Agenda item

Mr Sean Bidewell, Joint Borough Director at North West London Integrated Care Board (NWL ICB), noted that the report tracked Hillingdon’s progress against five priorities with a particular focus on live well, age well and early intervention.  Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that it was intended that the report considered at the next Board meeting would include updates on the metrics.  Mr Keith Spencer, the Co-Chair and Managing Director at Hillingdon Health and Care Partners, noted that partners now had a better understanding of the metrics with targets like ‘no criteria to reside’ being included in the New Hospital Programme (NHP).  Dr Alan McGlennan, Chief Medical Officer at The Hillingdon Hospitals NHS Foundation Trust, advised that the work being undertaken by partners had aligned with the development plans for the new hospital and had contributed towards about 60% of the documents that had fed into the NHP.  The only thing that had been missing had been what it meant to residents.  Partners were clear about what they were trying to do but residents were not clear about public health, what hubs provided or how services would be delivered.  This needed to be explained to residents and they needed to be advised of the part that they were required to play in keeping themselves healthy. 

It was suggested that there needed to be a focus on the application of the transformation work (as if it hadn’t happened).  For example, what was the impact of the intervention, had it stopped people from going to see a GP, etc.  It was clear that more work was needed to improve residents’ health literacy and explain and simplify the terminology and options alongside the transformation work.  Residents would often receive multiple notifications which could make it difficult to navigate the system. 

The challenges being faced in Hillingdon included the implementation of sustainable improvements, the growth in health conditions and winter pressures.  The work already undertaken had shown early signs of improvement in the flow and all three integrated neighbourhoods were fully operational.  A business case would be developed to satisfy a number of masters by the end of March 2026 for the neighbourhood hubs, which had been attracting a lot of local and political interest.  Although Hillingdon had been selected to participate in the national neighbourhood programme, this did not come with any associated funding so consideration was being given to how this would be funded. 

The outcomes in relation to hypertension had been strong with more than 70% of blood pressures (BPs) being under control (which was one of the best performances in London).  It was noted that a Boroughwide campaign was being developed in relation to hypertension which would run from February 2026 on the back of the British Heart Foundation’s Heart Month and would link into the pan-London Healthy Hearts Scheme.  Consideration needed to be given to what happened after individuals’ BP had been taken as it was not just about numbers.  GPs wanted to know residents’ results when they took their own BP even if the results were positive.  About one third of people who had their BP taken would need an onward referral and information needed to be available and handed out in relation to self care / self management and small changes that could be made to one’s lifestyle.  It would also be useful to encourage those who were able to, to monitor their own BP at home, as well as provide them with information about the risk factors and when it would be appropriate to go to a clinician.  It was noted that BP monitors were freely available for residents to use in libraries across the Borough so they did not need to buy their own machine if they could not afford one. 

A single Integrated Neighbourhood Team (INT) delivery team had been put together to deliver the live well and age well priorities in the community.  Frailty case management had also been progressing well, resulting in a 36% reduction in emergency admissions amongst the 350 high risk residents.  The frailty work would be fully expanded by April 2026.

The Primary Care Network (PCN) had been delivering services and the Pharmacy First initiative had proved to be very successful, providing an access route to support minor illnesses.  Further work would be needed in relation to dental access and strengthening mental health integration.

Partners had a clear and joined up view of the challenges and how to address them and exciting work had been planned in relation to rehabilitation and reablement. A number of reactive care schemes had been developed to strengthen the urgent and crisis response in the community and bring everything together.  The Council had started to deliver patients straight from the hospital front door to the reablement services.  However, improvements were needed to ensure that the therapies that were needed were available in the community.  The next steps would need the integration of teams into the discharge processes. 

It was hoped that the coordination hub would be launched in December 2025.  A six-month mobile diagnostics pilot had started and plans were afoot to increase capacity at the Lighthouse mental health service from six to ten.  At Hillingdon Hospital, work had been undertaken on the discharge pathway for those patients with ‘no criteria to reside’, putting the right escalation processes in place to help at times of pressure, reducing to 35 in the first three weeks.  Delayed discharges had been sustained at 34 per day, the Best Start In Life had been initiated to reduce inequalities and new dashboards for children and young people’s services were due to be launched next year with links to Early Years and Family Hubs. 

It was clear that, rather than building upon existing services, partners needed to simplify the processes and make them more linear and easier to understand.  It was agreed that partners needed to have a conversation about transformation capacity, capability and execution, particularly in light of the changes at the ICB.

RESOLVED:  That:

1.    the Board notes progress, endorses continued focus on preventative and urgent care priorities, and supports actions required to sustain flow and improve outcomes for children and families; and

2.    partners have a conversation about transformation capacity, capability and execution.