Health & Wellbeing Board

Minutes HEALTH AND WELLBEING BOARD 9 September 2025 Meeting held at Committee Room 5 - Civic Centre Board Members Present: Councillor Jane Palmer (Co-Chair), Keith Spencer (Co-Chair), Councillor Susan O'Brien (Vice-Chair), Professor Ian Goodman, Sean Bidewell, Amanda Carey- McDermott, Vanessa Odlin, Derval Russell, Shikha Sharma, Sandra Taylor and Lesley Watts Officers Present: Gary Collier (Health and Social Care Integration Manager), Gavin Fernandez (Assistant Director, Immediate Response Service) and Nikki O'Halloran (Democratic, Civic and Ceremonial Manager) 46. APOLOGIES FOR ABSENCE (Agenda Item 1) Apologies for absence had been received from Mr Tony Zaman. 47. DECLARATIONS OF INTEREST IN MATTERS COMING BEFORE THIS MEETING (Agenda Item 2) There were no declarations of interest in matters coming before this meeting. 48. TO APPROVE THE MINUTES OF THE MEETING ON 10 JUNE 2025 (Agenda Item 3) RESOLVED: That the minutes of the meeting held on 18 March 2025 be agreed as a correct record. 49. TO CONFIRM THAT THE ITEMS OF BUSINESS MARKED PART I WILL BE CONSIDERED IN PUBLIC AND THAT THE ITEMS MARKED PART II WILL BE CONSIDERED IN PRIVATE (Agenda Item 4) It was confirmed that Agenda Items 5 to 8 would be considered in public and Agenda Items 9 to 12 would be considered in private. 50. INTEGRATED HEALTH AND WELLBEING PERFORMANCE REPORT AND SERVICE UPDATE (Agenda Item 5) Mr Sean Bidewell, Joint Borough Director at North West London Integrated Care Board, advised that the report provided an update on the progress against the Health and Wellbeing Board’s key priorities and consolidated the latest developments across three core areas: 1. Health and Wellbeing Board metrics; 2. Integrated Neighbourhood Teams (INT) – three collocated multi -agency INTs would be established with three core functions: same day urgent primary care through three Neighbourhood Super Hubs, proactive care ; and a p reventative and anticipatory care programme; and 3. Reactive Care Programme – to prevent unnecessary non -elective episodes for patients with complex needs and to promote rapid recovery and prompt discharge after acute inpatient stay, a new Urgent Response Se rvice and a new Active Recovery Service would be implemented. In response to growing health needs, inequalities and system pressures, five strategic priorities had been established to strengthen prevention, reduce unplanned care and target inequality at neighbourhood level: Start Well; Live Well; Age Well; Healthy Places; and Equity and Inclusion. Delivery in the first two years would focus on Live Well, Age Well and Equity and Inclusion. Mr Bidewell advised that all three of the INTs were now live and 50% of the severe frailty cohort was being case managed, delivering a 36% reduction on non-elective admissions (the remaining 50% would be case managed by the end of April 2026). Hypertension prevalence recording had increased from 10% to 13.8% (with a target of 16% by March 2026), and 85% of diagnosed cases were under control. It was anticipated that the Reactive Care Coordination Hub would go live in December 2025 and there would be expanded capacity within the Lighthouse Mental Health Crisis model in the next four weeks. This had been made possible with additional funding from the Integrated Care Board (ICB) for additional staffing and a shift from a bedroom model to a mental health A&E model. It was recognised that someone in mental health crisis should not be presenting at the Emergency Department (ED) so the new model looked at promoting crisis alternative initiatives for “mental health only” issues. If someone with mental ill health presented at the ED, they needed to be walked through to the Lighthouse. It was suggested that this initiative needed to be widely publicised and information circulated through partners as well as in Hillingdon People. The report provided performance data against the target for each metric and the action being taken to remedy any shortcomings. Weekday hospital discharges had improved to an average of 55 per day (this had been 51 per day in June 2025) and, although weekend discharges had increased, improvements were still needed. A system taskforce and eight-week delivery plan had been put in place to reduce the number of patients with no criteria to reside during September / October 2025 (currently 46 against a target of 34). Conversations were being undertaken as it was not anticipated that this would improve unless radical action was taken. There were a number of challenges still being faced which included:  ED attendances remained significantly above target at 196 per day against a target of 164;  Urgent Treatment Centre activity was 189 per day against a target of 180; and  Estates and funding constraints risked delaying the Neighbourhood Super Hubs and full same day urgent care rollout. Insofar as diagnostics in care homes was concerned, discussions had been undertaken with an organisation that delivered mobile diagnostic solutions such as ultrasound and x-ray (including staffed solutions). Consideration needed to be given to the logistics for pathways from care homes to the Confederation Hillingdon CIC and a six-month pilot would be undertaken (it was hoped that the improvements would outweigh the cost). Whilst it was thought that the introduction of mobile diagnostics would help (and the technology was getting better and better), treatment escalation plans needed to be consistently in place for residents in care homes. Partners would be able to work with the care home staff forums and groups that were already in place. It was noted that there were around three hospital admissions from care homes each day so consideration would need to be given to what work needed to be undertaken with care homes to enable them to administer things like intravenous antibiotics (and whether this was something that carers could be trained to do). As around half of all London Ambulance Service (LAS) transfers came though NHS 111, and most of these were unnecessary, it was suggested that the ‘call before convey’ approach be more widely used. Partners had been proactive in taking action together before things became an issue as this would be the only way that the system could be managed effectively. Reactive care support needed to be taken forward to help Adult Social Care and residents to reduce hospital admissions and prevent people from going to the ED in an ambulance as they would be able to get better care at home. It was recognised that partners needed to be positive about developments but that they also needed to get better at implementing initiatives. To this end, consideration needed to be given to lessons learned and case studies so that partners did not try to reinvent flat tyres. Whilst the report set out the targets, it needed to show where Hillingdon was not meeting those targets (exception reporting). The report format would be developed to add deep dives and feedback from residents about specific initiatives. It should also show what had been learnt from past experiences and identify the barriers to progress. RESOLVED: That the discussion be noted. 51. COMMUNITY EQUIPMENT SERVICE UPDATE (Agenda Item 6) Mr Gary Collier, the Council’s Health and Social Integration Manager, advised that the community equipment service included hoists, beds, rails, etc. The report noted that the contracted provider had gone into liquidation so a new two year provider contract had been put in place with effect from 1 August 2025 (with the possibility of a one year extension). Due to the short implementation timescales, the services provided by the new contractor had initially been limited to concentrate on hospital discharge and repairs whilst capacity was built up. From this week, things would move to a business- as-usual position so that the number of prescribers could be built up over the remainder of the month. It was recognised that partners had worked hard to get the new contract in place quickly and in such a way that residents would not have been aware of the challenges being experienced. There were only a small number of companies that would have been able to fulfil the contract and the original contractor going into liquidation had affected other London boroughs who had not been as fortunate in getting a new provider in place so quickly. RESOLVED: That the report be noted. 52. PHARMACEUTICAL NEEDS ASSESSMENT (Agenda Item 7) Ms Shikha Sharma, the Council’s Public Health Consultant, advised that a new Pharmaceutical Needs Assessment (PNA) was required every three years and must link to other strategies such as the Health and Wellbeing Strategy. The PNA assessed the adequacy of pharmaceutical services in Hillingdon under five key themes and considered the Borough’s current and future needs over the next three years. The PNA had a dual purpose:  to provide the Health and Wellbeing Board with a framework for understanding the range and suitability of the local pharmaceutical services; in relation to the needs of the local populations; and  to support decision making process while considering application of new pharmacies. The document had been completed by following a four stage methodology: project planning and governance; research and analysis; PNA development; and consultation and final PNA production. The PNA was on track for publication by the 1 October 2025 deadline. Pharmacies in Hillingdon provided the following NHS England commissioned services:  Essential s ervices – including dispensing of medicines, Public Health, signposting and support for self care;  Advanced services – including Pharmacy First, flu vaccinations, contraception, and smoking cessation; and  Enhanced services – including Covid vaccinations and bank holiday opening. The Integrated Care Board commissioned end of life services through pharmacies and services that were commissioned locally by the local authority included sexual health and substance misuse services. For the purpose of the PNA, all essential services were considered necessary services. The advanced and enhanced services were considered relevant as they contributed towards the improvements in provision and access to pharmaceutical services. The current population of Hillingdon was 319,018 with a projected increase to 342,000 expected by 2031. Around 1,200 new dwellings were expected each year during the course of the PNA. Although deprivation was highest in the south of the Borough, there were pockets of deprivation in the north. There were 59 pharmacies contracted in Hillingdon, equating to 19 pharmacies per 100k population which was favourable compared to the England average of 17.7 (this figure was broken down further, showing that there were 20.1 in the north of the Borough and ≤18.9 per 100k population in the south). Although it had been found that 99.7% of residents lived within a five minute drive from a pharmacy, accessibility was more complex than that and conditions that people suffered from varied across the Borough. Progress had been made with regard to availability of preventative services like smoking cession but consideration needed to be given to how and which services were being provided from pharmacies. During the public consultation, 166 responses had been received, mainly commenting on things like the availability of medicines, location and the quality of services. 77% of respondents had stated that they were able to travel to a pharmacy in less than 15 minutes and 18% stated between 15 and 30 minutes. It was noted that pharmacy accessibility for residents in the Heathrow Villages had been incorporated into the feedback. It was noted that the community engagement work undertaken by partners in the Heathrow Villages linked to the gap in pharmacy provision in that area. As such, it was suggested that mention be made of this work in the PNA. Whilst it was acknowledged that there were parts of the Heathrow Villages that did not have a pharmacy (it was not recommended that residents drove the Heathrow airport to use their pharmacy), the Orchard and Village pharmacies provided services to the area. When looking at pharmaceutical services, consideration needed to be given to what needed to be done differently as a system – the “so what?” factor. Currently, half of the pharmacies in the Borough were open for 40 hours each week – it was questioned how this was deemed accessible and whether the service was really meeting the needs of residents (the needs of residents in Heathrow Villages did not seem to be being met). It was great that the basic essential services were being met but more could be done in relation to extended services. The report showed the difference between the north and south of the Borough in relation to things like the take up of the flu vaccination and contraception (with the most deprived areas having the least access to these services). As such. consideration needed to be given to how this could be improved. Pharmacies now provided more services than they ever had previously but thought was needed as to how they could be encouraged to do more in the future (for example, intravenous antibiotics). The care in the community work needed to be built upon and a communications strategy put together to publicise pharmaceutical services. It was suggested that the screens in GP waiting rooms be used to support this communication. RESOLVED: That it be noted that: 1. work on the 2025 PNA was on track for publication by 1 October 2025. 2. the Draft PNA had been signed off for consul tation in e arly June 2025 (a 60-day consultation was hosted on the Council website between 20 June and 19 August 2025). 3. two pieces of feedback had been received during the consultation period (one piece from a member of the public and one piece from a Boots branch), alongside feedback from: a. the Borough Lead Inequalities Pharmacist; b. the London Region Pharmaceutical Services Regulations Committee; and c. the Harmondsworth & Sipson Residents Association (following June’s Older People’s Assembly). 4. feedback was currently being reviewed and integrated accordingly into the draft PNA and included: a. changes to opening hours and trading names b. more detail on future housing developments within the localities c. further details on current and future provision, and any gaps d. the need to reiterate that many pharmacies who responded to the survey said they were willing to provide services if commissioned 5. authority be delegated to the Public Health and Business Intelligence teams, in consultation with the Co -Chairs, to make the amendments and sign off the document for publication by 1 October 2025. 6. the discussion be noted. 53. BOARD PLANNER & FUTURE AGENDA ITEMS (Agenda Item 8) Consideration was given to the Board Planner. It was noted that the Health and Wellbeing Board Strategy would be brought to the Board meeting on 2 December 2025 along with an update on the changes within the Integrated Care Board. A lot of work had been undertaken in relation to childhood obesity. As such, the Board would be provided with an update at the meeting on 2 December 2025. It was suggested that, as the issue had arisen during the meeting, consideration be given to holding a discussion about communication channels and maybe getting some feedback from residents on the effectiveness of partners’ communications. It was recognised that the world was changing, the Neighbourhoods needed to involve forums and that communications needed to be pushed out through the Neighbourhoods (which would each have their own approach based on the local population). This issue could be considered in March or June 2026. RESOLVED: That the Board Planner, as amended, be agreed. 54. TO APPROVE PART II MINUTES OF THE MEETING ON 10 JUNE 2025 (Agenda Item 9) RESOLVED: That the confidential minutes of the Health and Wellbeing Board meeting led on 10 June 2025 be agreed as a correct record. 55. THE 10 YEAR NHS PLAN: TOWARDS A NEW PLACE OPERATING MODEL FOR HILLINGDON (Agenda Item 10) Consideration was given to the confidential report. RESOLVED: That the report and discussion be noted. 56. HILLINGDON RESPONSE TO NWL INTEGRATOR SPECIFICATION (Agenda Item 11) This report was discussed as part of Agenda Item 10 - The 10 Year NHS Plan: Towards a New Place Operating Model for Hillingdon. 57. UPDATE ON CURRENT AND EMERGING ISSUES AND ANY OTHER BUSINESS THE CHAIRMAN CONSIDERS TO BE URGENT (Agenda Item 12) The Board discussed issues such as the Minor Injuries Unit and Hillingdon Hospital redevelopment and performance. RESOLVED: That the discussion be noted. The meeting, which commenced at 2.30 pm, closed at 4.21 pm. These are the minutes of the above meeting. For more information on any of the resolutions please contact Nikki O'Halloran on nohalloran@hillingdon.gov.uk. Circulation of these minutes is to Councillors, Officers, the Press and Members of the Public.

Hillingdon Health and Well-being Board Integrated Health and Wellbeing Performance Report and Service Update Report for Hillingdon Health and Well-being Board – 02nd December 2025 Health and Wellbeing Board Priorities Background and Overview 1. Purpose, Background and Overview This report provides the Health and Wellbeing Board with an overview of progress against its five strategic priorities and the major transformation programmes supporting them. It summarises delivery achievements, emerging performance trends, risks to outcomes, and the key areas where continued Board sponsorship is required. Hillingdon’s strategic priorities—Best Start in Life, Live Well, Age Well, Healthy Places, and Equity & Inclusion—are aligned with Core20PLUS5, NWL ICB priorities, and the Council’s policy framework. The first two years of delivery focus on Live Well, Age Well, and Equity & Inclusion, reflecting the scale of need, the opportunity to reduce inequalities, and the significant impact these priorities have on urgent and unplanned care. This update covers progress in three main areas: 1. Integrated Neighbourhood Teams (INTs) – delivering preventative, personalised care; early gains in hypertension control and frailty management; expansion of outreach and health checks. 2. Reactive Care Programme – strengthening urgent community response, improving flow, reducing “No Criteria to Reside” delays, and preparing for winter. 3. Best Start in Life – developing the Child Health Hub model, expanding school mental health support, and responding to high neurodevelopmental demand. The report sets out current performance, highlights improvements in preventative care and hospital flow, and identifies areas requiring further acceleration to meet ambitions for 2026. 2. Key Messages ü Emergency demand remains high. A&E attendances average 171/day, above the target of 164, meaning the system continues to operate under sustained pressure despite a reduction from last winter’s peak. ü There are early signs of improved hospital flow, driven primarily by the 27% reduction in “No Criteria to Reside” (NC2R) delays (48 → 35). These improvements help stabilise bed capacity, but performance remains fragile and highly sensitive to winter pressures. ü Neighbourhoods are now fully operational. All three INTs are live borough-wide, providing the foundation for proactive community care. ü Frailty management is reducing admissions. Around 50% of the severe frailty cohort is under enhanced case management, contributing to a 36% reduction in emergency admissions for these residents. ü Hypertension outcomes are strong. Recorded prevalence has risen to 13.8%, with 77% of known patients achieving blood pressure control—highest in NWL. ü Reactive Care model is maturing. The Coordination Hub launches December 2025, UCR now has daily Senior Clinical Decision Maker coverage, Lighthouse capacity has expanded to divert mental health demand from A&E and Mobile Diagnostics to Care Homes and People with Frailty has gone live ü Best Start in Life is progressing. Child Health Hub development is underway and school Mental Health Support Team (MHST) coverage is increasing from 60% to around 80%. ü Major challenges remain. The main cross-cutting risks are high A&E demand, sustaining NC2R improvements, growth in long-term conditions, CYP neurodevelopmental demand, and winter pressures. 3 Executive Summary 3. Executive Summary Hillingdon continues to make meaningful progress in delivering its Health and Wellbeing Strategy. Neighbourhood-based prevention, improved urgent community response, and stronger children’s mental health support are beginning to shift demand away from acute settings and improve outcomes for residents. However, system pressures remain significant and will require sustained collective focus through winter. • Neighbourhoods (Live Well & Age Well). All INTs are operational and delivering early impact. Frailty case management covers half of the cohort, reducing emergency admissions by 36% for those in scope. Hypertension case-finding has significantly expanded prevalence and 77% of patients now achieve blood pressure control. Next steps include full frailty coverage, expansion of anticipatory care, and integration with emerging Neighbourhood Local Access Hubs. • Reactive Care. Flow is improving, with NC2R reductions and expanded urgent community services including UCR, Senior Clinical Decision Makers, community IV antibiotics and direct GP-to-SDEC access. The Coordination Hub will simplify referral routes and strengthen rapid response. The key risk remains winter demand and sustaining 7-day discharge processes. • Best Start in Life. Work has commenced on a new Child Health Hub model aligned to the Family Hubs network. MHST expansion will extend support to ~80% of schools. Neurodevelopmental demand remains high, but additional funding will enable around half of the 2,000 waiting children to be assessed this year. The CYP dashboard will provide clearer oversight of outcomes and inequalities. • System Risks. The main cross-cutting risks are high A&E demand, workforce constraints, sustaining NC2R improvements, growth in long-term conditions, CYP neurodevelopmental demand, and winter pressures. Mitigations include continued development of community alternatives to hospital care, joint workforce planning, strengthened discharge pathways, expanded prevention and anticipatory care, targeted CYP investment, and activation of the winter resilience plan. • Investments: A number of targeted investments support delivery of the programme, including expansion of urgent community services, Lighthouse, neighbourhood prevention, and CYP backlog reduction. A full investment table is provided in Appendix 1 The Board is asked to note progress, endorse continued focus on preventative and urgent care priorities, and support actions required to sustain flow and improve outcomes for children and families. 4.1 Integrated Neighbourhood Teams: Purpose & Model Integrated Neighbourhood Teams (INTs) are the core delivery model for Hillingdon’s Live Well and Age Well priorities. Each Neighbourhood now brings together GPs, community services, social care, mental health and the voluntary sector into a single team focused on prevention, early intervention and personalised care. Neighbourhood working also aligns closely with Family Hubs and the Healthy Places agenda, ensuring joined-up support for families and communities. The model aims to keep residents healthier for longer, reduce avoidable hospital use, and ensure coordinated support for people with long-term conditions and frailty. INTs provide proactive case management, anticipatory care and integrated support planning across partners. Neighbourhoods (Live Well & Age Well) .4.2 Integrated Neighbourhood Delivery (Progress Update) • All INTs fully operational. Multidisciplinary teams are now active across all three localities, providing a consistent neighbourhood model for prevention and coordinated care. • Frailty case management progressing well. Around 50% of the severe frailty cohort (~1,000 residents) is now under enhanced case management, contributing to a 36% reduction in emergency admissions among these patients. Full coverage will be a key focus for 2026. • Hypertension and long-term conditions. A borough-wide case-finding drive has increased recorded hypertension prevalence to 13.8%, identifying thousands of residents previously not in care. 77% of known hypertension patients now have controlled blood pressure—one of the strongest performances in NWL. Work is underway to expand anticipatory care for COPD and diabetes. • Targeted outreach reducing inequalities. Community outreach in high-need areas is identifying significant undiagnosed risk and strengthening prevention, with rapid escalation to primary care and INT support. • NHS Health Checks. Approximately 350 high-risk residents have received proactive checks, improving early identification of cardiovascular risk factors. • Governance & infrastructure. A Neighbourhoods Steering Board now oversees delivery and alignment. Work has begun on the Integrated Neighbourhood Hub business case to co-locate primary care, community and voluntary services in Hayes, Ruislip and Uxbridge. 4.3 Primary Care, Pharmacy and Dentistry (See Appendix 1 and 2 for Key Metrics) • Primary Care Networks & Enhanced Services PCNs continue to deliver the NWL Enhanced Services Single Offer, strengthening prevention and long-term condition management in primary care. Shifts from hospital to community settings (e.g. anticoagulation monitoring) and strong performance in diabetes and mental health are contributing to more consistent care across practices. £6.78m annual funding is secured to 2028, enabling continued alignment between PCNs and INTs. • Pharmacy First Pharmacy First is now a major access route for minor illnesses (acute sore throat, uncomplicated UTIs, sinusitis and other minor infections). Between March–August 2025, 18,000+ consultations took place, including 3,000 referrals from NHS 111/GP/UTC. This has diverted low-acuity demand from GP practices and urgent care, supporting same-day access and relieving pressure on A&E. Ongoing Medicines Optimisation support ensures quality, safety and appropriate use of the service. • Dentistry (Access Expansion and Prevention): Ø Expanded NHS capacity. Fourteen dental practices in high-need areas have increased appointment availability, improving access for residents who previously struggled to secure NHS dental care. Ø Children’s Oral Health Pilot. Focused on the most deprived areas, the pilot is improving access to exams and fluoride treatments for children under 16, linking closely with Family Hubs. Ø Inclusion Dental Pilot. Provides longer, trauma-informed dental appointments for vulnerable groups, including people in temporary or emergency accommodation. Ø 24/7 urgent dental care via NHS 111. Ensures residents with urgent dental needs can access appropriate care while avoiding unnecessary A&E attendance. 5 Neighbourhoods (Live Well & Age Well) Narrative / Likely Cause Actions to Remedy Timeline Accountability Good progress has been made in scaling up from 10% baseline to 13.8%. However the scaling is slower than required to meet the 16% target by March 26. In order to meet the trajectory, acceleration is needed in Pharmacy, General Practice and INT outreach with a borough campaign. Accelerated rollout from Q3 25/26 SRO Neighbourhoods Narrative / Likely Cause Actions to Remedy Timeline Accountability Good progress has been made towards achieving the 80% controlled blood pressure target, driven by strong primary care management. Although performance is improving, it remains just below the target, and as prevalence increases this level of optimisation will need continued focus to ensure we reach and sustain 80% Strengthen and standardise optimisation approaches across all practices, including 24- hour BP monitoring and pharmacist-led medication reviews. Reinforce call-and-recall systems to ensure regular follow-up for patients with uncontrolled or borderline readings Ongoing SRO Neighbourhoods Narrative / Likely Cause Actions to Remedy Timeline Accountability Hillingdon have one of the best outcomes within NWL. Case management is effective. Launch of WSIC frailty radar to support case finding and management of frail patients Sustain INT scaling and expand anticipatory care. Full coverage by Apr 26 SRO Neighbourhoods Narrative / Likely Cause Actions to Remedy Timeline Accountability Meeting the quarterly target and yearly average is almost on target. Which shows the early impact of the frailty programme. Currently supporting 50% case management to patients with severe frailty. Full rollout to 100% severe frailty cohort. By April 2026 SRO Neighbourhoods Narrative / Likely Cause Actions to Remedy Timeline Accountability The 10 week average is currently at 211 attendances per day with an October average of 220. Revised delivery plan incorporating stronger front door diversion & capacity improvement. Phased Rollout from Q3 25/26 SRO Neighbourhoods 4.4 Neighbourhood Performance Metrics Neighbourhoods (Live Well & Age Well) 4.5 Key Issues & Risks (Neighbourhoods) Despite strong early progress, several risks could limit the scale and consistency of neighbourhood impact: Workforce Capacity & Capability Scaling preventative and proactive care depends on sufficient clinical and non-clinical workforce. Gaps remain in key roles (geriatricians, pharmacists, therapists, care coordinators). Without continued recruitment and skills development, INTs may struggle to expand frailty coverage, maintain quality, or keep pace with rising long-term condition demand. Variation in INT Maturity Not all INTs are operating at the same level of integration, shared processes or MDT coordination. This creates inconsistent resident experience and uneven delivery of prevention and anticipatory care. The Neighbourhoods Steering Board is addressing this through standardised operating models and planned investment in co-located Neighbourhood Hubs. Rising Demand Driven by Demographics & Long-Term Conditions The ageing population and increasing prevalence of long-term conditions continue to drive demand. As frailty case-finding expands towards 100% coverage, INT caseloads will grow substantially. Without matched capacity, there is a risk that proactive care becomes diluted, reducing its impact on avoidable admissions. Inequalities Across Localities Health outcomes vary significantly across Hillingdon, with areas such as Hayes & Harlington experiencing poorer health, lower life expectancy and higher prevalence of long-term conditions. Neighbourhood improvements may not reach these communities at the same pace unless metrics are monitored with an equity lens (e.g., frailty coverage, hypertension control, Health Checks). Targeted outreach and tailored interventions will be essential to avoid widening gaps. 4.6 Forward Plan (to March 2026) Over the next two quarters, the Neighbourhoods programme will focus on consolidating early progress and expanding delivery to ensure consistent, preventative care across all localities: Expand Frailty and Anticipatory Care Coverage • Continue scaling frailty case management towards full coverage by April 2026, ensuring remaining high-risk residents have an identified care coordinator and shared care plan. • Use the new WSIC frailty dashboard (launching early 2026) to identify gaps and monitor outcomes such as admissions, falls and MDT follow-up. • Broaden anticipatory care beyond hypertension to include COPD, diabetes, falls prevention and multimorbidity, prioritising residents at moderate risk. Implement the Hillingdon Hypertension Strategy • Finalise and adopt the borough-wide Hypertension Strategy (due December 2025) to sustain progress on prevalence, intensify outreach in high-inequality areas, and support movement towards the 16% prevalence target. • Strengthen annual prevention campaigns (e.g., Know Your Numbers) and extend them into wider long-term condition awareness and early detection. Neighbourhoods (Live Well & Age Well) 4.6 Forward Plan (to March 2026) By March 2026, we aim to have a consistent neighbourhood operating model across all localities, with full frailty coverage, expanded anticipatory care and clearer outcome dashboards to track impact and inequalities. Specifically: Strengthen Mental Health Integration • Ensure each INT has a named mental health practitioner by Q4, improving early support for anxiety, depression and emerging cognitive issues. • Enhance links between INTs, primary care and community mental health teams to reduce escalation to crisis pathways and improve access to brief interventions in neighbourhood settings. Introduce Neighbourhood Performance Dashboards • Develop and implement INT-level performance dashboards to provide near real-time insight into activity, outcomes, inequalities and variation between localities. • Align with the emerging Children & Young People dashboard, enabling whole-life-course neighbourhood monitoring and supporting targeted resource allocation. Progress Neighbourhood Estates (Hubs) • Continue development of the Integrated Neighbourhood Hub business case, with decisions on the proposed “Super Hub” anticipated by March 2026. • Use learning from the North Hillingdon Health Hub (launching November 2025) as the prototype for future hub design, co-location opportunities and community engagement. These actions aim to strengthen the consistency and impact of neighbourhood delivery, embed proactive and preventative care, and support the long-term ambition to reduce avoidable hospital use and improve outcomes across Hillingdon’s communities. 5.1 Reactive Care Purpose & Model The Reactive Care Programme strengthens urgent and crisis response in the community so that residents receive the right care, at the right time, in the right place, while reducing avoidable hospital use and supporting timely discharge. It brings together urgent community response, crisis support, and discharge pathways into a single, coordinated model with a simplified referral route via the new Coordination Hub. The programme has three core aims: • Rapid Urgent Community Response (UCR): Deliver fast, community-based interventions that stabilise health and social care crises and prevent avoidable A&E attendances or admissions. • Timely and Safe Discharge: Improve discharge planning and post-discharge support, ensuring residents who no longer meet criteria to reside (NC2R) leave hospital promptly and safely. • Bridging Preventative and Reactive Care: Strengthen the link between preventative care (INTs) and crisis response—ensuring early deterioration is managed proactively and repeat emergency use is reduced. The intended outcome is a joined-up reactive care system that reduces avoidable ED attendances, shortens hospital stays, improves the resident experience and strengthens resilience through winter. Reactive Care (Urgent & Crisis Response, Hospital Discharge) 5.2 Components of Reactive Care 1. Reactive Care Coordination Hub (Phase 1 – Dec 2025) The Coordination Hub will act as the single point of access for urgent community referrals, enabling rapid triage and directing residents to the right service (UCR, crisis social care, mental health, therapy, reablement or discharge support). Phase 2 in early 2026 will expand the Hub’s remit to include proactive case management and end-of-life coordination. This will provide a simpler, more reliable route for GPs, London Ambulance Service and other referrers. 2. Urgent Community Response (UCR) & Senior Clinical Decision Makers UCR provides a 2-hour response for urgent health and social care crises at home. Embedding Senior Clinical Decision Makers (SCDMs) from 8am–8pm seven days a week has strengthened decision-making for complex cases, enabling more people to be safely managed at home. Additional UCR staff capacity is being recruited for early 2026. This model reduces avoidable conveyance to ED and supports short- term stabilisation in the community. 3. Community IV Antibiotics Since July 2025, 6–8 daily doses of IV antibiotics have been delivered in homes and community settings for conditions requiring intravenous treatment but not hospitalisation. This prevents unnecessary bed days and enables earlier discharge when clinically appropriate. 4. GP-to-SDEC Pathways GPs can now refer suitable patients directly to Same Day Emergency Care (SDEC), bypassing the Emergency Department. This pathway ensures faster specialist review and avoids standard ED attendance for conditions that can be managed on the same day. For reactive care, this offers a reliable diversion route for patients who do not require full admission. 5. Mobile Diagnostics (X-ray) A mobile X-ray pilot is providing diagnostics for housebound and frail residents, preventing the need for hospital radiology attendance. Early activity shows good uptake, and evaluation will determine the case for scaling the model. This strengthens both urgent response and INT-based case management. 6. Lighthouse Mental Health Crisis Service The Lighthouse service provides an alternative to ED for residents experiencing mental health crisis. A new operating model went live in November 2025, increasing capacity from 4 to 6 patients at a time, with a further expansion to 10 patients planned following review. Lighthouse reduces psychiatric demand in ED and provides a calmer therapeutic setting with rapid access to follow-on support. 7. Discharge Pathways & NC2R Reduction A joint NHS–Local Authority NC2R Reduction Plan has introduced daily multi-agency ward reviews, weekly Gold Command oversight, revised standard operating procedures and strengthened discharge pathways. This has contributed to a reduction in NC2R from 48 to 35, improving flow and freeing bed capacity. Further work continues to operationalise changes and sustain progress made to date 9 Reactive Care (Urgent & Crisis Response, Hospital Discharge) Narrative / Likely Cause Actions to Remedy Timeline Accountability 10 week average is currently 171 per day with an October average of 170, seeing a month on month reduction from the winter peaks of 208 per day. Expansion of UCR is to be expanded along with the launch of the co- ordination hub, mobile diagnostics and the implementation of the new Lighthouse diversion from Oct 25. Phased Rollout from Q3 25/26 SRO Reactive Care Narrative / Likely Cause Actions to Remedy Timeline Accountability NC2R is an avg of 43 in month, with a 10 week avg of 45 (11 above the target). Drivers include: Discharge bottlenecks particularly P2, referral process delays across all Pathways, Family choice Delays. 8 week delivery plan has been developed and went live on the 13th October. Since the beginning of November we have seen averages of 35 per day compared to 43 during October Choice policy live Nov 25, 8 Week Delivery Plan Sept - Oct SRO Reactive Care Narrative / Likely Cause Actions to Remedy Timeline Accountability Overall we are meeting the discharge delay targets for P1 and P3 patients. But not meeting the target for P2 patients. Bottlenecks especially in the time to place P2 patients, with referral process delays across all pathways (D2A, District Nursing, Family Choice delays, Capacity constraints) and longer than expected LOS in community led services. 8 week Delivery Plan has been developed and went live on the 13th October. Integrated Bridging care and therapy D2A P1 services in place by December 2025 Phased Rollout from Q3 25/26 SRO Reactive Care Narrative / Likely Cause Actions to Remedy Timeline Accountability Variable Care Home capability in managing pts who have behaviours that challenge and also recognising signs of deterioration. Not all CHs have routine Pharmacy input to ensure pts at highest risk have a medication review. Specialist dementia support from CNWL now available to support CH with pts who have behaviours that challenge, PCN pharmacies being trained to undertake SMRs for most complex frail pts in CHs. CH being digitally enabled so they can access UCPs. Phased Rollout from Q3 25/26 SRO Reactive Care 5.3 Reactive Care Performance Metrics Reactive Care (Urgent & Crisis Response, Hospital Discharge) 5.4 Issues & Risks (Reactive Care) • Winter Pressures & ED Demand High A&E attendances continue to place pressure on flow and reactive services. Winter surges may reverse recent gains unless community capacity and same-day alternatives remain consistently available. • Workforce Fragility UCR, therapy, discharge teams and Lighthouse all rely on skilled staff. Any gaps—particularly in SCDMs, therapists or assessors—risk slower response times and reduced community capacity. • Variation in Discharge Processes The system remains over-reliant on senior escalation rather than routine operational practice, leaving performance vulnerable as we move into winter. Interim senior leadership for the Integrated Discharge Team and a rapid multi-agency redesign of the discharge operating model to be implemented to ensure the improvements made to date can be stabilised, embedded and sustained through winter and beyond. • Scaling New Models Mobile diagnostics, community IV and the Coordination Hub are early in implementation. Their full impact will depend on adoption by referrers, reliable staffing and integration across INTs and acute services. 5.5 Forward Plan (to March 2026) Over the coming months, the Reactive Care programme will focus on fully mobilising new services, strengthening discharge pathways and expanding community alternatives to hospital. Key actions include: 1. Full Mobilisation of the Coordination Hub (Dec 2025) • Phase 1 of the Coordination Hub will go live in December, providing single-call access for urgent community referrals (8am–8pm, 7 days a week). • The Hub will coordinate UCR, crisis response and discharge support in real time, simplifying access for GPs, LAS and hospital teams. • Planning for Phase 2 (early 2026) will include frailty pathways, end-of-life rapid response and mental health integration, moving towards a future 24/7 model. • A performance update (e.g., call volumes, referral patterns, ED diversions) will be reported back to the Board once the Hub has been operational for several months. 2. Lighthouse Mental Health Crisis Expansion • Following the December service review, capacity will increase to 10 patients at any time to divert more people in mental health crisis away from A&E. • CNWL will provide additional staffing and any required environmental adjustments. • The expected impact includes fewer psychiatric breaches in ED and faster access to therapeutic support, with outcome data reported to the Board in Q4. Reactive Care (Urgent & Crisis Response, Hospital Discharge) 5.5 Forward Plan (to March 2026) 3. Launch of an Integrated Rehabilitation & Reablement Service • Phase 1 goes live in early December, combining Council reablement workers and NHS community therapists into a single multidisciplinary team. • This integrated model will support faster discharge for Pathway 1 and 2 patients, ensuring seamless personal care and rehabilitation at home. • Work through Q4 will refine the operating model, governance and weekend capacity, with the aim of enabling consistent 7-day discharges. • Further expansion (including community rehab beds) will be explored to address Pathway 2 delays. 4. Sustain NC2R ≤34: • Work aggressively to sustain NC2R (medically fit) inpatients at or below 34 per day through winter and beyond. This involves Interim IDT Leadership, operationalising the daily multi-agency discharge huddles, weekly system reviews, Place Gold Command, reviewing functioning of IDT, and escalating any issue early. • By end of Q4, the aim is that Hillingdon will have a new baseline for delays significantly lower than the pre-plan baseline (e.g., ~30 instead of 48). • Achieving this may also require commissioning of any additional step-down beds or use of spot-purchase home care if needed during winter. • The Board’s oversight in keeping this a priority will help maintain cross-partner focus 5. Expand UCR Capacity and Link to Virtual Wards • Additional UCR staffing from January 2026 will increase 2-hour response capacity and support a strengthened Hospital at Home function for up to 17 days of community-based care. • The model will be increasingly aligned with Virtual Ward pathways—particularly frailty and heart failure—creating community “virtual beds” managed jointly by UCR and INTs. • By March 2026, the Coordination Hub should begin triaging appropriate patients directly into these virtual ward slots. These actions will strengthen community-based urgent care during the winter period, support sustained reductions in NC2R delays, and reduce avoidable pressure on A&E and hospital beds. By Q4, the Board should expect to see improvements in patient flow, community recovery times and overall system resilience. 12 Best Start to Life (Children & Young People) 6.1 Purpose The Best Start in Life programme aims to ensure every child in Hillingdon has the foundations for a healthy, safe and positive start. The programme focuses on: • Early identification and intervention: Detecting developmental, health and wellbeing needs as early as possible (during pregnancy, infancy and early childhood) and providing timely support through the Healthy Child Programme and early years checks. • Integrated children’s services: Bringing together health, social care, education and voluntary services around the child and family, supported by Family Hubs and the emerging Child Health Hub model, enabling families to access multiple services in a coordinated way. • Preventing ill-health: Tackling risk factors early by promoting healthy weight, good oral health, high vaccination coverage and positive mental wellbeing to reduce future problems. • Reducing inequalities: Targeting support to the most vulnerable children and communities, particularly those facing deprivation or at higher risk of poor outcomes. This aligns with Core20PLUS5 priorities, which highlight immunisation, obesity, mental health, oral health and asthma as key focus areas. • Through these priorities, Hillingdon aims to improve early years outcomes such as school readiness, healthy weight in Reception and Year 6, and longer-term health and wellbeing across the life course. 6.2 Delivery Update Recent progress in the Best Start in Life program include: Child Health Hub Development A multi-agency group met in November 2025 to begin designing Child Health Hubs aligned with the neighbourhood model. These hubs will provide a single, integrated point of access for paediatric clinics, developmental assessments and family support linked to Family Hubs. Partners have agreed a joint strategy and will now define the hub model and identify a prototype site. Integrated Paediatric Clinics Integrated paediatric clinics delivered over 130 clinics in 2024/25, supporting more than 800 children. Clinics cover common conditions such as CMPA, constipation and neonatal issues. The delivery model provides consistent access to specialist advice for children under five and supports earlier identification of developmental needs. CYP Neighbourhood Dashboard Work is underway on a Children & Young People dashboard to provide a consolidated view of key metrics by neighbourhood, including immunisations, A&E attendances for under-fives, developmental checks, school readiness, oral health and obesity. The dashboard will support improved outcome monitoring, transparency and targeted action where inequalities persist. Full development and launch are expected in 2026. Mental Health Support Teams (MHSTs) Hillingdon has been selected for the Wave 14 expansion of MHSTs, which will extend provision to an estimated ~80% of schools from January 2026 (up from ~60%). MHSTs provide early support for children with mild-to-moderate mental health needs and play a vital role in reducing escalation into specialist CAMHS service 13 Best Start to Life (Children & Young People) 6.2 Delivery Update Family Hubs Integration Child Health Hub planning is being aligned with the Family Hub network to avoid duplication and ensure parents receive joined-up support. Family Hubs already provide parenting programmes, health visitor clinics and early years support. The work now focuses on linking new paediatric pathways to existing community assets for maximum reach. Neurodevelopmental Pathways Demand for neurodevelopmental assessment has increased significantly, and Hillingdon currently has just under 2,000 children awaiting assessment. Additional NWL investment for 2025/26 will enable around 50% of these children to be assessed. CNWL is redesigning pathways—using digital tools and streamlined clinical processes—to increase productivity and reduce waiting times. 6.3 Metrics & Performance (CYP Outcomes) Key outcome measures for Best Start in Life are being consolidated into the new Children & Young People (CYP) dashboard. Current headline metrics include: Neurodevelopmental Waiting Times • As of October 2025, ~1,980 children are waiting for a neurodevelopmental assessment. • Additional NWL investment is expected to halve the waiting list by mid-2026 (towards ~1,000). • A major aim is to reduce the maximum waiting time to under 12 months by year-end, monitored through monthly assessment activity and throughput. Mental Health Support Teams (MHSTs) in Schools • MHSTs currently cover ~60% of schools. • With the Wave 14 expansion starting January 2026, coverage is projected to reach ~80% of schools by Q4. • Performance will track: number of schools supported, pupils reached, and uptake of interventions (individual support, groups, workshops). Early Years Outcomes • Two priority indicators—school readiness and children’s oral health—show room for improvement and are central to Best Start priorities. • Data for school readiness, immunisations, dental access and oral health prevalence will be incorporated into the CYP dashboard. • The Children’s Oral Health pilot is expected to improve the % of under-5s attending a dentist annually, particularly in high-need areas. • Childhood obesity (Reception and Year 6) will be monitored as a key long-term prevention measure. Service Utilisation and Preventative Reach • The dashboard will monitor uptake of Health Visitor reviews (new birth visit, 2–2½ year checks), immunisation coverage (including MMR), and A&E attendances for under-5s. • These metrics provide insight into access, prevention, and parental support. • The intention is to introduce an overall Best Start RAG rating in future reports to show progress and highlight areas requiring targeted action 14 Best Start to Life (Children & Young People) 6.4 Forward Plan (up to March 2026) Upcoming priorities for Best Start in Life focus on strengthening early years services, improving children’s health outcomes and embedding integrated models of support across Hillingdon. • Launch CYP Dashboard: Finalise and roll out the Children & Young People Neighbourhood Dashboard by the next Board meeting. This will provide a baseline and regular reporting on key metrics (health and development indicators), enabling the Board to track progress in real time. It will also highlight any locality-based disparities so resources can be targeted accordingly. • Prototype Child Health Hub: By Q4 2025/26, aim to establish a prototype Child Health Hub in one locality. This could involve co-locating a few services (e.g. a paediatrician or paediatric nurse practitioner working alongside a Family Hub team on specific days). The learnings from this prototype will inform the wider rollout. The prototype will focus on integrative care for issues like asthma, obesity, and developmental concerns in a community setting, testing the hub model in practice. • Enhance Community Paediatrics & Support Services: Utilising recent investments: • Bring the new Special School Nursing post on board permanently (recruitment by early 2026) to support children with medical needs in special schools. • Deploy the Wave 14 MHST effectively in Jan 2026, ensuring it quickly engages with its allocated schools and starts caseloads (the goal is to start seeing students within weeks of launch, given existing demand). • Continue neurodevelopmental assessments through late 2025 and into 2026 to hit the target of 50% backlog reduction. By spring 2026, evaluate the outcome – e.g. how much the wait times have improved – and develop a sustainability plan for 2026/27. • Stronger Links with Family Hubs and Early Years: Formalise pathways between maternity/early years services and Family Hubs. For example, when health visitors identify families in need, ensure warm handovers to parenting support at Family Hubs, and vice versa. In Q3–Q4, a plan will be developed to integrate health visiting data and Family Hub outreach efforts so that no families “drop off” after initial contacts. Also, tie the oral health and nutrition initiatives into the Family Hub network for broader reach. By having health, education, and social care speak with one voice in Family Hubs, the support for families (especially in the crucial 0-5 age range) will be more comprehensive. • Upcoming Initiatives: Hillingdon is preparing for Wave 15+ of MHST (to eventually reach 100% schools), and exploring participation in any new national pilots (e.g. early language development programs). Additionally, discussions are underway about improving transitions for young people (e.g. moving from children to adult mental health services, or preparing those with long-term conditions for adult care). Plans to strengthen transition support by 17-18 years old will be considered as part of the “Start Well” to “Live Well” continuum. The Board will be updated on these in subsequent reports. 15 Cross-Cutting System Risks & Mitigations 7.1 Cross-Cutting System Risks and Mitigations This section summarizes system-wide risks that span multiple programmes (Neighbourhoods, Reactive Care, Best Start) and their mitigation strategies: High ED Attendances: Emergency Department visits remain above target, risking overcrowding and missed performance standards. • Impact: Strains hospital resources, increases wait times, and could lead to poorer outcomes if patients aren’t seen timely. • Likelihood: High, given underlying demand and winter season. • Mitigation: Strengthen alternatives to ED – e.g. Front Door Diversion strategies such as GP direct-to-SDEC pathways and Pharmacy First referrals to handle minor cases. The UCR 2-hour crisis response and Lighthouse mental health diversion reduce unnecessary A&E arrivals. Continued public messaging to use 111 and community services for non-critical needs (including 24/7 urgent dental care via 111) also supports this. The new Coordination Hub will play a role by directing referrers to appropriate community options, further easing ED burden. NC2R (No Criteria to Reside) Relapses: After intensive effort, NC2R (delayed discharges) numbers have dropped to ~35, but could rise again without sustained focus. • Impact: High – rising NC2R leads to bed shortages, and ED backups (when wards are full). • Likelihood: Moderate; risk increases if winter capacity is strained or if processes slip. • Mitigation: Embed the discharge improvement measures as business-as-usual: daily multi-agency discharge huddles, a and strict escalation according to the NC2R SOP. The Place “Gold” command structure will continue oversight through winter to quickly resolve blockages. In addition, new community capacity (through integrated reablement and bridging care) coming online in Dec 2025 will help absorb more discharges promptly. Maintaining NC2R ≤34 is a key success criterion, and any upward trend will trigger a rapid response by the system resilience group Workforce Constraints: Across the system, recruiting and retaining skilled staff is a concern. • Impact: If key roles are unfilled (e.g. community nurses, care coordinators, GPs, therapists, psychologists), it hampers service delivery and innovation uptake. Burnout is also a risk with the current pressures. • Likelihood: High in certain areas (national shortages in nursing, therapy, social care). • Mitigation: A multifaceted approach – targeted recruitment drives (for example, NWL has funded 4 additional specialist nurses for palliative care to fill critical gaps), cross-skilling existing staff (training pharmacists and paramedics to take on expanded roles in UCR and care homes). The integration of teams also offers opportunity to better utilise the collective workforce – e.g., having PCN pharmacists assist with care home medication reviews, or mental health practitioners working within INTs, to spread expertise. 16 Cross-Cutting System Risks & Mitigations Long-Term Condition Growth: The population is experiencing growing prevalence of chronic conditions (diabetes, heart disease, COPD, etc.), which could drive future unplanned care demand. • Impact: Medium to long-term – without action, more people will present in crisis with preventable complications (strokes, heart attacks, decompensated COPD). • Likelihood: High, given demographic and national trends. • Mitigation: Prevention and early intervention are our main tools. The Neighbourhoods programme directly addresses this through hypertension and frailty initiatives (already showing success in reducing admissions), and the NWL Enhanced Services focus on Cardiovascular-Renal-Metabolic diseases will further help manage risk factors in primary care. Continued investment in wellness services (smoking cessation, weight management) and community engagement in healthy lifestyles (leveraging Healthy Places and Equity work) is crucial. Essentially, mitigating this risk means continuing the “left shift” of care – moving care into community and preventative settings – which is exactly the strategy of Live Well and Age Well interventions. CYP Neurodevelopmental Demand: The surge in demand for children’s assessments (autism/ADHD) remains a risk. • Impact: High for those families – long waits can worsen child outcomes and parental confidence in the system. Also impacts schools managing unmet needs. • Likelihood: Currently very high (referrals quadrupled nationally). • Mitigation: The immediate mitigation is the additional funding to cut the backlog by 50%, which is being executed now. For sustained mitigation, the pathway redesign with digital tools is key to increase throughput with existing resources. Also, exploring early support for children with possible neurodevelopmental issues before diagnosis (so needs are met without waiting for formal diagnosis) can reduce urgency – for example, parenting programs or school adjustments available based on need. The ICB and CNWL will monitor if referral rates continue at the new high; if so, they may need to commission additional permanent capacity or partner with independent providers to keep waits within acceptable limits. Winter Pressures: The winter period (Q3–Q4) brings heightened risk of simultaneous demand surges – flu, COVID-19, norovirus, and weather-related illness among frail elderly. • Impact: Could spike both community and acute demand beyond planned levels, testing all services. • Likelihood: High from Dec through Feb. • Mitigation: A comprehensive Winter Plan is in place. This includes: expanding vaccination uptake (flu and COVID campaigns) to reduce illness incidence; ensuring full use of intermediate care beds and possibly opening contingency beds; the Reactive Care Hub coordinating closely with London Ambulance Service for any surge (e.g. redirecting appropriate 999 calls to UCR); weekend working expansions (the End of Life care investment provided for weekend specialist cover, which can help manage palliative patients who might otherwise call 999); and emergency respite schemes via social care for times of extreme cold or workforce shortages. Additionally, the ED front-door in-reach by community teams is being strengthened (e.g. a community matron or palliative nurse in ED to pull patients out to community care faster). These combined actions are designed to mitigate the worst impacts of winter. The Board should note that if an exceptionally severe winter occurs, regional resources may be called upon as well. 17 Appendices 18 Appendix 1: Investments Summary Investment Area New Funding / Initiatives (2025/26) Expected Outcomes and Impact Urgent Community Response & “Hospital at Home” Additional recurrent funding for UCR expansion. Launch of a new Hospital at Home model (from Jan 2026) supporting patients for up to 17 days after urgent crisis ➤ Increased UCR capacity to reach patients within 2h and manage more cases at home (avoiding A&E/admissions). ➤ Hospital at Home will provide acute-level care in domiciliary settings for 3–17 days, reducing length of hospital stay and readmissions. “Lighthouse” Mental Health Crisis Hub Service model enhancement behind A&E – capacity raised from 4 to 6 patients (Nov 2025), with further expansion to 8–10 patients from 17 Dec 2025 ➤ More mental health patients diverted from A&E to a therapeutic setting, cutting A&E waits and crowding. ➤ Patients in crisis receive timely specialist care, improving outcomes and experience. MHST in Schools (Wave 14) Funding and approval for an additional MHST team in Hillingdon starting Jan 2026 (previous coverage ~60% of schools). ➤ Expanded mental health support in schools to ~80% coverage, allowing earlier help for children with mild/moderate issues. ➤ Expected reduction in severe cases over time and reduced CAMHS waiting lists due to early intervention. Children’s Neurodevelopmental Assessments Non-recurrent funding in Oct 2025 to tackle backlog – will cover ~50% of ~2,000 waiting children. Plus pathway redesign (digital tools) by CNWL to improve efficiency. ➤ ~1,000 extra children assessed in 2025/26, halving the waiting list and significantly shortening wait times (many from 2 years to <1 year). ➤ Modernised assessment process (e.g. some virtual elements) enabling sustained higher throughput and a more manageable service going forward. SEND – Special School Nursing Recurrent funding for 1 additional special school nurse post (bank staff in place as of Oct 2025 while permanent hire is made). ➤ Improved medical support in special schools – lower caseload per nurse, allowing more timely interventions for children with complex needs. ➤ Enhanced training and capacity in schools, potentially reducing emergency incidents and supporting inclusion. Community Dental Services (Access & Prevention) Expanded NHS Dental Capacity: Commissioned 14 practices in high-need areas for extra appointments. Children’s Oral Health Pilot: Launched Oct 2025 in Family Hub areas. Inclusion Dental Pilot: New service for vulnerable groups (homeless, refugees). 24/7 Urgent Dental Access: via NHS 111 for emergencies. ➤ More routine dental slots for residents in underserved communities, reducing waiting times for NHS dental care. ➤ Improved oral health in children: increased dental attendance among under-16s in pilot areas, early prevention of tooth decay. ➤ Dental care for vulnerable individuals leading to fewer dental issues escalating to A&E or acute pain situations. ➤ 24/7 urgent access ensures emergencies get prompt treatment and reassure patients to avoid A&E for dental needs. End of Life Care (Community) £1.7 million recurrent investment into community specialist palliative care and hospice support. Includes hiring 4 additional specialist nurses, funding extra Hospice@Home capacity, weekend coverage, and developing ED in-reach model. ➤ Expanded palliative care team to support patients at home, aiming to prevent unnecessary end-of-life hospital admissions and to honour patient preferences. ➤ Sustainability of local Hospice services ensured, preserving this critical resource for the community. ➤ 7-day service coverage in palliative care, meaning symptom crises can be managed out-of-hours, and potential to support patients in A&E so they can be discharged to home or hospice sooner. 19 Appendix 2: Neighbourhoods (Live Well & Age Well) Continuity Audit • Date of extraction: 01/09/2025 • As of Month 6, 2 PCNs demonstrate to be meeting the 2% metric target. • As of Month 5, 3 PCNs have achieved all bar 1 of the performance metrics for Diabetes L1. • 5 PCNs have met the performance metrics for the NDH service – excellent performance so far for 25/26. Enhanced service for diabetes 3.4 Neighbourhood Performance Metrics – PCN Enhanced Service Delivery 20 Appendix 3: Neighbourhoods (Live Well & Age Well) 3419 2975 2973 2832 2980 2861Hillingdon Mar Apr May Jun Jul Aug0 2000 4000 Pharmacy first consultations March- August 2025 Pharmacy first referrals April- September 2025 861 675 625 573 516 429 275 267 276 245 335 334 73 77 150 274 410 304 248 178 290 201 163 132 160 128 107 95 121 115 42 20 31 39 23 25 17 26 15 22 22 28 Acute Sore Throat Uncomplicated UTI Infected Insect Bites Sinusitis Acute Otitis Media Impetigo Shingles Mar Apr May Jun Jul Aug0 200 400 600 800 1000 1200 1400 1600 1800 Seven clinical conditions breakdown March- August 2025 34 70 63 68 65 68 58 49 37 83 40 50 467 342 338 359 346 420 37 19 21 13 17 16 Urgent Medicine Supply Clinical Pathways Consultation Minor Illness Referal Referrals from THH Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 0 100 200 300 400 500 600 700 The data shows that in a 6mth period over 18,000 Pharmacy 1st consultations took place, with over 3,000 referrals taking place (17% conversion rate). The majority of which were for minor illness. The most common condition is Acute sore throat, followed by uncomplicated UTI then Sinusitis 3.4 Neighbourhood Performance Metrics – Pharmacy First Delivery (first 6 months of 2025/26)

Health and Wellbeing Board report 2 December 2025 DRAFT JOINT HEALTH AND WELLBEING STRATEGY, 2026 - 2031 Relevant Board Member(s) Keith Spencer – Co-chair/Managing Director, Hillingdon Health and Care Partners Sandra Taylor – Corporate Director, Adult Social Care and Health Organisation London Borough of Hillingdon Report author Sharon Stoltz – Adult Social Care and Health Directorate, LBH Gary Collier - Adult Social Care and Health Directorate, LBH Keith Spencer – Hillingdon Health and Care Partners Papers with report Appendix 1 – Draft Joint Health and Wellbeing Strategy, 2026 - 2031 HEADLINE INFORMATION Summary This report presents the draft Joint Health & Wellbeing Strategy 2026–2031 for review and approval for public engagement. The strategy has been developed by Hillingdon Health and Care Partnership (HHCP) on behalf of the Health and Wellbeing Board and reflects extensive input from system partners. Contribution to plans and strategies The Health and Wellbeing Strategy is the overarching strategy that sets out partner ambitions to support the health and wellbeing needs of the Hillingdon Place. Financial Cost There are no direct cost implications from this report. Ward(s) affected All RECOMMENDATION That the Health and Wellbeing Board approves the draft Joint Health and Wellbeing Strategy for public and stakeholder engagement. BACKGROUND 1. The Board has a statutory duty under the Health and Social Care Act, 2012 to produce a Joint Health & Wellbeing Strategy. This draft attached as Appendix 1 is intended to replace the 2022 – 2025 Health and Wellbeing Strategy and represents the first fully integrated, life-course strategy for Hillingdon and aligns local ambitions with the North West London Integrated Care Strategy and the Hillingdon Place Operating Model. 2. The strategy responds to rising demand, widening inequalities and the requirements associated with the new Hillingdon Hospital. It is also the primary document for borough- wide resident and stakeholder engagement. Health and Wellbeing Board report 2 December 2025 Summary of the Strategy 3. The strategy sets a shared vision for a fairer, healthier, more integrated Hillingdon and is structured around the four life-course outcomes:  Best Start in Life  Live Well  Age Well  Healthy Places 4. Each life-course section sets out a small number of priorities; clear outcome measures and the actions partners will take collectively. Seven high-impact programmes are identified, including neighbourhood proactive care, hypertension detection, mental health early intervention, frailty and falls, and reducing No Criteria to Reside. 5. Delivery is underpinned by Hillingdon’s Place Operating Model, centred on:  Three Integrated Neighbourhood Teams, supported by Local Access Hubs  Family Hubs  A Borough-wide Reactive Care Service  The new Hillingdon Hospital, linked seamlessly into community provision Engagement 6. This draft will form the basis of the public and partner engagement process, running January–February 2026. Engagement will be delivered through neighbourhood workshops, Family Hubs, community groups, online tools and targeted outreach in areas with the greatest inequalities. A plain-English version and translated summaries will be produced. Health and Wellbeing Board report 2 December 2025 Appendix 1. Hillingdon Joint Health and Wellbeing Strategy 2026–2031 Executive Summary Hillingdon’s Joint Health and Wellbeing Strategy sets out our shared ambition to improve health, reduce inequalities and support all residents to live well from childhood through to older age. It has been developed by Hillingdon Health and Care Partnership (HHCP) on behalf of the Health and Wellbeing Board, bringing together the Council, the NHS, Primary Care, Family Hubs, the voluntary and community sector and wider partners. Hillingdon faces significant and growing challenges. Demand for urgent and emergency care is rising, mental health (MH) needs have increased, long-term conditions are more common, and too many residents experience poor health earlier in life. Inequalities are particularly concentrated in parts of Hayes, Yiewsley and West Drayton, where outcomes are consistently worse across childhood development, long-term conditions, and economic resilience. At the same time, the delivery of the new Hillingdon Hospital requires sustained improvement in discharge, a reduction in avoidable admissions, and a shift towards more proactive and preventative care delivered in the community. To meet these challenges, partners in Hillingdon have agreed a shared vision: to create a fairer, healthier borough where people of all ages can live well, stay well and age well. The strategy is structured around the life course—Best Start in Life, Live Well, Age Well and Healthy Places—reflecting our ambition to focus on prevention and early intervention at every stage. Within each life-course stage we identify a small number of priorities, the outcomes we aim to achieve, and the actions partners will take together. These priorities have been chosen because they will have the biggest impact on improving outcomes, reducing inequalities and supporting the sustainability of the new hospital. Delivering this strategy requires services to be organised differently. Hillingdon’s Place Operating Model sets out how partners will work together to deliver care through:  Three Integrated Neighbourhood Teams (INTs) aligned to primary care and supported by Local Access Hubs providing urgent, planned, community and diagnostic care closer to home.  Family Hubs delivering integrated early years, parenting, SEND and CYP mental health support aligned to neighbourhoods.  A Borough-wide Reactive Care Service providing urgent community response, Hospital at Home, integrated discharge and mobile diagnostics.  A new Hillingdon Hospital, delivering modern acute and specialist services linked seamlessly to community-based care. This integrated neighbourhood model will enable earlier intervention, reduce avoidable hospital attendances and admissions, shorten length of stay, support safe discharge and strengthen independence and wellbeing in the community. This draft strategy is also being used as the primary vehicle for engagement with residents, service users, carers and voluntary and community partners. Their insights will help shape the final version of the strategy before approval by the Health and Wellbeing Board. Health and Wellbeing Board report 2 December 2025 What success will look like By 2031 we will see:  More children achieving a good level of development and improved school readiness  Reduced inequalities in early childhood outcomes, immunisation, obesity, dental health and long-term conditions.  Earlier detection and better management of hypertension, diabetes and frailty  Improved emotional wellbeing and mental health support for children, young people and adults.  Fewer avoidable emergency attendances and unplanned admissions to hospital  Faster, safer discharge and sustained performance on “No Criteria to Reside”  More older adults supported to remain independent at home  Stronger neighbourhoods, improved housing stability and reduced homelessness  A clearer, more consistent experience of joined-up local services Next Steps Feedback from residents, partners and elected members will shape the final strategy. Their feedback will directly inform the final priorities, delivery plans and outcomes framework. A detailed Place Delivery Plan and outcomes framework will be developed to support implementation, with oversight from the Health and Wellbeing Board and HHCP. 1. Introduction and Purpose The Health and Wellbeing Board has a statutory responsibility to produce a Joint Health and Wellbeing Strategy for Hillingdon. This strategy sets the overarching framework for improving health and wellbeing across the borough between 2026 and 2031. It has been developed by Hillingdon Health and Care Partnership (HHCP), the borough’s Place-Based Partnership within the North West London Integrated Care System. HHCP brings together the Council, NHS organisations, Primary Care Networks, Family Hubs, the voluntary and community sector, schools, housing and wider local partners to plan and deliver integrated care. The strategy aligns with the North West London Integrated Care Strategy and reflects the shared priorities of partners across Hillingdon. This document is intentionally published in draft form to act as the primary vehicle for engagement with residents, service users, carers, community organisations and frontline staff. Over the coming months, we will use this draft to test our priorities, assess whether the proposed outcomes reflect local experiences, and gather feedback on the Place Operating Model and the changes it proposes. Engagement will take place through neighbourhood-based workshops, Family Hubs, community organisations, online surveys and targeted outreach in areas experiencing the greatest inequalities. To support broad and inclusive participation, a plain English and accessible version will also be produced, along with a shorter public-facing summary for wider engagement. Translated versions of the public summary will be available in the most commonly spoken community languages in Hillingdon to ensure meaningful participation from residents whose first language is not English. Feedback gathered through this engagement programme will directly shape the final Joint Health and Wellbeing Strategy. The refined strategy, together with a summary of consultation Health and Wellbeing Board report 2 December 2025 findings, will be presented to the Health and Wellbeing Board for approval in March 2026. A full Equality Impact Assessment (EQIA) will be undertaken alongside the consultation process and completed before the final strategy is presented for approval. The strategy is structured around a clear life-course framework—Best Start in Life, Live Well, Age Well and Healthy Places—reflecting our shared ambition to focus on prevention, intervene early and address inequalities at every stage of life. It begins with our vision, an assessment of population needs and the case for change, before setting out the key outcomes and priorities for each life-course stage. The strategy then describes how these outcomes will be delivered through Hillingdon’s Place Operating Model, including Integrated Neighbourhood Teams, Local Access Hubs, Family Hubs and the Borough-wide Reactive Care Service, supported by enabling work on workforce, digital, estates, data and community partnerships. Finally, the strategy outlines the financial framework, governance arrangements and performance approach that will support delivery and provide accountability through the Health and Wellbeing Board. 2. Strategic Vision Our shared vision is: By 2031, residents in Hillingdon will live healthy, happy lives connected to their communities and be enabled to reach their full potential. This vision is underpinned by three core ambitions: 1. A Fairer Hillingdon – where the gap in health outcomes between our most and least advantaged communities is narrowed, and where those facing the greatest barriers receive the greatest support. 2. A Preventative Hillingdon – where we focus on early help, prevention and proactive care, delaying or avoiding the need for hospital and long-term care wherever possible. 3. An Integrated Hillingdon – where services are organised around people and communities rather than organisational boundaries, and care is coordinated through integrated neighbourhood teams and family hubs. 3. Hillingdon – Place and People Hillingdon is the second largest London borough by area, spanning around 42 square miles. It includes a mix of suburban, urban and semi-rural environments, with significant transport infrastructure and Heathrow Airport in the south, and more affluent suburbs to the north of the A40. The borough is home to:  Diverse communities, with around half of residents from Black, Asian or minority ethnic backgrounds.  Pockets of significant deprivation in the south of the borough (Hayes, Yiewsley, West Drayton, Harefield) alongside more affluent areas in the north.  A growing population of older adults, with rising frailty and care needs.  A younger population in parts of Hayes and West Drayton, with higher birth rates, child poverty and housing pressures. Understanding this diversity – by locality, ward, neighbourhood and population group using Health and Wellbeing Board report 2 December 2025 population health management tools – is central to this strategy. The Place Operating Model and Integrated Neighbourhood Teams are intentionally structured to align with this geography. 4. Population Needs and Case for Change 4.1 Rising Long-Term Conditions and Complexity Nearly 48% of adults in Hillingdon now live with one or more long-term conditions (LTCs), such as hypertension, diabetes, obesity, chronic respiratory disease, anxiety and depression. The number of people living with multiple LTCs has doubled since 2017. LTCs are more common and more severe in our most deprived communities, contributing to earlier onset of illness and shorter healthy life expectancy. A small cohort of approximately 4,400 adults (around 1.6% of the adult population) account for 50% of all non-elective episodes at The Hillingdon Hospital. These are often people with multiple LTCs, frailty, mental health issues and complex social needs. Figure 1: Patients with Long Term Conditions 4.2 Inequalities and Wider Determinants The Core20PLUS5 framework and the NWL Shared Needs Assessment highlight that:  Child poverty, overcrowding, homelessness and food insecurity are concentrated in parts of Hayes, Yiewsley, and West Drayton.  Respiratory conditions, income, employment and education deprivation are key drivers of inequality in Harefield.  These same areas see higher rates of diabetes, hypertension, asthma, obesity and mental health need  Air pollution and environmental factors, particularly around Heathrow, contribute to respiratory and cardiovascular risk  People from South Asian and Black communities are disproportionately affected by certain conditions, including diabetes and hypertension Health and Wellbeing Board report 2 December 2025 The strategy therefore emphasises action in these neighbourhoods and for these groups, aligning with the “Core20” and “PLUS” elements of Core20PLUS5. Figure 2: Hillingdon by IMD Decile 4.3 Children and Young People Children and families face multiple, interlinked challenges:  Higher rates of child poverty and overcrowding in the south of the borough  Variation in outcomes such as school readiness, childhood obesity and oral health  Asthma as a leading cause of unplanned paediatric admissions  Growing demand for support with emotional wellbeing, mental health and neurodevelopmental needs  Increased complexity of Special Educational Needs and Disabilities (SEND) Without earlier and more integrated support, these challenges persist into adulthood and drive long-term demand on health, care, education and criminal justice systems. 4.4 Ageing and Frailty The population aged 65+ and 80+ is projected to grow significantly by 2031. Older residents account for a disproportionate share of healthcare and social care use, particularly unplanned hospital care and long-term care home placements. Frailty, falls, dementia and social isolation are key drivers of hospital admissions, delayed discharges, and demand for long-term care. Many older residents could remain independent for longer with earlier identification and tailored support delivered in neighbourhoods. Health and Wellbeing Board report 2 December 2025 4.5 Fragmented Services and Workforce Pressures Historic commissioning has created a “patchwork quilt” of around 170 separate service lines across health and care. Services often operate with different referral routes, hours and criteria, making navigation difficult and contributing to duplication and gaps. At the same time, Hillingdon has an ageing primary care and community nursing workforce, shortages in key roles, difficulties with recruitment and retention, and limited flexibility in how staff are deployed across organisational boundaries. 4.6 New Hillingdon Hospital Redevelopment The new hospital offers a major opportunity but comes with clear assumptions:  Reduced reliance on inpatient beds  Shorter length of stay  Fewer avoidable admissions  Lower ED attendances and sustained improvements in flow Without a fundamental shift in how care is delivered at Place and neighbourhood level, these assumptions will not be met, and the system will not be sustainable. 4.7 Why We Must Change These factors create a compelling case for change:  To improve outcomes and quality of life  To reduce inequalities  To ensure financial and operational sustainability  To enable the successful delivery of the new hospital model This strategy, and the new Place Operating Model, set out our collective response. 5. Our Strategic Framework: Principles and Approach Six principles shape this strategy and our new Place Operating Model. 5.1 Equity and Inclusion We will use population health management (PHM) and the Core20PLUS5 framework to focus resources where they are needed most, including:  The most deprived neighbourhoods: Hayes, Yiewsley, West Drayton and Harefield  Marginalised groups (e.g. people with severe mental illness, people experiencing homelessness, some migrant communities, people with multiple disadvantage)  People with particular clinical risks (e.g. hypertension, respiratory disease, cancer, perinatal mental health) We will work actively with communities to understand barriers to access and co-design solutions. Health and Wellbeing Board report 2 December 2025 5.2 Community Co-production and Voice Residents, carers and communities will be involved in shaping services through:  Co-produced service redesign within neighbourhoods  Patient and carer forums linked to each Integrated Neighbourhood  Engagement via Family Hubs, schools, VCSE organisations and community groups  Collaboration with Healthwatch Hillingdon We will prioritise the voice of seldom-heard groups and those with lived experience of inequality and disadvantage. 5.3 Life-Course Approach We will structure our work across four outcomes:  Best Start in Life – supporting pregnancy, early years, childhood and youth  Live Well – supporting adults of working age  Age Well – supporting older adults and those approaching the end of life  Healthy Places – addressing the physical and social environments that shape health This ensures continuity of support over time and coordinated action across sectors. 5.4 Prevention and Early Intervention We will move from reactive to proactive models of care by:  Investing in early years and Family Hubs  Using population data to identify people at rising risk  Providing anticipatory and proactive support for frailty and long-term conditions  Strengthening mental health early intervention and community support  Preventing crises that result in emergency admissions or long-term care placement 5.5 Integrated Neighbourhood Delivery Care in Hillingdon will be organised around three Integrated Neighbourhoods, each served by a co-located Integrated Neighbourhood Team (INT) and supported by a Local Access Hub providing proactive, multidisciplinary urgent, planned, community and diagnostic services closer to home. The three Hillingdon Neighbourhoods are:  North: covering Ruislip, Northwood, Harefield and Ickenham  South West: covering Uxbridge, Yiewsley and West Drayton  South East: covering Hayes and Harlington Together, these Neighbourhoods will form the foundation of our population-based model of care, enabling earlier intervention, improved access and more integrated support across local communities. Each INT will bring together:  GPs and primary care teams  Community nursing  Adult social care  Community mental health services Health and Wellbeing Board report 2 December 2025  Allied health professionals and therapies  Mobile diagnostic teams  Selected acute outpatient services  Voluntary and community sector partners  Family Hubs, paediatrics and children’s services (through strong operational links) 5.6 Shared Leadership, Accountability and Resources We will:  Develop integrated leadership for INTs and the Reactive Care Service  Progress pooled budgets and shared risk arrangements where appropriate (e.g. through Section 75 agreements)  Establish a clear Place governance architecture with the HWB at its apex  Use shared data, dashboards and outcomes frameworks to identify, risk stratify and monitor progress 6. Delivering Outcomes Across the Life Course Improving outcomes requires a coordinated, prevention-focused approach across the life course. By organising care through our Integrated Neighbourhood Teams (INTs) incorporating Local Access Hubs, Family Hubs and the Borough-wide Reactive Care Service, we will improve health, independence and wellbeing for all residents. The following priorities set out the key actions and measurable improvements we will deliver. 6.1 Best Start in Life 6.1.1 Early Years (0–5) Ambition: Children are born healthy, families are well supported, and early development lays strong foundations for lifelong health and wellbeing. Family Hubs provide the central early years offer & work in close partnership with INTs, ensuring that families—particularly those with higher or more complex needs receive seamless, coordinated support from pregnancy through early years. Priority BSIL1: Improve maternal health and reduce maternity inequalities Why this matters: Maternal health and smoking in pregnancy are major determinants of lifelong outcomes, with clear inequalities across neighbourhoods. Actions: 1. Provide targeted and culturally tailored maternity support in the most deprived neighbourhoods. 2. Strengthen smoking cessation in pregnancy via opt-out referral and neighbourhood-based support. 3. Improve access to antenatal education, healthy pregnancy pathways and early postnatal support. Delivery Measures:  Reduce Smoking at time of delivery (SATOD) to ≤3% (Hillingdon Baseline: 3.3-3.4%) Health and Wellbeing Board report 2 December 2025  Reduce neighbourhood variation in stillbirth and neonatal mortality by 20% by 2030. (Hillingdon Baseline 3.9 per 1,000)  Increase personalised maternity pathway access for Black, Asian and deprived women. (Core20PLUS5)  Increase the % of infants totally or partially breastfed at 6-8 weeks (target tbc) Priority BSIL2: Increase childhood immunisation coverage Why this matters: Vaccination saves lives and protects against avoidable childhood illness; uptake remains below the 95% WHO standard in some neighbourhoods. Actions: 1. Strengthen call/recall and outreach through INTs and primary care 2. Target communities with lower uptake, particularly in Hayes, Yiewsley and West Drayton 3. Expand vaccination delivery in community venues and Family Hubs. Delivery Measures:  Increase routine vaccination coverage from 89% to ≥95% by age 5 in every neighbourhood by 2027  Reduce variation between neighbourhoods to within ±2% by 2027 Priority BSIL3: Improve early child development and school readiness Why this matters: Early development predicts lifelong health, wellbeing and educational attainment; clear developmental gaps exist between disadvantaged and other children. Actions: 1. Expand speech, language and communication (SLC) support in all neighbourhoods. 2. Strengthen HV–early years–INT links to identify needs earlier. 3. Increase access to high-quality early education, especially for disadvantaged 2-year-olds. 4. Improve parental engagement through Family Hubs and schools. Delivery Measures:  Increase the proportion of Children achieving a Good Level of Development (GLD) above the current baseline of 70% and increase GLD for disadvantaged children above 51.9%. by 2030  Reduce the 19 percentage point GLD inequality gap for disadvantaged children by 20% by 2030.  Establish a Borough wide baseline for uptake of funded early education places and Increase uptake of 2-year-old funded places by 10pp by 2030. 6.1.2 School Age (5–16) Ambition: Children and young people are healthy, resilient and engaged in education. Young and young adult carers are identified and supported. Health and Wellbeing Board report 2 December 2025 Priority SA1: Improve emotional wellbeing and mental health Why this matters: Emotional wellbeing underpins attendance, behaviour, attainment and safeguarding. Actions: 1. Expand school-based mental health support, including Mental Health Support Teams (MHSTs) and early intervention practitioners working through schools and Family Hubs. 2. Strengthen joint working between schools, CAMHS, educational psychology and INTs for earlier identification and support 3. Deliver community-based resilience and wellbeing programmes in high-need neighbourhoods. 4. Work with education providers to identify young and young adult carers and sign-post to appropriate support. Delivery Measures:  Increase MHST and school based mental health support coverage from 44% → 60% by 2027.  Reduce % of pupils reporting anxiety/behavioural difficulties by 10% in targeted schools by 2028  Reduce MH-linked persistent absence by 5percentage points by 2028. Priority SA2: Strengthen school attendance and engagement Why this matters: Attendance is the strongest predictor of attainment, safeguarding risk and long-term outcomes. Actions: 1. Strengthen multi-agency attendance pathways (schools, Early Help, youth, social care). 2. Target intensive support at persistently/severely absent pupils. 3. Improve health–education pathways for pupils with LTHC, anxiety or neurodiversity. Delivery Measures:  Reduce persistent absence by 3pp by 2028. Hillingdon Baseline above the national rate (21.2%)  Reduce fixed-term exclusions in highest-need schools by 20% by 2030 (following establishment of a baseline in 2025/26).  Increase Early Help engagement for persistently absent pupils by 25% by 2030. (following establishment of a baseline in 2025/26) Priority SA3: Reduce childhood obesity and improve physical activity Why this matters: Obesity at 11 predicts adult health outcomes; rates are highest in deprived neighbourhoods. Actions: 1. Expand active travel, after-school sport and community programmes. 2. Strengthen school- and community-based healthy eating programmes. 3. Integrate school nursing, INTs and early years services to support earlier intervention. Health and Wellbeing Board report 2 December 2025 Delivery Measures:  Reduce proportion of Year 6 who are overweight/obese from 38.3% → 34% by 2030.  Increase physical activity (5–16-year-olds) from 43.5% → 50% by 2030.  Increase uptake of targeted healthy-eating programmes in high need neighbourhoods by 20% by 2030 following establishment of a baseline in 2025/26 6.1.3 Children and Young People’s Mental Health & SEND (0–25) Priority CM1: Expand early intervention and community mental health support Why this matters: Demand continues to rise; early support prevents crisis and improves educational engagement. Actions: 1. Expand neighbourhood-based CYP mental health support through schools, Family Hubs and VCSE partners by 2027 2. Embed CYP MH practitioners within INTs by 2027 3. Strengthen joint CAMHS–school–Early Help early intervention pathway by 2026 Delivery Measures:  Increase proportion of young people accessing early intervention support (baseline to be established 2025/26).  Reduce CYP crisis presentations and emergency referrals by 10% by 2030.  Expand MHST and community MH community coverage from 44% to 60% by 2027.  Increase health input into Education, Health and Care Plan (EHCP) annual reviews by 25% by 2030. Priority CM2: Strengthen neurodevelopmental (ND) pathways Why this matters: Demand for ASD/ADHD support is high; families report long waits and fragmented support. Actions: 1. Develop a coordinated ND pathway across paediatrics, CAMHS, schools and Family Hubs. 2. Provide early pre-diagnostic support. 3. Improve transition from assessment to education and support plans. Delivery Measures:  Reduce ND assessment waiting times (baseline to be established 2025/26) by 2027  Increase proportion of children receiving early pre-diagnostic support by 20% by 2030 (baseline to be established 2025/26)  Reduce exclusions for CYP with ND needs by 20% by 2030.  Reduce the number of CYP with ND needs not in education, employment or training (NEET) by 20% by 2030. Priority CM3: Improve support to families and joint SEND planning Why this matters: Parents-Carers report difficulty navigating services; strong early support Health and Wellbeing Board report 2 December 2025 prevents escalation. Actions: 1. Expand Family Hub and VCSE parent-carer support. 2. Strengthen joint commissioning and planning across education, health and care. 3. Improve SEND navigation pathways for information access, assessment and support Delivery Measures:  Increase parent-carer satisfaction/participation in SEND and early help pathways by 20% by 2030. (Baseline to be established)  Improve EHCP timeliness to ≥60% within 20 weeks by 2030.  Reduce repeat specialist referrals by 15% by 2030 through stronger early support. (Baseline to be established 2025/26) 6.2 Live Well Ambition: Adults in Hillingdon are supported to live healthier lives, manage long-term conditions, maintain independence and stay emotionally well. Integrated Neighbourhood Teams (INTs) are the key vehicle for delivering this ambition, bringing together primary care, community health, mental health, social care, the voluntary sector and public health to provide proactive, personalised and community-based support. Adult carers are identified, listened to and supported. Priority LW1: Earlier detection and management of long-term conditions & rising-risk frailty Why this matters: LTCs and early frailty are major drivers of preventable admissions. Adults aged 45–70 with multimorbidity, obesity, hypertension, diabetes or early frailty indicators are at the greatest risk of deterioration. INTs provide the local platform for early identification, proactive case management and coordinated support. Actions: 1. Use PHM and INT Multi-disciplinary Team (MDTs) meetings to identify rising-risk adults. 2. Deliver neighbourhood hypertension/Cardiovascular disease (CVD) programmes. 3. Increase NHS Health Checks and targeted screening. 4. Strengthen diabetes and lifestyle change support. 5. 40% of carers (2021 census baseline) are registered on the carers’ register by 2030. 6. Increase proportion of adult carers saying they have as much social contact as they like from 2025/26 baseline. Delivery Measures:  Increase hypertension prevalence capture 13.8% → 16% by 2026, towards 24% by 2028.  Maintain BP control in ≥85% of diagnosed cases by 2028  Provide proactive case management to 5,000 rising-risk adults by 2027.  Reduce CVD NEL admissions by 30% by 2030. Priority LW2: Improve mental wellbeing through neighbourhood support Why this matters: Mental health needs are rising, with increasing levels of anxiety, depression Health and Wellbeing Board report 2 December 2025 and isolation. Hillingdon experiences high crisis presentations and unplanned mental-health bed days. Earlier, neighbourhood-based support prevents escalation and reduces pressure on acute service. Actions: 1. Embed MH practitioners in all INTs. 2. Expand talking therapies, social prescribing and wellbeing support. 3. Increase community programmes to reduce loneliness and isolation. Delivery Measures:  Increase talking-therapy access to ≥25% by 2027.  Reduce MH crisis presentations by 10% by 2030.  Reduce unplanned MH bed days by 10% by 2030. Priority LW3: Reduce health-harming behaviours Why this matters: Smoking, inactivity, obesity and poor diet are major contributors to long-term conditions and health inequalities. Tackling these behaviours is essential to reducing preventable illness and emergency demand. Actions: 1. Deliver targeted smoking cessation, weight management and physical activity programmes via INTs. 2. Strengthen nutrition, cooking and healthy-eating support in schools, Family Hubs and community settings. 3. Embed lifestyle interventions within proactive care and long-term condition pathways. Delivery Measures:  Reduce adult smoking prevalence from 11.8% → 9% by 2030.  Reduce adult obesity 26.3% → 23% by 2030.  Increase physically active adults 55.8% → 62% by 2030.  Increase by 20% identified adults on the PCN CRM register lifestyle improvement with completion of holistic assessment, including 6 pillars of lifestyle medicine by 2028. 6.3 Age Well Ambition: Older adults in Hillingdon are supported to live independently, safely and with dignity for as long as possible. INTs and the Reactive Care Service are the primary vehicles for delivering this ambition, enabling proactive frailty care, urgent community response, safe discharge, integrated rehabilitation and coordinated end-of-life support. Priority AW1: Proactive frailty care and rapid support Why this matters: Frailty is a major driver of avoidable admissions, ED attendance & long-term care. Early Neighbourhood proactive support reduces deterioration & helps people stay independent. Health and Wellbeing Board report 2 December 2025 Actions: 1. Identify and stratify people with severe frailty using the Frailty Index/PHM and INT MDTs. 2. Deliver proactive personalised care plans with wrap around care to all severely frail people (~5,000). 3. Implement NWL Frailty Pathway 4. Expand UCR and mobile diagnostics to provide same day alternatives to ED 5. Use the Reactive Care Co-ordination Hub as the single referral point for urgent community support 6. Implement and scale Hospital at Home to provide acute level care in familiar surroundings Delivery Measures:  100% of people with severe frailty to have a personalised care plan by 2027.  Reduce ED attendances to 164/day by 2026  Reduce frailty NEL admissions by 10% by 2028.  90% of appropriate UCR referrals seen within 2 hours by 2026.  Implement Hospital at Home by 2026 and scaled to ≥10 patients/day by 2027.  Maintain rate of people 65 + permanently admitted to care homes per 100,000 at 2025/26 baseline. Priority AW2: Improve falls, rehabilitation, reablement and discharge Why this matters: Falls, deconditioning and delayed discharge are key drivers of avoidable harm for older adults. Strengthening Home First, delivering 7-day integrated reablement/rehabilitation and reducing NC2R are essential to maintaining independence, reducing long-term care need and enabling the new Hillingdon Hospital model to function safely Actions: 1. Merge falls services into a single strengthened offer with a clear delineated pathway. 2. Deliver 7-day integrated reablement and rehabilitation with expanded capacity. 3. Implement the Place ‘No Criteria to Reside (NC2R)’ Improvement Plan to reduce discharge delays. 4. Redesign IDT with clear escalation and decision-making. Delivery Measures:  Reduce falls related non elective admissions by 10% by 2030.  ≥65% P0/P1 same/next-day discharge by 2026.  Sustain NC2R at ≤34 throughout 2026 and beyond.  ≥85% patients discharged from hospital to reablement who remain in the community within 12 weeks of discharge. Priority AW3: Improve care home, dementia and end-of-life support Why this matters: Care Home Residents, people with dementia and those nearing end of life have complex needs. Good neighbourhood-based support improves outcomes and aligns care with people’s wishes. Actions: 1. Strengthen INT-led care home support with GP, therapy and pharmacy input. 2. Deploy UCR and rapid mobile diagnostics into care homes. Health and Wellbeing Board report 2 December 2025 3. Increase dementia diagnosis and post-diagnostic support. 4. Review care home capacity including the balance between commissioned and directly provided services. 5. Implement Palliative Integrated Care Service (PICS) across Hillingdon. Delivery Measures:  Reduce avoidable care home admissions by 10% by 2030.  Increase dementia diagnosis to ≥66.7% by 2027.  Increase post-diagnostic support by 20% by 2028.  Increase deaths in usual place of residence by 10% by 2030.  Reduce length of stay at Hillingdon Hospital for patients at the end of their life to below the NWL average by 2026 6.4 Healthy Places Ambition: Places and communities support healthier, more connected lives. Priority HP1: Improve housing stability and reduce homelessness Why this matters: Housing insecurity and temporary accommodation undermine mental and physical health, disrupt education, and increase demand on services. Actions: 1. Strengthen joint Housing–INT–Family Hub early identification. 2. Improve pathways for people facing homelessness, including hospital discharge. 3. Target enforcement/support for unsafe private rented homes. Delivery Measures:  Reduce households in temporary accommodation by 10% by 2028. Baseline 1,700 households Priority HP2: Create safer, healthier neighbourhoods Why this matters: Safety and the physical environment influence wellbeing, confidence, activity levels and community cohesion. Actions: 1. Strengthen the joint working between the Health and Wellbeing Board and the Safer Hillingdon Partnership. 2. Develop a Health in All Policies approach to embedding health and wellbeing concerns into council plans and strategies. Delivery Measures:  Cross representation between the Health and Wellbeing Board and the Safer Hillingdon Partnership.  Development of a Health in All Policies framework to be adopted by all partners. Health and Wellbeing Board report 2 December 2025 Priority HP3: Reduce social isolation and improve community connection Why this matters: Loneliness is strongly associated with poor mental and physical health and increased use of urgent and emergency care. Actions: 1. Support community-led connection programmes. 2. Use INTs and Family Hubs to connect residents into local groups. 3. Expand digital/social inclusion support for older adults and vulnerable groups. Delivery Measures:  Reduce the proportion of Adults reporting loneliness from ~24% → 20% by 2030.Baseline: 23-25% (ONS/PHOF indicators). 7. High-Impact Priorities Given finite resources and the scale of challenge, Hillingdon will prioritise a small number of programmes that can deliver the greatest improvement in population health, reduce inequalities and relieve system pressure. These priorities have been selected because they:  affect large population groups  address the biggest drivers of avoidable hospital use  have strong evidence of impact  support the delivery model for the new Hillingdon Hospital  align directly with our neighbourhood model, Family Hubs, and the Reactive Care Service  have measurable baselines and clear outcomes Together, these programmes will drive the most significant improvements across the life course. 1. Proactive and Preventative Neighbourhood Care Identifying and supporting rising-risk adults before frailty develops, intervening early to prevent deterioration and avoid escalation. Delivered through INTs using PHM, risk stratification, proactive case management, early long- term condition support and targeted outreach. Examples of impact: reduced crisis activity; fewer avoidable admissions; reduced progression to moderate/severe frailty. 2. Hypertension and Cardiovascular Risk Management The highest-impact component of neighbourhood prevention. A focused programme to improve detection, diagnosis and control of hypertension and cardiovascular risk — the largest preventable drivers of stroke, heart disease and unplanned bed days. Examples of impact: hypertension detection ↑; blood pressure control ≥85%; reduced CVD admissions. Health and Wellbeing Board report 2 December 2025 3. Mental Health Early Intervention Preventing escalation, crisis presentations and avoidable hospital use by strengthening early support for children, young people and adults. Delivered through schools, Family Hubs, INTs and community mental health services. Examples of impact: improved access to early help; reduced crisis and ED presentations; improved resilience. 4. Frailty, Falls and Community Support for Older Adults Providing intensive support for people already living with moderate or severe frailty, maintaining independence and avoiding admissions. Includes frailty identification for those with established frailty, personalised care plans, falls prevention, UCR, mobile diagnostics and Hospital at Home. Examples of impact: falls-related admissions ↓; improved independence; fewer care home admissions. 5. NC2R and Discharge Improvement A critical system priority enabling the new hospital model. Focuses on Home First, improving P0–P3 pathways, redesigning the IDT, delivering 7-day rehabilitation and reablement, and ensuring rapid community response through the Reactive Care Service. Examples of impact: NC2R ≤34 sustained; improved flow; reduced length of stay. 6. Healthy Childhood: Immunisation, Healthy Weight and Early Prevention Addressing the strongest drivers of early inequality and future long-term health. Delivered through Family Hubs, health visiting, schools and INTs, focusing on immunisation, healthy weight, early physical activity. Examples of impact: immunisation coverage ≥95%; reduced obesity; 7. Family Hubs and Early Years Preventing disadvantage from becoming entrenched and improving early childhood development. Integrating early help, perinatal mental health, health visiting, SEND early intervention and VCSE support through the Family Hub network. Examples of impact: improved GLD; reduced inequalities in school readiness; stronger parental support. Health and Wellbeing Board report 2 December 2025 8. The Hillingdon Place Operating Model This section sets out how we will deliver the strategy through our integrated Place Operating Model. 8.1 Overview The Hillingdon Place Operating Model consolidates and integrates existing services into a coherent system of:  Three co-located Integrated Neighbourhood Teams (INTs) supported by Local Access Hubs, bringing together primary care, community health, adult social care, mental health, therapies, diagnostics and the voluntary sector.  A network of Family Hubs providing early years support, parenting, SEND pathways and early help.  A Borough-wide Reactive Care Service providing rapid community response, integrated discharge, rehabilitation, bridging support and Hospital at Home.  A new Hillingdon Hospital working seamlessly with neighbourhood teams, so residents receive the right care in the right place.  Shared leadership, integrated workforce and pooled budgets where appropriate It is designed to:  Reduce fragmentation and duplication  Enable multidisciplinary working around populations of c.100,000  Deliver both proactive (prevention, long-term conditions, frailty) and reactive (urgent care, discharge) functions  Support the activity and flow assumptions underpinning the new hospital 8.2 Integrated Neighbourhood Teams (INTs) The three Hillingdon Neighbourhoods are:  North: Ruislip, Northwood, Harefield and Ickenham  South West: Uxbridge, Yiewsley and West Drayton  South East: Hayes and Harlington Together, these Neighbourhoods will form the foundation of our population-based model of care, enabling earlier intervention, improved access and more integrated support across local communities. Each INT will bring together:  GPs and primary care teams  Community nursing  Adult social care  Community mental health services  Allied health professionals and therapies  Mobile diagnostic teams including Xray, Ultrasound  Selected acute outpatient services  Voluntary and community sector partners  Family Hubs and children’s services (through strong operational links) Health and Wellbeing Board report 2 December 2025 Place Operating Model Core functions include:  Same Day Urgent Primary Care delivered  Proactive Care for high-risk and rising-risk populations, including people with frailty and multiple LTCs  Preventative and Anticipatory Care, including for hypertension and other key risks  Interface with Family Hubs around families with complex needs or safeguarding concerns The INTs and local access hubs will be co-located in modern fit for purpose accommodation and will be designed as highly accessible, multi-agency spaces that support:  Reduced demand on ED and UTC  Earlier diagnosis  Better access to planned and urgent care in the community 8.4 Borough-wide Reactive Care Service The Reactive Care Service is a high-intensity, mobile multidisciplinary service that:  Provides a 2-Hour Urgent Community Response, in line with national standards.  Supports safe and timely discharge from hospital, including bridging arrangements.  Integrates nursing, therapies, social care, mental health and palliative care in a single response model.  Coordinates activity via a Reactive Care Coordination Hub, which acts as the operational point of contact for ED, wards, GPs, LAS, NHS 111 and care homes. This service is integral to achieving:  Sustained NC2R at or below 34  Reduced length of stay and fewer delayed transfers  Reduced readmissions and improved patient experience Health and Wellbeing Board report 2 December 2025 8.5 Children, Families and Family Hubs in the Place Model Within the operating model:  Family Hubs are formally linked to INTs and local neighbourhood governance  CYP mental health and SEND teams are connected into INT meetings, planning and pathways  Schools, Early Help, youth services and VCSE organisations are recognised as key neighbourhood partners  Safeguarding arrangements are embedded within neighbourhood governance structures This ensures that Better Start in Life outcomes are not treated separately from the integrated Place model but are a core component. 9. Enablers of Delivery To deliver this strategy we will strengthen: 9.1 Workforce and Organisational Development  Develop integrated leadership roles across partners.  Implement a “workforce passport” approach to enable flexible deployment across organisations.  Provide shared training on population health, trauma-informed practice, equality, cultural competence and neighbourhood working.  Support staff wellbeing and retention.  Develop an integrated accommodation schedule for the three neighbourhood super hubs. 9.2 Digital, Data and Population Health Management  Improve data sharing between partners, aligned to PHM goals  Develop neighbourhood dashboards for INTs and HWB oversight  Use the Whole System Integrated Care (WSIC) database and other tools to identify high-risk and rising-risk cohorts  Support residents’ digital inclusion where appropriate 9.3 Estates and Super Hubs  Develop and implement estates plans for the three Neighbourhood Super Hubs (Hayes, Ruislip, Uxbridge)  Maximise use of existing public estate and co-location opportunities  Align estates plans with the new hospital redevelopment and other capital programmes 9.4 Finance and Pooled Budgets  Explore and implement appropriate Section 75 agreements to support pooled budgets and shared risk  Align Place resources to the strategic priorities in this strategy  Use transformation and BCF resources to pump-prime integrated models such as the Reactive Care Service 9.5 VCSE and Community Partnerships  Strengthen collaboration with 3ST and wider VCSE partners  Support community-led projects, especially in Core20 neighbourhoods Health and Wellbeing Board report 2 December 2025  Recognise and fund the VCSE sector as a key delivery partner, particularly in prevention, mental health, carers’ support and loneliness reduction 10. Finance and Resources Delivering this strategy requires coordinated investment and budgetary alignment across the Council, NHS partners, Primary Care and the voluntary and community sector. Hillingdon Health and Care Partnership (HHCP), as the Place-Based Partnership, will oversee the financial framework that ensures resources are aligned to our shared priorities. 10.1 How the Strategy Will Be Funded Delivery will be supported through a blend of existing and new funding streams, including:  Existing NWL ICB budgets (with specific new investment into End of Life, Urgent Community Response, Hospital at Home, the Lighthouse,)  Local Authority budgets (Public Health, Children’s Services, Adult Social Care, Housing)  Better Care Fund  Primary Care (ARRS and enhanced services)  Voluntary and community sector grants  Capital investment linked to the new Hillingdon Hospital and development of Local Access Hubs HHCP will coordinate these resources to reduce duplication, maximise value and ensure investment is focused on prevention, neighbourhood delivery and reducing inequalities. 10.2 Pooled Budgets and Joint Commissioning To support integrated delivery, Hillingdon will explore the expansion of pooled budgets and joint commissioning through Section 75 agreements across key areas such as:  Integrated Neighbourhood Teams  Reactive Care and discharge pathways  Early years and Family Hubs  Community mental health and prevention  Intermediate care, rehabilitation and reablement This will enable shared accountability, clearer governance and more efficient use of local resources. 10.3 Resourcing the Place Operating Model Funding for the Place Operating Model will come from:  Core service realignment, bringing together existing community, primary care, mental health and social care resources at neighbourhood level  BCF and transformation funding to support Reactive Care, Home First, 7-day reablement and intermediate care  Public health, early years and children’s services budgets aligned to Family Hubs and neighbourhood working  Capital and estates solutions for Local Access Hubs using licence-to-occupy, space swaps and flexible use of section 106/Community Interest Levy (CIL) while longer-term hub Health and Wellbeing Board report 2 December 2025 developments progress This approach ensures the Operating Model is deliverable within current resources, with targeted investment for system change. 10.4 Financial Oversight and Assurance Oversight will be delivered through:  HHCP Finance and Performance Committee  Joint Commissioning arrangements and Section 75 governance  Regular assurance to the Health and Wellbeing Board and NWL ICB A shared monitoring framework will track spend, outcomes and the impact of investment on reducing inequalities. 11. Governance, Accountability and Oversight The Health and Wellbeing Board will:  Provide strategic oversight and stewardship of this strategy  Receive regular updates on progress, risks and impact  Hold partners collectively to account for delivery Supporting arrangements at Place will include:  A Place Executive / Partnership Board to oversee operational delivery and alignment with ICS frameworks.  A Finance & Performance Committee to monitor resource use and outcomes.  A Quality & Safety Committee to ensure quality, safety and safeguarding.  Children’s and adults’ safeguarding arrangements will be aligned and clearly embedded within the governance structure. 12. Measuring Success and Monitoring Progress A balanced Outcomes and Performance Framework will be agreed, including:  System metrics – ED attendances, admissions, length of stay, NC2R, discharge delays  Population health metrics – prevalence and control of hypertension, diabetes, frailty, mental health conditions  Children & Families metrics – school readiness, obesity, dental decay, children’s asthma admissions, CYP MH outcomes  Experience metrics – patient, carer and staff experience measures  Inequalities metrics – outcomes in Core20 localities and for priority groups The Health and Wellbeing Board will receive regular assurance reports using a shared dashboard, with deep dives on key priorities. Where baselines are not currently available, these will be confirmed as part of the development of the Place Outcomes Framework by Q4 2025/26.” Health and Wellbeing Board report 2 December 2025 13. Implementation and Next Steps Following approval of this strategy, partners will:  Develop detailed delivery plans for each outcome domain and high-impact priority  A detailed delivery timeline will be developed alongside the final strategy.  Refresh or align organisational plans and commissioning intentions to this strategy  Agree implementation milestones for the Place Operating Model, including INTs, Super Hubs and Reactive Care  Finalise the outcomes framework and dashboard for HWB oversight

Health and Wellbeing Board report 2 December 2025 CHILDHOOD OBESITY UPDATE Relevant Board Member(s) Sharon Stoltz – Interim Director of Public Health Julie Kelly – Corporate Director, Children’s Services Organisation London Borough of Hillingdon Report author Sharon Stoltz – Interim Director of Public Health Papers with report None HEADLINE INFORMATION Summary This report is to brief the Board on the long-term impacts of childhood obesity, the local picture of childhood overweight and obesity and highlights some of the work going on to address it. Contribution to plans and strategies The work focused on the prevention and management of childhood overweight and obesity contributes to the delivery of the Joint Health and Wellbeing Strategy 2022-2025 and the Council Strategy 2022-2026. Financial Cost There are no financial implications in this report. Ward(s) affected All RECOMMENDATION That the Health and Wellbeing Board notes the content of the report. INTRODUCTION 1. Excess weight impacts negatively on children’s health and wellbeing outcomes and can have a significant long term negative impact on their educational and life chances into adulthood. Some of the key health impacts include:  Emotional and behavioural issues such as stigmatisation, bullying, low self- esteem  Educational issues such as school absence and educational attainment  Physical health issues such as high cholesterol, high blood pressure, pre- diabetes, bone and joint problems, breathing difficulties  Increased risk of becoming overweight and obese adults  Increased risk of ill-health and premature mortality in adult life 2. Excess weight in parents can have a negative impact on the healthy weight of their children. Having an obese mother increases the child’s risk of experiencing excess weight by over 40% as shown in figure 1 below: Health and Wellbeing Board report 2 December 2025 Figure 1. Impact of Parent’s BMI Status on their Children 3. Women experiencing excess weight in pregnancy is also a risk factor for a number of health issues for the mother and her baby. These include gestational diabetes and hypertension (high blood pressure), pre-eclampsia, miscarriage and even death. There is also an increased risk of needing medical intervention during childbirth resulting in increased recovery time following the birth, challenges with breastfeeding and a risk to the bonding experience with their baby as well as poorer mental health outcomes. These risks are described in figure 2 below: Figure 2. Obesity in Pregnancy 4. Excess weight in childhood can often lead to obesity in adulthood. On average, obesity reduces a person’s life expectancy by around 3 years with severe obesity shortening life by as much as up to 10 years (Severe obesity is a BMI of 40 or higher or a BMI of 35 with Health and Wellbeing Board report 2 December 2025 co-existing health conditions such as hypertension or diabetes). The most recent data from 2023/24 shows that Hillingdon has a high percentage of adults classified as overweight or obese at 63%. This is higher than the London average of 57.8% but slightly better than the England average of 64.5%. 5. Tackling the risk factors for obesity such as diet and physical activity reduces the risk of more than 20 long term health conditions, increases economic productivity by having a healthier workforce and reduces demand on health and social care services. The 202 Global Burden of Disease study shows obesity as one of the biggest risk factors driving death and disability in England alongside hypertension, excess alcohol use and smoking as shown in figure 3 below: Figure 3. 6. The long-term cost of obesity and the impact on the quality of life for those who are overweight or obese means that system-wide action is required to reduce the level of childhood obesity in Hillingdon. CHILDHOOD OBESITY IN HILLINGDON 7. Data on childhood obesity has been collected by the National Childhood Measurement Programme (NCMP) since 2006. The NCMP is a mandated public health programme which measures the height and weight of children in Reception (aged 4 to 5 years) and Year 6 (aged 10 to 11 years) in schools in England. The participation rate in Hillingdon in the most recent year (2024/25) was 99.4% in Reception children and 98.5% for children in year 6. Health and Wellbeing Board report 2 December 2025 8. In 2024/25 19.9% of children in Reception were overweight or living with obesity. This is similar to the London average (21.1%) and lower than the England average (23.5%) but represents a 1.2% increase in Hillingdon since 2023/24. 9. In 2024/25 36.2% of children in year 6 were overweight or living with obesity. This shows a downward trend of 1.3% since 2023/24 for Hillingdon and is now slightly lower than the London average (37.3%) and the same as the average for England (36.2%). 10. Although levels of overweight and obesity can be found in all areas of Hillingdon, it is more prevalent in some areas than others with a strong link with deprivation as shown below. Source data from Office of Health Improvement and Disparities (OHID). Figure 4. Prevalence of Obesity in Hillingdon MSOAs in Children 4 to 5 years Figure 5. Prevalence of Obesity in Hillingdon MSOAs in Children 10 to 11 years Health and Wellbeing Board report 2 December 2025 KEY PROGRESS AREAS 11. Understanding the school food landscape: Public Health and Education agreed a proposal for using the underspend from the GLA grant for universal free primary school meals implementation. School Food Matters undertook a survey of school food, with 46% primary schools responding and a full day audit in 12 schools. It showed:  low levels of awareness and compliance with statutory responsibilities around school food  lunch offer is largely compliant with School Food Standards, however, compliance across the whole school day is minimal. Food offered in wraparound provision is largely processed food and non-compliant.  Insufficient food education being delivered to meet requirements of the curriculum  Support for school around procurement and contract management is needed 12. Improving school food provision: Over the past six months, significant collaboration has taken place between Council teams, particularly Education and Environmental Health. Strategic objectives have been developed and agreed with Children’s Services DMT.  Year 1 priorities are aligned to the Education Strategy Preparation for Adulthood objective and focus on school Leadership around food and health, access to and quality of school food.  Key Actions and development include:  Local guidance with resources for each strategic priority, available on LEAP that includes: a whole school food policy, self-assessment tools, contract templates  Establishing a new Hillingdon School Food Working Group (Public Health, Education, Environmental Heath and Oral Health Community Service)  Promotion of the new Healthy Schools London (HSL) programme, with the local priority being addressing a whole school approach to food  The Education team actively engaging school leaders in conversations regarding school food compliance and improvements aligned to universal Preparation for Adulthood  Environmental Health Officers undertaking School Food Standards compliance checks alongside statutory scheduled food hygiene inspections. 13. Increasing uptake of universal free school meal provision (primary schools) A big success this year has been more provision of free school meals for all primary school aged children. Led by Education, Hillingdon have recently implemented an Auto Enrolment process so families who are eligible for means tested free school meals are automatically enrolled; over 1000 additional children have been identified this year. This saves a family over £500 a year and gives their children access to better quality food. This is important as we know from the audits carried out by School Foo Matters, over 80% or packed lunches were not compliant with School Food Standards. It should also be noted that schools receive extra financial support for those children as well. 14. Healthy School London (HSL) Programme The revised Healthy Schools London (HSL) programme is endorsed by Public Health and Education as a tool for health improvement, aligned with universal Preparation for Adulthood and the new Ofsted framework. Relaunched by the GLA in September 2025, it has been locally supported through school information sessions and governor training. Resources have been developed to help schools achieve awards, including a guide for implementing The Daily Mile. In July 2025, two schools achieved Gold status by Health and Wellbeing Board report 2 December 2025 improving school food: introducing water-only policies, reducing sugary desserts, starting growing projects, and promoting sugar swaps. Currently:  Two schools are working towards Gold by enhancing Daily Mile activities and running Couch to 2K clubs.  One school is focusing on a whole-school approach to food, healthy eating, and food education. 15. Parent information sessions 2 sessions for parents on how to have confident conversations regarding raising the issue of weight are planned. We have worked with partners from Hillingdon’s Strategic Obesity Group to ensure the content reflects the needs identified by local services who work with parents. 16. Partnership with The Felix Project There is a strong correlation between obesity and deprivation, with children living in the more deprived areas experiencing a higher prevalence of obesity. Active promotion of the Felix Project by Public Health has led to a 39% increase in families receiving healthy food during school holidays, from 709 families in 2024 to 1,159 in 2025. Hillingdon families received 159,018 meals, up 68% from 2024 and valued at £265K worth of food. Access to food provision had a significant community impact, with schools reporting high demand and quick uptake of food deliveries, increased engagement with families, enabling wider support and requests for weekly deliveries following summer success. 17. Free access to physical activity in the community Parkrun at Stockley Park has been set up, providing a weekly event with up to 100 residents walking, jogging, running each week. This has led to plans for Junior parkrun, at Lake Farm Country Park, with 12 resident volunteers recruited. Following successful implementation of the LTA tennis court renovation programme, Public Health have recruited volunteers to deliver the Free Parks tennis programme. This has led to 1362 attendances over 18months (772 from south of the borough); tennis activation in under- presented communities acknowledged by DCMS (twice). 18. Children’s weight management programme A child healthy lifestyle programme for 5–17-year-olds above a healthy weight was approved in February 2025 by the Cabinet Member for Health and Social Care. This is being delivered by GLL, the council’s leisure services provider. The programme includes Xplore, an 8-week family-based intervention and Junior Gym, a 12-week programme for eligible 11–17-year-olds. A web-based programme is also in development. In addition to the Xplore programme, GLL provide a universal offer to participating schools, delivering a whole school assembly and the Activate programme to Year 5 pupils. This has been delivered to 2 schools and active discussion are taking place with 6 schools to schedule this for January 2026.

Health and Wellbeing Board Report 2 December 2025 HILLINGDON HEALTH PROTECTION COMMITTEE Relevant Board Member(s) Sharon Stoltz – Interim Director of Public Health Organisation London Borough of Hillingdon Report author Sharon Stoltz – Interim Director of Public Health Papers with report Draft Terms of Reference – Health Protection Committee HEADLINE INFORMATION Summary This report is to seek a decision from the Board to establish a Health Protection Committee for Hillingdon. Proposed Terms of Reference for the Committee are attached as an appendix. Contribution to plans and strategies The Health Protection Committee will ensure that the local authority statutory responsibilities for health protection as set out in the Health and Social Care Act 2012 and associated public health regulations are adequately delivered. Financial Cost There are no financial implications. Ward(s) affected All RECOMMENDATIONS That the Health and Wellbeing Board: 1. approves the establishment of a Health Protection Committee for Hillingdon 2. comments on the proposed Terms of Reference and membership 3. agrees to receive an Annual Health Protection Report , prepared by the Director of Public Health, to document health protec tion system activities over the previous year and set out priorities for the different areas of health protection for the next 12 months. INFORMATION 1. Health Protection can be defined as “the protection of individuals, groups and communities through expert advice and effective collaboration to identify, prevent and mitigate the impacts of infectious diseases and environmental, chemical and radiological threats” (Vivanos R, Leonardi G, Elliot A. Health Protection: Principles and Practice. Health protection surveillance. Oxford University Press). Local authorities have a statutory duty under the Health and Social Care Act 2012 for protecting the health of their population from preventable health threats and this duty is discharged by the local authority Director of Public Health. 2. The Director of Public Health has a statutory duty to ensure that local health protection arrangements to protect the individuals and communities they serve are robust and Health and Wellbeing Board Report 2 December 2025 implemented appropriately to meet local needs. This includes seeking assurance that all organisations involved in health protection co-operate and work together including developing outbreak response plans, agreeing roles and responsibilities and operational levels of response to incidents and outbreaks. The Director of Public Health also requires an agreed process for escalating concerns to the Health and Wellbeing Board when they believe local needs are not being met. Duties of a Hillingdon Health Protection Committee 3. The Health Protection Committee will provide assurance to the Director of Public Health, the council and the Health and Wellbeing Board that there are safe and effective arrangements in place to protect the health of the people of Hillingdon. 4. The Committee will include the following areas of health protection:  Vaccination and immunisation – monitor uptake and performance.  Cancer and non-cancer screening programmes – quality assurance, monitoring uptake and performance.  Communicable diseases – including case and outbreak response and management.  Environmental hazards including adverse weather and extreme weather response and preparedness.  Disease surveillance – monitor local picture of infectious disease and any emerging trends.  Data sharing and notification processes.  Workforce capacity and capability e.g. training and exercising of local plans. The proposed Terms of Reference and membership are attached as an appendix.

Page 1 of 4 Appendix: Hillingdon Health Protection Committee Proposed Terms of Reference 1. Purpose The Hillingdon Health Protection Committee, through the Director of Public Health, will provide assurance to the Health and Wellbeing Board, Hillingdon Council, and its partners that there are safe and effective plans in place to protect the health of the population of Hillingdon, including.  Communicable disease management and control, including outbreak management  Infection prevention and control including healthcare associated infections, Tuberculosis (TB), and Blood-borne virus (excluding HIV)  Environmental health impacts e.g. contamination, poisoning, radiation  Public protection e.g. food control, tattoo parlours, sunbeds, product safety, e.g. Botox  Emergency Preparedness Resilience and Response related to health  NHS national screening programmes including: - Abdominal Aortic Aneurysm (AAA) - Antenatal and Newborn - Breast - Bowel - Cervical - Diabetic Eye  Immunisation and vaccination (adults and children)  Adverse weather impacts on health  Migrant health The Committee will provide a setting for the exchange of information, scrutiny of plans and analysis of data will all partners with a role in the delivery of health protection in Hillingdon, ensuring they are acting jointly and effectively to protect the population’s health. 2. Specific Responsibilities a) Provide strategic oversight for health protection and provide assurance to the Health and Wellbeing Board and partner agencies that there are safe and effective health protection arrangements in place for the Hillingdon Council area b) Develop, implement, and oversee performance against an agreed health protection plan c) Ensure there is a process in place to assure there are effective arrangements for health protection incidents and outbreaks with key risks identified and appropriate mitigation measures undertaken Page 2 of 4 d) Review learning from health protection incidents and outbreaks to identify and share lessons learnt and make recommendations to commissioners/providers/partners regarding necessary changes e) Receive analysis and reports from and contribute to the Joint Strategic Needs Assessment on health protection issues f) Review and assess the health protection risks to the local population and ensure these are captured in a Risk Register for reporting to the Health and Wellbeing Board and the Council g) Act in an advisory capacity to support a local response to, and recovery from, any incident that directly and/or indirectly affects the health and wellbeing of Hillingdon population h) Support the Director of Public Health in exercising the Local Authority function in planning for and responding to those emergencies that present a risk to health as set out in section 30 of the Health and Social Care Act 2012 and Health Emergency Preparedness, Resilience and Response (April 2013). Ensure adequate resourcing to prevent and cover potential risks. i) Interpret strategic guidance or policy formulated by the ADPH, UKHSA and OHID which impacts on local emergency and contingency plans ensuring that organisations act on it j) Ensure that the Council emergency planning arrangements have embedded key actions needed to respond to a health-related incident, including the process for accessing clinical resources from the NHS, hand over procedures and contain clearly defined roles and responsibilities for health k) Ensure there are escalation processes in place with neighbouring boroughs in respect of mutual aid and cross border issues l) Ensure that appropriate plans, training, and testing arrangements are in place, with other organisations as required m) To have strategic oversight of all NHS delivered screening and immunisation services and services commissioned to tackle infectious diseases in Hillingdon n) Receive reports from members for discussion at Committee meetings to include: - Current situation - Progress against health protection outcomes (activity, quality, plans, epidemiological summaries) - Incidents managed and actions taken - Recommendations for process improvement 3. Principles The Health Protection Committee expects all members to:  Support the aims and objectives of the Committee  Inform the Committee of organisational changes and changes in personnel that may impact on partnership working  Proactively manage risk and acknowledge the principle of shared risk within the context of partnership working for health protection  Share relevant information and promote collaborative and innovative work both within Hillingdon and across boarders as appropriate. Page 3 of 4 4. Membership The Committee will be made up of key professional partner members with health protection responsibilities. Partner members should be in a position to provide assurance on behalf of their organisation or partnership that they represent. Each member will be responsible for reporting back to their organisation or partnership on the work of the Committee The Committee will include: Director of Public Health (Chair) Hillingdon Council (LBH) Consultant in Public Health (Deputy Chair) Hillingdon Council (LBH) Consultant in Health Protection UK Health Security Agency Adult Social Care Representative Hillingdon Council (LBH) Children Services Representative Hillingdon Council (LBH) Emergency Planning Officer Hillingdon Council (LBH) Environmental Health/Port Health Hillingdon Council (LBH) Hillingdon ICB representation NWL ICB The Confederation Hillingdon representative The Confederation NHS representation Central & North West London NHS Foundation Trust (CNWL) NHS representation The Hillingdon Hospital NHS Foundation Trust (THH) Integrated Sexual Health Service Representation London North West University Healthcare NHS Foundation Trust (LNWH) H4All/3ST - Representative Hillingdon H4All/3ST Health Watch Representative Hillingdon Health Watch Other members can be coopted to attend meeting(s) as and when required. 5. Frequency of meetings The Health Protection Committee will meet on a quarterly basis unless otherwise required to meet at short notice at the discretion of the Chair. The meetings will be held on Microsoft Teams unless the Committee decide that an in-person event is preferred. 6. Quorum There is an expectation that Committee members will prioritise attendance. The Committee will be quorate with a third of membership present which includes at least one representative from: - Public Health, Hillingdon Council - NHS - One other organisation Page 4 of 4 7. Administration of Meetings The administration support will be provided by the Council’s Public Health Directorate. The agenda and papers will be circulated at least five working days prior to the meeting. All decisions will be recorded in the notes of meetings and circulated with an action log within 20 days after the date of the meeting. 8. Dealing with sensitive matters and possible conflicts of interest The Committee may, at times, have to consider confidential information on matters related to individuals, organisations, or performance. These issues will remain confidential, and any conflict of interest must be declared. The meeting minutes will be confidential and must not be published on any public facing website or attached as an appendix to a report in the public domain. 9. Communication All members will be responsible for communicating actions to appropriate colleagues within their own organisation following each meeting. 10. Terms of Reference Terms of Reference agreed: The Terms of Reference will be reviewed annually. END.

Health and Wellbeing Board report 2 December 2025 OCCUPATIONAL THERAPY SERVICE UPDATE Relevant Board Member(s) Julie Kelly – Corporate Director, Children’s Services Organisation London Borough of Hillingdon Report author Gary Binstead – Head of Commissioning Papers with report None HEADLINE INFORMATION Summary This report is to brief the Board on the challenges of the delivery of Occupational Therapy (OT) statutory contacts for children with SEND, as outlined in their Education, Health, and Care Plans (EHCPs). Contribution to plans and strategies The delivery of therapies outlined in a child’s EHCP is part of a statutory duty related to the SEND code of practice, and CNWL are jointly commissioned to deliver these therapeutic interventions on behalf of Hillingdon Council and the ICB. Financial Cost £2,739,345 overall contract value for therapies (LBH & ICB) Ward(s) affected All RECOMMENDATION That the Health and Wellbeing Board note the content of the report. INFORMATION 1. This report relates to the number of children who did not receive their full number of statutory contact hours for OT during the last academic year (2024 / 25), setting out a recovery plan with approximate timescales. The information below sets out the number of children affected. 2. In the academic year 2024 / 25, approximately 400 children and young people did not receive their full allocation of OT contacts as set out in their EHCP, although more than half of all contacts were delivered as expected, and only a handful of children and young people did not receive any contacts. 3. This matter is being brought to the Board’s attention because of the potential risk if the service is unab le to meet the current demand and sets out how the CNWL service will recover from the current backlog. Context 4. The number of EHCPs in Hillingdon have been growing significantly over the years like many Health and Wellbeing Board report 2 December 2025 Local Authorities are experiencing . More recently, the growth has slowed compared to previous trends due to robust annual reviews, more opportunities for young people to be supported into employment and a range of other factors. 5. Not all children will have therapy input in their EHCPs but many children do. A number of children have personal budgets in place for therapy or have a private provider due to specific needs. The rest of the children with OT in their EHCPs will have their therapy delivered by CNWL as part of the commissioning arrangements. Background 6. This issue was highlighted to CNWL during the last academic year, and CNWL have been working closely with the Head of Commissioning in the Council to agree a plan to recover from the backlog. 7. There is a national shortage of OTs due to a range of factors which are impacting service delivery across many regions , and CNWL has not been immune to the recruitment and retention challenges in the country. This has impacted the current workforce, and in turn, the capacity to deliver all statutory contacts. 8. These pressures have been evident through a reduced workforce due to maternity leave, recruitment challenges and other factors, and has reduced the OT capacity for a prolonged period of time, despite CNWL efforts to recruit to the appropriate staffing levels. 9. As a result, there are a number of children and young people who have not received their statutory number of contacts during the last academic year as outlined above, and work is underway to correct this as set out below. Recovery Plan 10. Where a child or young person has been identified for not receiving any contacts, plans have been put in place to recover these through separate commissioning arrangements in conjunction with families, and some of these have been delivered already. 11. The therapy needs of all the other affected children are being assessed, and plans are being developed to ensure their individual needs are met appropriately. This will include input from children, families, therapists, and schools. Once these assessments are complete, appropriate therapy will be provided as agreed. 0% 2% 4% 6% 8% 10% 12% 14% 2022/23 2023/24 2024/25 2025/26 (current) Net Growth of EHCPs - Hillingdon v. National Hillingdon National Health and Wellbeing Board report 2 December 2025 12. CNWL are planning to commission additional capacity from the independent therapy market, in order to ensure that the appropriate level of therapy is provided to all children as outlined in their EHCP and also keep pace with the increased demand for assessments . T hese discussions are well developed , and CNWL are aiming to have additional capacity commissioned before the end of December. 13. It is expected that the appropriate OT provision will have been delivered by the end of the Spring term at the end of March for the children impacted during the 2024 / 25 academic year. 14. Reassuringly, all the scheduled OT statutory contacts are forecast to be delivered by the end of the Autumn term at the end of December as planned, showing a marked improvement due to additional capacity. 15. Discussions will continue between all organisations involved, and t he recovery plan will remain under review. Plans will be updated as necessary to ensure the appropriate levels of therapeutic input are delivered to all children and young people as outlined in their EHCPs.

Health and Wellbeing Board report 2 December 2025 REPORTS REFERRED FROM CABINET / HEALTH AND SOCIAL CARE SELECT COMMITTEE: GP COVERAGE IN HILLINGDON SINGLE MEETING REVIEW Relevant Board Member(s) Councillor Jane Palmer Keith Spencer Organisation London Borough of Hillingdon Hillingdon Health and Care Partners Report author Nikki O’Halloran, Democratic Services Papers with report Appendix A – GP Coverage Update Template 1. HEADLINE INFORMATION Summary To consider when future updates will be brought to the Board. Contribution to plans and strategies Joint Health & Wellbeing Strategy Financial Cost None Relevant Select Committee Health and Social Care Select Committee Ward(s) affected N/A 2. RECOMMENDATION That the Health and Wellbeing Board notes the plans to bring updates on the implementation of recommendations from the Health and Social Care Select Committee review of GP Coverage to future meetings and determines the frequency thereof. 3. INFORMATION Supporting Information At its meeting on 19 June 2025, the Health and Social Care Select Committee confirmed that it would undertake a single meeting review of General Practitioner (GP) coverage in Hillingdon. The review , which was undertaken on 22 July 2025, aimed to consider the number and geographical location of GPs in the Borough as well as the adequacy of the provision in serving the local population now and into the future. The report that was subsequently produced highlights the challenges faced by GP practices amid population growth and evolving healthcare demands, and outlines recommendations to improve service deliv ery and patient experience. The Committee devised the following recommendations which are based around meeting future demand, the expansion of the champions role, awareness raising, s treamlining IT systems, improving online bookings and equality: Health and Wellbeing Board report 2 December 2025 That the insight and findings of the Health and Social Care Select Committee be welcomed and that: 1. officers work with partners to identify where GP surgeries are likely to be needed by 2035; 2. The Health and Wellbeing Board partners be asked to: a. investigate a red uction in the complexity and quantity of data governance and IT systems currently being used in Hillingdon to enable patient data to be easily passed between professionals; b. subject t o the outcome of the pilot, expand the provision of champions to other health related issues; c. increase awareness that the nature of community care is changing; and 3. The Confederation Hillingdon CIC be asked to: a. investigate the possibility of increasing p atients’ use of online bookings systems, including being able to specify convenient call back times; and b. ensure equality with regard to the ability to request to be seen by the same sex medical professionals at GP surgeries; and 4. The Health and Social Car e Select Committee be provided with an update by March 2027 on any progress made in progressing these recommendations alongside the implementation of the NHS 10 Year Health Plan and the development of neighbourhoods. To ensure that partners have oversigh t of the implementation of the recommendations , the Cabinet Member for Health & Social Care added the following recommendation: 5. Actions to progress all the above recommendations from the Select Committee be regularly monitored at Health & Wellbeing Board m eetings and added to its work programme. The report and recommendations were considered and resolved by Cabinet on Thursday 20 November 2025 and consideration now needs to be given to how frequently the Board would like to receive updates on the implementation of the recommendations . To aid in the provision of these updates, a template has been drafted and attached to this report at Appendix A. 6. BACKGROUND PAPERS Health and Social Care Select Committee single meeting review report of GP Coverage in Hillingdon - https://modgov.hillingdon.gov.uk/documents/s64999/05%20- %20REPORT%20251120%20-%20CABINET%20REPORT%20- %20GP%20Coverage%20REPORT%20CHECKLIST%201.pdf . Health and Wellbeing Board report 2 December 2025 APPENDIX A GP Coverage in Hillingdon Resolutions Updates RECOMMENDATION 1 Officers work with partners to identify where GP surgeries are likely to be needed by 2035; RECOMMENDATION 2 The Health and Wellbeing Board partners be asked to: a. investigate a reduction in the complexity and quantity of data governance and IT systems currently being used in Hillingdon to enable patient data to be easily passed between professionals; b. subject to the outcome of the pilot, expand the provision of champions to other health related issues; c. increase awareness that the nature of community care is changing; RECOMMENDATION 3 The Confederation Hillingdon CIC be asked to: Health and Wellbeing Board report 2 December 2025 a. investigate the possibility of increasing patients’ use of online bookings systems, including being able to specify convenient call back times; and b. ensure equality with regard to the ability to request to be seen by the same sex medical professionals at GP surgeries; and RECOMMENDATION 4 The Health and Social Care Select Committee be provided with an update by March 2027 on any progress made in progressing these recommendations alongside the implementation of the NHS 10 Year Health Plan and the development of neighbourhoods. RECOMMENDATION 5 (added by Cabinet Member for Health & Social Care) Actions to progress all the above recommendations from the Select Committee be regularly monitored at Health & Wellbeing Board meetings and added to its work programme.

Health and Wellbeing Board report 2 December 2025 BOARD PLANNER & FUTURE AGENDA ITEMS Relevant Board Member(s) Councillor Jane Palmer Keith Spencer Organisation London Borough of Hillingdon Hillingdon Health and Care Partners Report author Nikki O’Halloran, Democratic Services Papers with report Appendix 1 - Board Planner 2025/2026 1. HEADLINE INFORMATION Summary To consider the Board’s business for the forthcoming cycle of meetings. Contribution to plans and strategies Joint Health & Wellbeing Strategy Financial Cost None Relevant Select Committee N/A Ward(s) affected N/A 2. RECOMMENDATION That the Health and Wellbeing Board considers and provide s input on the 2025/2026 Board Planner, attached at Appendix 1. 3. INFORMATION Supporting Information Reporting to the Board The draft Board Planner for 2025/2026, attached at Appendix 1, is presented for consideration and development in order to schedule future reports to be considered by the Board. Members may also wish to consider any standing items (regul ar reports) and on what frequency they are presented. The Board Planner is flexible so it can be updated at each meeting or between meetings, subject to the Co-Chairs’ approval. Board agendas and reports will follow legal rules around their publication . As such, they can usually only be considered if they are received by the deadlines set. Any late report (issued after the agenda has been published) can only be considered if a valid reason for its urgency is agreed by the Co-Chairs. Health and Wellbeing Board report 2 December 2025 Advance reminders for reports will be issued by Democratic Services but report authors should note the report deadlines detailed within the attached Board Planner . Reports should be presented in the name of the relevant Board member. With the Co-Chairs, Democratic Servic es will review the nature of reports presented to the Board in order to ensure consistency and adequate consideration of legal, financial and other implications. It is proposed that all reports follow the in -house “cabinet style” with clear recommendations as well as the inclusion of corporate finance and legal comments. The agenda and minutes for the Board will be published on the Council's website , alongside other Council Committees. Board meeting dates The Board meeting dates for 2025/2026 were considered and ratified by Council at its meeting on 16 January 2025 as part of the authority’s Programme of Meeti ngs for the new municipal year. The proposed dates and report deadlines for the 20 25/2026 meetings have been attached to this report as Appendix 1. Financial Implications There are no financial implications arising from the recommendations in this report. 4. EFFECT ON RESIDENTS, SERVICE USERS & COMMUNITIES Consultation Carried Out or Required Consultation with the Chairs of the Board and relevant officers. 5. CORPORATE IMPLICATIONS Hillingdon Council Corporate Finance comments There are no financial implications arising from the recommendations in this report. Hillingdon Council Legal comments Consideration of business by the Board supports its responsibilities under the Health and Social Care Act 2012. 6. BACKGROUND PAPERS NIL. Health and Wellbeing Board report 2 December 2025 APPENDIX 1 BOARD PLANNER 2025/2026 3 Mar 2026 2.30pm Committee Room 6 Business / Reports Lead Timings Reports referred from Cabinet / Policy Overview & Scrutiny (SI) LBH Report deadline: 3pm Thursday 19 February 2026 Agenda Published: 23 February 2026 Board Planner & Future Agenda Items LBH PART II - Update on current and emerging issues and any other business the Co- Chair considers to be urgent All 11