Children, Families, Health & Care SC

Minutes CHILDREN, FAMILIES, HEALTH & CARE SELECT COMMITTEE 21 July 2026 Meeting held at Committee Room 6 - Civic Centre, High Street, Uxbridge UB8 1UW Committee Members Present: Councillors Ekta Gohil (Chair), Jane Palmer (Vice-Chair), Hedson Farinha De Castro, John Garner, Jan Sweeting (Opposition Lead) and Anil Taneja and Mr Tony Little (Co- Optee) Also Present: Julian Lloyd, Chief Executive, Age UK Hillingdon, Harrow & Brent Megan Redhouse, Services & Development Manager, Nucleus Legal Advice LBH Officers Present: Gary Collier (Health and Social Care Integration Manager), Sandra Taylor (Corporate Director of Adult Social Care & Health) and Nikki O'Halloran (Democratic, Civic and Ceremonial Manager) 15. APOLOGIES FOR ABSENCE (Agenda Item 1) Apologies for absence had been received from Councillor Sophie Dror. 16. DECLARATIONS OF INTEREST (Agenda Item 2) Councillor Jane Palmer declared a non pecuniary interest in Agenda Item 5 – Hillingdon Advice Partnership Update, as she had been the Cabinet Member involved in letting the contract, and remained in the room during the consideration thereof. 17. MINUTES OF THE MEETING HELD ON 23 JUNE 2026 (Agenda Item 3) RESOLVED: That the minutes of the meeting held on 23 June 2026 be agreed as a correct record. 18. EXCLUSION OF PRESS AND PUBLIC (Agenda Item 4) RESOLVED: That all items of business be considered in public. 19. HILLINGDON ADVICE PARTNERSHIP UPDATE (Agenda Item 5) Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that the former Health and Social Care Select Committee had undertaken a review of adult social care early intervention and prevention (EIP) which had considered a number of associated contracts. At one of the witness sessions, Members had received testimony from Hillingdon Advice Partnership (HAP) which had been commissioned to provide EIP and had been up and running for three weeks. Members had requested an update on progress of the service in twelve months. Public Document Pack Mr Julian Lloyd advised that he was the Chief Executive at Age UK Hillingdon, Harrow and Brent (the lead partner at HAP) which was also legally responsible for the organisation. He noted that the Committee had changed since he had last attended a Select Committee meeting and that new Members were now involved. The report provided an overview of the service that had been commissioned by the Council and case studies had been circulated separately to Members of the Committee. Members noted that the majority of the case studies seemed to be in relation to people that were in crisis and had not demonstrated early intervention or prevention. They queried what had been done to identify residents in need at an early stage. Mr Lloyd advised that HAP was open access and that the organisation had been doing what it could to provide a service. A high number of referrals had come through from community prescribers but the people being referred were often the type that did not reach out until they had reached crisis which then took longer to resolve their issues. Mr Collier advised that HAP had been making every contact count. There had been an increase in the number of people aware of the HAP service which then facilitated referrals coming in. HAP offered information, advice and guidance to residents aged 18+ to empower them and support their resilience and moved away from the old model of delivery which had tended to foster dependence. The organisation had been structured as a partnership of organisations with complementary skills, with services being delivered by Age UK, Bell Farm Christian Centre, Dash, the Council and Nucleus. Nucleus interacted with people of working age about issues such as housing and debt (and also provided these services in Kensington & Chelsea and Ealing), Bell Farm operated from West Drayton and had forged relations with hard-to-reach communities, and Dash was able to help adults with learning disabilities. The ambition was to deliver services in partnership with the Council and build on relations locally. Consideration would need to be given to the interface with primary care as there was often an overlap between health and social care. Mr Lloyd noted that HAP had been provided with indicative demand as part of the tender process based on the previous provision but he was aware that the previous provider had struggled to meet those volumes. There had been an increase in the number of people being referred into the service over the course of the year. Over the last nine months, 3,326 people had been supported across 4,418 cases with 16,000 repeat contacts. The age profile of these contacts continued to be biased towards older residents (which was partly because of the Borough’s demographics) but ethnicity had been fairly well reflected. Members queried how long each contact took to resolve and how many could be resolved on the first contact. Ms Megan Redhouse, Services and Development Manager at Nucleus, advised that each case was very different but that the aim was to resolve the majority of cases at first contact by providing clients with the information that they needed to resolve their issues themselves. Referrals to case workers were different in that they might be able to resolve the issues quickly but, depending on the issue, it could take up to nine months or more (HAP would be in contact with the resident throughout this period). Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that, since the contract had started in June 2025, HAP had been making a real difference, providing advice and information in relation to issues such as debt and housing and reducing the costs to the Council by providing this early intervention in line with the contract. The volume and complexity of the issues that arose had been reflected across adult social care and the third sector. Ms Taylor noted that it would be helpful for HAP to provide a little more substance and an explanation in relation to some of the data and figures presented at the meeting (for example, slide four). It was suggested that HAP be invited to attend a future meeting to talk to the Committee about cost avoidance against a baseline and provide Members with some case studies in relation to young service users. Mr Lloyd noted that the Return On Investment calculations would not provide real time savings to the Council. This information had been drawn from more detailed reports that had been shared with the Council and had been based on the costs to the local authority or NHS that had been avoided as a result of HAP’s work with residents. He would be happy to provide more detail. In terms of showing value for money, calculations had been made using national tools and had been based on prevention. Ms Taylor advised that the cost avoidance figures had been based on a national assumption of what it would have cost if the individual had come to adult social care. It highlighted the difference that HAP’s contribution had been making. Members questioned the performance management framework included as Appendix 1 to the report and whether each of the specified outcomes had been achieved (or not). Mr Lloyd advised that he would need to come back with this information. Mr Lloyd advised that the team triaged the referrals and allocated them to case workers to take forward. It was noted that someone with a physical disability would be most likely to approach Dash in the first instance (rather than other partners within HAP) and that specialisms would develop over time within each of the partners organisations. Face to face contact was available but the highest volume of contacts took place on the internet and telephone. With higher levels of demand and less resource, the offer of face to face appointments tended to be given to those who needed them the most. Outreach was offered in Hayes, Ruislip, Uxbridge and West Drayton. Whilst drop ins were permitted, residents were encouraged to make an appointment. Consideration also needed to be given to the possibility of trialling the colocation of HAP within primary care practices. Members welcomed the introduction of face to face appointments in Harefield and Heathrow Villages and queried whether there would be any additional funding for this. Mr Lloyd noted that HAP had been looking at the possibility of getting free use of existing venues that were accessible whilst also providing private space for confidential meetings. It was suggested that HAP liaise with the three churches in Harefield who would be happy to work with them and that conversations should be undertaken with the two churches and scout group in Heathrow Villages and that Heathrow Airport should be approached for funding. It had become apparent that a number of residents in Hillingdon would benefit from digital training to enable them to support themselves. There had also been an increase in the number of enquiries in relation to debt and housing across the age spectrum. Over the next two years, HAP planned to do more to: help upskill residents so that they were able to help themselves (with things like access to low cost devices and data); improve automation and efficiency; and develop more effective hand offs to statutory partners (for example, Hillingdon Health and Care Partners had been looking at the introduction of passports). With a funding ceiling and a 40% increase in service users, Members queried whether HAP had been experiencing capacity issues and queried whether artificial intelligence was being used to help absorb the increase in demand for services. Mr Lloyd advised that it could be challenging at times and the team could sometimes be stretched but that demand ebbed and flowed. HAP had managed to keep on top of the growing demand for its services and continued to identify individuals that needed to be prioritised. Quick Text and Copilot Enhanced had been introduced to transcribe and produce notes from telephone conversations and face to face meetings (although quicker that manually typing up notes, they still needed to be checked and validated). However, further work was needed in relation to improving automation and streamlining the single point of access. To this end options were being investigated to improve the telephone system and thought was needed to improve the consistency of data capture. Work had also been undertaken to leverage additional funding and grants and discussions were underway to establish whether funding could be secured from the NHS for support and advice. Insofar as volunteers were concerned, Mr Lloyd advised that HAP wanted to build the team to be able to cover the first point of contact. However, this had proved to be difficult as many volunteers would get trained up and develop their skills before they then quite quickly moving on to paid employment (the volunteers tended to be young people and two young graduates had recently been appointed as Housing Officers). HAP would need to develop its volunteer strategy to build around this trend. Members queried whether there had been an increase in the number of queries related to addictions. Ms Redhouse advised that drugs and alcohol were becoming a bigger issue. There had been a number of residents in debt that had been referred to HAP where the subject of addiction had been broached and additional support for that from other services had been arranged. Mr Lloyd noted that someone with an addiction would be treated in the same way as someone with mental health issues which meant working more closely with statutory partners. It would be important to ensure that this work was joined up with that of the ARCH service to recognise the issues and stop these individuals from falling through the cracks. Consideration was also being given to opening up Age UK to young people who were isolated and / or lonely. Ms Redhouse advised that it was sometimes difficult to get responses for clients from the Council. Mr Lloyd noted that the team had built relationships with Council staff but that there was always going to be a churn of staff. To address this, HAP attended team meetings and had a central point of contact in each team that they dealt with so that issues could be escalated if needed. HAP had been working with the Council to promote its services through Hillingdon People and on the local authority’s website. Bell Farm, Dash and Citizens Advice promoted the HAP service but effort would be needed to grow the HAP brand. Surveys had been used to capture satisfaction with the service provided and positive and a small amount of negative feedback had been received. It was not as high a response rate as would have been liked and would benefit from follow up telephone calls but this was not an attractive task for volunteers. The issues raised in negative feedback had been resolved. Ms Redhouse confirmed that residents fairly regularly dropped out of the system before their issues were resolved but that this information was not recorded. The Committee had been provided with a high level overview of the services provided by HAP. Council officers held quarterly monitoring meetings with HAP to identify what the service was doing and any response that was needed. Monthly meetings were also held with the Crisis and Resilience Team. RESOLVED: That: 1. Mr Julian Lloyd send a copy of the slides to the Democratic, Civic and Ceremonial Manager for circulation to the Committee; 2. Mr Julian Lloyd provide the Committee with further information on whether or not each of the outcomes specified within the performance management framework in Appendix 1 of the report had been achieved; and 3. the report and discussion be noted. 20. PHARMACIES & PHARMACY FIRST SCOPING REPORT (Agenda Item 6) Consideration was given to the proposed amendments to the draft scoping report for the review of pharmacies and Pharmacy First which had been circulated to Members on 17 July 2026. The changes had been suggested to ensure that the aims of the review would be achievable within the given timeframe and alongside the Committee’s other responsibilities. It was suggested that the changes could be seen to water down the aims and robustness of the review but it was agreed that the review needed to be delivered within the proposed timescales. Members requested that a map of the current pharmacies in Hillingdon be provided, along with statistics on population and ward profiles so that pinch points could be identified. Witnesses would need to be included from all over the Borough. Healthwatch Hillingdon and service users would be invited to attend the first meeting on 13 October 2026 (additional meeting) to establish their feelings on the Pharmacy First initiative. RESOLVED: That: 1. Members be provided with a map of the pharmacies in Hillingdon, population statistic sand ward profiles; and 2. the Pharmacies and Pharmacy First scoping report, as amended and attached to these minutes at Annex A, be agreed. 21. CABINET FORWARD PLAN MONTHLY MONITORING (Agenda Item 7) Consideration was given to the Cabinet Forward Plan. It was noted that the Committee did not have the capacity to be able to consider all of reports on the Forward Plan that fell within its remit. As such, Members would need to provide a rationale for specific reports that they would like the Committee to comment on so that this could then be discussed. On behalf of the Committee, the Chair thanked Councillor Denys and the Members of the former Health and Social Care Select Committee for their work on the review of Adult Social Care Early Intervention and Prevention, which would be considered by Cabinet on 23 July 2026. If agreed, this Committee would receive an update on the implementation of the recommendations in due course. RESOLVED: That Cabinet Forward Plan be noted. 22. WORK PROGRAMME (Agenda Item 8) The Democratic, Civic and Ceremonial Manager would aim to get information in relation to the two possible minor review topics circulated to the Committee before its next meeting on 22 September 2026 (a minor review could not be undertaken until the major review witness sessions had been completed). Members noted that the information in the youth offer report had been incomplete and requested an information item on progress in clearing the backlog across the Borough. It was agreed that officers be asked to provide Members with a briefing note to be circulated outside of the meetings. RESOLVED: That: 1. the Democratic, Civic and Ceremonial Manager circulate information on the two possible minor review topics to Members by its next meeting; 2. officers be asked to provide a briefing note for Members on progress made in clearing the backlog in relation to the youth offer; and 3. the Work Programme be agreed. ANNEX A The meeting, which commenced at 6.30 pm, closed at 7.51 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. Children, Families, Health & Care Select Committee Review Scoping Report – 2026/2027 A Review of Pharmacies and Pharmacy First in Hillingdon 1. OBJECTIVES Aim of the review At its meeting on 23 June 2026, the Children, Families, Health and Care Select Committee elected to undertake a major review of pharmacies and the Pharmacy First service in Hillingdon. This review aims to look at the services provided by pharmacies to alleviate the pressure on primary care, including the Pharmacy First initiative, to understand the contribution pharmacies make to the wider health and care system in Hillingdon and identify opportunities to s trengthen partnership working and maximise the benefits of pharmacy services for residents. Terms of Reference The following Terms of Reference are suggested for the review, subject to any changes agreed by the Committee: 1. to gain a n understanding of the services currently provided by pharmacies in Hillingdon; 2. to understand how pharmacy services are commissioned and by which organisations; 3. to review the current availability of support for pharmacies; 4. to establish what services have already been commi ssioned from pharmacies to alleviate pressure on primary care and identify how successful th ese services have been in achieving this objective; 5. to explore the possibility of pharmacies providing additional services to alleviate the pressure on primary care; and 6. subject to the Committee’s findings, to draw conclusions, propose actions and make service and policy recommendations to the decision-making Cabinet (which may then refer formally to a relevant external body). Page 1 Minute Annex A 2. BACKGROUND Context and Key Information Pharmacies (also known as chemists) are healthcare facilities where medicinal drugs are prepared, dispensed and sold. These establishments serve as crucial points of access for individuals seeking medications, health advice and various pharma ceutical services. Managed by licensed pharmacists, pharmacies ensure the safe and effective use of medication, adhering to regulatory standards and professional guidelines. Healthcare commissioning is the process by which the health needs of a populatio n are assessed, the responsibility is taken for ensuring that appropriate services are available to meet these needs and the accountability for the associated health outcomes is established. Since April 2013, a number of commissioners have had a role in commissioning services from community pharmacies. The following general rules apply, but there are grey areas which may result in local variation on which commissioner takes a lead in commissioning a service:  Local NHS England teams - commission all services in the NHS Community Pharmacy Contractual Framework (CPCF), i.e. Essential, Advanced and Enhanced Services. Other commissioners cannot commission these services from community pharmacies. Enhanced Services are those pharmaceutical services that are listed in The Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013. Other commissioners may choose to commission some of these Enhanced Services from community pharmacies, but they would be classed as locally commissioned services and not Enhanced Services.  Integrated Care Boards (ICBs) - the services that the ICB commissions include planned hospital care, rehabilitative care, urgent and emergency care (including out -of-hours and accident and emergency services), most community health services, maternity services, mental health and learning disability services. From community pharmacy, ICBs may wish to commission services such as minor ailments services and palliative care schemes.  Local Authorities (LAs) - have responsibility for commissioning a wide range of services, including most public health services and social care services. The following public health services provided by community pharmacies would be commissioned by local authorities:  Supervised consumption;  Needle and syringe programme;  NHS Health Check;  EHC and contraceptive services;  Sexual health screening services;  Stop smoking;  Chlamydia testing and treatment;  Weight management; and  Alcohol screening and brief interventions. LAs will use their own contracts or the standard public health contract to commission services from community pharmacies. There are a small number of circumstances where a public health service is commissioned by another organisation, e.g. NHS England commissions vaccination services from GPs, community pharmacies and other providers. There may also be circumstances where ICBs may wish to be involved in commissioning a public health service, due to the impact the service may have on the development or management of long-term conditions. This may involve co-commissioning a service, which Page 2 is likely to happen on a more regular basis as a resu lt of the full introduction of the Better Care Fund in 2015/16. Community Pharmacy England believes that some public health services (which are widely commissioned at a local level ) could be more effectively and efficiently commissioned within the national Community Pharmacy Contractual Framework (CPCF). However, the Government’s localisation agenda and the current commissioning landscape, where NHS England commissions the CPCF but LAs hold funds for public health services, means that it is unlikely that such services could be commissioned via the national CPCF in the near future. Whilst the Council commissions a number of public health services delivered through community pharmacies, Pharmacy First is a nationally commissioned NHS service. The Council’s Children, Families, Health and Care Select Committee will consider how local partners can work together to maximise the benefits of the service for Hillingdon residents. What Services are Provided at Pharmacies? Pharmacies offer a wide range of services beyond the mere dispensing of medications. Key services include:  Prescription Dispensing: Preparing and providing prescribed medications to patients.  Over-the-Counter (OTC) Sales: Supplying non -prescription medications and health products.  Health Advice and Consultations: Providing guidance on the safe use of medications, managing minor ailments and preventive health measures.  Vaccinations: Administering immunisations for flu, COVID -19 and other preventable diseases.  New Medicine Service (NMS) : providing support for people with specific l ong-term conditions newly prescribed a medicine to help improve medicines adherence  Health Screenings: Offering services such as blood pressure monitoring, cholesterol checks and diabetes screenings.  Pharmacy Contraception Service (PCS): o Providing initiation and on-going supply of oral contraceptives, and o Free access to emergency contraception pills; and  Smoking Cessation Programmes: Supporting individuals in their efforts to quit smoking through counselling and nicotine replacement therapies. The cost of commissioning pharmacies can vary significantly based on the scope of services provided, the geographical location and the contractual agreements in place. In the UK, the NHS allocates a substantial budget to community pharmacies, covering dispensing fees, service payments and additional reimbursements for specific health programmes . Precise financial figures are often determined through detailed budget planning and negotiations between healthcare authorities and pharmacy representatives. What is the Local Pharmaceutical Committee (LPC)? The local organisation for community pharmacy is the Local Pharmaceutical Committee (LPC) – there are around 55 LPCs throughout England. The LPC is the focus for all community pharmacists and community pharmacy owners and is an independent and representative group. The LPC works locally with NHS England Area Teams, ICBs, local authorities and other healthcare professionals to help plan healthcare services. Page 3 The LPC negotiates and discusses pharmacy services with commissioners and is available to give advice to community pharmacy contractors and ot hers wanting to know more about local pharmacy. LPCs liaise closely with their medical equivalent the Local Medical Committees (LMCs) so that GPs and pharmacists can work together to deliver services to patients. LPCs also work closely with Local Dental Committees (LDCs) and Local Optical Committees (LOCs). What is a Pharmaceutical Needs Assessment? Pharmaceutical Needs Assessments (PNAs) have been in place for 20+ years and provide a comprehensive evaluation process that determines the local needs for pharmaceutical services within a specific area or population. It aims to ensure that the provision of these services aligns with the healthcare needs of the community. PNAs are particularly crucial for healthcare planners, policymakers and service providers as they help in the strategic planning and development of pharmacy services, ensuring that resources are utili sed effectively and efficiently. One of the primary objectives of a PNA is to identify gaps in existing pharmaceutical services. This involv es assessing the availability, accessibility and quality of current services and determining whether they meet the population's needs. By highlighting these gaps, PNAs provide a foundation for developing strategies to address unmet needs, improve service delivery and enhance patient outcomes. It should be noted that a gap in existing pharmaceutical services was identified some time ago in the Heathrow Villages as, although geographically close, the pharmacies located in the airport terminals are not acces sible for residents. A PNA serves as an essential tool for healthcare commissioners and providers, guiding the development and commissioning of new services or the modification of existing ones. It ensures that decisions are evidence -based, taking into account the specific needs of the population, demographic changes and emerging health trends. This targeted approach helps in optimising resource allocation and improving the overall efficiency of healthcare delivery. Hillingdon’s current PNA can be foun d at: https://pre.hillingdon.gov.uk/strategies-policies- projects/needs-assessments. How Do Pharmacies Alleviate Pressure On Primary Care And What Else Could Be Done Pharmacies play a critical role in alleviating demand pressures on primary care by:  Managing Minor Ailments: Providing treatment and advice for minor health issues, reducing the need for GP consultations.  Offering Preventive Services: Administering vaccinations and health screenings, thereby preventing more serious health issues that would require GP intervention.  Medication Management: Conducting medication r eviews and ensuring proper medication use, thus preventing complications that might necessitate a GP visit.  Health Education: Educating the public on health maintenance and disease prevention, which helps reduce the incidence of illnesses that would burden GPs. Pharmacy First The Pharmacy First service builds on the NHS Community Pharmacist Consultation Service which started in October 2019. The consultation service enabled patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply. The new Pharmacy First service was launched on 31 January 2024 and adds to the existing Page 4 consultation service. It enables community pharmacies to complete episodes of care for 7 common conditions following defined clinical pathways. In May 2023, NHS England and the Department of Health and Social Care announced a Delivery plan for recovering access to primary care. Part of the plan include enabling patients to get certain prescription medications directly from a pharmacy, without a GP appointment. It was anticipated that t his new service would free up GP appointments for patients who needed them most and would give people quicker and more convenient access to safe and high-quality healthcare. It include d the supply of appropriate medicines for 7 common conditions including earache, sore throat, and urinary tract infections, aiming to address health issues before they got worse. It is anticipated that this will also reduce the number of residents presenting at Hillingdon Hospital ’s Accident and Emergency / Urgent Treatment Centre when they could have been seen by the Pharmacy First service or a GP. The Pharmacy First initiative was launched to make greater use of community pharmacists’ skills and opportunities to engage patients and ensure patients receive the right treatment at the right time. As part of the initiative, pharmacists can help patients to manage the following seven conditions where not complex across various age ranges (patients outside these age ranges should consult their GP for treatment):  Earache: Ages 1 to 17 years  Impetigo: Ages 1 year and over  Infected insect bites: Ages 1 year and over  Shingles: Ages 18 years and over  Sinusitis: Ages 12 years and over  Sore throat: Ages 5 years and over  Uncomplicated urinary tract infections (UTIs) in women: Ages 16 to 64 years Patients can access the Pharmacy First service by attending or contacting the pharmacy directly without the need for referral (although they can also be referred by other organisations including general practice, urgent and emergency care settings, and NHS 111 (online and via telephone)). Pharmacies have private consultation rooms that can be used for consultations with patients, and pharmacists can see patients for clinical services without always needing an appointment. After a consultation with the pharmacist, the pharmacy will send a notification to the patient’s GP on the same day or on the following working day. Pharmacies have the potential to further reduce the demand pressure on GPs by expanding their scope of services. Potential areas for enhancement include:  Chronic Disease Management: Taking on a greater role in managing chronic conditions such as diabetes, hypertension and asthma through regular monitoring and patient education.  Advanced Clinical Services: Providing more advanced clinical services such as minor injury treatment, thus diverting cases that do not require a GP's expertise.  Telehealth Services: Implementing telehealth consultations to offer advice and support remotely, thereby increasing accessibility and convenience for patients.  Collaborative Care Models: Working closely with GPs and other healthcare professionals to deliver integrated care plans that optimi se patient outcomes and resource utilisation. Patient Experience Community pharmacies play an increasingly important ro le within the local health and care system, providing accessible healthcare advice, medicines optimisation, and an expanding range of clinical services closer to where residents live. For many people, pharmacies are the most accessible point of contact wi th the NHS, often offering timely support without the Page 5 need for an appointment. As the role of community pharmacy continues to evolve through initiatives such as Pharmacy First, it is important that any review considers not only the contribution pharmacies make to reducing pressure on general practice and urgent care services, but also the experiences of the residents who rely on them. Understanding whether residents are aware of the services available, know when it is appropriate to use Pharmacy First instead of their GP and have confidence in the care provided will be essential to assessing the effectiveness of the service. Consideration needs to be given to potential barriers, including opening hours, transport, digital exclusion, language, disability , consultation privacy and awareness of the services offered by individual pharmacies. Previous resident feedback has highlighted issues relating to communication between GP practices and pharmacies, repeat prescriptions, medicine shortages, variations in commissioned services and a lack of clear information about which pharmacies provide specific services. The review therefore presents an opportunity to understand the local implementation and impact of Pharmacy First by examining service activity, referral pathways and residents' experiences, rather than assuming its effectiveness. Engaging with a broad range of stakeholders (including Pharmacy First users and non-users, community pharmacists, GP practice representatives and voluntary and community organisations) could provide a more comprehensive understanding of how pharmacy services are experienced in practice and whether they are meeting the needs of all residents consistently and equitably. Executive Responsibilities The portfolio Cabinet Member responsible is Councillor Susan O’Brien. 3. EVIDENCE & ENQUIRY Potential witnesses (including service users) Witnesses will be identified by the Committee in consultation with relevant officers and may include:  Service users  Local Pharmaceutical Committee  Community Pharmacists  Voluntary Sector Organisations  West and North London Integrated Care Board  Sharon Stoltz, Director of Public Health, LBH  Dr Ritu Prasad, Chair of The Confederation Hillingdon CIC  Keith Spencer, Managing Director, Hillingdon Health and Care Partners  Samreen Nawshin, Healthwatch Hillingdon Lines of Enquiry Lines of enquiry can be expanded as the review progresses or included in relevant witness session reports. However, lines of enquiry may include: 1. What community pharmacy services are currently commissioned in Hillingdon? 2. How do services provided by pharmacies in Hillingdon alleviate the pressure on primary care? 3. Are the current pharmacy services being used as well as they could by residents? If not, how could this be improved? 4. What additional services could be provided by pharmacies to alleviate pressure on primary care? Page 6 5. How is service quality and patient experience monitored across community pharmacy services and how is learning used to support continuous improvement? 6. How aware are Hillingdon residents of Pharmacy First and other pharmacy services? 7. What is the service user experience in relation to the availability / accessibility of services? 8. What prevents residents from using pharmacies as a first point of contact? 9. How is the scope of provision geographically located and does this meet the needs of residents? Are there particular communities or areas of the Borough where pharmacy access is weaker? 10. Are services available consistently across Hillingdon, including evenin gs and weekends? 11. How are pharmacy-related complaints, concerns, and patient feedback captured and acted on? Surveys, site-visits or other fact-finding events Such opportunities will be identified as the review progresses. Future information that may be required Further information may be identified as the review progresses. 4. REVIEW PLANNING & TIMETABLE Proposed timeframe and milestones for the review: Meeting Date Action Purpose / theme Witnesses / officers attending 21 July 2026 Agree Scoping Report Information and analysis TBC 13 October 2026 Witness Session 1 Information and analysis  Healthwatch Hillingdon  Service Users 12 November 2026 Witness Session 2 Information and analysis TBC 12 January 2027 Witness Session 3 Information and analysis - To discuss key findings and identify potential recommendations TBC Outside the committee – workshop / survey / networking session / consultation / informal meeting with users, etc... 16 February 2027 Agree recommendations To agree recommendations 11 March 2027 Approval of draft final report To agree draft final report to Cabinet Page 7 Meeting Date Action Purpose / theme Witnesses / officers attending 29 April 2027 Final report to be presented to Cabinet Resource requirements The review will be undertaken within existing resources. Equalities impact The 2010 Equality Act outlines the provisions of the Public Sector Equalities Duty which requires Public Bodies to have due regard to the need to:  eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Equality Act 2010.  advance equality of opportunity between people from different groups.  foster good relations between people from different groups. The broad purpose of this duty is to integrate considerations of equality into day business and keep them under review in decision making, the design of policies and the delivery of services. There are no equality impact issues relating to the matters set out in this report. Background Papers / further reading None. Page 8

Minutes CORPORATE PARENTING PANEL 28 July 2026 Meeting held at Committee Room 6 - Civic Centre, High Street, Uxbridge UB8 1UW To Members of the Panel: Voting Members: Councillor Ekta Gohil (Chair) Councillor Jane Palmer (Vice-Chair) Councillor Jan Sweeting Non-voting Members: Representatives of the Children in Care Council, and Care Experienced Young People Ash Knight, Children’s Participation and Co-Production Team Manager Officers Present: Poppy Reddy, Assistant Director, Care, Support & Transition Lisa Steel, Virtual School Headteacher Kudakwashe Kurashwa, Head of Service, Youth and Adolescent Services Ryan Dell, Democratic Services Officer Also Present: Katie Randall, Clinical Services Manager , Harrow 0 -19 Service, CCN Team, Special School Nursing and Looked After Children, CNWL * This meeting was co-chaired by a Children in Care Council member 1. APOLOGIES FOR ABSENCE (Agenda Item 1) Apologies had been received from Dr Kate Head. 2. DECLARATIONS OF INTEREST IN MATTERS COMING BEFORE THIS MEETING (Agenda Item 2) None. 3. MINUTES OF THE PREVIOUS MEETING (Agenda Item 3) RESOLVED: That the minutes of the meeting dated 19 March 2026 be approved as an accurate record. 4. OVERVIEW OF CORPORATE PARENTING RESPONSIBILITIES (Agenda Item 4) Officers introduced the report which outlined the corporate parenting responsibilities for Cared for Children and Care Experienced Young People. Following consultations with young people, terminology had been updated locally to replace looked after children, care leaves, and unaccompanied asylum-seeking children with cared for children , care experienced young people , and unaccompanied children seeking asylum. It was noted that looked after children was a nationally statutory phrase that was still used where required. Our children was another newly used term. Members commended consulting the young people on this. It was noted that it may not only be Hillingdon who had updated its terminology, but Hillingdon was thought to be the only authority in west London. The young people noted that lots of their peers lived with young people placed by other boroughs who would all have different experiences, and that different language can make them stand out. It was hoped that Hillingdon practise would transfer out to other boroughs. The young people noted that Hillingdon h ad done a lot to make them feel like they were not just a number. It was suggested that a trauma informed practise document could be shared. The young people noted that it was good for professionals to be aware of updated language, but also for everyone to know. Corporate parenting responsibilities extend ed beyond a young person ’s 18 th birthday, continuing until they were 21 and up to 25 if they requested or consented to support. There were three main routes into care: • Care orders: Made by the courts under Section 31 of the Children Act 1989, where the local authority was granted parental responsibility • Voluntary accommodation: Under Section 20 of the Children Act 1989, where parents or those with parental responsibility agreed for the child to be accommodated by the local authority (or when a child is lost, abandoned or the person who has been caring for the child is being prevented from providing suitable accommodation or care) • Youth justice system: Since 2013, all youn g people remanded into custody were supported as cared for children When a young person needed to be looked after, efforts were made to keep the young people with family except as a last resort. Where this was not possible, extended family or connected carers would be the next option. After this, fostering or adoption would be considered. The voice of young people was very important, and co-production was encouraged. Officers supported transition into adulthood by actively promoting young peoples’ mental wellbeing, education, training, and employment, whilst always maintaining high aspirations and ensuring they have access to safe and appropriate housing options including ‘staying close’ and ‘staying put’: • Staying close: is designed for young people moving across from residential care or foster care. It provides an enhanced package that includes move -on accommodation, practical and emotional support • Staying put: allows young people who were in foster care to continue living with their foster carers af ter they turn 18. The support continues until they are 21, thereby providing stability and continuity during their transition to adulthood As a port authority there was lots of demand due to unaccompanied young people seeking asylum. When an unaccompanied young person seeking asylum arrived, there was only seven days for two officers to meet the young person, interview them, verify their documents and write a report. From September up until last week, there had been 133 referrals. All cared for children were on roll with the virtual school, and every cared for child aged 2-18 had an allocated virtual school officer. They would meet the young person at least once per term and worked to help the young people reach their full potential. RESOLVED: That the Panel: 1. Noted the developments and achievements outlined in this report; and 2. Endorsed the continued embedding of corporate parenting principles across all services 5. CARE STRATEGY FOR CHILDREN AND CARE EXPERIENCED YOUNG PEOPLE (Agenda Item 5) Officers presented an update on the Care Strategy for Children and Care Experienced Young People, noting that it was a requirement for all Local Authorities to have a strategy. Following consultation with young people, the strategy does not use terms such as looked after children or children in care , and instead refers to these young people as cared for children and care experienced young people, terms that were chosen by young people and that they felt better reflect ed their experiences and strengths. It was noted that the Panel could also be renamed to reflect this. One aim of the strategy was for it to be in conjunction with partners and young people, to help young people achieve safety, stability and outcomes. As at 30 June 2026, Hillingdon was Corporate Parent to 323 cared for children. Corporate parenting was a collective responsibility, across elected Members, officers and services, to act as effective corporate parents and to secure the best possible outcomes for cared for children and care experienced young people . The voice of young people was essential to this, and i t was also a responsibility to support young people in their transition into adulthood. The core principles of the strategy were:  Supportive relationships  Holistic support  Advocacy and participation  Continuity and stability  Aspirations and achievements  Our commitment to improvement The strategy included six pledges:  Help and support to stay safe and healthy  Support through education and planning for the future  Celebrate achievements  Listen and involve children and young people in decisions about their lives  Help all children feel they belong  Ensure young people feel fully prepared for transition to adulthood Celebrating the young people’s achievements was done, in part, through the Kids in Care Awards (KICA). Education support came from the Virtual School and other providers. Helping children to feel they belong included providing access to a range of suitable accommodation options, including supported lodgings, semi-independent living, Staying Close, staying put (staying with foster carers) arrangements and help accessing social housing or private renting such as houses of multiple occupation (HMOs) or shared accommodation. The young people noted that Hillingdon had done a lot to help them feel belonging. The Local Offer had been published so that young people kn ew what support was on offer. This included financial support, housing and accommodation, health and wellbeing, and education and employment. The young people would be consulted on potentially renaming the Local Offer. The strategy intended to turn ambitions and aspirations into reality by working closely with young people and ensuring that they had an active role in informing strategic objectives. Officers were committed to working in partnership with young people and ensuring co -production and collaboration was at the heart of the approach. By embedding y oung people ’s voices in decision -making and holding themselves accountable through robust monitoring and evaluation, officers were dedicated to turning ambitions and aspirations into meaningful, lasting change for every child and young person in Hillingdon. Members asked about accommodation pathways and the pressures of unaccompanied children seeking asylum. It was noted that most of these young people were in supported accommodation, and that housing officers could be invited to future Panels. The young people advised that lots of their peers had similar experiences, and it was important to have someone to believe in you. The young people commended the Participation Manager for having a positive impact on their life , and also noted that lots of social workers do more than is expected of them. Members asked how often social workers met and shared experiences with each other. Officers advised that team meetings were a forum of sharing experiences. An example of positive feedback from a young person was shared. Members commended this but noted that all young people need these positive experiences. It was important to measure these markers and officers advised that this was embedded in their practise. There were fortnightly all staff meetings with over 300 officers. Feedback from young people was also gained where young people sat on interview panels. There were also monthly case audits, in which young people were involved. Officers noted that the y were open to scrutiny and had invited the recent peer review. There was also a mock Ofsted inspection ongoing. The young people noted that while it was important to share negative feedback, they did not want to name names. Officers noted that feedback should include ‘what went well’ and ‘even better if’. Members asked about procedures for young people to raise concerns. The young people noted that some good news stories were not recent, and that renewed methods of collecting feedback were needed. This could include a form to submit anonymously. Members noted that this Panel was a forum for scrutiny and ensuring that young people’s voices were heard directly. It was suggested that young people could raise concerns through their peers, however the young people noted that they did not get enough contact time with their social workers/ PAs to discuss their own experiences. The Health reps noted that when young people attended their health assessments, if they attended alone they often wanted to disclose something. The Health reps would follow up on this and had anonymous client satisfaction surveys. Officers noted that the Youth Justice System had implemented feedback forms and exit surveys. More information on this would be included in the annual plan which was due to be published soon. The young people noted that lots of help is offered up until the age of 21. If young people were unable to benefit from this during these years, they were unable catch up at later ages. Officers advised that Independent Reviewing Officers took part in reviews. There were also regular monthly audits, and auditors spoke with the young people. It was important to ensure that all feedback was received. RESOLVED: That the Panel noted the update 6. REDUCING THE CRIMINALISATION OF CARED FOR CHILDREN (Agenda Item 6) Officers presented a report on reducing the criminalisation of cared for children. The purpose of the report was to note the national protocol relating to cared for children and care experienced young people. This was a priority for the Department for Education, and it was noted that cared for children continue to be disproport ionately represented within the youth justice system. In 2025/26, 14 cared for children had entered the Youth Justice System, accounting for 12% of all entrants. This was despite cared for children representing only 0.4% of the local 0-17 population. The number of first-time entrants to the Youth Justice System among cared for children had reduced from eight in 2024/25 to two in 2025/26. Analysis of the ethnicity of cared for children who entered the Youth Justice Service over the last three financial years highlighted important differences when compared with both the wider Youth Justice Service entrant cohort and the local population. The gender of cared for children entering the Youth Justice Service was broadly similar to the profile of all Youth Justice Service entrants. Male young people were over - represented, though the gap was reducing slightly. Hillingdon had a considerably higher percentage of care experienced young people starting orders than the national and London rate during Q1, Q2 and Q3 of 2025/26 , though there had been some improvement. It was noted that the improvement in Hillingdon was not seen nationally or in London. Training work was ongoing with magistrates and practitioners. All young people in the Youth Just ice Service were screened for speech and language needs. There were intervention feedback forms, focus group discussions and a new co - production group to get feedback from young people. Reducing the unnecessary criminalisation of cared for children improved outcomes for some of Hillingdon's most vulnerable residents. It support ed improved emotional wellbeing, greater placement stability, increased educational engagement, reduced offending, improved life chances and better transitions into adulthood. It also ensure d the Council fulfil led its corporate parenting responsibilities and promote d positive outcomes for children and young people. Often there were no alternatives to custody. Outcome 22 had been implemented by the Police in Hillingdon from 01 April 2026. It was asked if there was a correlation between being known to the Youth Justice Service and exclusions/ suspensions from school. There was no known correlation. RESOLVED: That the Corporate Parenting Panel: 1. Noted the national expectations and principles set out within the National Protocol on Reducing the Unnecessary Criminalisation of Looked -After Children and Care Leavers; 2. Endorsed reducing the criminalisation of children in care as a continuing Corporate Parenting priority in Hillingdon; 3. Receive annual performance information relating to children in care entering the youth justice system, first -time entrants, diversion outcomes and use of restorative approaches; and 4. Supported continued multi-agency partnership working between Children's Services, Youth Justice Service, Police, Health, Education and care providers to prevent unnecessary criminalisation and improve outcomes for children in care and care leavers. 7. CHILDREN’S SERVICES PERFORMANCE DATA (Agenda Item 7) Officers presented the quarterly performance data report. Members asked and officers noted that statistical neighbours could be included in future reports. RESOLVED: That the Panel noted the content of the report. 8. ANNUAL REPORT: CARED FOR CHILDREN HEALTH TEAM (Agenda Item 8) Health reps from CNWL introduced their 2024/25 annual report, which gave an overview of staffing; demographics, trends and changes in health needs; activities; health assessments and meeting targets; and challenges. Initial Health Assessments 230 requests to complete IHAs had been received. Of these, 198 were completed. The reason 32 were not completed were that the young person had moved, they were no longer CLA or they declined to attend appointment. Of the 198 IHAs completed, 149 were seen within 20 days of the child becoming cared for. 100% of IHA’s were completed on time. Review Health Assessments 347 requests for RHAs had been received. 209 were placed in Hillingdon and 138 were placed out of borough. 58 children who had requests raised in the reporting period were seen in the next reporting year. Appointments were offered at home or in clinic, and at a time that suit ed the young person, with virtual or telephone appointments were appropriate. Continuity was attempted by allocating the same nurse if possible. 100% of the RHAs were s een on time. Challenges Challenges included:  Late notifications  Children placed out of borough  Increase in safeguarding and strategy meetings  Complex health issues, leading to longer appointments  Staffing capacity  High number of children not brought to appointments Examples of anonymous feedback were shared, and new methods of sharing feedback were being looked into. Next steps  New client satisfaction survey  Multi agency working, with a view to improving uptake of health assessments  Deliver training to social care, health and medical colleagues  Taking on feedback from service users An interim plan was in place as there was currently no named nurse for Hillingdon. The named nurse for Harrow was covering both roles. Members asked if the young people were aware of this and were advised that both borough ’s Corporate Parenting Panels had to be informed first. Members asked about addressing capacity issues. Guidance was that the health professional best known to the young person should attend their strategy meeting, though other professionals would attend where necessary. Health reps from CNWL shared an update on behalf of the West and North London ICB:  The organisational redesign remains ongoing. The plan for the newly merged West and North London Integrated Care Board is to create a smaller, more strategic commissioning organisation serving 4.5 million residents across 13 boroughs. This is part of a national NHS programme to reduce ICB running costs whilst shifting more responsibility to local places and neighbourhoods.  The organisational change has followed a formal programme inclusive of consultation on the new operating model and consequent recruitment and slotting into the new structure.  An independent Consultation will commence for Safeguarding and CLA staff within the next few weeks, and a robust structure will be stood up following this process.  From a Children Looked After and Safeguarding perspective, the ICB will be expected to continue to discharge all statutory functions via the Designated Doctor and Designated Nurse for CLA.  There is an Interim Designated Nurse for CLA in post who will remain in post until the new Safeguarding/ CLA structure is stood up.  The Designated Doctor is working with the health provider to ensure access to Dental treatment is highlighted as a concern (this reflects the national picture)  The Designated Doctor is planning to commence work to ensure specific healt h screening for UASC is consistent across the footprint. RESOLVED: That the Corporate Parenting Panel noted the report. 9. WORK PROGRAMME (Agenda Item 9) Members considered the work programme. Officers advised that Housing officers and the Cabinet Member for Planning, Housing & Property would be invited to attend the next meeting. RESOLVED: That the Corporate Parenting Panel considered the Work Programme The meeting, which commenced at 5:30 pm, closed at 7:25 pm. These are the minutes of the above meeting. For more information on any of the resolutions, please contact Ryan Dell on democratic@hillingdon.gov.uk. Circulation of these minutes is to Councillors and officers.

Children, Families, Health and Care Select Committee – 22 September 2026 Classification: Public HEALTH UPDATES Committee name Children, Families, Health and Care Select Committee Officer reporting Nikki O’Halloran, Democratic Services Papers with report Appendix A – Royal Brompton and Harefield Hospitals, Guy's and St Thomas’s NHS Foundation Trust Appendix B – The Confederation, Hillingdon CIC Appendix C – Central and North West London NHS Foundation Trust Ward n/a HEADLINES To enable the Committee to receive updates and review the work being undertaken with regard to the provision of health services within the Borough. RECOMMENDATION: That the Children, Families, Health and Care Select Committee notes the presentations. SUPPORTING INFORMATION Hillingdon Health and Care Partners (HHCP) Hillingdon Health and Care Partners (HHCP) is the ‘Place Based’ alliance of health and care organisations that seeks, through collaboration and co-design, to make significant improvements to the quality and cost of care in Hillingdon. HHCP is made up of Hillingdon Hospitals NHS Foundation Trust, Central and North West London NHS Foundation Trust (CNWL), H4All (a partnership of voluntary sector health care providers) and Hillingdon’s Confederation (which brings together all of Hillingdon’s GPs). HHCP works together closely with the London Borough of Hillingdon and North West London Integrated Care Board (NWL ICB) to deliver 3 key strategic aims:  Improving the outcomes for our population - delivering Hillingdon’s Joint Health and Wellbeing Strategy  Delivery of sustainable, person-centred, joined up models of care aligned to the new hospital plans and activity assumptions  Delivering the NWL Integrated Care System (ICS) priorities through local care models building from a population health management approach Shared delivery models are through 6 integrated Neighbourhood Teams and a range of joined up Borough wide teams across health and care. The Hillingdon Hospitals NHS Foundation Trust (THH) The Hillingdon Hospitals supplies services from two sites; Hillingdon Hospital and Mount Vernon Hospital and has an annual turnover of around £320 million, employing approximately 3,700 staff. We are proud to deliver services for our local borough of Hillingdon, and to those living in the surrounding areas of Ealing, Harrow, Buckinghamshire and Hertfordshire, giving us a total catchment population of over 350,000. Hillingdon Hospital is the only acute hospital in the London Borough of Hillingdon and offers a wide range of services, including accident and emergency (A&E), inpatient care, day surgery, outpatient clinics and maternity services. The Children, Families, Health and Care Select Committee – 22 September 2026 Classification: Public Trust’s services at Mount Vernon Hospital include routine day surgery, an Urgent Care Nurse Practitioner service and outpatient clinics. The Trust hosts several other organisations that supply health services at the Mount Vernon site including East & North Hertfordshire NHS Trust’s Cancer Centre. Royal Brompton and Harefield Hospitals (RBH) The Royal Brompton & Harefield Hospitals merged with Guy's and St Thomas’s NHS Foundation Trust (GSTT) in February 2021 and, from April 2022, joined with the cardiorespiratory services at GSTT to form a new Heart & Lung & Critical Care Group across the three sites. At the same time, the Evelina Children’s Hospital took over the running of the paediatric services at Royal Brompton. The merger of the two NHS foundation trusts was approved by the Boards and Councils of Governors of both organisations in December 2020 and came into effect on 1 February 2021. This merger saw the creation of a newly expanded Guy’s and St Thomas’ NHS Foundation Trust, with Royal Brompton and Harefield forming a new Clinical Group within the Trust. Since 2017, Guy’s and St Thomas’ and Royal Brompton & Harefield NHS Foundation Trusts have been working together, and with colleagues across King’s Health Partners, to develop plans to transform care for adults and children with heart and lung disease. This merger is a key step towards achieving these ambitions. To begin with, the merger will mean clinicians and teams working more closely together, building on the partnership work over the last three years, but generally providing services to the same patients and in the same places as they do now. Subject to the necessary public consultation, children’s services will move from the Royal Brompton Hospital site to an expanded Evelina London Children’s Hospital at St Thomas’ in around four to five years’ time. Subsequently, and again subject to consultation, the Trust hopes to build a new centre for heart and lung services at St Thomas’, which will be the home to adult heart and lung services from across the new Trust and potentially other partners as well. There are no plans to move services from Harefield Hospital, but these services will be an integral part of the integration across the new Trust. Central and North West London NHS Foundation Trust (CNWL) CNWL is a large and diverse organisation, providing health care services for people with a wide range of physical and mental health needs. The Trust employs approximately 7,000 staff who provide integrated healthcare (more than 300 different health services) across 150 sites and in many other community settings. Types of services include:  Physical health: Community treatment for physical conditions that do not require general hospital treatment or conditions that require long-term care. This includes district nursing, health visitors, stroke care and support for people in recovery.  Mental health: Community and hospital treatment for children, adults and older people with mental health problems. Services range from counselling support for mild conditions to rehabilitation treatment for long and enduring mental health problems.  Learning disabilities: Assessment and treatment for people with learning disabilities who also have complex mental health needs and/or challenging behaviour. Services are provided in the community or hospital.  Eating disorders: Admission to hospital or appointment sessions are provided to support men and women with an eating disorder.  Addictions: Community drug and alcohol treatment services are provided, as well as hospital admission when it is needed. Specialist services to address problem gambling, compulsive behaviour and club drug problems are also available. Children, Families, Health and Care Select Committee – 22 September 2026 Classification: Public  Sexual health: Appointment and walk-in services are available for anyone who needs them. This includes contraceptive choices, treatment of sexually transmitted infections and HIV testing and treatment.  Prison and offender care: Full healthcare services, including primary healthcare, addictions and mental health support, are provided in a number of prisons. Mental health support is also provided in the community for people who have offended in the past or people at risk of offending. West and North London Integrated Care Board (WNL ICB) In response to the NHS long term p lan, which suggested that the number of CCGs will be significantly reduced to align with the number of emerging Integrated C are Systems (ICSs), North West London (NWL) CCGs launched a case for change for commissioning reform on 29 May 2019. The case for c hange recognised that there were questions on how the CCGs respond to the configuration issues raised by the long term plan which required exploration and resolution. Following the engagement period , the recommendation to governing bodies was to proceed to a formal merger of CCGs from 1 April 2021 , using 2020/21 as a transition year to focus on the following:  System financial recovery  Development of integrated care at PCN, borough and ICS level  Building closer working relationships with the local authorities  The development of a single operating structure across the c ommissioning system, and meet the expectations of NHSE that the CCG would operate in 2020/21 under a single operating framework, with the associated reduction in management costs and streamlined governance  To work with providers to develop alternative reimbursement structures from 2020/21 to support delivery of ICP/ICS On 1 April 2021, the eight Clinical Commissioning Groups in North West London (NWL) became one organisation, and the ICS then came into being in 2022. On 1 April 2026, NWL ICB merged with North Central London ICB to become the West and North London ICB, now covering 13 London boroughs. Healthwatch Hillingdon Healthwatch Hillingdon is a health watchdog run by and for local people. It is independent of the NHS and the local Council. Healthwatch Hillingdon aims to help residents get the best out of their health and social care services such as doctors, dentists, hospitals and mental health services and gives them a voice so that they can influence and challenge how health and care services are provided throughout Hillingdon. Healthwatch Hillingdon can also provide residents with information about local health and care services, and support individuals if they need help to resolve a complaint about their NHS treatment or social care. Healthwatch Hillingdon is one of 152 community focused local Healthwatch. Together, they form the Healthwatch network, working closely to ensure consumers’ views are represented locally and nationally led by Healthwatch England. Healthwatch Hillingdon is all about local voices being able to influence the delivery and design of local services. Not just people who use them, but anyone who might need to in the future. By making sure the views and experiences of all people who use services are gathered, analysed and acted upon, Healthwatch can help make services better now and in the future. Children, Families, Health and Care Select Committee – 22 September 2026 Classification: Public To make sure that the voices of children and young people are heard, Healthwatch Hillingdon created Young Healthwatch Hillingdon (YHwH). YHwH is made up of volunteers who represent the views of children and young people living, working or studying in Hillingdon. They do this by: o Sharing and promoting information about health issues and services that affect children and young people through events, social media updates and reports. o Speaking to children and young people and gathering their views about what health issues and services are important to them. o Working with health and social care services representatives to try to shape and improve services for children and young people. Witnesses Representatives from the following organisations have been invited to attend the meeting: 1. The Hillingdon Hospitals NHS Foundation Trust (THH) 2. Central and North West London NHS Foundation Trust (CNWL) 3. Royal Brompton & Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust (RBH) 4. Hillingdon Health and Care Partners (HHCP) 5. Integrated Care Board (ICB) 6. Healthwatch Hillingdon (HH) 7. The Confederation Hillingdon CIC

Appendix A 1 Update Paper for Hillingdon Health and Social Care Select Committee Royal Brompton and Harefield Hospitals Part of Guy’s and St Thomas’ NHS Foundation Trust September 2026 1.0 Performance 1.1 Referral to Treatment (RTT) and Long Waiting Patients Significant progress has been made to reduce the number of patients waiting 65-weeks for treatment, Recovery plans are now shifting focus on to the reduction against the 52 week backstop. Amongst the most challenged services are cardiology and cardiac surg ery with waiting times for the former being highest at the South London sites. As of September 2026 Harefield has 34 patients waiting more than 52 weeks with 27 awaiting cardiac surgery, 5 cardiology & 2 sleep services. Clinically urgent elective cardiac surgery continues to represent a significant operational and safety risk. The Trust currently has approximately 952 patients waiting for elective cardiac surgery, representing 53% of the pan London waiting list . This include s a large cohort of P2 category patients that require surgery within four weeks. As outlined at previous meetings, these patients are closely monitored through the Ortus platform to ensure early identification of deteriorating symptoms which triggers a prompt clinical review. A recovery plan has been developed to increase the throughput of cardiac surgery cases and reduce the waiting times. This plan includes a reduction in cancellations, extended operating days and an increased availability of dedicated critical care capacity which is often the rate limiting factor. July/August cardiac surgery activity data across London was favourable with the combined performance of all 7 units delivering 117% of the elective plan. The Royal Brompton hospital was the highest performing unit during this time hitting 141% of plan with Harefield and St Thomas sites delivering 103% & 110% respectively. 1.2 Diagnostics (DMO1) There are particular challenges around achieving the d iagnostic performance standard of having <5% of patients waiting more than 6 weeks. This compliance issue is driven in large part by growth in demand for specialist services. Across Harefield there are 1288 active patients awaiting diagnostic tests with 221 currently waiting more than 6 weeks. In order to improve compliance, there is currently a demand management action plan being developed in order to reduce the volume of repeat tests with increased senior clinical vetting to ensure capacity is used for the most essential patient cohorts. As mentioned in previous reports there continues to be increased demand on sleep services due to the dramatic increase in referrals associated with patients trying to access weight loss drugs with Obstructive Sleep Apnoea (OSA) being a key criterion for accessing these medications. 2.0 Cardiothoracic Transplant 2025/26 finished with Harefield having performed 71 transplants the highest volume since 2019. In the first 5 months of this financial year there have been 17 heart and 17 lungs transplanted meaning the current run rate is a further 14% increase on the prior years activity. Appendix A 2 Transplant wards remain with a high occupancy level, and Harefield continues to manage a significant cohort of post-transplant patients and increasing referrals for transplant assessment. The Trust has invested significa ntly in an ex vivo lung perfusion machine which reconditions marginal donor lungs to bring them to a standard for transplantation. This project is part of a national pilot involving transplant centres with Harefield aiming to become the lung centre offering this service to London and the surrounding regions. 3.0 Robotic Programme During April 2026 Harefield rolled out the use of the latest Da Vinci D5 thoracic surgical robot. The utilisation of robotic assisted thoracic surgery as an alternative to conventional video-assisted robotic surgery (‘VATS’) and open surgery for lung cancer resections has been steadily expanding worldwide. This latest surgical robot compliments the programme already well established at the Royal Brompton. Funding has been awarded for a new bronchoscopy suite at Harefield hospital which is due to be constructed and opened by October 2027. This 2-room facility is designed to house the latest in robotic navigational bronchoscopy for the diagnosis and treatment of lung cancers at an early stage of disease . The new facility will represent a significant increase in capacity for NWL and the surrounding regions. The funding has been awarded by NHSE as part of the plan to improve cancer diagnosis and treatment across the region along with funding from the Royal Brompton and Harefield Hospitals Charity in support of a wider Robotics programme. 4.0 Ward closures As part of the wider trusts financial improvement plans there has been a planned reduction in bed numbers across GSTT. At Har efield hospital, as a benefit of improved flow, there has been a closure of 10 level 1 surgical beds. A temporary vacancy freeze allowed the hospital to re -deploy the staff in to other appropriate wards and clinical areas meaning staff retention remains high. Improved processes and flow has meant that the operational impact on the running of the hospital has been minimal with no impact on patient care or activity. A comprehensive escalation plan remains in place should the reduction in beds negatively impact on the site treating patients. 5.0 Harefield Clinical Strategy and site development The vision for Harefield Hospital is: To be international leaders in the management of advanced heart and lung disease, whether acute or non-acute, delivered at scale through the most complete repertoire of treatment modalities, supported and aligned with cutting edge science. The ambition is utilise the space, clinical expertise and academic links to create a fully integrated life sciences campus on the Harefield hospital site in partnership with pharma and MedTech. This development will provide modern facilities for the delivery of highly specialised health care with particular focus on Harefield being a leading centre for heart and lung transplantation, advanced cardiac and respiratory failure support and an acute Heart Attack Centre, with a national and international referral footprint. The clinical strategy was endorsed by the Board in November 2025, and the programme has now moved into the planning / implementation phase.

Appendix B Children and Young People’s Hubs Update The Confederation has delivered young people’s services in partnership with the hospital and GPs for many years. Although the services have always been highly valued by patients and professionals alike, the contractual arrangements had always been short term and on countless occasions were run ‘at risk’ by the Confederation. In addition to this the Confed provides paediatric phlebotomy across Hillingdon on behalf of practices as part of the GP enhanced services arrangements. During the 2025/26 contract period we were informed of changes in the contracting process; the Enhanced Services single offer was updated to incorporate Children and Young People’s (CYP) hubs. The high-level specification was very similar to the longstanding Hillingdon service offer with some minor differences. Following discussions with general practice colleagues it was agreed with all the PCNs that to deliver the new CYP model the CPAC and IPCC service should continue to be delivered by the Confederation, with some small adaptations to meet the new specification. Hub Locations The existing hub locations are at Pembroke Centre (North neighbourhood) and Civic Centre where we have a small clinical site serving the SW neighbourhood. There is currently no hub location for the SE of the Borough, although through use of practice locations for these services we ensure that young people across the borough can access the services at a location close to them. Integrated Paediatric Community Clinic (IPCC) Locations North Hub – Pembroke Centre Central Hub – Civic Centre South Hub – Rotational in south practices currently Hayes Medical Centre and will then move to the Pine Medical Centre Community Paediatric Ashma Clinic (CPAC) Locations are rotational; we use a combination of practices as the hub site or our own hub locations to maximise access opportunities for children and their parents/carers Other Specialist Paediatric Clinic Locations Eczema – Pembroke Constipation – Civic & Pembroke Diabetes – Pembroke. Multi-Disciplinary Team (MDT) Working As part of the new contract there is a specific focus on MDT case discussions. The aim is to bring together Consultant Pediatrician, GP, clinical psychology and other health and care colleagues (including Family Hub Leads, school nursing and health visiting) to discuss patient cases and agree the most appropriate next steps for the child or young person. This may include providing clinical advice and guidance, onward referrals to the joint clinic, secondary care, community and mental health services, school nursing, health visiting, Best Start Family Hubs and follow-up by the GP or other appropriate pathways. Feedback from the discussion is provided to the child or young person and their family or carer, as well as to the referrer. Hillingdon has had an MDT approach in the past but this had fallen way in recent years and was not part of the previous specification. Under the planned new arrangements in order to achieve this earlier this year work started with key partners in Hillingdon to develop the terms of reference and referral pathways for the MDTs. Within PCNs leads were identified to ensure that each part of the borough was represented. Amanda Carey-McDermott, CEO Confederation Hillingdon CIC Sept 2026 Referral criteria are broad and inclusive to encourage participation and include; complex and high-risk patients, frequent hospital attenders, patients with respiratory conditions, and those with safeguarding or neurodiversity-related complexity. The first relaunched MDT took place 15th July with the second on 9th September. MDTs will now be delivered on a monthly basis. In addition to GPs, representatives from across the borough have included CAHMS, Hillingdon Family Hub, Consultant Pediatricians and School Nurses. We welcome the new approach which is highly consistent with Hillingdon’s long-standing successful model, and gives a new level of security of funding and a consistent approach across WNL ICB. General Neighbourhood Hub Update Work continues to progress the development of the three proposed Neighbourhood Hubs, aligned to the three Hillingdon neighbourhoods: Pembroke – North, Uxbridge Civic Centre – South West, Nestlé, Hayes – South East. Development of the Outline Business Case (OBC) for the three-hub programme is continuing, with completion planned by the end of October 2026. In the meantime service delivery continues across the Borough, including both the existing Pembroke sites alongside multiple practice and community services locations which provide care close to home for Hillingdon patients.

Appendix C Central and North West London NHS F T 12 September 2026 SHINE (Specialist Hub for Integrated Neurodevelopmental Evaluation) We are pleased to report that our new SHINE pathway went live across CNWL on 3 August 2026. SHINE represents a significant redesign of the way neurodevelopmental assessments are delivered for children and young people. Rather than separate pathways for ASD and ADHD, SHINE provides a single integrated neurodevelopmental assessment pathway. This reduces duplication, streamlines the assessment experience for families and reflects the reality that many children present with overlapping needs. The pathway has introduced new digital technologies and redesigned clinical processes which are expected to significantly increase service capacity and improve the experience of children, young people and families. To support the pathway, we now have a new purpose-built website to support children, families and professionals – www.cnwl.nhs.uk/shine The website provides a resource of materials to support people and signposts to further support for families whilst waiting for, and after diagnosis. We have shared the website with the Hillingdon SEND Youth Forum (Aim High) who are discussing in their September meeting and providing feedback. We have communicated these changes out to relevant stakeholders. All GP’s in North West London have been notified through the GP Bulletin, and we have also worked with council communications teams to share with schools. These communications include details on the changes to the referral pathway and how these work. Any referrals through the previous route are still being accepted until the end of September, with the referrer being informed of the new route through the Single Point of Access. These improvements build on the substantial progress made through non-recurrent funding provided by the NWL ICB during 2025. Prior to receiving this support, almost 2,000 Hillingdon children were waiting for neurodevelopmental assessment. The additional investment enabled approximately 1,500 assessments to be undertaken, resulting in a substantial reduction in waiting lists and creating the foundation for the launch of the new pathway. We currently now have 774 children waiting for a neurodevelopmental assessment in Hillingdon, of which 612 are ASD, 159 ADHD and 3 combined. CAMHS Performance As requested by the Committee, below is a breakdown of our CAMHS waiting times for this financial year to date: Appendix C Referral to Assessment  100% of children have been seen for assessment within 18 weeks of referral  On average children have waited 2 weeks for assessment Referral to Treatment  87% of children have started treatment within 18 weeks of referral, against an 85% target  On average children have waited 12 weeks for treatment  Only four children have waited longer than 24 weeks for treatment Integrated Neighbourhood Teams As part of Hillingdon's neighbourhood development programme, Child Health Hubs continue to bring together primary care, community paediatrics, CAMHS and other specialist services to support children with complex needs. The hubs provide a structured forum for joint care planning and clinical decision-making, reducing fragmentation and ensuring families receive more coordinated support from a single multidisciplinary team approach Alongside developments for children and young people, significant progress is being made within our neighbourhood model for older adults. Multidisciplinary Frailty MDTs are now supporting proactive identification and management of residents with complex needs, bringing together primary care, community services, mental health professionals and social care colleagues to develop coordinated care plans. This work forms part of a wider ambition to further integrate community physical health and older adult mental health services, recognising that frailty, physical health, mental wellbeing and cognitive health are often closely interconnected and require a joined-up response Integrated Crisis Response The Hillingdon Reactive Care Hub is due to go live in October and will act as a single coordination point for adults experiencing a health crisis who could be safely supported within the community. The Hub will bring together primary care, community health services and social care partners, with plans to further integrate mental health services as the model develops. By improving coordination and rapid decision-making, the Hub aims to reduce avoidable hospital attendances and support more people to remain safely at home Mental Health Support Teams (MHSTs) Whilst MHSTs have been established in Hillingdon for some time, the service continues to expand and evolve. National funding continues to increase the coverage of schools able to access MHST support with an ambition of 100% coverage across schools by 2029. The service ensures more children and young people can receive early intervention for mild to moderate mental health needs within Appendix C their school environment. Alongside direct support for young people, the teams continue to work closely with school senior mental health leads, provide advice and consultation to school staff, and deliver a range of preventative initiatives focused on emotional wellbeing and resilience. The service has launched a programme of open- access parent webinars to provide practical advice and support for families. 24/7 Neighbourhood Mental Health Centres CNWL is scheduled to receive capital funding to support the development of a 24/7 Neighbourhood Mental Health Centres in the borough in 2027/28. This major national programme is aimed at transforming access to community mental health support. These centres will provide open-access, neighbourhood-based support, bringing together community mental health teams, primary care, voluntary sector organisations and other partners into a single, integrated offer. The ambition is to provide earlier support, reduce fragmentation and prevent people reaching crisis point before receiving help. Work is currently underway to develop the Hillingdon model and we will shortly run sessions with stakeholders and patients to help design the vision and model. Assertive Outreach A new Assertive Outreach service is currently being mobilised to provide intensive, community-based support for adults with complex mental health needs who have disengaged from services. The service is designed to proactively engage individuals who may be at risk of repeated crises, poor outcomes or hospital admission, ensuring support is delivered where and when it is needed most. Working as part of Hillingdon's integrated neighbourhood model, Assertive Outreach will strengthen our ability to intervene earlier, reduce the risk of mental health crisis and reduce reliance on inpatient services by supporting people to remain well within their own communities.

Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public JOINT HEALTH AND WELLBEING STRATEGY 2026-2031 Committee name Children, Families, Health and Care Select Committee Officer reporting Keith Spencer – Managing Director, Hillingdon Health and Care Partners Sandra Taylor – Corporate Director, Adult Social Care and Health Papers with report Appendix 1 – Hillingdon’s Operating Model: Care Closer to Home Appendix 2 – Neighbourhood Working In Action Appendix 3 - Priority Strategy Programmes Ward All 1. SUMMARY 1.1 The Joint Health and Wellbeing Strategy explains how the Council, the NHS and other local partners intend to improve health and wellbeing in Hillingdon between 2026 and 2031. Its central aim is to help people stay well for longer, reduce unfair differences in health and make local services easier to understand and use. 1.2 The strategy covers the whole population, from pregnancy and early childhood through to later life. It gives particular attention to children and families, unpaid carers, older people, disabled people and communities where health outcomes are poorest. The accompanying delivery plan sets out actions, targets and dates. 1.3 This report contains several references to ‘Place’. In short, this means the local community and the organisations that serve it, working together as one system to support residents. The ‘Hillingdon Place’ means the people who live within the boundaries of the London Borough of Hillingdon and supporting organisations. 2. RECOMMENDATIONS That the Children, Families, Health and Care Select Committee: 1. notes the content of Joint Health and Wellbeing Strategy, 2026 – 2031 and its supporting delivery plan. 2. comments on the proposed arrangements for measuring progress, addressing inequalities and managing delivery risks. 3. INFORMATION About the Strategy 3.1 The Health and Wellbeing Board is under a legal obligation to produce a joint strategy for improving the health and wellbeing of Hillingdon’s residents. This strategy provides the shared plan for the Council, NHS organisations, GP practices, schools, family hubs, housing services, voluntary and community organisations and other partners from 2026 to 2031. 3.2 The shared vision is: To create a fairer, healthier borough where people of all ages can live well, stay well and age well. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Why change is needed 3.3 Hillingdon faces a range of connected pressures, including:  Nearly 48% of adults registered with a Hillingdon GP live with one or more long-term health conditions, such as hypertension (also known as high blood pressure), diabetes, obesity, breathing problems, anxiety or depression.  Around 4,400 residents account for half of emergency hospital admissions. Many have several health conditions, frailty, mental health needs or difficult social circumstances.  Children and families in parts of Hayes, Yiewsley and West Drayton are more likely to experience poverty, overcrowding, poorer school readiness, childhood obesity and asthma.  Demand for children's mental health, special educational needs and disabilities, autism and attention deficit hyperactivity disorder (ADHD) support is increasing, and families report long waits and disjointed services.  The number of older people is growing. Frailty, falls, dementia and isolation can lead to avoidable hospital stays and loss of independence.  More than 170 separate health and care services operate across Hillingdon, and residents often need support from multiple organisations at the same time.  Residents can face different referral routes, opening hours and eligibility rules. This can make support difficult to navigate and can cause duplication or gaps.  The planned new Hillingdon Hospital depends on fewer avoidable admissions, shorter stays and stronger community services. A Life-course Approach 3.4 A life course approach considers the critical stages, transitions, and settings where large differences can be made in promoting or restoring health and wellbeing. The strategy groups priorities under four headings linked to the life-course approach, and these are summarised below. A Life-course Approach Summarised  Start Well: Supporting healthy pregnancy, early years, children, young people and families.  Live Well: Helping adults stay healthy, manage long-term conditions and maintain good mental wellbeing.  Age Well: Helping older people remain independent, avoid unnecessary hospital stays and receive dignified care.  Healthy Places: Improving the housing, neighbourhoods and community connections that affect health. 3.5 What this means for children and families: The Start Well part of the strategy covers from pregnancy to age 25. It proposes:  More targeted maternity support in the neighbourhoods with poorer outcomes, including culturally appropriate support.  Higher childhood vaccination rates, with outreach in communities where uptake is lower. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public  More help with speech, language, early learning and school readiness through family hubs, health visiting and early education.  More school-based and community-based mental health support.  Closer joint working to improve school attendance and reduce exclusions.  More opportunities for physical activity and healthy eating to reduce childhood obesity.  Earlier help for children awaiting autism, ADHD or other neurodevelopmental assessments; and  Clearer routes through special educational needs and disabilities services, including more timely Education, Health and Care Plans (EHCPs). 3.6 What this means for working-age adults: The Live Well part of the strategy focuses on preventing illness and providing help before a person reaches crisis. It proposes:  Earlier checks and treatment for high blood pressure and diabetes.  More support to stop smoking and maintain a healthy weight.  Improved access to talking therapies and stronger community support to reduce loneliness.  Identification of more unpaid carers and connecting them with information, advice and support. 3.7 What this means for older people: The Age Well part of the strategy aims to help older people live safely and independently at home for as long as possible. It proposes:  Earlier identification of frailty and personalised care plans for people with severe frailty.  Rapid support at home, better falls prevention, seven-day rehabilitation and reablement.  Improved dementia and end-of-life care. 3.8 It also aims to reduce delays when a person is medically ready to leave hospital. Reablement means short-term support that helps a person regain skills and confidence after illness or a hospital stay. 3.9 Healthy places: This is about improving some of the key settings that are wider determinants of health for residents. How local services are expected to work differently 3.10 Crucial to supporting the delivery of life-course actions is the mobilisation of the Hillingdon Place Operating Model, which is illustrated in Appendix 1. The model is based on services being organised around three neighbourhoods rather than around organisations. In practical terms, there are five main parts to this model:  Three Integrated Neighbourhood Teams: Local teams bringing together GP practices, community health, adult social care, mental health, therapists and Frailty Explained Frailty is associated with issues like reduced muscle strength and fatigue and can lead to falls, weight loss, poor nutrition, physical inactivity, cognitive impairment, and multiple medicine use. About 10% of people aged over 65 live with frailty. This rises to up to 50% for those aged 85 and above. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public voluntary organisations. Appendix 2 illustrates neighbourhood working in practice.  Local Access Hubs: Three neighbourhood-based buildings where residents can receive a wider range of urgent, planned and specialist care closer to home.  Family hubs: Four neighbourhood-based buildings where children, young people and families can obtain joined-up early help, parenting support, mental health support and help with special educational needs and disabilities.  A borough-wide Reactive Care Service: Rapid help at home, support to avoid unnecessary hospital admission and coordinated support for people leaving hospital.  A new Hillingdon Hospital that is seamlessly linked into community services. 3.11 The intention is that residents should experience one coordinated system, with less need to repeat their story and less confusion about which organisation is responsible. Priority Programmes 3.12 As Hillingdon faces many challenges and limited resources, which means that it is not possible to do everything at once. Priority in the delivery plan has been given to programmes that:  Affect large population groups.  Address the biggest drivers of avoidable hospital use.  Have strong evidence of impact.  Support the delivery model for a new Hillingdon Hospital.  Align directly with the neighbourhood model, family hubs and the Reactive Care Service.  Have measurable baselines and clear outcomes. Hillingdon’s Neighbourhoods Southeast North Southwest Local Access Hubs  North (Pembroke Centre, Ruislip): Opened Nov 2025.  Southeast (Civic Centre, Uxbridge): Opening by Jan 2029  Southwest (Nestles Building, Hayes): Opening Dec 2027 Family Hubs  South Ruislip Hub: Queens Walk, South Ruislip  Uxbridge Hub: Civic Centre, Uxbridge  West Drayton Hub: Platinum Jubilee Centre, West Drayton  Hayes Hub: College Way, Hayes Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public 3.13 The priority programmes are summarised in Appendix 3. Resident Feedback 3.14 Consultation took place between February and April 2026 through an online survey and discussions with resident groups. Fifty-five residents completed the online survey. The main messages were:  Services need to work together better, and people should not have to repeat the same information.  Timely help is not always easy to access, especially urgent and mental health support.  Online-only services can exclude some residents.  Residents want clear accountability and person-centred care.  There was support for local hubs, but residents wanted clear information about services, opening hours, appointments, walk-in access and public transport.  Carers wanted clearer routes to information, advice and support, particularly when someone leaves hospital. 3.15 The Health and Wellbeing Board has agreed that consultation will be repeated in 2028/29 to test whether people’s experience of using health and care services has improved. Oversight and Accountability 3.16 The Health and Wellbeing Board will provide overall oversight. Supporting partner oversight groups will monitor delivery, finance, performance, quality, safety and safeguarding. Resident feedback is expected to continue through surveys, forums, family hubs, voluntary organisations, Healthwatch and neighbourhood engagement. Next Steps 3.17 Additional work is required to ensure that there is alignment between the strategy and delivery plan and agree baselines. Final approval of the strategy and its supporting delivery plan will be sought once completed, which will be in Q3. 4. Performance Data 4.1 The strategy delivery plan creates a single framework for measuring its impact and this is illustrated below. Impact Area What should be evidenced Operating model mobilisation: Are we building and scaling the model across the borough? • Delivery milestones for following mobilisation workstreams:  System engine (central function to coordinate the programme).  Integrated Neighbourhood Teams.  Reactive Care.  Hospital to community.  Digital integration.  Diagnostics and community intravenous therapy.  Workforce. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Impact Area What should be evidenced Place outcomes: Are we reducing demand, improving flow through the health and care system and shifting care from hospital to community? Core System Metrics: • Non-Elective Admissions – 20,180 per year • Non-Elective Admissions ≥2 days – 9,827 per year • Emergency Department (A & E) Attendances – 40,600 per year • Urgent Treatment Centre Attendances – 120 per day • No Criteria to Reside (NC2R) – ≤34 patients per day • Average length of stay for adults staying ≥2 days – 8.5 days • Outpatient activity – 300,911 per year • Hypertension prevalence – 24% • Hypertension target-to-treatment – 80% • Permanent admissions to care homes – 170 per year Wider strategy outcomes: Are we supporting better resident health and reducing inequalities? • Improvement in Core20PLUS5. • Improvements in Best Start and Healthy Places’ measures. • Delivery of E quality and Human Rights Impact Assessment (EHIA) actions. • Improved resident and carer experience. 5. Resident Benefit 5.1 As a result of the delivery of the strategy residents should receive help earlier, experience fewer hand-offs between organisations and have more services available closer to home. Children and families should have clearer routes to early help, mental health support and special educational needs and disabilities support. Adults should receive earlier help with long-term conditions and mental wellbeing. Older people should receive faster support at home and better help to recover after illness or a hospital stay. 5.2 The strategy also aims to narrow the gap between communities with the best and worst health outcomes. This will require resources and outreach to be directed towards neighbourhoods and groups with the greatest need, while maintaining fair access for all residents. Core20PLUS5 Explained This is a national framework. The Core 20 refers to the most deprived 20% of the national population as identified by the Index of Multiple Deprivation. The Plus5 refers to priorities identified locally from maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case-finding. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public 6. Corporate Implications Financial Implications 6.1 Delivery will use a mixture of existing Council and NHS budgets, primary care funding, and transformation funding. Capital funding linked to the new Hillingdon Hospital and Local Access Hubs is also expected to support delivery. Pooled budgets will be used to facilitate integration by enabling funding to be deployed to address the needs of the Hillingdon Place. 6.2 The delivery model depends partly on existing staff and services being reorganised around neighbourhoods. Targeted investment will be needed for some changes, including the Reactive Care Service, seven-day rehabilitation and reablement, digital systems and local buildings. Detailed financial decisions will need to follow the relevant Council and NHS approval processes. Legal Implications 6.3 The Health and Social Care Act 2012 places a duty on the Health and Wellbeing Board to develop a Joint Health and Wellbeing Strategy. The Equality Act 2010 requires the Council and its partners to consider the need to eliminate discrimination, advance equality of opportunity and foster good relations. An Equality and Human Rights Impact Assessment has been completed in accordance with the public sector equality duty under the Equality Act, 2010, and actions arising from this are reflected in the strategy delivery plan. 7. Background Papers None. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Appendix 1 Hillingdon’s Operating Model: Care Closer to Home This model is delivered in partnership with residents, voluntary and community organisations an across health and care partners to improve outcomes for all. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Neighbourhood Working in Action Appendix 2 Key: COPD – Chronic obstructive pulmonary disease. Hypertension – High blood pressure Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Appendix 3 Priority Strategy Programmes Programme 1: Proactive and preventative neighbourhood care Objective: Early identification and intervention of rising risk adults before frailty develops to prevent increasing need and loss of independence. Programme 2: Hypertension and cardiovascular risk management Objective: To improve detection, diagnosis and control of hypertension and cardiovascular risk. These are the largest drivers of stroke, heart disease and unplanned days in hospital. Programme 3: Mental health early intervention Objective: To prevent people getting into crisis and avoidable attendances at hospital by strengthening early support for children, young people and adults. Programme 4: Frailty, falls and community support for older adults Objective: To maintain the independence of people already living with moderate or severe frailty and prevent avoidable hospital admissions. Programme 5: NC2R and discharge improvement Objective: Minimising the stay of people in hospital who do not need to be there for treatment. Programme 6: Healthy childhood – immunisation, healthy weight and early prevention Objective: To address the strongest drivers of early inequality and future long-term health need. Programme 7: Family hubs and early years Objective: To prevent disadvantage from becoming entrenched and improving early childhood development.

Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public CABINET FORWARD PLAN Committee name Children, Families, Health and Care Select Committee Officer reporting Nikki O’Halloran, Democratic Services Papers with report Appendix A – Latest Forward Plan Ward As shown on the Forward Plan HEADLINES To monitor the Cabinet’s latest Forward Plan which sets out key decisions and other decisions to be taken by the Cabinet collectively and Cabinet Members individually over the coming year. The report sets out the actions available to the Committee. RECOMMENDATION That the Children, Families, Health and Care Select Committee notes the Cabinet Forward Plan. SUPPORTING INFORMATION The Cabinet Forward Plan is published monthly, usually around the first or second week of each month. It is a rolling document giving the required public notice of future key decisions to be taken. Should a later edition of the Forward Plan be published after this agenda has been circulated, Democratic Services will update the Committee on any new items or changes at the meeting. As part of its Terms of Reference, each Select Committee should c onsider the Forward Plan and, if it deems necessary, comment as appropriate to the decision -maker on the items listed which relate to services within its remit. For reference, the Forward Plan helpfully details which Select Committee’s remit covers the relevant future decision item listed. The Select Committee’s monitoring role of the Forward Plan can be undertaken in a variety of ways, including both pre-decision and post-decision scrutiny of the items listed. The provision of advance information on future items listed (potentially also draft reports) to the Committee in advance will often depend upon a variety of factors including timing or feasibility, and ultimately any such req uest would rest with the relevant Cabinet Member to decide. However, the 2019 Protocol on Overview & Scrutiny and Cabinet Relations (part of the Hillingdon Constitution) does provide guidance to Cabinet Members to:  Actively support the provision of relevan t Council information and other requests from the Committee as part of their work programme; and  Where feasible, provide opportunities for committees to provide their input on forthcoming executive reports as set out in the Forward Plan to enable wider pr e-decision scrutiny (in addition to those statutorily required to come before committees , i.e. policy framework documents – see paragraph below). As mentioned above, there is both a constitutional and statutory requirement for Select Committees to provide comments on the Cabinet’s draft budget and policy framework proposals after pub lication. These are automatically scheduled in advance to multi -year work programmes. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Therefore, in general, the Committee may consider the following actions on specific items listed on the Forward Plan: Committee action When How 1 To provide specific comments to be included in a future Cabinet or Cabinet Member report on matters within its remit. As part of its pre-decision scrutiny role, this would be where the Committee wishes to provide its influence and views on a particular matter within the formal report to the Cabinet or Cabinet Member before the decision is made. This would usually be where the Committee has previously considered a draft report or the topic in detail, or where it considers it has sufficient information already to provide relevant comments to the decision-maker. These would go within the standard section in every Cabinet or Cabinet Member report called “Select Committee comments”. The Cabinet or Cabinet Member would then consider these as part of any decision they make. 2 To request further information on future reports listed under its remit. As part of its pre-decision scrutiny role, this would be where the Committee wishes to discover more about a matter within its remit that is listed on the Forward Plan. Whilst such advance information can be requested from officers, the Committee should note that information may or may not be available in advance due to various factors, including timescales or the status of the drafting of the report itself and the formulation of final recommendation(s). Ultimately, the provision of any information in advance would be a matter for the Cabinet Member to decide. This would be considered at a subsequent Select Committee meeting. Alternatively, information could be circulated outside the meeting if reporting timescales require this. Upon the provision of any information, the Select Committee may then decide to provide specific comments (as per 1 above). 3 To request the Cabinet Member considers providing a draft of the report, if feasible, for the Select Committee to consider prior to it being considered formally for decision. As part of its pre-decision scrutiny role, this would be where the Committee wishes to provide an early steer or help shape a future report to Cabinet, e.g., on a policy matter. Whilst not the default position, Select Committees do occasionally receive draft versions of Cabinet reports prior to their formal consideration. The provision of such draft reports in advance may depend upon different factors, e.g., the timings required for that decision. Ultimately any request to see a draft report early would need the approval of the relevant Cabinet Member. Democratic Services would contact the relevant Cabinet Member and Officer upon any such request. If agreed, the draft report would be considered at a subsequent Select Committee meeting to provide views and feedback to officers before they finalise it for the Cabinet or Cabinet Member. An opportunity to provide specific comments (as per 1 above) is also possible. 4 To identify a forthcoming report that may merit a post- decision review at a later Select Committee meeting As part of its post-decision scrutiny and broader reviewing role, this would be where the Select Committee may wish to monitor the implementation of a certain Cabinet or Cabinet Member decision listed/taken at a later stage, i.e., to review its effectiveness after a period of 6 months. The Committee should note that this is different to the use of the post-decision scrutiny ‘call-in’ power which seeks to ask the Cabinet or Cabinet Member to formally re-consider a decision up to 5 working days after the decision notice has been issued. This is undertaken via the new Scrutiny Call-in App members of the relevant Select Committee. The Committee would add the matter to its multi- year work programme after a suitable time has elapsed upon the decision expected to be made by the Cabinet or Cabinet Member. Relevant service areas may be best to advise on the most appropriate time to review the matter once the decision is made. Health and Social Care Select Committee – 29 April 2025 Classification: Public BACKGROUND PAPERS  Protocol on Overview & Scrutiny and Cabinet relations adopted by Council 12 September 2019  Scrutiny Call-in App

Status Consultation / Scrutiny Ref Business Item Further information Ward(s) NEW ITEM CABINET meeting Cabinet Member Shareholder Committee Full COUNCIL Cabinet Member(s) Responsible Relevant Committee Report Author Corporate Director Responsible Public or Private (with reason) Consultation related to any decision & planned scrutiny committee engagement 93 Stronger Families / Family Help Strategy The Cabinet Member will consider a strategy that aligns with emerging national reforms and strengthens the delivery of early help and family support across the borough. The strategy aims to modernise practice, improve operational effectiveness, and ensure services remain responsive to the diverse and evolving needs of children and families. A central element of this transformation is the redesign of the Stronger Families Early Help service in line with the Family Help model. This model emphasises earlier, more effective intervention; seamless multi ‑ agency collaboration; and the empowerment of families to build resilience and reduce the need for statutory involvement. It also seeks to improve access to the right support at the right time, while embedding a child ‑ centred and whole ‑ family approach within all areas of practice. All Def from June September Cllr Susan O'Brien Children, Families, Health & Care Antony Madden / Vali Danciu / Tehseen Kauser Julie Kelly Public SI The Hillingdon Care Company Ltd. Reporting The Shareholder Committee, comprising relevant Cabinet Members, will receive the Annual Accounts and Annual Business Plan for the Council's care services and trading company. N/A 17 September Shareholder Committee Members Children, Families, Health & Care TBC Dan Kennedy Private (3) 136 Corporate Peer Review The Local Government Association (LGA) conducts Corporate Peer Challenges to provide councils with constructive peer feedback on their performance and improvement strategies. Reports and action plans are published following these reviews, detailing findings and recommendations, which will be presented to Cabinet for consideration. All 22 October Cllr Steve Tuckwell All LGA Tony Zaman / All Public 145 Provision of residential services for Children with disabilities Cabinet will consider proposals regarding the provision of residential services and accommodation for Children with learning disabilities. N/A 22 October Cllr Susan O'Brien Children, Families, Health & Care Alex Coman Julie Kelly Private (3) 63 Carers Strategy Update Cabinet will receive a progress report on the Carers Strategy and Delivery Plan and the priorities going forward. N/A 22 October Cllr Susan O'Brien Children, Families, Health & Care Gary Collier Sandra Taylor Public Select Committee Decision-Maker Cabinet / Committee Leads & Officers SEPTEMBER 2026 OCTOBER 2026 1 Status Consultation / Scrutiny Ref Business Item Further information Ward(s) NEW ITEM CABINET meeting Cabinet Member Shareholder Committee Full COUNCIL Cabinet Member(s) Responsible Relevant Committee Report Author Corporate Director Responsible Public or Private (with reason) Consultation related to any decision & planned scrutiny committee engagement Decision-Maker Cabinet / Committee Leads & Officers 132 Regional End to End Fostering model Cabinet is being asked to approve Hillingdon’s adoption of the Government’s new endto end fostering model published in February 2026. This involves aligning the borough’s fostering service with national reforms to grow the number of foster carers, strengthen support for families, simplify rules, improve assessments and allegations handling, and prioritise trusted relationships. Approval will allow Hillingdon to redesign its recruitment, assessment and approval processes to meet the new England ‑ wide standards - such as the proposed six ‑ month assessment timeframe and enhanced quality assurance. It will also enable fuller participation in strengthened regional arrangements, including expanded regional recruitment hubs and future Regional Care Cooperatives. N/A 22 October Cllr Susan O'Brien Children, Families, Health & Care Alex Coman Julie Kelly Public 161 The Annual Report Of Adult and Child Safeguarding Arrangements This report provides the Cabinet with a summary of the activity undertaken by the Safeguarding Children Partnership Board and the Safeguarding Adults Board to address the identified local priorities. The Cabinet will consider this report and approve the activity and the local priorities for the two boards. All 22 October Cllr Susan O'Brien Children, Families, Health & Care Alex Coman / Susan- Sidonia Gladish Sandra Taylor Public Select Committee consultation SI Reports from Select Committees Reports, findings and recommendations for consideration by the Cabinet, when referred from the appropriate Committee. All 22 October TBC TBC Democratic Services Public SI Public Preview of matters to be considered in private A report to Cabinet to provide maximum transparency to residents on the private matters to be considered later in Part 2 of the Cabinet meeting and agenda. TBC 22 October TBC TBC Democratic Services Public 169 Appointeeship Client Fees Following consultation, Cabinet will consider a proposal to introduce charges for the Council's appointeeship service, which manages benefits and finances on behalf of vulnerable adults who are unable to do so themselves. Under the proposal, clients with savings exceeding £1,000 would contribute towards the cost of the service, helping to offset associated administration and support costs. N/A NEW ITEM 19 November Cllr Susan O'Brien Children, Families, Health & Care Philip Hedges Pete Carpenter Public Consultation with clients 151 Send Mediation Services Cabinet will consider the procurement of SEND (Special Educational Needs and Disabilities) mediation services contracts, where councils buy- in an independent service to help resolve disputes with families about SEND decisions, to underpin statutory duties. N/A 19 November Cllr Susan O'Brien Children, Families, Health & Care Gary Binstead / R Verma Julie Kelly Private (3) SI Reports from Select Committees Reports, findings and recommendations for consideration by the Cabinet, when referred from the appropriate Committee. All 19 November TBC TBC Democratic Services Public NOVEMBER 2026 2 Status Consultation / Scrutiny Ref Business Item Further information Ward(s) NEW ITEM CABINET meeting Cabinet Member Shareholder Committee Full COUNCIL Cabinet Member(s) Responsible Relevant Committee Report Author Corporate Director Responsible Public or Private (with reason) Consultation related to any decision & planned scrutiny committee engagement Decision-Maker Cabinet / Committee Leads & Officers SI Public Preview of matters to be considered in private A report to Cabinet to provide maximum transparency to residents on the private matters to be considered later in Part 2 of the Cabinet meeting and agenda. TBC 19 November TBC TBC Democratic Services Public SI Public Preview of matters to be considered in private A report to Cabinet to provide maximum transparency to residents on the private and confidential matters to be considered later in Part 2 of the Cabinet meeting and agenda. TBC 17 December TBC TBC Democratic Services Public SI Reports from Select Committees Reports, findings and recommendations for consideration by the Cabinet, when referred from the appropriate Committee. All 17 December TBC TBC Democratic Services Public SI Public Preview of matters to be considered in private A report to Cabinet to provide maximum transparency to residents on the private and confidential matters to be considered later in Part 2 of the Cabinet meeting and agenda. TBC 14 January TBC TBC Democratic Services Public SI Reports from Select Committees Reports, findings and recommendations for consideration by the Cabinet, when referred from the appropriate Committee. All 14 January TBC TBC Democratic Services Public SI Urgent Cabinet- level decisions & interim decision- making (including emergency decisions) The Leader of the Council has the necessary authority to make decisions that would otherwise be reserved to the Cabinet, in the absence of a Cabinet meeting or in urgent circumstances. Any such decisions will be published in the usual way and reported to a subsequent Cabinet meeting for ratification. The Leader may also take emergency decisions without notice, which may be ratified at Cabinet later. Various Cabinet Member Decision - date TBC Cllr Steve Tuckwell TBC TBC Public / Private TBC SI School Governing Bodies, Instruments of Government and Governors / Authorising Academy Appointments To approve appointments, nominate appointments and make reappointments of local authority governors and to approve any changes to school governing body constitutions. To also authorise any Member to be a Governor or Director of an Academy. N/A Cabinet Member Decision - date TBC Cllr Susan O'Brien Children, Families, Health & Care Helen Boundy Public SI Release of Capital Funds The release of all capital monies for capital spend and projects requires formal Member approval over £100k (or may be referred to the Cabinet) TBC Cabinet Member Decision - date TBC Cllr Eddie Lavery TBC various Public but some Private (1,2,3) Corporate Finance SI Petitions about matters under the control of the Cabinet Each month, Cabinet Members will consider a number of petitions received by local residents and decide on future action. Some petitions may be referred to a Petition Hearing where the lead petitioner and ward councillors can have their say directly to the Cabinet Member. These hearings will be scheduled on the Council's meeting calendar. TBC Cabinet Member Decision - date TBC All TBC Democratic Services Public DECEMBER 2026 JANUARY 2027 Schedule of Individual Cabinet Member Decisions that may be taken each month (standard items non key-decisions) 3 Status Consultation / Scrutiny Ref Business Item Further information Ward(s) NEW ITEM CABINET meeting Cabinet Member Shareholder Committee Full COUNCIL Cabinet Member(s) Responsible Relevant Committee Report Author Corporate Director Responsible Public or Private (with reason) Consultation related to any decision & planned scrutiny committee engagement Decision-Maker Cabinet / Committee Leads & Officers SI To approve compensation payments To approve compensation payments in relation to any complaint to the Council in excess of £1000. n/a Cabinet Member Decision - date TBC All TBC various Private (1,2,3) SI All Delegated Decisions by Cabinet to Cabinet Members, including tender and property decisions Where previously delegated by Cabinet, to make any necessary decisions, accept tenders, bids and authorise property decisions / transactions in accordance with the Constitution. TBC Cabinet Member Decision - date TBC All TBC various Public / Private (1,2,3) SI School Redundancy Payments To consider requests for School Redundancy Payments and council funding of it, and decide whether to approve them on behalf of the Local Authority TBC Cabinet Member Decision - date TBC Cllr Susan O'Brien Children, Families, Health & Care Abi Preston Private (1,3,4) SI External funding bids To authorise the making of bids for external funding where there is no requirement for a financial commitment from the Council. n/a Cabinet Member Decision - date TBC All TBC various Public SI Response to key consultations that may impact upon the Borough A standard item to capture any emerging consultations from Government, the GLA or other public bodies and institutions that will impact upon the Borough. Where the deadline to respond cannot be met by the date of the Cabinet meeting, the Constitution allows the Cabinet Member to sign- off the response. TBC Cabinet Member Decision - date TBC All TBC various Public SI = Standard Item that may be considered each month/regularly The Cabinet's Forward Plan is an official document by the London Borough of Hillingdon, UK 4

Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public WORK PROGRAMME Committee name Children, Families, Health and Care Select Committee Officer reporting Nikki O’Halloran, Democratic Services Papers with report Appendix A – Work Programme Ward All HEADLINES To ena ble the Committee to no te future meeting dates and to for ward plan its work for the current municipal year. RECOMMENDATION: That the Children, Families, Health and Care Select Committee considers its Work Programme for the year and agrees any amendments. SUPPORTING INFORMATION Following the creation of the Children, Families, Health and Care Select Committee, the following meeting dates have been set with each meeting starting at 6.30pm: Meetings Room Tuesday 23 June 2026, 6.30pm CR5 Tuesday 21 July 2026, 6.30pm CR6 Tuesday 22 September 2026, 6.30pm CR5 Tuesday 13 October 2026, 6.30pm CR5 Thursday 12 November 2026, 6.30pm CR6 Tuesday 12 January 2027, 6.30pm CR6 Tuesday 16 February 2027, 6.30pm CR6 Thursday 11 March 2027, 6.30pm CR5 Tuesday 20 April 2027, 6.30pm CR6 Following the meeting on 23 June 2026, Members discussed the volume of work that the Committee would need to undertake and the need for an additional meeting in October 2026. To ensure that this additional meeting fits around other scheduled meetings, it has been arranged for 13 October 2026. Implications on related Council policies The role of the Select Committees is to make recommendations on service changes and improvements to the Cabinet, who are responsible for the Council’s policy and direction. How this report benefits Hillingdon residents Select Committees directly engage residents in shaping policy and recommendations and the Committees seek to improve the way the Council provides services to residents. Financial Implications None at this stage. Children, Families, Health and Care Select Committee – 22 September 2026 Part I – Public Legal Implications None at this stage. BACKGROUND PAPERS NIL.

MULTI-YEAR WORK PROGRAMME 2026/27 2027/28 September October November December January February March April May 22 13 12 No meeting 12 16 11 20 No meeting Major Review Topic: Pharmacy First Topic selection / scoping stage Witness / evidence / consultation stage X X X Findings, conclusions and recommendations X Final review report agreement X Target Cabinet reporting 29th Minor Review Topic Suggestions: Child immunisations (minor) London Ambulance Service (minor) Regular service & performance monitoring Cabinet Forward Plan Monthly Monitoring X X X X X X Cabinet Member for Children, Families, Health and Care X Health BCF Update Minor Injuries Unit Update CAMHS Update HHCP Place Based Service Delivery Mount Vernon Cancer Centre Hillingdon Hospital Redevelopment Update X X Health Updates X X Quality Accounts (outside of meetings) X Social Care Hillingdon Advice Partnership Update Supporting Carers Update X Joint Health and Wellbeing Strategy X Social Care Reforms Children & Families Corporate Parenting Panel Minutes X X X Corporate Parenting Panel Membership (annual) Youth Justice Service Strategy 2024-2029 (to note) Families First Reforms and Children's Wellbeing & Schools Bill X Schools School Place Planning: School Organisation Plan update (comment on report) X School Admissions Update (to note) X Outcome of the consultation for the proposed changes to Hillingdon Community School Admissions Arrangements X SEND Sufficiency Strategy, SEND Reforms and Alternative Provisions (to note) Annual Standards of Education in Hillingdon (to include Edu Standards, Music Hub and Edu Strategy) X Past review delivery Adult Social Care Early Intervention and Prevention (June 2026) GP Coverage (July 2025) X Persistent Absenteeism (September 2025) X Fostering (April 2026) Children, Famililes, Health & Care Select Committee