Agenda and minutes

Apologies for absence had been received from Councillor June Nelson. 

There were no declarations of interest in matters coming before this meeting. 

RESOLVED:  That the minutes of the meeting held on 22 July 2025 be agreed as a correct record. 

RESOLVED:  That all items of business be considered in public. 

The Chair welcomed those present to the meeting.

Ms Lesley Watts, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust (THH), noted that she had previously spoken to the Committee about the Minor Injuries Unit (MIU) at Mount Vernon Hospital. She advised that health services in Hillingdon, specifically the acute trust, had a history of overspending and not achieving great performance standards. Action was needed in relation to elective recovery whilst also looking after existing staff, attracting and developing new staff and building a new hospital, all within budget.

Discussions had been undertaken in relation to processes and the proposal had been considered by the Board in July 2025 where it had been agreed to transfer the MIU work from Mount Vernon Hospital to Hillingdon Hospital. Engagement had been undertaken with a range of people including colleagues in Hertfordshire and Berkshire, as well as residents associations and MPs. A meeting with residents had been held on Friday which had also been attended by the local MP and a consultation was currently underway with staff.

Dr Alan McGlennan, Chief Medical Officer and Managing Director at THH, advised that around 35-45 patients were seen each day at the MIU at Mount Vernon Hospital, whereas there were around 200 per day at the Urgent Treatment Centre at Hillingdon Hospital. Around 50% of the patients seen at the MIU were not Hillingdon residents and a large number of the presentations were minor illnesses or wound management issues which should be dealt with through primary care, social care or pharmacy care. It was anticipated that the move would initially see an additional 30 patients per day at Hillingdon Hospital but that this would reduce over time and productivity would increase.

Members queried how the MIU proposals would fit in with the NHS 10 year plan to shift more care into the community and whether the Pembroke Centre Hub in Ruislip would be able to cope with the resultant increase in demand. Dr McGlennan advised that around half of the patients presenting at the MIU needed an x-ray (for example, for a fractured finger or twisted ankle). A shuttle bus would still be available but half of the patients currently seen at the MIU could go to their GP. The proposals would fit in with the NHS 10 year plan.

The Ruislip Hub had been initiated and was still growing. Its availability had been well received by residents as it put the right care in the right place. Injuries requiring an x-ray would always need to be seen at Hillingdon Hospital but minor illnesses previously seen at the MIU should be going to their GP. Patient with things like urinary tract infections should go to their local pharmacy and chronic wounds and infections should be dealt with by the GPs. The Hubs would be developed so that they could deal with urgent care and some diagnostics.

Patients currently called NHS 111 and were given options on the places that they could attend. The MIU was not  ...  view the full minutes text for item 23.

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that health and social care services were always challenged and that understanding demographic growth was hard with the level of complexity of residents’ increasing over the last year. Although the total number of services users had not increased very much over the last ten years, the cost of care had increased significantly. The Council had to take proactive steps to manage the available resources to be able to provide and manage a good service at a good unit cost value.

There were challenges in relation to managing demand and pressures. Demand drivers of increased costs included an increase in National Insurance (which would increase again in April 2026). Whilst officers did what they could to maintain fair prices and use brokerage services, they recognised that it was also a challenging time for care providers. Autism had also become an increased driver for services.

Mr Martyn Storey, the Council’s Head of Finance – Adult Social Care, advised that the bottom of Table 2 in the report had showed a £5.4m overspend on adult social care placements in the last year and that the pressure had been mitigated by holding vacancies. Table 5 showed that an £8.2m overspend in total services operating budgets had been forecast at Month 2 and that officers might be in a better position to comment on this at the next meeting.

Members were advised that the combined effect of the living wage and National Insurance increases had increased the wage bill by just under 9%. Although providers with existing care placements understood that the Council was under financial pressure, new placements were costing more.

Concern was expressed that there was always an overspend in social care as forecasting did not appear to be accurate and queried where the analysis was in the report that could give Members confidence in the forecasting. Mr Storey noted that the officers would be able to get better at forecasting by modelling using the data that was available.

Ms Taylor advised that the Council had purchased its own care home to try to manage some of the pressures but that care packages for people with learning disabilities in supported living had the highest costs. These were also often long term costs as these residents tended to be younger when they first needed the support.

The Council had had to look at things differently and work was being undertaken accordingly (although not yet at a stage where it could be reported to Members). Analytics were monitored and all local authorities were required to report annually so Hillingdon was able to benchmark its costs to ensure that the Council was achieving best value. It was agreed that further information on this would be brought to a future meeting.

Members acknowledged the pressure faced by health and social care but noted that the Committee was only being given figures for Month 2 when Cabinet would be considering Month 4 later in  ...  view the full minutes text for item 24.

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that it had been some time since this issue had last been reported to committee. The report provided definitions about the prevalence of issues faced by those with autism as well as the development and achievements over the last three years. It was agreed that the draft Autism Strategy be brought to a future meeting to consult with the Committee.

Mr Graham Puckering, the Council’s Assistant Director – Sustained Support, advised that there had been a dramatic increase in the number of people with autism that did not have an associated learning disability. It was thought that this had partly resulted from the pandemic which had prompted people to consider whether autism could be a factor in difficulties faced in managing day to day activities. Improvements in diagnostics was also highlighted to the Committee. The report showed that, in 2019/20, there had been 18 autistic adults supported with a package of care by adult social care. In 2025/26, this had risen to 374. These figures did not reflect the number of referrals that were being made, nor the amount of short intervention work that was undertaken which prevented the provision of more significant support.

There had been a restructure in adult social care which had created an autism specialism within the team. Previously, people with an autism and an associated learning disability had been dealt with by the Learning Disability Team.

Ms Sonal Sisodia, the Council’s SEND Service Manager, noted that the Post 16 Team had been working with young people on their Education and Health Care Plans (EHCPs) to provide them with the skills to be able to look after themselves. Members queried whether the rise in autism only in adults had been reflected in children and young people. Ms Sisodia advised that 26% of those with EHCPs had autism and that this number had been rising over the last few years. Research had shown that the number of children and young people with autism had not increased but that the diagnoses had.

Members thanked the officers for the report and for providing case studies therein to illustrate the issues. They queried whether there was a breakdown available in relation to the level of support provided to the 374 autistic people in Hillingdon. Mr Puckering advised that, whilst all 374 had Care Act eligibility needs, their level of need was not broken down. There were people with autism in every sector of social care and an increasing number of people referring themselves (autism would have a profound effect on the lives of some of these people and not so much on others). Those with the highest needs would receive full time care and those with the lowest might receive two hours of support with things like reading their mail. The support that they were provided built up their skills and confidence. The cost of support could be up to £6k-7k per week per person.

Chart 1 in  ...  view the full minutes text for item 25.

Members agreed that any minor changes to the draft report be delegated to the Democratic, Civic and Ceremonial Manager in consultation with the Chair and Labour Lead. 

RESOLVED: That the draft final report of the GP coverage single meeting review be agreed and any minor amendments be delegated to the Democratic, Civic and Ceremonial Manager in consultation with the Chair and Labour Lead.

Members requested that the Committee be able to comment on the Technology Enabled Care Plan report before it was considered at the Cabinet meeting on 20 November 2025.

RESOLVED: That:

1.     the Cabinet Forward Plan be noted; and

2.     the Committee be able to comment on the Technology Enabled Care Plan report at its meeting on 11 November 2025.

Consideration was given to the Committee’s Work Programme. 

RESOLVED: That the Work Programme be noted.