Agenda and draft minutes

There were no apologies for absence.

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

RESOLVED:  That the minutes of the meeting held on 3 December 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 Sharon Stoltz, the Council’s Director of Public Health, advised that, although the Borough compared favourably to London and England, there were plans to improve the overall health of residents to address variation across Hillingdon: there were some pockets with far worse outcomes in relation to far shorter lives and higher rates of cardiovascular disease, respiratory disease and cancer.  Action would be taken to narrow the gap but it was acknowledged that this would take time.  Some things could be improved over a short period but other changes would take a generation to have an impact. 

A review of the services commissioned in Hillingdon had been identified as one of the short-term priorities, for example, heath visiting and smoking cessation.  It was anticipated that the review would look a quality and outcomes and would ensure that the services were delivering what the Council needed them to deliver.  Giving a child a healthy start (from conception to two years old) would set them up well for life.  Members asked that they be provided with an update on this review of services at a future meeting. 

Consideration would also be given to how people of working age could be supported to be more healthy and how older people could be helped to be more active and prevented from being socially isolated.  Ms Stoltz advised that those areas of focus would need to be targeted using national data alongside local intelligence. 

Members were advised that the Public Health Strategy would be brought to the Committee in six months or so, once consultation on the development had been undertaken with partners and residents.  The Strategy could look at a ten year period (although it could be three or five years) and would be able to identify small, medium- and long-term priorities underpinned by a local outcomes framework that set out indicators that measured progress.  It was noted that not all indicators in the national framework were relevant to the local authority strategy.  The Council would not be able to look at everything and would need to focus on the most relevant issues which, in Hillingdon, would include childhood obesity, cardiovascular disease, heart disease, stroke and cancer.  Public Health would not be able to tackle these issues alone and would need to work in partnership with other teams from across the local authority, using Public Health grant and commissioning powers to achieve the greatest benefit.  It was agreed that the Committee would like to have a full meeting to look at the Public Health Strategy once it had been developed. 

With regard to proposals for the healthy integrated lifestyle offer, Ms Stoltz advised that there were currently separate services for different things like smoking cessation and weight management and separate referral processes to each of these services (which was fragmented and not necessarily helpful).  As people had such busy lives, it would be useful for them to not have to go to different places for the various  ...  view the full minutes text for item 49.

Consideration was given to the report.  Members asked whether or not officers could be confident that the proposed budget gave the best estimation of the budget that was needed for the next year.  Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health advised that officers had spent months working through the growth model for the next five years to be able to set the 2026/27 budget, which included some catch up and rebasing.  Consideration had also been given to the drivers for increased costs which included the increase in demand and the increase in the cost of care (which had risen exponentially).  The detailed model had looked at every primary support reason but focussed on how costs and the market were expected to be managed over the next three years. 

Members were advised that there had been a decrease in the number of older people needing a care home placement but that there had been an increasing number of younger people with special educational needs that would eventually need support from adult social care.  The Burroughs nursing beds and other care services that had been developed in house would help to alleviate the cost pressure. 

Mr Steve Muldoon, the Council’s Corporate Director of Finance, advised that the starting point had been to understand the current position and to consider demand and deliverability.  There had been ongoing costs that had not been included that should have been incorporated into the budget so funds had been put into the base to cover this expenditure.  Insofar as modelling was concerned, officers had looked back over recent years at the different rates of growth, and how this had changed, to provide a more realistic position. 

The savings proposals had been discussed and assumptions probed at the challenge sessions with Cabinet Members and Corporate Directors.  Pressure would now need to be maintained to ensure that delivery of these savings retained momentum and detailed delivery plans had been developed for complex areas to ensure success. 

Members expressed concern that delivery plans only worked if there was accountability.  Mr Muldoon advised that the savings had been identified by the directorates themselves and had been supported and owned by the relevant Corporate Director and their team, with a specific person identified as responsible for the delivery of each project.  To ensure that the responsible officer was held to account for delivering the savings, the higher risk projects would be discussed at monthly meetings and CMT would receive regular updates on the savings progress.  An app had been developed which could be used by Heads of Service to monitor their savings performance and the onus would be on the Corporate Directors to ensure that the savings stayed on track (a high proportion of the savings within adult social care would be transformational). 

Mr Martyn Storey, the Council’s Head of Finance – Adult Social Care and Health, advised that he would need to work closely with the Corporate Director and her team to ensure that the  ...  view the full minutes text for item 50.

Consideration was given to the report.  Although there had been a favourable move in the budget position since the last report to the Committee, there was still an overspend and Members queried future movement.  Mr Martyn Storey, the Council’s Head of Finance – Adult Social Care, advised that the overspend had been as a result of a mixture of things and had happened mostly at the end of 2024/25 after the budget had been set.  It had resulted from some growth in demand during the year and partly through anticipated savings that had not been achieved.  However, the current position was now relatively stable as officers had a good handle on what was happening and were addressing issues properly. 

Members queried whether the £7.2m pressure had been put into growth or whether this was being left to one side.  Mr Storey advised that this had been put into growth and that the savings slippage was being dealt with separately.  There had been a renegotiation around 2026/27 and Section 117 funding would be partly delivered in 2026/27 and partly in 2027/28.

RESOLVED:  That the 2025/26 Month 7 budget monitoring position be noted.

Consideration was given to the report.  Although it was recognised that Hillingdon benchmarked well in terms of a good quality service, Members queried how service user satisfaction rates could be increased.  Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that she had been disappointed with only 35% of service users being satisfied as this was at odds with the responses saying that service users’ quality of life was good.  Consideration would need to be given to why this figure had been so low and undertake local engagement with residents (national data from 2024/25 had been used). 

It was noted that the Council was starting to see good data in relation to the residential and nursing home placements that it made.  Statistically, the Council had previously been reporting its short and long term placements but other local authorities had only been reporting their long term placements (Hillingdon had now corrected this to only report long term placements).  Adult Social Care Outcomes Framework (ASCOF) and Short and Long Term Services (SALT) data source indicators had also changed recently and needed to be investigated further as some of the data seemed weird.  However, dashboards were now available to enable data comparison. 

Ms Taylor noted that the cost per head per 100k population across all primary support groups provided very good value for money and Hillingdon had the fourth lowest net spend in London.  The data could be broken down into groups to enable officers to identify where the costs for specifics was higher than the London average. 

It was queried whether the presence of Heathrow Airport in the Borough had impacted on the Council’s performance.  Ms Taylor advised that the low cost of services provided by the Council had been as a result of how the local authority had managed its contracts and how it had worked collaboratively.  The airport had had had less of an impact on adult services and more of an impact on children and young people’s services (although the repatriation of adults with significant health needs could be challenging).  Heathrow Airport offered opportunities for employment and leisure. 

Members congratulated Adult Social Care on achieving ‘Good’ in its CQC inspection and queried how frequently these inspections would be undertaken.  Ms Taylor advised that the inspection had been undertaken in July 2024 using the new framework and that almost all local authorities had now been inspected.  Directors of Adult Social Care worked together to determine why some local authorities had performed well in the CQC inspection and help others to improve.  It was anticipated that the CQC’s next inspection in Hillingdon would take place at the end of this year / beginning of next and that it would be targeted at issues that the CQC felt were weaker (the outcome would not change the overall rating already achieved).

It was suggested that the report include information about what actions and initiatives had worked and what had been learnt / not learnt from this work.  For  ...  view the full minutes text for item 52.

Consideration was given to the Cabinet Forward Plan.

RESOLVED: That the Cabinet Forward Plan be noted.

Consideration was given to the Committee’s Work Programme. 

RESOLVED:  That the Work Programme be agreed.