provide a wide range of social, health, and mental health services in a single, accessible facility targeting uptake in areas facing inequality or barriers to access.

Looking ahead to 2026–2029, a key target for Walsall is achieving a Good Level of Development (GLD) for all five-year-olds, ensuring that at least 74.7% of children in Walsall reach this level by the end of the 2027/28 academic year, with disadvantaged children benefiting equally.

Families are supported through a coherent, joined-up Start for Life offer, including midwifery, health visiting, mental health support, infant feeding advice, safeguarding, and special Educational Needs and Disabilities services. Family hubs provide welcoming spaces for families to access these services physically, virtually, and through outreach, while digital and telephone offers ensure families can get information when they need it.

Wellbeing Networks

Wellbeing networks operate alongside neighbourhood teams and family hubs, connecting health, social care, and community services, and bringing together existing offers such as physical activity, healthy eating, creative health, and support for frail older people into a coordinated system that meets the needs of each neighbourhood.

Physical activity: Social prescribers were given a tour of the Oak Park Living facility and considered effective ways to signpost people to available services. The group held wide-ranging discussions on strengthening links between primary care and the developing physical health strategy, and explored how existing guided walking schemes could be adapted to better engage those who would most benefit. Participants also discussed ways of linking physical activity with nature to enhance both meaning and health benefits. Active Black Country has a strategic lead focused on physical activity and long-term conditions, and this emerging partnership will become increasingly integrated into neighbourhood health approaches.

In other news…

From local impact to national honour: We are delighted to congratulate Janet Davies on being awarded a British Empire Medal (BEM) in the King’s New Year Honours List for services to the voluntary sector. This highly deserved recognition reflects Jan’s exceptional commitment to communities across Walsall and her long-standing leadership within the voluntary, community, faith and social enterprise (VCFSE) sector.

As our VCFSE Representative on the Board, Jan brings a strong and trusted community voice into partnership working. Her extensive knowledge, skills and experience are instrumental in supporting the development of neighbourhood teams, strengthening collaboration and helping to ensure that work remains focused on local need and reducing health inequalities.

West Midlands Mayor visits WorkWell programme at Blakenall Village Centre: The Mayor of the West Midlands has visited Blakenall Village Centre to see first-hand how the WorkWell programme is supporting Walsall residents with health conditions or disabilities to access and stay in employment. Read the full story here.

We Are Walsall 2040 - Building Our Business Future Event: This free event is filled with practical insights on Walsall’s future business growth and regeneration plans, and support available. Hear from keynote speakers and panels, and learn how other local businesses, Small and Medium Enterprises, and community interest companies have unlocked funding. It is taking place on Wednesday 11 February and will run from 9.30an-1.30pm. You can book your place by visiting the following link https://booking.wmbf.co.uk/we-are-walsall-2040/.

Market Place Event: Stakeholders, partners and colleagues are invited to meet key voluntary and community sector organisations from Walsall Community Network to find out more about the projects, activities and services being delivered across Walsall. Drop into Brownhills Community Centre, Pelsall Road, WS8 7JE, anytime between 10am-1pm on Tuesday 3 March.

Have your say on Drug and Alcohol Services in Walsall: Walsall Public Health are keen to understand the views and ideas of members of the public and stakeholders about the needs of local people affected by substance misuse and whether needs are being met by the local treatment system. You can have your say by completing a survey at https://online1.snapsurveys.com/nzf2xr. Please share this link as far and wide as possible and encourage members of the public, staff and volunteers to complete it by 20 Feb 2026. Paper copies of the questionnaire are available by contacting paul.hargrave@walsall.gov.uk.      

Active Black Country Stakeholder Survey:  Active Black Country believes that being active has the power to improve people’s lives, that it is everyone’s right to be active and play sport. The charity wants to ensure it has an even greater impact on people’s physical and mental wellbeing over the coming 12 months and beyond. Your voice is vital to this work. Have your say, fill in the form here - Active Black Country Stakeholder Survey 

Walsall town centre is changing - Notice about Park Street disruption: From 26 January 2026, Butler’s Passage on Park Street will close, with construction hoardings going up around the buildings either side. This closure is essential to demolish the buildings as part of the Connected Gateway scheme. For more information visit: ​​​​https://go.walsall.gov.uk/business/regeneration-and-investment/regenerating-walsall-town-centre

Frailty and Falls - Feel Good Friday Clinic

The Feel Good Friday Clinics were developed to proactively support older people living with frailty through early, holistic intervention, improving outcomes and independence while reducing avoidable emergency department attendances, pressure on intermediate care, and longer-term care costs.

The clinics launched on 17 October 2025 as a 12-week pilot in the North Locality. To date, seven clinics have been delivered, supporting 24 participants who meet defined frailty referral criteria. Delivered at the Stan Ball Centre, the clinics bring together a multidisciplinary health and social care team to undertake Comprehensive Geriatric Assessments and co-produce personalised care plans. Early feedback from service users and carers has been consistently positive, with people reporting improved confidence, better access to support, and highly valued social connection.

The pilot will conclude in January 2026, after which a full evaluation will assess impact and outcomes and inform decisions on potential expansion to additional localities. Subject to the findings, governance approvals will be progressed in February and March to enable a seamless transition from April, supported by business case development.

Delivery is led by a core multidisciplinary team including a GP, Pharmacist, Occupational Therapist, Community Frailty Nurses, and Social Prescribers, with physiotherapy recruitment underway to strengthen falls and mobility assessment. Community partners play a key role in engagement and social connection, with strategic oversight provided through the Falls and Frailty Steering Group.

Through earlier identification and proactive management of frailty we hope to is enable more older people to remain independent for longer, reducing avoidable emergency attendances and admissions, easing pressure on intermediate care services, and delivering better outcomes within a sustainable care model.

Insights:

  • Pre/Post clinic surveys

  • Face to face conversations with patients, families/carers and staff

  • Follow up conversations aligned to the Walsall Well-Being Outcomes Framework

Here is what we have heard from staff, service users and family/carers:

“It is a wonderful service and very good” 

“Whole experience very good.  It is the first time we have been able to sit with anyone and explain any difficulties instead of waiting a month for a GP appointment” 

“The clinics were very good. Mom was able to get a prescription for better pain killers”

“This is true MDT working”

Case Study: Margaret Edwards, 86

When Margaret, 86, was invited to attend the Feel Good Friday Clinic, she felt unsure, saying she “didn’t know what to expect.” Having stopped driving, her opportunities to go out had become limited and life was beginning to feel like “looking at four walls.”

During her visit, she spoke with Ellen, the social prescriber, about transport options. With this support, she contacted Ring & Ride, enabling her to attend the Stan Ball Centre more regularly. She also shared her excitement about an upcoming Christmas coach trip to Cornwall.

That day, a Christmas party was taking place in the Bistro at the Centre. Although Margaret had arranged a taxi home, she asked if she could stay when she heard the singer performing. A staff nurse liaised with Centre staff so she could join the celebration.

Margaret left feeling happy, included, and socially connected. She later told a friend about the clinic, who was also keen to attend. Her story highlights how listening, flexible support, and accessible activities can make a meaningful difference to wellbeing.

Margaret’s visit shows how social support and accessible activities can reduce isolation. Attending the clinic and Centre activities helped her reconnect socially and move beyond feeling like she was “looking at four walls,” highlighting the value of flexible support and transport in improving wellbeing.

 

Margaret Edwards sitting with Ellen, a social prescriber, at the Feel Good Friday Clinic

 

Neighbourhood Health

Neighbourhood Teams (NTs) are multidisciplinary teams (MDT) that can share information and support people jointly to provide personalised and holistic care to prevent people from needing urgent/crisis support. 

They aim to:

  • empower individuals to manage their own health
  • address health inequalities by making care more accessible
  • focus on early intervention and prevention
  • reduce pressure on current health and care services

In Walsall, seven NTs have formed around Primary Care Network (PCN) boundaries with five out of seven have agreed an initial cohort for management through formal weekly MDT meetings. The North NT has established the Feel Good Friday clinics (as referenced above). West 1 and West 2 have an active MDT meeting. South 2 are looking at high intensity users. East 2 and South 2 have agreed to support the adult social care 'Live Well' pilot.

The service specifications for the Live Well pilot have been finalised and put out to tender. There is a weighting towards quality over cost, including that providers must have a CQC rating of good or higher. Discussions have progressed with regards to delegation of healthcare tasks to care providers. Colleagues in Walsall Healthcare NHS Trust community are supporting with the identification of appropriate tasks, competency frameworks and training for the providers, as well as escalation pathways into community services when appropriate.

In other news, a range of risk stratification tools are currently being trailed and evaluated. A Section 251 data sharing agreement is in progress across the Black Country. We also have a range of pilot solutions for shared care planning and Technology Enabled Care.

We held the first stakeholder forum in December, which was very well attended. Q&As were recorded with copies available on request. Future sessions will take place monthly, bookable via Eventbrite, with the next one on 21 January at 3pm.

The partnership has approved a small funding pot, from within its existing allocation, to support involvement and engagement. Recruitment of a Community Advisor, to act as the strategic lead for citizen voice for neighbourhood health and care, is in progress. The individual will have a specific focus on bringing the voice of those furthest away from services.

Finally, the focus for January to March will include establishment of a dedicated operational group to produce a design blueprint for day-to-day integrated working across community services, community mental health, general practice and social care, to support around 10% of the local population, who are estimated to be able to benefit from multi-professional teams.

Intermediate Care

A review of Intermediate Care is taking place to ensure the service delivers timely, person-centred care that promotes rapid recovery, minimises avoidable hospital admissions, and achieves the best outcomes in a financially sustainable way through an effective, skilled multidisciplinary workforce.

In September, non-recurrent workforce funding was approved to test the model outlined in the investment case, and early results show a positive impact. Pathway 1 service users receiving therapy within 72 hours post-discharge had a 7-day shorter length of stay and fewer care calls, with some able to exit at the 72-hour review, avoiding unnecessary stays and reducing dependency. The home pathway also saw a 3.73-day reduction in length of stay, and these improvements are contributing to overall budget savings.

Due to the success of the non-recurrent investment, this funding is now being made recurrent, and the data will continue to be monitored to inform workforce requirements and future service improvements. The next phase of the Intermediate Care review will evaluate the Swan House pilot and develop a business case for a dedicated rehab unit, enabling faster functional recovery so people can return to their home sooner and with greater independence. Recruitment across Health and Social Care is essential to ensure a skilled, multidisciplinary workforce is in place to deliver the required outcomes.

This will enable more people to recover faster and return home sooner with greater independence, reducing avoidable hospital stays, lowering ongoing care needs, and delivering better outcomes within a sustainable financial model.

Modern General Practice

Modern General Practice is focussed on improving access to GP services. It is a core component of neighbourhood health, so whilst it remains an ICB/GP responsibility, we are now starting to report it through the partnership.

Overall compliance with GP access requirements is high across Walsall.92% (45 of 49 practices) are compliant with same-day online consultation response standards, while 84% (41 of 49 practices) are compliant with maintaining all three access routes during core hours.Non-compliance is limited to a small number of practices and is primarily linked to workforce and operational capacity pressures.

Targeted support and ongoing monitoring are in place, providing assurance that improvement actions are being actively managed.

Family Hubs

Family Hubs are part of a national programme supported by the

Department for Education and Department of Health and Social Care, running from 2022 to 2028. They focus on six key areas of action outlined in the Best Start in Life vision of 2021. They provide a wide range of social, health, and mental health services in a single, accessible facility targeting uptake in areas facing inequality or barriers to access.

Looking ahead to 2026–2029, a key target for Walsall is achieving a Good Level of Development (GLD) for all five-year-olds, ensuring that at least 74.7% of children in Walsall reach this level by the end of the 2027/28 academic year, with disadvantaged children benefiting equally.

Families are supported through a coherent, joined-up Start for Life offer, including midwifery, health visiting, mental health support, infant feeding advice, safeguarding, and special Educational Needs and Disabilities services. Family hubs provide welcoming spaces for families to access these services physically, virtually, and through outreach, while digital and telephone offers ensure families can get information when they need it.

Complex Care

Adults with a learning disability die around 10 years earlier than the general population, with even poorer outcomes for people from minority ethnic groups. Cancer is one of the leading causes of death. There is a clear opportunity to improve bowel cancer prevention and screening in this population, helping to increase healthy life expectancy and reduce avoidable hospital admissions.

Improving bowel health for people with a learning disability requires action across several areas. These include universal health behaviours such as diet and physical activity; awareness and understanding of bowel health among people with a learning disability and their carers; and how health services communicate with, identify, screen, and treat people with a learning disability.

The partnership is scoping current practice around health checks in primary care, establishing the local and national data and evidence base, and seeking the views and experiences of people with a learning disability.

Wellbeing Networks

The Walsall Together model of health, care and wellbeing includes communities at its heart. As we develop our integrated neighbourhood teams, the partnership is keen to ensure we give sufficient focus to preventative and wellbeing services and support. Voluntary, Community, Faith, Social Enterprise and social housing providers support the wellbeing of the population by addressing the social determinants of health, the non-medical and economic factors such as loneliness, education and employment.

Wellbeing networks operate alongside neighbourhood teams and family hubs, connecting health, social care, and community services, and bringing together existing offers such as physical activity, healthy eating, creative health, and support for frail older people into a coordinated system that meets the needs of each neighbourhood.

Delivery relies on collaboration across statutory services, voluntary organisations, neighbourhood teams, and social prescribers, ensuring local ownership and reach while connecting people to the services they need.

In other news...

Five-year Food Plan: Walsall has unveiled a five-year plan driven by an ambitious vision to create a fairer, healthier and more sustainable food system across the borough. The aspirations around food will link well with emerging approaches to neighbourhood health and wider NHS provisions. For more information contact helen.billings@nhs.net

Physical Activity Strategy for Walsall: A new framework has launched, setting out a cross-sector approach to create more opportunities for residents to make physical activity a natural part of everyday life. The strategy aims to support healthier, happier, and more resilient communities.

The partnership, led by Active Black Country and Public Health, is now in the early stages of mobilisation. The approaches will be inclusive and go well beyond traditional ‘sports’ activities. Early priorities are closely aligned with Walsall Together and our emerging approach to neighbourhood working.

Creative Health: Creative health in Walsall is continuing to develop with an event being planned for late January/early February to mobilise further. In the meantime there are several new initiatives improving health and wellbeing. Walsall’s primary school children are taking part in an exciting creative health project for Children’s Mental Health Week. ‘Harmony’ is a fun 25-minute interactive video created in partnership with Walsall’s Music Education Team and Public Health to raise mental health awareness through music and connection. This offers simple wellbeing advice alongside engaging information on the 8 steps to wellbeing, breathing exercises, songs and a lively karaoke session.

Delivering neighbourhood health. How do you make the best use of your estate?: Catch up on this online event exploring how health and care leaders can optimise existing estates to support neighbourhood health, discussing ways to overcome funding, technical, and cultural barriers to maximise shared spaces and create environments that enhance service delivery.

Caring together - a joint vision for the future of cooperation between adult social care and the NHS: We’re proud to be featured in the newly published joint report with NHS Confederation the Association of Directors of Adult Social Services (ADASS) and RLDatix Caring Together: a joint vision for the future of co-operation between adult social care and the NHS.

Quit Smoking Support: Make 2026 the year we help more people quit smoking for good. Encourage friends, family, colleagues, and residents to take a positive step towards a smoke-free future. With free, expert support from Be Well Walsall, quitting is possible – even for those who’ve tried before. Refer or start a quit journey at www.bewellwalsall.co.uk or text SMOKEFREE to 60777.

Monthly Brief December 2022

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Monthly Brief  January 2022