Agenda and draft minutes

Apologies for absence had been received from Councillor Susan O’Brien, Mr Edmund Jahn (Ms Amanda Carey-McDermott was present as his substitute), Ms Sue Jeffers (Mr Sean Bidewell was present as her substitute), Ms Julie Kelly, Ms Kelly O’Neill (Ms Shikha Sharma was present as her substitute) and Mr Tony Zaman.

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

RESOLVED:  That the minutes of the meeting held on 18 March 2025 be agreed as a correct record. 

It was confirmed that Agenda Items 5 to 8 would be considered in public and Agenda Items 9 to 11 would be considered in private. 

Mr Keith Spencer, Co-Chair and Managing Director of Hillingdon Health and Care Partners, advised that this item would also cover the discussion that would have taken place under Agenda Item 7: Proactive Care Developments Update / Neighbourhood Health.  He noted that a discussion had taken place at the last Health and Wellbeing Board meeting in relation to the need to identify a smaller number of priorities.  The report provided more detail on:

1. five proposed health and wellbeing priorities:

1. start well - improve early years outcomes, reduce child obesity and promote readiness for school and life.
2. live well - prevent and / or delay the onset of Long Term Conditions, particularly hypertension, improving mental wellbeing and enhancing access to early intervention and support for carers.
3. age well - implement ‘at scale’ proactive frailty management and better end-of-life care that enabled people with multi morbidity to maintain independence for as long as possible in order to: avoid non elective presentations; avoid admission to long term care; and promote early discharge.
4. healthy places - tackle housing, environment, employment and social isolation.
5. equity and inclusion - target resources and interventions where inequalities were greatest using Core20PLUS5: specifically Hayes, Yiewsley, and West Drayton.

2. progress to implement these priorities; and
3. a series of metrics and diagrams to quantify progress.

It had been proposed that the first two years would focus on the ‘ii. live well’, ‘iii. age well’ and ‘v. equity and inclusion’ priorities, whereby resources would be targeted on areas with the greatest inequity.  Work would still also be undertaken in relation to the ‘i. start well’ and ‘iv. healthy places’ priorities, but to a lesser degree.  Professor Ian Goodman, North West London Integrated Care Board (NWL ICB), suggested that, if effort was going to be focussed on priorities ii, iii and iv, this would need to be discussed outside of the medical model and moved away from acute medical care.

Mr Spencer advised that the priorities would be delivered through a new seven-day place operating model and two key transformation programmes in 2025/26: integrated services focused on preventing crisis (live well/equity); and integrated services focused on responding to crisis (age well/equity).  Preventing crisis would involve the neighbourhood teams which had progressed well with three strands:

1. access to primary care to prevent overspill into acute care;
2. proactive care for those with multi morbidity; and
3. preventing long term conditions. 

Consideration needed to be given to the place-based offer available to help people live at home for longer and prevent them from going into hospital. It was suggested that the key metrics needed to be clear and should be built from the hospital redevelopment programme, national targets (for example in relation to Better Care Fund and reablement) and hypertension.  Board members were asked if they would be happy to adopt these as the initial metrics which could then be built upon or changed at a later date (progress on these had been highlighted in the report). 

Hillingdon performed well with regard to neighbourhood health and proactive care  ...  view the full minutes text for item 39.

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that the 2025/26 Better Care Fund (BCF) Plan had been submitted and was compliant with national requirements.  There had been a 3.93% increase in the NHS contribution to adult social care and a 13% increase in Disabled Facilities Grant (DFG) funding.  The North West London Integrated Care Board (NWL ICB) discharge fund had been ringfenced, but the value was the same as it had been for 2024/25. 

The Board was advised that the BCF Plan had been restructured to make it simpler and more streamlined.  The submission had included the Plan template with details of three metrics and financials.  The overall value of the Plan had reduced from £100m to around £74m due to a reduction in the contributions from the local authority and NWL ICB.  The ICB had reduced its additional contribution to the BCF in 2025/26 by 50% which had resulted in savings of £796,619.  The expectation was that the NHS additional contribution to the BCF would reduce by a further £718,608 from 2026/27 making a full year saving for 2026/27 of £1,515,227.  Whilst some of these savings would be quite straight forward, others would need an equalities impact assessment undertaken.

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that this £1.5m reduction meant that it would not be possible to just roll over what had been done in previous years.  Everything had had to be realigned and would need to be constantly reviewed. 

With regard to mental health, Mr Collier confirmed that there was nothing that had been included in the 2024/25 Plan that would be coming out of the 2025/26 Plan.  In response to a query about whether the overall funding had gone up, down or stayed the same, the Board was advised that funding for mandated schemes had increased and that there had been a reduction in the NWL ICB contribution.  However, although the local authority contribution had decreased, there had been no change to the services provided which were funded outside of the BCF. 

There were three national metrics in 2025/26 in relation to emergency admissions to hospital, discharge delays and permanent admissions to care homes.  These improved NHS targets had been based on the data that had been available but there had been some issues with the data available in relation to discharge to the usual place of residence.  The 2024/25 projected outturn had been used as a baseline to create base lines for the 2025/26 plans and a 1% improvement applied.  Ms Lesley Watts, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust, noted that this 1% did not just sit here and consideration needed to be given to what more could be done with the funding that was available.  There would be an opportunity to review the targets when the Q1 update was undertaken next month. 

The Whole System Integrated Care (WSIC) dashboards linked provider data from four acute, two mental health and  ...  view the full minutes text for item 40.

The Board discussed this item as part of Agenda Item 5 - Hillingdon's Joint Health & Wellbeing Strategic Priorities, Dashboard and Progress Update.

Consideration was given to the Board Planner and future agenda items.

RESOLVED:  That the Board Planner be agreed.

Consideration was given to the confidential minutes of the meeting held on 18 March 2025.

RESOLVED: That the PART II minutes of the meeting held on 18 March 2025 be agreed as a correct record.

Consideration was given to the confidential report and it was agreed that further information be considered at the Board’s next meeting on 9 September 2025.

RESOLVED:  That the discussion be noted.

Consideration was given to issues at Mount Vernon Hospital.

RESOLVED:  That the discussion be noted.