Sandwell Health & Wellbeing: Where Are the Outcomes, Accountability and Resident Voice?
Sandwell's Health and Wellbeing Board meets on Wednesday 2 September 2026 at 5.30pm in the Council Chamber, Sandwell Council House, Oldbury.
The meeting is open to the public and, importantly, it can also be watched online.
📄 Agenda and full reports pack:
Sandwell Health and Wellbeing Board – 2 September 2026
📺 Watch the meeting live:
Health and Wellbeing Board – Sandwell Council webcast
And this is one meeting I think is worth keeping an eye on.
I have spent quite a bit of time going through the 126-page agenda pack. There is some genuinely important work in it — mental health, maternity, air quality, neighbourhood healthcare, health inequalities and a £76.363 million Better Care Fund.
There is also an awful lot of the usual public-sector vocabulary: strategies, partnerships, transformation, co-production, alignment, frameworks, pathways, priorities, programmes and — naturally — more partnerships.
I sometimes wonder whether there is a warehouse somewhere in Sandwell where they keep all the partnerships when they're not being strategically aligned.
But behind all of that language are some extremely serious issues.
And having attended Health and Wellbeing Board meetings myself, I have a fundamental question:
Is this Board actually improving the health of Sandwell residents — or are we sometimes watching a very expensive talking shop congratulate itself?
I ask that as a critical friend, because I actually want the Board to succeed.
Sandwell badly needs it to.
Never mind the glossy presentations — look at Sandwell's health
Before anybody gets carried away congratulating everybody else on another successful initiative, perhaps we should look at the actual outcomes.
Sandwell's own Joint Strategic Needs Assessment contains some sobering figures.
Healthy life expectancy is around 52.7 years for men and just 51.3 years for women — around eight or nine years below the equivalent national figures.
Infant mortality is recorded at 7.4 deaths per 1,000 live births compared with 4.2 nationally.
Premature mortality is substantially above the England figure.
Childhood obesity remains extremely high.
Cancer-screening performance is below national levels in several areas.
Vaccination uptake presents problems.
Tuberculosis remains a significant concern.
These aren't abstract statistics.
They're Sandwell residents.
And that is ultimately what the Health and Wellbeing Board exists to improve.
So perhaps the first rule of these meetings should be:
Nobody gets a gold star simply for having an initiative.
The question is whether it worked.
£76 MILLION — where are the outcomes?
The biggest financial item before the Board is the Sandwell Better Care Fund for 2026/27.
The pooled health and social-care budget is:
£76,363,330
Not exactly small change.
It includes money from the NHS, the Council's Better Care Grant, Disabled Facilities Grant and additional council contributions.
It funds everything from reablement and hospital discharge to community alarms, carers, social care, adaptations, intermediate care and schemes intended to prevent unnecessary hospital and residential-care admissions.
Much of that is valuable work.
But here's where I would like to see the Board become considerably more inquisitive.
The papers themselves acknowledge previous findings around:
duplication;
under-used capacity;
inefficiencies;
workforce deployment;
manual processes;
poor performance visibility;
and the need to demonstrate better value for money.
Fine.
At least somebody is looking.
But with £76 million on the table, I don't want the scrutiny to finish with:
"Thank you for that very comprehensive report."
"Excellent partnership working."
"Any further comments?"
"No?"
"Noted."
Next item.
I want some much simpler questions.
What did we spend?
What did residents receive?
What improved?
What didn't improve?
Which services provide good value?
Which don't?
What are we changing because of that evidence?
There is a peculiar habit in the public sector whereby a programme can apparently be regarded as successful because lots of activity took place.
"We trained 700 people."
Fine.
What changed?
"We made 27,000 contacts."
Fine.
What changed?
"We held six workshops."
Lovely.
WHAT CHANGED?
Activity is not automatically an outcome.
Neighbourhood Health — I actually like the principle
One proposal I think has genuine potential is Sandwell's new Neighbourhood Health and Care Model.
The idea is to organise services around Sandwell's six towns:
Oldbury, Rowley Regis, Smethwick, Tipton, Wednesbury and West Bromwich.
Health, Adult Social Care, primary care, mental health, community services, voluntary organisations, public health, social prescribing and other support are supposed to work together around local communities.
The Council's own presentation sums up the ambition as:
“fewer hand-offs, earlier support, better resident experience and better use of public money.”
I can't argue with that.
If it works, excellent.
But residents don't experience a colourful diagram showing six interconnected circles.
They experience whether somebody answers the telephone.
Whether they can obtain an appointment.
Whether the GP knows what the hospital is doing.
Whether Adult Social Care knows what the NHS is doing.
Whether an elderly person comes home from hospital with the right support.
Whether a carer receives help before reaching breaking point.
And whether somebody with complex needs has to tell their entire life story yet again to Department Number 17 because apparently Department Number 16 can't speak to it.
That's how the neighbourhood model must eventually be judged.
There is also the slightly awkward fact that the Health and Wellbeing Board currently has no Primary Care representative, despite primary care being absolutely central to much of what this new model intends doing.
The papers say discussions are continuing to find one.
Hopefully locating a representative from Sandwell's primary-care system doesn't become a new five-year strategic workstream.
Apparently “lived experience” is important...
One phrase appears everywhere these days.
Lived experience.
Apparently public bodies are very keen on it.
And I agree with them.
The previous Health and Wellbeing Board minutes themselves acknowledge the importance of hearing people's lived experience when addressing health inequalities.
Excellent.
Because I have plenty of it.
So do thousands of other Sandwell residents.
People know what it's like living with chronic illness.
They know what it's like navigating hospitals.
They know what it's like trying to get a GP appointment.
They know about disability.
Mental health.
Caring.
Social care.
Hospital discharge.
Waiting lists.
Being passed between organisations.
And trying to persuade several different parts of "the system" that they are all talking about the same human being.
So why isn't there a much clearer mechanism for residents to contribute directly to this Board?
One sentence in the governance paper particularly caught my attention:
“Engagement outside of the Board's membership is not required.”
Now, let's be fair.
That sentence relates specifically to the report concerning the Board's membership, terms of reference and work programme. It doesn't mean Sandwell has declared the public permanently surplus to requirements.
Elsewhere the papers make quite a song and dance about engagement, co-production and lived experience.
But perhaps that's precisely why the wording bothers me.
If residents' experience is so valuable, let some residents speak directly to the Board.
Why not have a proper public-question session?
Why not invite somebody with relevant lived experience when a particular issue is being discussed?
Why not establish a resident reference group which can report directly to the Board?
Why must "resident voice" always have to pass through another organisation, another consultation exercise or another professionally facilitated workshop before anybody important hears it?
Sometimes the most useful contribution might simply be somebody from Sandwell saying:
"That's not how it works when you're actually trying to use the service."
It might make proceedings slightly less comfortable.
Good.
Talking of governance... where has the Work Programme gone?
There is another curiosity in this pack.
The Board is being asked to approve its 2026/27 Work Programme.
The report says this appears at Appendix C.
Appendix A appears.
Appendix B appears.
Then we arrive at page 22:
“This page is intentionally left blank.”
And the next agenda item begins on page 23.
Unless the Work Programme has developed an exciting new stealth capability, Appendix C appears to be missing from the published pack.
Perhaps there is an innocent administrative explanation.
But the Work Programme is rather important.
It's supposed to tell members — and residents — what this statutory Board intends looking at during the year.
When Sandwell has major problems involving infant mortality, obesity, premature mortality, vaccination, TB and other health inequalities, I would quite like to know when the Board intends returning to them.
You can't scrutinise progress if nobody knows when progress is coming back.
Maternity — this is serious, so concentrate on what is serious
The maternity report deserves proper attention.
There have been serious concerns around patient safety, staffing, leadership, escalation of care, culture and reports of racism and discrimination.
My position is quite straightforward.
Where there is genuine evidence of racist behaviour or discriminatory treatment, investigate it thoroughly and deal with it.
If somebody received poorer treatment because of their race, if discriminatory behaviour affected clinical decisions, or if prejudice contributed to unsafe care, then that is serious.
No argument from me.
But I am far less interested in public organisations disappearing down the rabbit hole where every badly chosen word, disagreement, unpopular opinion or somebody feeling offended automatically becomes a major equality incident.
Racism is serious precisely because racism is serious.
It shouldn't be diluted until it simply means "somebody said something I didn't like".
Concentrate on the evidence.
Was there discriminatory treatment?
Was patient safety compromised?
Were complaints ignored?
Did women receive unequal standards of care?
Were concerns escalated properly?
Were staffing and leadership adequate?
What happened to mothers and babies?
Those are questions worth answering.
And Sandwell's infant mortality rate of 7.4 per 1,000 births compared with 4.2 nationally means there is already plenty of serious work requiring attention.
This is not an area for box-ticking.
Nor should "received for information" become the end of the Health and Wellbeing Board's interest.
Air quality — pollution matters, but don't confuse it with the Net Zero religion
The Air Quality Annual Status Report is another area where I think the debate needs separating into two very different things.
Sandwell has recorded four consecutive years meeting the statutory annual nitrogen dioxide — NO₂ — objective.
If that continues, the borough-wide Air Quality Management Area could potentially be revoked.
Good.
That is something worth welcoming.
But this doesn't mean air pollution has disappeared.
The report still identifies PM2.5 fine particulate pollution as a significant public-health issue.
And this is where my position differs from the fashionable Net Zero narrative.
I am not persuaded by policies which treat carbon dioxide as though it is simply another form of filthy local air pollution and then attach almost anything to the banner of "clean air" or "climate action".
The climate-policy argument around CO₂ is one debate.
Actual local pollutants affecting people's health are another.
I am concerned about:
PM2.5.
PM10.
Nitrogen dioxide.
And other harmful pollutants from combustion, traffic and industry.
Those are things we should properly monitor.
Find the hotspots.
Understand where the pollution comes from.
Publish the results.
Understand the effects upon health.
Then take sensible and proportionate action.
But please don't tell me that because I don't want children breathing fine particulate pollution beside a busy road I must therefore support every anti-car scheme, traffic restriction and Net Zero policy somebody has attached to it.
That's quite a leap.
Clean-air policy should concentrate on making the air cleaner.
Not bad for a revolutionary idea.
Mental health — there is some good work here
I don't want this blog to become "everything is rubbish", because it isn't.
There is mental-health work in these papers that appears genuinely worthwhile.
Targeted work has been undertaken with men, carers, Eastern European communities, faith groups and others.
There is suicide-prevention work.
There are community-based programmes.
And Talking Therapies Plus reports 1,058 referrals, 824 people entering treatment and a 74% recovery rate using nationally recognised clinical outcome measures.
Now that is useful information.
It tells us more than simply how many leaflets were distributed or how many people "engaged".
It begins to answer the question:
Did the intervention work?
That's the direction I would like every major initiative to take.
A Board or a mutual-appreciation society?
And that brings me back to my biggest concern.
Partnership working is essential in health and social care.
But there's an inherent risk when nearly everybody around the table is part of the same partnership system.
One organisation presents its work.
Another organisation praises it.
Somebody thanks the officers.
Somebody else praises the partnership.
The Chair congratulates everyone involved.
The report is noted.
Repeat.
And before you know it, the Health and Wellbeing Board risks becoming a mutual-appreciation society with minutes.
Somebody has to ask the difficult questions.
That is particularly important for the elected councillors sitting on this Board.
Councillors should not merely become another part of the health bureaucracy.
They have a democratic mandate.
If the figures look bad, challenge them.
If targets have been missed, ask why.
If an initiative hasn't delivered, say so.
If somebody says a project is a success, ask them to demonstrate it.
If £1 million has been spent, ask what taxpayers received for the £1 million.
And if the answer involves a twelve-minute explanation featuring "strategic alignment", "stakeholder engagement", "system transformation" and "journey to maturity" but somehow never includes an actual measurable result...
ask the question again.
I want the Board to succeed
That is the important point.
I support much of what the Health and Wellbeing Board is supposed to achieve.
Better coordination between health and social care.
Supporting people to remain independent.
Earlier intervention.
Better mental-health services.
Improved maternity safety.
Reducing genuine health inequalities.
Cleaner air.
Services closer to communities.
All good.
But Sandwell does not need another body which measures success by the thickness of its report pack.
It needs a Health and Wellbeing Board prepared to scrutinise whether all these plans and all this spending are actually improving people's lives.
Less self-congratulation.
Less jargon.
Fewer reports simply “noted”.
More measurable outcomes.
More accountability.
More challenge.
And considerably more opportunity for actual residents — including those of us with plenty of this much-celebrated “lived experience” — to contribute.
Because with poor health outcomes continuing across Sandwell and £76 million passing through the Better Care Fund alone, residents have every right to ask:
Where are the outcomes?
Where is the accountability?
And where is our voice?
Meeting details
📅 Wednesday 2 September 2026
🕠 5.30pm
📍 Council Chamber, Sandwell Council House, Oldbury
📄 Read the agenda and reports:
Health and Wellbeing Board – Agenda and Documents
📺 Watch live online:
Health and Wellbeing Board – Sandwell Council webcast
#Sandwell #SandwellCouncil #HealthAndWellbeing #NHS #PublicHealth #BetterCareFund #HealthInequalities #AirQuality #Maternity #Accountability #ResidentVoice #SandwellInsight
No comments:
Post a Comment