Children, Families, Health & Care SC

Minutes CHILDREN, FAMILIES, HEALTH & CARE SELECT COMMITTEE 22 September 2026 Meeting held at Committee Room 5 - Civic Centre Committee Members Present: Councillors Ekta Gohil (Chair), Jane Palmer (Vice-Chair), Sophie Dror, Hedson Farinha De Castro, John Garner, Jan Sweeting (Opposition Lead) and Anil Taneja Also Present: Amanda Carey-McDermott, Chief Executive Officer, The Confederation Hillingdon CIC Dr Alan McGlennan, Chief Medical Officer and Managing Director, The Hillingdon Hospitals NHS Foundation Trust Samreen Nawshin, Operations Manager, Healthwatch Hillingdon Vanessa Odlin, Managing Director for Hillingdon and Mental Health Services, Goodall Division, Central and North West London NHS Foundation Trust (CNWL) Dr Ritu Prasad, Chair, The Confederation Hillingdon CIC Keith Spencer, Managing Director, Hillingdon Health and Care Partners (HHCP) Michael White, Harefield Hospital General Manager, Guy's & St Thomas' NHS Foundation Trust LBH Officers Present: Nikki O'Halloran (Democratic, Civic and Ceremonial Manager) 23. APOLOGIES FOR ABSENCE (Agenda Item 1) Apologies for absence had been received from Mr Tony Little. 24. DECLARATIONS OF INTEREST (Agenda Item 2) There were no declarations of interest in matters coming before this meeting. 25. MINUTES OF THE MEETING HELD ON 21 JULY 2026 (Agenda Item 3) RESOLVED: That the minutes of the meeting held on 21 July 2026 be agreed as a correct record. 26. EXCLUSION OF PRESS AND PUBLIC (Agenda Item 4) RESOLVED: That all items of business be considered in public. 27. CORPORATE PARENTING PANEL UPDATE (Agenda Item 5) Consideration was given to the minutes of the Corporate Parenting Panel meeting held on 28 July 2026. RESOLVED: That the minutes of the Corporate Parenting Panel meeting held on 28 July 2026 be agreed. 28. HEALTH UPDATES (Agenda Item 6) The Chair welcomed those present to the meeting. She noted that one of the reports had not been provided by the deadline given and had been sent to officers the day before the meeting. This had then not been forwarded to Members of the Committee until just a few hours before the meeting which, given the amount of information included in the report, had not given them enough time to fully digest the information contained therein before the start of the meeting. The Chair asked for assurance that health partners would, in future, provide the information requested by the deadline provided. Central and North West London NHS Foundation Trust (CNWL) Ms Andrea Shand, Service Director for CAMHS & Eating Disorders - Goodall Division at CNWL, advised that a new service, Specialist Hub for Integrated Neurodevelopmental Evaluation (SHINE), had been introduced across North West London on 3 August 2026 to reduce waiting times and provide children and young people with fairer access to support. The separate waiting lists for Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder had led to patient dissatisfaction and long waits. The Single Point of Access had been expanded to include a single digital front door for SHINE and had been combined with neurodevelopmental access. This meant that pre information could be collected from various agencies and partners to eradicate the need for follow ups and reduce duplication. A new website had been developed to support families, children and professionals and provided information about where support could be accessed. Work was currently underway to migrate 4,000 records into SHINE which would help to reduce the diagnosis waiting times from 18-24 months to 6-12 months. Ms Shand advised that the transformation work had been undertaken within existing funding. The old model had coped with around 30% of the demand and the new model was currently at around 60%. Consideration was being given to developing the model further and communication had already been undertaken with schools and GPs. With regard to the national key performance indicator, CAMHS had assessed 100% of referrals within 18 weeks (RTT – Referral to Treatment) with the average referral time for assessments in Hillingdon at around two weeks. The caseload in Hillingdon averaged at about 2,500 at any one time, with around 200 of these being neurodevelopmental disorder (ND) assessments. Ms Vanessa Odlin, Managing Director – Goodall Division at CNWL, advised that work around reactive care related to unplanned care was being led by the Council. CNWL provided urgent care teams and work had start to look at how these could be linked to the reactive care hub which would be live from October 2026. An outreach service was being developed providing support to mental health patients that found it hard to reach out to services themselves. This was a smaller cohort than those being seen by the Community Mental Health Team and it was hoped that the service would go live by November 2026. Work had been undertaken on the first wave pilot of 24/7 neighbourhood mental health centres / hubs (these were like a walk in centre). CNWL had liaised with The Confederation Hillingdon CIC about where the first centre should be located to ensure that it was well used. The centre would have an interface with the reactive care hub and was expected to open on 1 April 2027. It was anticipated that, based on current demand, there would need to be 6-8 of these hubs in Hillingdon. Members queried whether the SEND reforms and EHCP plan proposals had impacted on the number of children and young people coming through the front door. Ms Shand advised that this was not currently having an impact but was causing some concern. A 12-18 month pilot had been set up in Ealing and Brent in relation to ND. Harefield Hospital (HH) - Guy's & St Thomas' NHS Foundation Trust (GST) Mr Michael White, Harefield Hospital General Manager at GST, advised that the Trust had made significant progress to reduce the number of patients waiting 65-weeks for treatment. Recovery plans were now shifting the focus onto the reduction against the 52 week backstop. Support was needed in cardiology – 34 patients had been waiting longer than a year and 28 of these were cardiology patients. Of the 952 patients waiting for cardiac surgery across the three hospitals in the group, around half were priority patients that needed surgery within four weeks (P2). These patients were closely monitored using the Ortus platform to ensure early identification of deteriorating symptoms (which would trigger a prompt clinical review). There had also been a move to “day of” admission to reduce length of stay. In July and August, the seven units across London had delivered 117% of the elective cardiac surgery plan. The Royal Brompton hospital had been the highest performing unit during this time (hitting 141% of plan), with the Harefield and St Thomas’ sites delivering 103% and 110% respectively. Harefield Hospital performed around a quarter of all cardiothoracic transplants – by the end of 2025/26, Harefield had performed 71 transplants which was the highest volume since 2019 (the aim was to eventually undertake 200 transplants in a year). In the first 5 months of this financial year, there had already been 17 hearts and 17 lungs transplanted. If this level of activity continued in-year, it would result in a further 14% increase on the prior year’s activity. Occupancy on the transplant wards was 98-100%. Members queried what assurance there was about patient safety during this expansion of surgery. Mr White advised that HH dealt with a smaller cohort of patients with higher risk. Although the Trust needed to increase its throughput, this needed to be done slowly (over a ten year period). Staff retention was good but it was difficult to recruit new employees so the shuttle bus that ran from St Thomas’ to Harefield enabled staff to work between the two sites when needed. The Trust has invested in an ex vivo lung perfusion machine which reconditioned marginal donor lungs to bring them to a standard for transplantation as part of a national pilot involving transplant centres. Two transplants had been successfully undertaken so just one more was needed for Harefield’s bid to become the lung centre offering this service to London and the surrounding regions. The Da Vinci D5 thoracic surgical robot had arrived at HH in April 2026 and had been in use for thoracic surgery and lung cancer resections within two weeks of arrival. Although this surgery resulted in more incisions, these were smaller so recovery was quicker. This addition had accelerated what was possible so that HH was now three years ahead of others. Funding had also been provided for a new bronchoscopy suite at HH which was expected to be opened in October 2027. Royal Brompton Hospital had been using the new bronchoscopy machines for about a year so was able to provide advice and guidance to HH. The Trust was experiencing financial challenges (HH already had a £6m overspend at the end of Month 5) and, as such, a planned reduction in bed numbers had been included in its financial improvement plans. At HH, fourteen surgical beds had been closed and four other beds had been opened up (net loss of ten surgical beds). As there had been a recruitment freeze, there were fewer staff impacted and these individuals had been redeployed. The closures had not appeared to have had a significant impact but the situation was being kept under review and consideration was being given to reopening the closed beds as a bronchoscopy day care unit. Mr White advised that around 70% of cancellations had been due to a lack of beds in the ITU – there were 24 ITU beds and very few instances of delayed discharge. There were five theatres at HH, three of which were capable of cardiac surgery. HH tended to get the more complicated cases which then needed a longer length of stay. Healthwatch Hillingdon (HWH) Ms Samreen Nawshin, Operations Manager at HWH, advised that the summer period tended to be quite slow but access to care continued to be a major concern across GPs, dentistry and the hospital, largely around issues such as communication and appointments. There had been some residents experiencing communications challenges when trying to register with a GP and then falling off the grid when they failed to get a response. The difference between a positive and negative patient experience was often down to the way that they were communicated with. If a patient was having to wait a long time for a response, they would often start to contact other organisations in the interim. Digital exclusion also continued to be an issue as these residents were often not able to get help from elsewhere. Mr Keith Spencer, Managing Director at Hillingdon Health and Care Partners, expressed concern about this feedback from residents and would speak to Ms Nawshin about it after the meeting. Ms Nawshin noted that feedback from residents had been consistent in relation to the high levels of professionalism of the staff that they came into contact with at the GP surgeries and hospital. HWH had undertaken a review of hospital discharge and produced a report which Ms Nawshin would be happy to share with the Committee. The review had identified that around 70% of patients had had a positive experience but that 40% had waited more than three hours without being given an explanation for the delay (delays were often in relation to things like needing assistance to leave or prescriptions). HWH continued to provide signposting for residents and act as a point of referral. Ms Nawshin queried who HWH should drive residents to as a last resort. The Hillingdon Hospitals NHS Foundation Trust (THH) Dr Alan McGlennan, Managing Director and Chief Medical Officer at THH, advised that urgent and emergency care performance had improved over the last 18-24 months and, for the last four weeks, Hillingdon had been the best performing hospital in London thanks to a lot of hard work by the staff. However, things were still not perfect and more work was needed to improve performance against the four hour target in paediatrics. Work continued on the waiting lists in relation to RTT and performance had been improving. This had moved from 61% meeting the 18 week target (in the bottom third nationally) to 67% now (possibly 70% by the end of the year) with a target of 92% in three years. It was noted that there could be very long waits for specialist units with a small number waiting more than 52 weeks - plans had been put in place to improve performance in relation to ENT and upper limb surgery. Performance in relation to echocardiography and audiology test had been very good against the six week target. There had also been some improvements in relation to endoscopy and colonoscopy. The faster diagnosis standard for cancer diagnostics meant that the Trust should be able to tell if a person had cancer within 28 days in 85% of cases. Over the last 14 months, the Trust had been getting much better at identifying cancer earlier in the pathway and had been performing above the 85% level for the last three to four months. Although the Trust had historically not met the 62 day treatment standard for about two years, it had been achieving it in the last two months. GP access to MRIs and CT scans and other innovations had resulted in easier diagnosis. For example, THH had been leading on using an innovative sponge for gynaecological cancer and there had been some changes to the way that gut cancer was scanned through a CT virtual colon. It would be important to monitor performance against cancer targets as this could drop off quickly. Insofar as the new hospital was concerned, Dr McGlennan advised that, although the Council had granted planning permission for the development in 2023, the New Hospitals Programme (NHP) had required changes to the design (although it was still broadly the same masterplan). As such, further engagement had been undertaken with the community and a new planning application was being drawn up for submission in 2027. This process was being used to ensure that the right schedule of accommodation was being put in place that would meet the needs of the local population for the next twenty years. It was recognised that the longer the process of getting a new hospital took, the more expensive it would be as costs and inflation continued to increase. This also made it more difficult to make decisions on the lifecycle of hospital equipment (how long it would last) as NHP expected 70% of the equipment in the new hospital to be new but the Trust could not compromise care at any point in the interim. To this end, THH was currently renovating same day emergency care to bring it closer to the ED (the new equipment that was being purchased would move to the new hospital once built). Concern was expressed that, with a number of services having been decanted to the site, travel could be difficult for elderly and disabled residents in the south of the Borough when they were referred to Mount Vernon Hospital (MVH), sometimes taking up to 90 minutes on public transport. It was queried whether this had resulted in an increased number of patients that did not attend (DNA) or who cancelled their appointments. Dr McGlennan advised that services such as ophthalmology and outpatient physiotherapy had been moved to MVH (these services would be moved to the hubs in due course) but the Trust had been monitoring the situation and there had been no real difference. A comprehensive package of patient transport options was available to residents that were having problems getting to MVH and met specific criteria. Patients could speak to their GP to see if they were eligible and to request access these services. Ideally, there would be a TfL bus route running direct from Hillingdon Hospital to MVH. Dr McGlennan advised that Hillingdon Hospital had merged with MVH a very long time ago and that the Trust’s parent organisation had changed more recently. THH had partnered with Chelsea and Westminster NHS Foundation Trust and that the two shared the same Chief Executive. THH was also part of the Acute Provider Collaborative in North West London which enabled partners to do things at scale. Members queried whether patient experience of care was improving. Dr McGlennan advised that the Trust tended to measure numbers and whether things had been diagnosed early enough. There were two experience measures: one for patients and one for staff. The staff survey results took about six months to collate and analyse so were out of date once they became available. THH tended to be mid-table on its staff survey results in comparison to other Trusts but had made a lot of improvements based on staff responses. For patients, a friends and family test was distributed in maternity, ED and general wards. Responses in relation to ED were getting better, general wards showed a steady improvement and the maternity ward went up and down (but had not improved much in the last three months). There would be a new focus on patient experience. Hillingdon Health and Care Partners (HHCP) Mr Keith Spencer, Managing Director at HHCP, noted that HHCP was a local partnership that brought together hospitals, GPs, community services, mental health teams, social care and charities to provide more joined-up care for residents in Hillingdon. The partnership included organisations such as THH, The Confederation Hillingdon CIC, CNWL and Hillingdon 4 All and worked closely with the Council and the Integrated Care Board (ICB). Mr Spencer advised that Hillingdon’s Joint Health and Wellbeing Strategy had been approved by the Health and Wellbeing Board in September 2026. It was a shared Strategy for partners in relation to the health of residents in the Borough but was not just about healthcare. The document focussed on residents living well, ageing well and not being bounced between services. Mr Spencer would be happy to attend a future meeting to provide further update. Neighbourhoods were being organised in three areas of Hillingdon and a single Borough-wide reactive care service was being created to avoid hospital admission by introducing initiatives such as mobile diagnostics to bring care closer to home. Concern was expressed about whether sufficient staffing and infrastructure would be in place when the hubs opened. Mr Spencer advised that there were Local Access Hubs (LAHs) and Children’s Hubs. Of the three LAHs, one was already open at the Pembroke Centre, which was really busy. The other two sites (one in the South West of the Borough and one in the South East) had to have premises in place by 2029 (the Civic Centre would be one of these sites). Funding would become available in October 2026 and an extended range of facilities, including mobile diagnostics and home administered IV antibiotics, would be available. There was a possibility that the business case would not be supported but it was unlikely as the new hospital development was contingent on having the hubs in place. It was queried why the hubs had not been prioritised in the areas where there was most need and why the infrastructure had not been put in place before their creation. Mr Spencer advised that the report set out the realignment of services to bring greater capacity. The availability of premises had impacted on the timings – whilst the Nestle hub was needed sooner rather than later as it was in an area of greater need, the building would not be available until 2029. Ms Amanda Carey-McDermott, Chief Executive Officer at The Confederation Hillingdon CIC, advised that not all services needed to be delivered from a hub building and that partners were delivering services as they were able to. Although Hillingdon’s performance was one of the best in London, more could still be done. Consideration needed to be given to whether or not services were improving and if life was improving for Hillingdon residents. Mr Spencer advised that 4,400 residents created a significant proportion of the work in health and social care in Hillingdon but around one third of these people could be treated away from the hospital. These 4,400 individuals tended to be aged 65+, frail and had an acute exacerbation of underlying health conditions. If partners could case manage these residents and wrap care around them, the residents would know who to contact if they started to deteriorate and would therefore be able to stay at home for longer. No other London borough was doing more or having a bigger impact on health and social care. Concern was expressed that, although there was a plan to deal with this cohort of residents, the residents didn’t seem to know what the plan was. Mr Spencer noted that more needed to be done to promote what was being done to support patients. For example, action was currently underway to increase the number of frail patients being case managed from 5k to 12k. Mr Spencer noted that the ICB had needed to make significant savings and that there was no longer any borough-based ICB teams (these functions had been absorbed by partners). There needed to be an increased focus on place and Hillingdon was preeminent in North West London for innovation. As such, the ICB would be investing £3.8m to scale up what was being done at place. Mr Spencer was optimistic about putting a greater emphasis on place – the ICB no longer had the resources so would need to delegate to the boroughs. Dr McGlennan advised that the main function of the ICB was now to act as the strategic commissioner of care and that the integration of care had been delegated to place. The Place Board then put together responses. It was noted that there were three local authority seats on the West and North London (WNL) ICB Board which needed to represent 13 different boroughs (this was one of the largest ICBs in the country with a budget of 0.25% of GDP). Consideration was currently being given to how the three seats should be occupied (for example, rotated around the 13 boroughs). The Confederation Hillingdon CIC (The Confed) Ms Amanda Carey-McDermott, Chief Executive Officer at The Confed, advised that young people’s services had been delivered with the hospital from practice locations across the Borough for many years. Up until now, these contracts had run from year to year and had provided no certainty for GPs. The WNL ICB would be rolling out a new model across the area which would provide more security for GPs within their enhanced contracts. The ICB officer that would be putting this new model in place across WNL would be hosted in Hillingdon. Dr Ritu Prasad, Chair of The Confed, noted that the new children and young people’s hubs would take a multi-disciplinary approach, with one based in each of the three neighbourhoods. Services had previously been rotating around GP practices which had worked well and clinics for issues such as respiratory, diabetes and gastroenterology had been undertaken in the community with children and young people being seen within two weeks. This work had been combined with mental health services through the Multi Disciplinary Team (MDT) which provided an element of education for the professionals and reduced the bounce back for the patients (MDT had been part of the core offer). Ms Carey McDermott, advised that Mr Spencer was the sponsor for the development of the three new general hubs. An outline business case was currently being put together for these hubs and was expected to be completed by October 2026. Members queried how the figures for waiting times were collated and if data was collected on any serious incidents / mortality figures related to the wait. For example, if someone who had been waiting for their appointment for six weeks did not attend that appointment, would their wait time restart. Mr White advised that each partner would be different but, at HH, if the patient was discharged after a number of DNAs, the calculation of their wait time would restart. Dr McGlennan added that most hospitals would have a policy whereby some patients were able to pause and whilst they were on the waiting list, the information provided by their GP would be interrogated to get a sense of what was wrong with the patient. They would then be monitored for any harm that resulted from the wait and any issues reported through the hospital and at a regional level. RESOLVED: That the discussion and reports be noted. 29. JOINT HEALTH AND WELLBEING STRATEGY (Agenda Item 7) Mr Keith Spencer, Managing Director at Hillingdon Health and Care Partners, covered this item in his presentation under Agenda Item 6 - Health Updates. 30. CABINET FORWARD PLAN (Agenda Item 8) Consideration was given to the Cabinet Forward Plan. It was recognised that there were a lot of reports on the Forward Plan that fell within the Committee’s remit but that the Committee did not have the capacity to consider all of these reports. If Members had a particular reason for wanting a report included on an agenda, they could specifically ask. Also, if, after consideration at Cabinet, Members wanted more information on a subject, they could specifically ask. The Democratic, Civic and Ceremonial Manager was asked to circulate the Cabinet Safeguarding report to the Committee once it had been published to see if Members had any concerns. RESOLVED: That: 1. the Democratic, Civic and Ceremonial Manager circulate the Cabinet Safeguarding report to the Committee once it had been published; and 2. the Cabinet Forward Plan be noted. 31. WORK PROGRAMME (Agenda Item 9) Consideration was given to the Committee’s Work Programme. It was agreed that the SEND Reforms be considered at the meeting on 12 January 2027 and that Members receive a briefing note on the SEND Sufficiency Strategy in due course. It was noted that the Committee was not going to be able to undertake two minor reviews within this municipal year. Members agreed that they would like to undertake a single meeting review of the London Ambulance Service at their meeting on 20 April 2027. Concern was expressed that the Committee’s remit was too big to be able to consider issues to a sufficient depth. It was suggested that, rather than add in more meeting dates, there might be times when the existing meetings would need to go on longer to be able to cover everything. Insofar as the major review of Pharmacy First / Pharmacies was concerned, Members were advised that there was a map available of all of the pharmacies in Hillingdon but that it did not include opening times. The Democratic, Civic and Ceremonial Manager would look to collate a separate list of the pharmacy opening times. RESOLVED: That: 1. a report on SEND Reforms be considered at the meeting on 12 January 2027 and that Members receive a briefing note on the SEND Sufficiency Strategy in due course; 2. a single meeting review of the London Ambulance Service be undertaken on 20 April 2027; 3. the Democratic, Civic and Ceremonial Manager circulate the map of pharmacies to the Committee and collate a list of pharmacy opening times; and 4. the Work Programme be agreed. The meeting, which commenced at 6.30 pm, closed at 8.53 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 and Care Select Committee – 13 October 2026 Part I – Public PHARMACIES AND PHARMACY FIRST REVIEW – FIRST WITNESS SESSION Committee name Children, Families, Health and Care Select Committee Officer reporting Nikki O’Halloran, Democratic Services Papers with report Appendix A - Scoping Report Appendix B - Pharmaceutical Needs Assessment 2025 Appendix C - Healthwatch Report Ward All HEADLINES At its meeting on 21 July 2026, the Committee approved the terms of reference for the review of Pharmacies and Pharmacy First. Pharmacies are healthcare facilities that prepare, dispense and sell medicinal drugs. This report provides the Committee with information about the Pharmacy First service which was launched at the end of January 2024. Pharmacy First allows patients to obtain treatment for seven common health conditions directly from community pharmacies without needing a GP appointment. The conditions that are included in Pharmacy First are sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and uncomplicated urinary tract infections in women. In Hillingdon, community pharmacies actively contribute to national programmes like Pharmacy First, vaccinations and smoking cessation. The uptake of these programmes could be increased by raising awareness about their availability within the community pharmacy setting through improved communication with patients and residents. 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. RECOMMENDATIONS That the Children, Families, Health and Care Select Committee: a) notes the content of the report; and b) question attendees on any aspect of the report. SUPPORTING INFORMATION The skills and expertise of community pharmacy teams should be utilised to alleviate some of the pressures and ever-increasing demands on the NHS and social care services. Community pharmacies are well positioned to support independent living, the promotion of self-care and contribute to a reduction in A&E attendances and hospital admissions. Pharmacists are a key partner in the delivery of plans to address the prevention of ill health which was demonstrated during the COVID-19 pandemic. The current level of essential Children, Families, Health and Care Select Committee – 13 October 2026 Part I – Public services in Hillingdon is considered necessary and good based on the existing needs and choices of residents. The level of advanced services is relevant to local needs. In May 2025, there were 59 community pharmacies in Hillingdon, serving a population of around 319,000 residents (ONS Mid-year Estimate, 2023) - 21 pharmacies in the North of the Borough (serving around 104,350 people – 5,640 in Harefield Village), 18 in the Southwest (serving around 95,350 people) and 20 in the Southeast (serving about 110,970 people – 19,700 in Wood End). The Hillingdon Pharmaceutical Needs Assessment 2025 states that pharmacies tend to be concentrated in town centres (e.g., Ruislip, Hayes Town) and are well distributed in areas of deprivation and high health need. 99.7% of households are within a 5-minute drive of a pharmacy; most pharmacies are within 1 mile of another. The Pharmacy First scheme and Community Pharmacist Consultation Service (CPCS) are actively used to relieve pressure on GPs and hospitals, with high uptake reported, especially in the North of Hillingdon with acute sore throat seeing the largest number of consultations under Pharmacy First. It would be useful to understand what action has been taken to identify the number people that have been diverted from GPs and hospitals to pharmacies to be able to quantify the effectiveness of the service. GP practices use telephony systems and receptionists to direct patients to Pharmacy First for relevant conditions. Most GP practices also have a self-help/Pharmacy First section on their websites and community roadshows and engagement events have taken place to educate patients about pharmacy services. Patient survey feedback indicated that many residents valued the ability to access advice and treatment from pharmacies, especially when GP appointments are hard to obtain. There have been a number of suggestions for improvement include greater transparency about available services and more extended opening hours. It has been suggested that there are a number of additional services that could be provided by Pharmacy First and many pharmacies have expressed a willingness to expand services if commissioned. Currently, the scheme covers sinusitis, sore throat, earache, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections in women, and enhanced services already offered include emergency contraception, vaccinations (flu, COVID-19, pneumococcal), blood pressure checks, stop smoking support and supervised administration. Potential additional services (as suggested by pharmacies) could include: o Shingles vaccine o RSV (Respiratory Syncytial Virus) vaccine o Chickenpox vaccine o Phlebotomy (blood tests) o Minor ailments (expanding the list of treatable conditions) o Vitamin injections o Sexual health screening o NHS Health Checks o Cholesterol testing/treatment RESIDENT BENEFIT The approach and related services addressed in this report are intended to support the continued independence of residents, prevent ill-health and reduce or delay the demand for more intensive, restrictive and expensive types of care. Children, Families, Health and Care Select Committee – 13 October 2026 Part I – Public FINANCIAL IMPLICATIONS There are no direct financial implications arising from this report. LEGAL IMPLICATIONS There are no legal implications arising from this report. BACKGROUND PAPERS None.

Appendix A 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). Appendix 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 Appendix A 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. Appendix A 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 Appendix A 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 Appendix A the most accessible point of contact wi th the NHS, often offering timely support without the 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  Samreen Nawshin, Healthwatch Hillingdon  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 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? Appendix A 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 evenings 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 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 Appendix A 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.

1 Pharmaceutical Needs Assessment 2025 September 2025 Appendix B 2 Contents List of tables ........................................................................................................................................5 List of graphs and figures .....................................................................................................................6 List of maps ..........................................................................................................................................9 1. Summary ........................................................................................................................................... 10 1.1. Overview of the London Borough of Hillingdon ........................................................................ 12 1.2. Community Pharmacies in Hillingdon ..................................................................................... 13 1.3. Conclusions ............................................................................................................................. 13 2. Introduction ....................................................................................................................................... 15 2.1. Purpose of the PNA .................................................................................................................. 15 2.2. Scope of the PNA ..................................................................................................................... 16 2.3 Process for developing the PNA ............................................................................................ 19 3. Hillingdon population demographics ............................................................................................. 21 3.1. Population Projections ............................................................................................................ 23 3.2. Births and Fertility ................................................................................................................. 25 3.3. Ethnicity .................................................................................................................................. 25 3.4. Languages .............................................................................................................................. 27 3.5. Religion ................................................................................................................................... 28 3.6. Homelessness ........................................................................................................................ 29 3.7. Patient Group Demographics ................................................................................................ 29 3.8. Deprivation ............................................................................................................................. 30 3.8.1. CORE20 (PLUS5) ................................................................................................................. 33 3.9. Low Income ............................................................................................................................ 34 3.10. Economic activity (employment and unemployment) ....................................................... 34 3.11. Benefit claimants .................................................................................................................. 36 3.12. Access to transport: Public and Private transport ............................................................ 38 4. The Health of Hillingdon’s Residents ............................................................................................. 39 4.1. Life Expectancy ...................................................................................................................... 39 4.2. Mortality .................................................................................................................................. 40 4.3. Disease Prevalence ................................................................................................................ 41 4.3.1. Cardiovascular Disease ...................................................................................................... 43 4.3.2. Respiratory Disease ............................................................................................................ 46 4.3.3. Excess Weight and Obesity ................................................................................................ 47 4.3.4. Mental Health & Neurological Conditions.......................................................................... 49 4.3.5. Long-Term Conditions ........................................................................................................ 50 3 4.3.6. Learning Disabilities and SEND ......................................................................................... 52 4.4. Smoking .................................................................................................................................. 52 4.5. Seasonal influenza ................................................................................................................. 52 4.6. Sexually transmitted infections............................................................................................. 53 4.7. All-age Vaccinations .............................................................................................................. 54 4.8. Under 18s conceptions .......................................................................................................... 54 4.9. Substance misuse: Drugs & Alcohol .................................................................................... 55 5. Pharmacy provision within Hillingdon............................................................................................ 57 5.1. Access to a pharmacy............................................................................................................ 65 5.2. Travel times to a pharmacy ................................................................................................... 67 5.3. Public Transport to Pharmacies ............................................................................................ 72 5.4. Other NHS providers that affect pharmaceutical services .................................................. 75 5.4.1. Local NHS transformation programme .............................................................................. 76 5.5. Pharmacy Services ................................................................................................................ 76 5.5.1. Essential services ............................................................................................................... 76 5.5.2. Advanced Services ............................................................................................................. 80 5.6. Enhanced Services ................................................................................................................ 83 5.7. Analysis of the Pharmacy Questionnaire .................................................................................... 85 5.7.1 Essential Services: .............................................................................................................. 86 5.7.2. Gaps in provision: Essential Services ............................................................................... 88 5.7.2.1 Opening hour changes in 2025 ........................................................................................ 89 5.7.3. Advanced Services ............................................................................................................. 89 5.7.4. Gaps in provision: Advanced Services .............................................................................. 91 5.8. Enhanced / Other services .................................................................................................... 92 5.8.1 Seasonal Influenza Vaccination – current provision by locality ....................................... 93 5.9. Enhanced Services: Current provision by locality .............................................................. 94 5.10.1. Disease Specific Medicines Management ....................................................................... 95 5.10.2. Vaccinations ...................................................................................................................... 95 5.10.3. Vaccinations: Current provision by locality .................................................................... 97 5.11. Gaps in provision: Enhanced / Other Services ................................................................. 98 5.12. Delivery services & non-commissioned services ............................................................. 98 5.13. Bank-holiday access .......................................................................................................... 100 5.14. Dispensing Appliance Contractors (DACs) ...................................................................... 100 5.15. Dispensing GP practices ................................................................................................... 100 5.16. PhAS pharmacies ............................................................................................................... 100 5.17. Future service provision .................................................................................................... 100 6. Patient Survey ................................................................................................................................. 102 4 6.1 Pharmacy usage .................................................................................................................... 102 6.2 Pharmacy choice ................................................................................................................... 104 6.3 Accessing a pharmacy.......................................................................................................... 106 6.4. Free Text Feedback .............................................................................................................. 107 6.5. Survey Respondent Demographics .................................................................................... 108 6.6. PNA Localities ...................................................................................................................... 109 6.6.1. North Locality .................................................................................................................... 110 6.6.2. Southeast Locality ............................................................................................................ 112 6.6.3. Southwest Locality............................................................................................................ 114 7. PNA Consultation ............................................................................................................................ 116 8. Conclusions ..................................................................................................................................... 116 9. Data Sources ................................................................................................................................... 117 10. Glossary ......................................................................................................................................... 119 11. Pharmacy opening hours ............................................................................................................... 120 5 List of tables Table Page Table 1: Hillingdon age breakdown, 2022/23 23 Table 2: Community pharmacies in Hillingdon by ward and locality 57 Table 3 Pharmacies changes since 2022 58 Table 4: Drive Times to local pharmacies 66 Table 5: Opening hours overview (borough) 88 Table 6: Enhanced / other services 92 Table 7: Screening services 95 Table 8: Vaccinations 95 Table 9: Delivery and non-commissioned services 98 Tables 10 to 16: patient survey equalities monitoring 108 Table 17: North locality opening hours overview 110 Table 18: Southeast locality opening hours overview 112 Table 19: Southwest locality opening hours overview 114 Table 20: North locality detailed opening hours 120 Table 21: Southwest locality detailed opening hours 122 Table 22: Southeast locality detailed opening hours 124 6 List of graphs and figures Graph or Figure Page Figure 1: Hillingdon population density 21 Figure 2: Household size 22 Figure 3: Population Pyramid 23 Figure 4: Census changes between 2011 and 2021 24 Figure 5: Broad ethnic groups 25 Figure 6: Percentage of population ethnicity 26 Figure 7: Ethnicity by age 26 Figure 8: Country of birth 27 Figure 9: Religion 28 Figure 10: Religion by ward 28 Figure 11: Homelessness trend 29 Figure 12: Deprivation deciles 31 Figure 13: Income 34 Figure 14: Economic activity 35 Figure 15: Employment rate 35 Figure 16: Benefits claimant count 36 Figure 17: Universal credit overview 37 Figure 18: Universal credit, Oct 2024 38 Figure 19: Life expectancy 39 Figure 20: Healthy life expectancy 39 Figure 21: Disability-free Life Expectancy 40 Figure 22: Mortality trend 40 Figure 23: Premature deaths 41 7 Figure 24: Disease prevalence spine chart 41 Figure 25: Atrial Fibrillation prevalence 43 Figure 26: Coronary Heart Disease prevalence 43 Figure 27: Heart Failure prevalence 44 Figure 28: Hypertension prevalence 44 Figure 29: Peripheral Arterial Disease prevalence 45 Figure 30: Stroke and Transient Ischaemic Attack prevalence 45 Figure 31: Asthma prevalence 46 Figure 32: COPD prevalence 46 Figure 33: Obesity prevalence, adults 47 Figure 34: Obesity trend, adults 47 Figure 35: Obesity (Reception) NCMP trend 48 Figure 36: Obesity (Year 6) NCMP trend 48 Figure 37: Dementia prevalence 49 Figure 38: Depression prevalence 49 Figure 39: Mental health prevalence 50 Figure 40: Cancer prevalence 50 Figure 41: Chronic Kidney Disease prevalence 51 Figure 42: Diabetes Mellitus prevalence 51 Figure 43: Non-diabetic hyperglycaemia prevalence 52 Figure 44: Influenza vaccinations 53 Figure 45: STI spine chart 53 Figure 46: Vaccinations spine chart 54 Figure 47: Under 18s conception trend 55 Figure 48: Drug treatment completions 55 Figure 49: Alcohol admissions spine chart 55 8 Figure 50: Essential Services: Dispensing by locality 77 Figure 51: BNF high volume 77 Figure 52: BNF medium volume 78 Figure 53: BNF low volume 78 Figure 54: Dispensing flows, North locality 78 Figure 55: Dispensing flows, Southwest locality 79 Figure 56: Dispensing flows, Southeast locality 79 Figure 57: Discharge Medicine Service 80 Figure 58: Advanced Services: Pharmacy First performance 81 Figure 59: Lateral Flow Device 81 Figure 60: Flu vaccination provision 82 Figure 61: Community Pharmacy Consultation Service provision 82 Figure 62: Contraception provision 82 Figure 63: Blood Pressure checks 83 Figure 64: New Medicine Service 83 Figure 65: Pharmacy Survey: pharmacy responses 85 Figure 66: Consultation rooms 85 Figure 67: Languages 86 Figure 68: Appliance provision 86 Figure 69: DMS provision 87 Figure 70: Advanced Services provisions 91 Figure 71: Influenza vaccination provision 93 Figure 72: Enhanced services provision 94 Figure 73: Enhance service provision continued 95 Figure 74: Vaccination provision 97 9 Figure 75: Delivery and non-commissioned service provision 99 Figure 76: Patient survey respondents 102 Figure 77 - 85: Patient survey responses 102 List of maps Map Page Map 1: Indices of Multiple Deprivation 31 Map 2: IDACI deprivation 32 Map 3: IDAOPI deprivation 32 Map 4: CORE20 (PLUS5) 33 Map 5: Primary Care Networks 42 Map 6: Pharmacies in Hillingdon and those outside the boundary 61 Maps 7 to 9 – Hillingdon pharmacies by locality 62 Map 10: One mile distance around each pharmacy 65 Map 11: Walking by time 67 Map 12: Walking by distance 68 Map 13: Travel by car, by distance 69 Map 14: Travel by car, non-rush hour 70 Map 15: Travel by car, rush hour 71 Map 16: Public transport, weekday morning 72 Map 17: Public transport, weekday afternoon 72 Map 18: Public transport, weekday evening 73 Map 19: Public transport, weekend morning 73 Map 20: Weekend afternoon 74 Map 21: Weekend evening 74 Map 22: Hospitals with a 5-mile radius 75 10 Map 23: North locality pharmacies 111 Map 24: Southeast locality pharmacies 113 Map 25: Southwest locality pharmacies 115 1. Summary Every Health and Wellbeing Board (HWB) has a statutory duty to carry out a Pharmaceutical Needs Assessment (PNA) every three years. The PNA provides Hillingdon’s Health & Wellbeing Board (HWB) with a framework that supports the local health and care system to: − understand the demographics of the local population − understand current provision of pharmaceutical services, including - the range of providers and choice - their premises (including facilities), the location and geographical spread across the area - the range of services provided − make appropriate decisions on applications for inclusion in a pharmaceutical list − commission appropriate and accessible services from pharmacies and dispensing appliance contractors − identify and address any local gaps in pharmaceutical services − target services to reduce health inequalities within local health communities. Pharmaceutical services are provided by pharmacy and dispensing appliance contractors from premises that are registered on a pharmaceutical list within each HWB area. In addition, some GP surgeries provide a dispensing service to eligible patients registered to their practice, and some pharmacy contractors provide services under a local pharmaceutical services contract. Pharmacy contractors provide services under the national Community Pharmacy Contractual Framework (CPCF) which sets out three levels of service: 1. Essential Services: these are the services that every community pharmacy providing NHS pharmaceutical services must provide and includes the dispensing of medicines and appliances, disposal of unwanted medicines, clinical governance, and promotion of healthy lifestyles 2. Advanced Services: there are nine services that Community Pharmacy Contractors and Dispensing Appliance Contactors (DACs) can choose to provide. Provision of these services are subject to accreditation as set out in the Secretary of State Directions 3. Enhanced Services: these are nationally commissioned services (commissioned directly by NHS England) that have been introduced to assist the NHS in improving and delivering a better level of care in the community. Pharmacy contractors can choose to provide any of these services Locally commissioned services can also be commissioned by the Local Authority (LA) or the Integrated Care Board (ICB). These are services that community pharmacy contractors could choose to provide and are included in the PNA. 11 For this PNA, Essential Services and the dispensing service provided by some GP surgeries are defined as ‘necessary services’, while Advanced and Enhanced Services are defined as ‘other relevant services.’ Other locally commissioned providers may also provide specific services that impact the need for local community pharmacy services. These specific services include sexual health services, stop-smoking support and needle exchange services. The geographical location of pharmaceutical providers determines access to services in terms of distance from a resident's home or work (either within Hillingdon or neighbouring boroughs). The surrounding location is included in the access criteria, and whether the service is accessible via public transport, whether there is the ability of service users to drive and park and the access to services for residents with a disability. Locating a service within or near to other services (for example within a supermarket) may influence choice by reducing travel. However, access is determined by more than just location; opening times are also an important aspect of access and service availability. Pharmaceutical services need to be available during ‘normal’ day-time hours (e.g. weekdays 9 am to 5- 6pm) when many other professional services might be expected to be available. The needs of specific groups of residents also need to be considered, for example: - workers being able to access pharmacy services after 6 pm or during lunchtime hours - those who access general practice in extended hours, e.g. up to 8pm on weekdays - those with more urgent self-care, unplanned care needs or for end-of-life care needs, at non- routine times, including weekends and in the evening. The Hillingdon Council Business Intelligence Team has completed the PNA in collaboration with the LA Public Health Team, Customer Engagement, the Council Communications Team, the Local Pharmaceutical Committee for Hillingdon and Healthwatch Hillingdon. The PNA has been overseen by the Hillingdon Health & Wellbeing Board to ensure it is fit for purpose as per the NHS Regulations. The process of developing this PNA has consisted of: - gathering and analysing data and information of population demographics, public health data, prescribing and service use data - mapping and evaluating existing pharmacy services - assessing service gaps based on population growth and access issues - a 60-day public consultation to gather feedback from stakeholders and the public running between June and August Lastly, reviewing feedback from the resident and pharmacy provider consultation to finalise the PNA, ahead of publication on the Council website within the national timeframe. Data presented throughout the PNA are accurate as of May 2025, unless stated otherwise. Any subsequent changes to pharmacy service provision in Hillingdon will be monitored, including any changes to the availability of pharmaceutical services reflected through supplementary statements (published alongside the PNA document), as and when appropriate. 12 1.1. Overview of the London Borough of Hillingdon Hillingdon is the second largest of London’s 32 boroughs in terms of land area, and shares its borders with Hertfordshire, Buckinghamshire, Surrey, and the London boroughs of Hounslow, Ealing and Harrow. Hillingdon has 21 electoral wards within three localities: North (8 wards), Southeast (7 wards) and Southwest (6 wards). The borough has been split into these localities based on the 2022 ward structures and data is widely available at ward or LSOA level for analysis to support the information used in the PNA. These localities align with the Primary Care Network structures and the Integrated Neighbourhood Teams (INT) that are the local vehicles of primary and community care delivery. Each locality shares several socio-economic characteristics which makes analysis easier. The current population of Hillingdon is 319,018 (ONS Mid-year Estimate, 2023). This represents growth of 8,337 residents from 2022 (2.6%). At locality level, 33.6% of the borough live in the North INT area, 30.6% in the Southwest and 35.7% in the Southeast. Over the course of this three-year PNA duration we can expect to see an average increase of 1,200 new dwellings per year, with most of the growth in population associated with new homes in the southern localities, specifically the Southeast. 48.2% of residents in Hillingdon are White. This is lower percentage than London and England. 33.3% of Hillingdon residents are Asian/Asian British; higher than London and England. There is a higher proportion of White and older residents in the North and Southwest localities, and southern localities, especially the Southeast locality have higher proportions of younger Asian and Black residents (Census 2021). Population at ward level ranges from 5,640 residents in Harefield Village to 19,701 residents in Wood End ward. The south of the borough is more densely populated with approximately two thirds of residents living in the southern wards. Wards in the south have higher levels of overcrowding and higher proportions of households with six or more residents. Hillingdon has a mixed socio-economic profile. The 2019 English Index of Deprivation ranks Hillingdon as 21st most deprived out of the 33 London boroughs. The boroughs average deprivation score masks the differences at ward level where northern wards are the least deprived and wards in the south have higher levels of deprivation than the Hillingdon average. Hillingdon has no LSOAs in decile 1 (the 10% most deprived areas) on the overall national indices. The long-term London Shared Needs Assessment (2024) and the Core20Plus 5 framework highlights that Hillingdon’s long term population health is deteriorating, with: - significant socio economic and environmental deprivation factors are driving the increasing prevalence of long-term conditions particularly in our most deprived communities (Yiewsley, Hayes, and West Drayton). This includes a high child poverty rate (31%), low mean income post housing costs, food insecurity and higher than NWL average rates of overcrowding and homelessness - 48% (127,264) of the Hillingdon registered Adult (18+) population are currently living with 1 or more Long Term Conditions (LTCs); making Hillingdon joint highest with Harrow in NWL for the highest weighted average % of patients with LTCs. The top five LTC’s within the Borough are: 13 Hypertension, Anxiety, Depression, Obesity & Diabetes. This is double the number of people recorded as living with one or more LTC compared to 2017 1.2. Community Pharmacies in Hillingdon There are 59 pharmacies in Hillingdon that provide pharmaceutical services, a rate of 19.0 per 100,000 residents. Since the 2022 PNA was published, five Hillingdon pharmacies have either closed or consolidated; Lloyd's Pharmacy have permanently closed all pharmacies within Sainsbury’s stores (within Hillingdon these are branches at Hayes and South Ruislip), one Boots branch has closed (Whitby Road, Eastcote) and two Boots branches have consolidated with other branches (Uxbridge and Northwood Hills). Hillingdon has better coverage of pharmaceutical services per 100,000 population than England, but slightly less than London. The rate is higher in the boroughs North locality (20.1) compared with the other two localities (Southwest 18.9/100,000 population and Southeast 18.0/100,000 population). There is variation in pharmacy coverage at ward level, with more pharmacies located in town centre areas within the localities (i.e. Ruislip and Hayes Town). There are good public transport links to town centres within Hillingdon and across the borough boundary in neighbouring boroughs. Three of the five pharmacies that have closed or consolidated since 2022 were located on existing high streets with other pharmacies close by. This enabled residents to maintain access to local pharmacy services. Data indicates that dispensing services from the closed pharmacies in Northwood Hills, South Ruislip and Uxbridge have transferred to pharmacies nearby. In Hayes this appears to differ due to the increased choice of provision in very close proximity along the Uxbridge Road and Coldharbour Lane. The national framework for pharmaceutical services requires every pharmacy to open for a minimum of 40 hours a week to provide essential services (necessary services). Although the south of the borough has less pharmacies than the north, some of these pharmacies have longer opening hours, and more are open on Sundays. There is a good spread of pharmacies that open early, remain open late and at weekends, all with good accessibility. There is an even spread of pharmacies in areas of deprivation in the south of the borough, and in areas with higher proportions of older people and people with long term conditions. During certain days and times of the week, community pharmacies are often the only healthcare facility available. Pharmacy provision is good across all three localities in Hillingdon. In the pharmacy survey pharmacists stated their willingness to provide services that may be required in the future. This flexibility and adaptability of pharmacists indicates that there are opportunities to develop services and that the scope of services and the number of pharmacies is sufficient to manage the need of the population over the course of this PNA. 1.3. Conclusions For this PNA, Essential Services for Hillingdon are defined as Necessary Services. Advanced and Enhanced Services are considered relevant as they contribute toward improvement in provision and access to pharmaceutical services. 14 Locally Commissioned Services are those that secure improvements or better access to or that have contributed towards meeting the need for pharmaceutical services in Hillingdon. These services are commissioned by the ICB or the local authority, rather than NHSE. The Hillingdon HWB considered the number, distribution, access and choice of providers of pharmaceutical services covering each of the three localities in Hillingdon and conclude that the evidence reviewed to inform this PNA based on the national criteria indicates that residents are adequately served by providers of pharmaceutical services in the borough. No current or future gaps have been identified in the provision of necessary and other relevant services across Hillingdon. Changes affecting pharmaceutical services provision such as substantial changes in current provision through business closure and/or changed population demographics will be monitored and reviewed by the HWB. The PNA will be updated with supplementary statements where necessary to explain the impact of any changes and what this means for the availability and accessibility of pharmaceutical services in Hillingdon. 15 2. Introduction Since the 2022 PNA, alongside the changes mentioned in the previous section, the following changes have also occurred: - There has been an update to the Pharmaceutical Regulations 2013 in May 2023 in response to the number of requests for temporary pharmacy closures with changes made to the: - Notification procedures for changes in core and supplementary opening hours - Notification procedures for 100-hour pharmacies to be able to reduce their hours to no less than 72 hours per week - Local arrangements with ICBs for the temporary reduction in hours - requirement for all pharmacies to have a business continuity plan that allows them to deal with temporary closures - Integrated Care Boards (ICB) have replaced Clinical Commissioning Groups (CCGs) as part of Integrated Care Systems (ICS). In an ICS, NHS organisations in partnership with local councils and other public sector and voluntary and community sector organisations take collective responsibility for managing resources, delivering NHS standards of care and improving the health of the population they serve. ICBs took on the delegated responsibility for the commissioning of pharmacy services from NHS England from 1 April 2023. - The Pharmacy First Service builds on the Community Pharmacist Consultation Services (CPCS) and was launched at the end of January 2024. Pharmacy First allows patients to obtain treatment for their health conditions directly from community pharmacies without needing a GP appointment. The conditions that are included in Pharmacy First are sinusitis, sore throat, earache, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections in women. - Hypertension Case-Finding Service requirements were updated from 1 December 2023. This service can be provided by suitably trained and competent pharmacy staff (previously, only pharmacists and pharmacy technicians could provide the service). - The Hepatitis C testing service was decommissioned at the beginning of April 2023. 2.1. Purpose of the PNA The purpose of the PNA is to assess and set out how the provision of pharmaceutical services can meet the health needs of the population of Hillingdon for the next three years. The PNA links closely to other strategies and needs assessment, notably the Joint Local Health & Wellbeing Strategy (JLHWS) and the Joint Strategic Needs Assessment (JSNA). The PNA sets out how health needs can be met by pharmaceutical services commissioned by the ICB on behalf of the NHS in England. If a pharmacy or a dispensing appliance contractor wants to provide pharmaceutical services, they are required to apply to the ICB to be included in the pharmaceutical list for the HWB area in which they wish to have premises. Their application must demonstrate how they will meet a need that is set out in the HWB’s PNA, or to secure improvements or close an access to service gap identified in the areas PNA. There are however some exceptions to this, for example, applications offering benefits that were not foreseen when the PNA was published (‘unforeseen benefits applications’). As well as identifying if there is a need for additional premises, the PNA will also identify whether there is a need for an additional service or services, or whether improvements or better access to existing services are required. Identified needs, improvements or better access may be needed or will arise within the three-year lifetime of the PNA. 16 Whilst the PNA is primarily a document for the ICBs to use to make commissioning decisions, it may also be used by local authorities. A robust PNA will ensure those who commission services from pharmacies and Dispensing Appliance Contractors (DACs) where to target services to areas of health need and reduce the risk of overprovision in areas of less need. 2.2. Scope of the PNA The Pharmaceutical Regulations 2013 detail the information required to be contained within a PNA. A PNA is required to measure the adequacy of pharmaceutical services in the HWB area under five key themes: • Necessary services: current provision • Necessary services: gaps in provision • Other relevant services: current provision • Improvements and better access: gaps in provision • Other NHS services In addition, the PNA details how the assessment was carried out. This includes: • How the localities were determined • The different needs of the different localities • The different needs of people who share a particular characteristic • A report on the PNA consultation To comprehend the definition of 'pharmaceutical services' as used in this PNA, it is important to understand the types of NHS pharmaceutical providers in the pharmaceutical list maintained by NHSE. The types of NHS pharmaceutical providers are: • Pharmacy contractors • DACs • LPS providers • Dispensing GP surgeries Pharmaceutical services provided by community pharmacies, dispensing GP surgeries and appliance contractors are defined by the Pharmaceutical Regulations 2013 and consist of services that are/may be commissioned under the provider’s contract with NHSE. For this PNA, ‘necessary services’ are understood to be equivalent to Essential Services, while ‘other relevant services’ are equivalent to Advanced and Enhanced Services. Pharmacy contractors operate under the NHS Community Pharmacy Contractual Framework (CPCF) which sets out three levels of service under which pharmacy contractors operate: 17 Essential Services: These are nationally negotiated and must be provided by all pharmacies: • Dispensing Medicines • Dispensing Appliances • Repeat Dispensing • Discharge Medicine Service (DMS) • Public Health and Health Promotion • Signposting • Support for Self-Care • Disposal of Unwanted Medicines • Clinical Governance Advanced Services: These services are nationally negotiated, and any contractor may provide any of these services if they meet the requirements of the Pharmaceutical Regulations 2013 and service specification associated with each service. They are: • Appliance Use Reviews (AURs) • Pharmacy First • Seasonal Influenza Vaccination Service • Hypertension Case-Finding Service • New Medicine Service (NMS) • Stoma Appliance Customisation (SAC) • Smoking Cessation Service Enhanced Services (national and local): In December 2021 provisions were made within the NHS Pharmaceutical and Local Pharmaceutical Services Regulations 2013 to provide a new type of enhanced pharmaceutical service. These are developed by NHS England and commissioned to meet specific health needs. Enhanced Services can include: • Care home service • Chlamydia Screening & Treatment • Emergency Hormonal Contraception (EHC) service • Minor ailment service • Needle and Syringe Programme (NSP) • Patient group direction (PGD) service • Smoking Cessation Service (SCS) • Pharmacy Based Supervised Administration Programme (PBSAP) 18 National Enhanced Services (NES) Enhanced Services are all considered relevant for the purpose of this PNA. Under the pharmacy contract, Enhanced Services are those directly commissioned by NHSE. There is currently one National Enhanced Service commissioned in Hillingdon, the COVID-19 vaccination service. This service is provided from selected community pharmacies who have undergone an Expression of Interest Process, and the service is commissioned by NHSE. Pharmacy owners must also provide the Flu Vaccination Service for a selected cohort of patients. Pharmacy Access Scheme (PhAS) providers The PhAS has been designed to capture the pharmacies that are most important for patient access, specifically those pharmacies where patient and public access would be materially affected should they close. The PhAS takes isolation and need levels into account. Pharmacies in areas with a dense provision of pharmacies remain excluded from the scheme. In areas with high numbers of pharmacies, public access to NHS pharmaceutical services is not at risk. The scheme is focused on areas that may be at risk of reduced access, for example, where a local population relies on a single pharmacy. DSPs, DACs, LPS contractors and dispensing GP practices are ineligible for the scheme. From 1 January 2022, the revised PhAS is to continue to support patient access to isolated, eligible pharmacies and ensure patient access to NHS community pharmaceutical services is protected. There are six PhAS in Hillingdon; Howletts (Ruislip), Boots landside in Terminal 3 and Terminal 5 in Heathrow Airport, Carters Pharmacy (Northwood Hills), Orchard Pharmacy (West Drayton) and Village Pharmacy (Harlington). Dispensing Appliance Contractors (DACs) DACs operate under the Terms of Service for Appliance Contractors as set out in Schedule 5 of the Pharmaceutical Regulations 2013. They can supply appliances against an NHS prescription, are not required to have a pharmacist, do not have a regulatory body and their premises do not have to be registered with the General Pharmaceutical Council. There are no DACs in Hillingdon. Other providers of pharmaceutical services in neighbouring areas There are six other neighbouring boroughs that border Hillingdon: • Ealing • Harrow • Hertfordshire • Hounslow • Spelthorne • South Buckinghamshire 19 In determining the needs for pharmaceutical service provision to the population of Hillingdon, consideration has been made to the pharmaceutical service provision from the neighbouring HWB areas. Although these pharmacies have not been included in the survey of contractors this PNA includes maps showing their proximity to Hillingdon. 2.3 Process for developing the PNA Hillingdon HWB has statutory responsibilities under the Health and Social Care Act to produce and publicise a revised PNA at least every three years. Hillingdon’s last PNA was published in September 2022 and is due to be refreshed and published by the end of September 2025. Other strategies considered include: Joint Strategic Needs Assessment (JSNA) The aim of the JSNA is to improve the health and wellbeing of the local community and reduce health inequalities for residents of all ages, identifying those groups where health and care needs are not being met and those residents which are experiencing poorer health and wellbeing outcomes. Hillingdon’s JSNA is currently being refreshed and is in the process of being replaced by the Hillingdon Datahub; the Datahub has been used to populate many of the figures within the PNA. Health and Wellbeing Strategy (HWS) Hillingdon’s draft Joint Local Health & Wellbeing Strategy 2025-28 seeks to improve the health and wellbeing of all our residents and reduce disparities in health and care across our communities to achieve a vision shared by all health and care partners in the borough. The priorities and objectives include: ➢ Thriving Healthy Households: - whole-population approaches to prevent ill health and promote wellbeing through self- management - tackling the social determinants of poor health - improving air quality and built environment ➢ Early Intervention and Prevention: - optimising preventative care for people with LTCs with an emphasis on hypertension - maximising independence and choice - preventing reliance on health and care services ➢ Targeted long-term care and community support for people with complex health and care needs: Provide proactive, personalised and integrated case management and care across primary, community, mental health, social care and voluntary services for high-need, high-utilisation patients to: - Maintain their independence for as long as possible - Reduce non-elective presentations - Reduce admissions to long term care A small number of high impact actions and key performance indicators (KPIs) have been created to monitor performance of the objectives, which will be monitored through the Health & Wellbeing Board. 20 Included in the HWS is the Core20PLUS5 framework, an NHS England initiative aimed at reducing healthcare inequalities, which focuses on the most deprived 20% of the population (CORE20), additional marginalised groups (PLUS) and five (5) key clinical priority areas. Hillingdon’s draft Health & Wellbeing Strategy (2025-28) shows how these priorities relate to Hillingdon: Pharmaceutical service providers have the potential to play a greater role in identifying and helping address priority health needs as they are strategically placed in the community and have daily interactions with the local populations. To help understand local health needs and how pharmaceutical service providers can be involved in various interventions, the next sections look at Hillingdon’s population and major causes of ill health. 21 3. Hillingdon population demographics The current population of Hillingdon is 319,018 (ONS Mid-year Estimate 2023). This represents growth of 8,337 residents from 2022 (2.6%). The largest element of change between 2022 and 2023 was from international migration; natural change (births minus deaths) accounted for an additional 2,000 residents, internal migration accounted for a decrease of 3,950 residents and international migration accounted for a net change of 10,100 residents – giving overall growth of approx. 8,000 residents between 2022 and 2023. The current dataset of ward population estimates 310,681 residents (2022); population totals at borough and ward level vary as there is a lag in the publication of data at different geographies. Population between wards varies; Harefield Village has the smallest population (5,640) and Wood End the largest (19,701). The south of the borough is more densely populated with approximately two thirds of residents living in the southern wards; 8 of the top 10 most densely populated wards are in the south, with Belmore topping the ranks with the most residents per square km. Wards in the south have higher levels of overcrowding, with up to 20% of households having fewer bedrooms than required (1 or 2 or less than needed). Wards in the south have higher proportions of households with six or more residents. Figure 1: Hillingdon Population Density: 22 Figure 2: Household size in Hillingdon (2021): The GP registered population in Hillingdon This population is estimated at 346,632 (2023/24); the difference between this and the usual resident population is that some people registered with a Hillingdon GP will be non-Hillingdon residents. Similarly, some Hillingdon residents will be registered with GPs outside of the borough. Daytime / workday population The population of an area changes as people move in and out of an area to work or study. Census 2011 indicated that the working age population increases by 17.3% during the workday (or 34,700 people); Census 2021 took place during the Covid pandemic when a nationwide lockdown was still in place, with many people working from home. Although the pandemic has now passed, applying the 2011 percentage to the current population estimates that we could have an additional 55,000 people potentially accessing services within Hillingdon during the working day, similarly just as a percentage of our residents will access services outside our boundary, i.e. a pharmacy near their place of work, study or end destination. Data from the NHS Business Services Authority shows that in September 2024 approximately 11% of prescriptions dispensed by pharmacies in the borough were from GPs outside the borough boundary. Gender by age range The Hillingdon population is split 49.9% male (159,326) and 50.1% female (159,692), with variations by age range which can be seen in Figure 3 which also shows the age distribution in comparison to London and England. Hillingdon has higher proportions of younger residents aged 0-18 than London and England. 23 Figure 3: Hillingdon Population by gender and age compared to London and England: 2023: The North locality has higher proportions of residents aged 65 years and older, with the Southeast and Southwest localities having higher proportions of younger residents aged under 19 years. Table 1: Hillingdon age breakdown, 2022/23 Age Band Hillingdon Persons Hillingdon % of population North locality Southeast locality Southwest locality London England Age: 0-3 16,731 5.2% 4.6% 5.4% 5.6% 4.7% 4.2% Age: 4-18 61,350 19.2% 17.6% 20.9% 19.5% 17.7% 17.8% Age: 19-64 198,420 62.2% 58.5% 63.5% 63.9% 65.4% 59.3% Age: 65-74 22,200 7.0% 9.2% 5.9% 6.2% 6.6% 9.5% Age: 75+ 20,317 6.4% 10.0% 4.4% 4.9% 5.6% 9.2% 3.1. Population Projections At the current time (February 2025), no Sub-National Population Projections have been published since 2018; an updated data set is due in 2025. Using the growth data between the 2011 and 2021 Census (11.7%) we could expect the population in 2031 to be 342,000. Figure 4 shows the large growth in the older population since Census 2011, with some younger age cohorts seeing a decrease; the largest growth was in those aged 55 to 59, who between 2021 and the next census will further increase the older population. 24 Figure 4: Since 2021 the North locality has seen a very small reduction in the number of residents (a net reduction of 157 residents overall). The Southeast has seen the largest growth (3,004 extra residents) and the Southwest saw growth of 1,917 residents. Over the course of this PNA we can expect to see an average increase of 1,200 new dwellings per year, with most of the growth of the associated new population in the southern localities, specifically the Southeast. 3.5% of the planned developments are in the North locality; those in Harefield Village and Northwood are located near existing provision. Planned development in lower Harefield is served by the 331-bus route to towns within Hillingdon (Harefield, Ruislip, Northwood and Uxbridge) as well as across the boundary into Denham. 58% of the planned development is in the Southeast locality, the majority of which are near Hayes Town with good current provision and choice of providers. Other locations of development within this locality are near the Uxbridge Road and Lansbury Drive. 38% of the planned development is in the Southwest locality; a large proportion of these are RAF Uxbridge, which are within walking distance of Uxbridge town centre. Other large developments are planned in Hillingdon East ward (close to Long Lane and Ickenham, currently with good provision), 25 Cowley (good transport links into Uxbridge or Yiewsley, and walkable to Brunel University) and in Yiewsley (where good provision currently exists). With all planned developments and the growing population current provision will need to be monitored over the life course of the PNA. There are no known firm plans for developments which would change the pattern of local social traffic and therefore access to services (i.e. shopping centres or significant shopping developments in a town, on the edge of town or out of town developments). 3.2. Births and Fertility Births In Hillingdon have fallen from 4,500 in mid-2016 to 4,100 in mid-2023. Wards in the Southeast locality have seen the highest numbers of births (specifically Belmore, Wood End and Hayes Town) alongside Yiewsley in the Southwest locality. The Total Fertility Rate in Hillingdon has fallen to 1.72 in 2023 (from 1.79 in 2020) with rates also having fallen in London and England. 3.3. Ethnicity 48.2% of residents are White, lower than London and England; 33.3% are Asian/Asian British, higher than London and England. Figures 5 and 6 show the borough data. Figure 5: Broad Ethnic Groups in Hillingdon (2021): 26 Figure 6: Percentage of Population by Ethnic Group (excluding white population), 2021: There is a higher proportion of White and older residents in the North and Southwest localities, and the southern localities have higher proportions of younger Asian and Black residents, as shown in Figure 7. Figure 7: Ethnicity by Age Range, Census 2021: 27 3.4. Languages Census 2021 shows that 75% of borough residents aged 3 years and older have English as their main language. For residents who do not have English as their main language, 17.5% can speak it well or very well. There is variation at locality level, with Belmore ward (Southeast locality) having the lowest level of residents aged 3 years+ with English as the main language (58.3%), whereas Harefield Village ward (North locality) has 90.2% of residents with English as their main language. The top three main languages spoken by residents in Hillingdon (after English) is Panjabi (4.5%), Polish (1.6%) and Tamil (1.6%). Over 80 languages are spoken by Hillingdon residents. 3.5. Country of Birth 62% of borough residents were born in the UK, with a further 19.8% from Middle & East Asia. Figure 8: Country of Birth by region of Hillingdon residents (excluding Europe): 2021: 28 There is variation at locality level, with Hayes Town ward (Southeast locality) having the lowest level of residents born in the UK (43.8%), whereas Ruislip ward (North locality) has 77.9% of residents who were born in the UK. 3.5. Religion Census 2021 shows that the majority of residents in Hillingdon identify as having a Christian faith, followed by No Religion and Muslim; 6% chose not to answer the optional question. Figure 9 shows the borough proportions and Figure 10 shows the variation at ward level. Figure 9: Recorded religion in Hillingdon, Census 2021: Figure 10: Reported religion by ward: Hillingdon, 2021: 29 3.6. Homelessness Hillingdon has seen a large increase in households in temporary accommodation since 2021/22. Figure 11 shows Hillingdon’s trend data, which has shown larger increases than London and England. Figure 11: Homelessness: households in temporary accommodation: Rough Sleepers Monthly data from the Ministry of Housing, Communities & Local Government shows that in September 2024 there were - 86 people sleeping rough over the month - 47 new people sleeping rough over the month (an increase of 21% since September 2023. 3.7. Patient Group Demographics 3.7.1. Student population Students studying and resident on campus during term times can impact on service needs. Hillingdon is home to Brunel University, Buckinghamshire New University’s Uxbridge campus and Uxbridge College (spread over two campuses - Uxbridge and Hayes): • The Brunel University campus includes a medical centre and pharmacy and is close to Uxbridge Town Centre • Buckinghamshire New University is close to Uxbridge Town centre • Uxbridge College campuses are close to Uxbridge or Hayes Town centres 3.7.2. Immigration Removal Centre Within Hillingdon’s boundary is the Heathrow Immigration Removal Centre (HIRC); situated two miles away from Heathrow Airport comprising of two separate buildings (Harmondsworth IRC and Colnbrook IRC), it has a combined capacity of 965 residents. 3.7.3. Military Veterans Data from Census 2021 shows that 3,443 residents have previously served in UK regular armed forces, a further 1,211 have served in the UK reserve armed forces and an additional 177 have served in both (a total of 4,831 residents aged 16+). 30 3.7.4. RAF base Hillingdon is home to RAF Northolt in South Ruislip ward. 2,000 service personnel (from all three Armed Forces), civil servants, and contractors work at RAF Northolt, which has an onsite medical centre and dentist. 3.7.5. Immigration Immigration statistics from the Home Office show that in December 2024 Hillingdon was supporting 3,816 people under three pathways; the Homes for Ukraine, Afghan Resettlement Programme and Supported Asylum that account for 1.2% of the borough population, the highest proportion of all local authorities in Great Britain. 3.7.6. Travellers Census 2021 counted 472 Gypsy or Irish Travellers living in Hillingdon, 0.2% of the borough population. The majority live in the Southwest of the borough (60.4%, 285), 26.7% live in the Southeast (127) and 12.7% live in the North (60). There are 691 Roma residents, 0.2% of the population; 41.4% live in Southwest wards (286), 33% live in Southeast wards (228) and 25.6% live in the north of the borough (177). Census counted six residents who responded as ‘other traveller’, all live in Yiewsley ward. 3.7.7. Unpaid Carers Census 2021 counted 22,464 residents (aged 5+) who provide unpaid care. The number of hours per week varies but 5,007 residents provide 20 to 49 hours per week, and 6,445 residents provide 50+ hours per week. Note that Census 2021 took place during the COVID pandemic, which may have affected how people responded. Some of these patient groups will be included within the normal resident population. 3.8. Deprivation Hillingdon is ranked 21st most deprived of the 33 London Boroughs (including City of London). The following 3 maps show the various versions of IMD ranking in Hillingdon: • Overall Indices of Multiple Deprivation (IMD): Hillingdon has no LSOAs among the 10 per cent most deprived nationally • Income Deprivation Affecting Children Index (IDACI) ranking: Hillingdon has two LSOAs in the south of the borough in the most deprived 10% of LSOAs in England • Income Deprivation Affecting Older People Index (IDAOPI): Hillingdon has six LSOAs in the south of the borough in the most deprived 10% of LSOAs in England Deprivation in older people is associated with poor health outcomes; this has implications for health and care services, including pharmacy services. 31 Map 1: IMD by Hillingdon ward, 2019: Figure 12: Percentage of Hillingdon LSOA in each national deprivation decile: 32 Map 2: Income Deprivation Affecting Children Index, 2019: Map 3: Income Deprivation Affecting Older People Index, 2019: 33 3.8.1. CORE20 (PLUS5) On the overall Indices of Multiple Deprivation (Core20), 4% of the borough's population live within the most deprived 20% of LSOAs (12,541 residents) – Hillingdon’s has no LSOAs in the most deprived decile. All these LSOAs fall within southern wards. The population increases when looking at the indices affecting children and older people; all LSOAs are still in the south of the borough: - Indices affecting children – 5.9% of residents (18,401) - Indices affecting older people – 12.6% of residents (39,029) Map 4: The most deprived 20% of LSOAs in the overall indices: Source: SHAPE Atlas by the Department of Health & Social Care 34 3.9. Low Income Hillingdon has lower rates of children under 16 living in families with low income when compared to London and England, though there will be variation at ward level. Figure 13: Number of Children living in families with a low income, 2014/15-2022/23 3.10. Economic activity (employment and unemployment) Economic activity relates to whether a person (aged between16 and 64 years) is working or looking for work. Residents who are unemployed, or who are in poorly paid occupations tend to have poorer health outcomes. 35 In June 2024, Hillingdon had lower proportions of economically active males compared with London and England, and a higher proportion of economically active females. This is mirrored for employment rates in both genders. Figure 14: Economic Activity in Hillingdon compared to London and England, by gender (June 2024): Of residents economically inactive 43.9% are students and 14.1% are long term sick. Figure 15: Employment Rate n Hillingdon compared to London and England, by gender (June 2024): 36 3.11. Benefit claimants The proportion of residents claiming out of work benefits is increasing, both in Hillingdon and across London. Figure 16: Benefit Claimants: Hillingdon compared with London and England, November 2024: 37 3.11.1. Universal Credit Universal Credit (UC) is a single payment for households on low income or out of work to help with living costs. UC replaces six legacy benefits. Introduced in Hillingdon in October 2018, the data shows an increase in claims that could be a natural increase or the phased switchover of existing benefits. Figure 17: Universal Credit Claims: Hillingdon compared with London and England, October 2024: 38 Figure 18: Proportion of people claiming UC by duration of claim: Hillingdon compared with London and England, October 2024: 38% of UC claimants are in employment. Wards in the south of the borough have higher claim rates of most benefits; 48% of people claiming Universal Credit live in the Southeast locality of Hillingdon. 3.11.2. Pension Credit In May 2024 Hillingdon had 5,400 residents claiming pension credit (data from DWP on Stat-Xplore); 40.2% of claims were from the Southeast locality. Nationally, almost 90% of all prescription items are dispensed free of charge, with almost 63% of all prescription items dispensed free of charge to patients claiming age exemption (aged 60 years and over). 3.11.3. Carers Allowance In May 2024 Hillingdon had 4,300 residents claiming pension credit (data from DWP on Stat-Xplore); 43.4% of claims were from the Southeast locality. 3.12. Access to transport: Public and Private transport In 2024 there were 165,300 licensed vehicles registered within Hillingdon (cars, motorcycles and light and heavy goods vehicles). Hillingdon is well served by the London Underground; the Central, Metropolitan and Piccadilly Lines start and end within the borough and provide good links into London, alongside the Elizabeth Line that runs through the south of the borough. Hillingdon also has overground rail links and a good network of bus routes. Maps detailing distance to pharmacies are presented in Section 5.

One year on: How is Pharmacy First working for patients? June 2025 Contents Executive summary ................................ ................................ ................................ ..... 2 Introduction ................................ ................................ ................................ ........................ 4 This report: What we did ................................ ................................ ......................... 5 1. Use of Pharmacy First service ................................ ................................ ....... 2 2. What’s working well ................................ ................................ ................................ 9 3. Understanding non-users: Barriers and opportunities ........12 4. Challenges................................ ................................ ................................ ................... 16 5. The future of pharmacy services ................................ ............................. 21 Conclusion and recommendations ................................ ......................... 25 2 Executive summary In January 2024, Pharmacy First went live , help ing people get treatment for seven common conditions faster. It allows community pharmacists to diagnose and supply prescription -only medicines without needing a GP. One year on , 98% of pharmacies have signed up to Pharmacy First , and over two million consultations have been delivered for the seven conditions offered through the scheme . Ahead of the scheme’s launch in 2023 , we investigated people’s experiences of and attitudes towards pharmacy services . We found that 72% of people had used a community pharmacy in the past three months and valued the service . A majority also liked the idea of getting help from a pharmac ist for common conditions. However, people did face challenges . These included supply shortages on some medicines, pharmacies closing, and rising prices that prevent people from getting an NHS prescription or over -the-counter medication because they can't afford it. A year later , we have found that public satisfaction with pharmacy services remains high. However, issues with medicine supply and lack of awareness of the Pharmacy First service persist. Key findings • There are high levels of satisfaction with Pharmacy First services . Almost nine in ten (86%) reported a positive experience of visiting their pharmacy for support with one of the seven common conditions. • Awareness of Pharmacy First has improved, but there is more to do. Nearly three in ten people (29%) who said they were unlikely to use a pharmacy for the seven conditions were unaware that pharmacies can provide treatment and advice for them. A lmost one in three (32%) of this group would still prefer to see their GP. • Regional differences exist in awareness , usage, and appetite for expan ding Pharmacy First . Local Healthwatch reports show variable levels of awareness, from 39% in Halton to 72% in Stockton -on-Tees. • Pharmacy First has led to changes in why people visit their pharmacies. Compared with our November 2023 results, our research and other studies indicate a possible shift in attitudes towards using pharmacies for symptom management and health advice. More research is needed to see if this growing openness to using the pharmacy for a wider range of conditions will lead to lasting change. • Medication shortages continue to affect people . There has been almost no improvement since last year in terms of people experiencing medicine shortages when visiting their pharmacy (24% to 23%). 3 • Privacy concerns are a key driver of poor experiences . Just under one in ten (8%) people felt uncomfortable discussing their health concerns in the pharmacy, citing issues including having to talk in front of other customers and a lack of space for priva te conversations. Key recommendations Addressing barriers to pharmacy access and drivers of poor experience will increase confidence in pharmacy services and the Pharmacy First scheme. There must also be action to raise awareness of the scheme and realise its untapped potential to reach and support more people . Support is also needed to continue improvements and process efficiencies, while looking to the future of the scheme in terms of its potential to expand. • Continue raising awareness of the Pharmacy First Scheme. To ensure more people can benefit from the scheme, national campaign work must continue , with updated campaign materials and proactive outreach to targeted groups. • Give pharmacy teams the support they need to provide more Pharmacy First consultations. To continue delivering services, funding provision must increas e, while pharmacy premises should be reviewed for appropriateness, accessibility and comfort. • Expand the Pharmacy First scheme to provide consultations for more conditions . In consultation with key stakeholders and the public, more conditions should be considered for delivery through the scheme. • Formally collect , publish, and measure patient experience of community pharmacy services, including the Pharmacy First scheme. To understand access and satisfaction with pharmacy services and for service improvement, transparent data and targets should be introduced. • Take action to mitigate the impact of medication shortages . Almost one in four people are still impacted by medicine shortages, so action must be taken to give pharmacy teams more dispensing flexibilit y, while providing official information and advice to those affected by supply issues. 4 Introduction Background to Pharmacy First GP access has been a critical pressure point in the NHS in recent years. Over the last five years , national data , Healthwatch reports and media coverage have all brought to light stories of people struggling to make appointments, GPs overwhelmed by demand , and patients fac ing long wait ing times . In 2024 , access to GP appointments was the most common issue people contact ed He althwatch about . Despite record numbers of GP appointments, Health Foundation research from November 2024 found that 38% of the public ranked GP access as the top NHS priority . The Department for Health and Social Care (DHSC) launched the Pharmacy First initiative in January 2024 , a key part of the primary care recovery plan of May 2023 , which identified expanding access to pharmac ies as a key strategy for reducing demand for GP services . This enabled pharmacies in England to provide treatments for seven common ailments through the service . The se are ear infections, impetigo, shingles, sinusitis, sore throat, infected insect bites and uncomplicated urinary tract infections (UTIs). Pharmacy First mark ed a significant shift in how community pharmacies work within the NHS . They moved from a traditional role of dispensing medicines to diagnos ing and treat ing certain conditions themselves , without patients needing to see a GP first. Our previous research Given the significance of this policy shift, Healthwatch England began tracking public attitudes even before Pharmacy First launched. This research builds upon our first report , ‘Pharmacy: What people want’ , published in April 20 24. We conducted a nationally representative poll 1 and interviewed pharmacists and members of the public in November 2023 , shortly before the launch of Pharmacy First . This timing gave us a useful starting point to compare how people ’s views and experiences have changed since then. The November 2023 results were broadly encouraging for the new policy – we found that most of the public was already more likely to go to a pharmacy than a GP for five of the seven new conditions . However, barriers to access around costs, pharmacy closures and medicine shortages undermined Pharmacy First's potential. Almost one in four (24%) had experienced shortages when trying to get medicine, and 42% had experienced problems getting medicine in general . Pharmacies permanently closing and temporary closures also caused 1 Yonder carried out this poll in November 2023. It included a nationally representative sample of 1,641 adults in England. 5 frustration. We found t here was little transparency about temporary closures , and little information given to local residents when temporary closures occur red. In a follow -up piece of work published in September 2024 , we submitted Freedom of Information requests to all 42 Integrated Care Boards . These revealed that over 430 community pharmacies closed permanently in 2023 , with nearly 14 ,000 temporary closures reported. This report: What we did This new report summarises our research and findings over one year after our initial report and the launch of Pharmacy First. By asking people similar questions to those in our earlier study , we wanted to see what early effects the primary care recovery plan and Pharmacy First services might be having on how people think about and use pharmacy services. We commissioned two national polls and gathered qualitative insights to explore how the Pharmacy First policy in England is working in practice over a year since its launch on 31 January 2024. Due to the documented low levels of public awareness around Pharmacy First , we made the methodological decision to ask about the seven pharmacy services that the Pharmacy First scheme offers, rather than asking about Pharmacy First by name. Many people who receive consultations may not realise they have used the Pharmacy First service. This approach found that from February 2024 to March 2025 , 3,104 out of 7 ,039 people self -reported using pharmacy services for one of the seven conditions . This reflect s broader, self -reported use and , therefore , is not reflective of official NHS Pharmacy First statistics , which include stricter definitions and clinical recording. This discrepancy is intentional – designed to capture the full scope of pharmacy care interactions , regardless of awareness levels. • Yonder carried out the first poll in November 2023. It included a nationally representative sample of 1,641 adults in England. The survey was conducted online, and the figures have been weighted to be representative of the adult population (aged 18+). You can find a full analysis of this poll in our first report . • Savanta conducted a follow -up poll between March and April 2025. This nationally representative survey, which involved 7,029 adults across England and was also conducted online, has been weighted to ensure representation of the adult population (aged 16+). • We also hosted two roundtable events in early 2025 with staff from 17 Healthwatch teams from across England. These participants regularly gather public feedback about pharmacy services in their local areas and shared their insights into the rollout of Pharmacy First. 6 • We also analysed qualitative feedback from the public submitted to local Healthwatch services between January and April 2025. This feedback helped us understand people’s experiences in greater depth . We would like to thank all the l ocal Healthwatch teams who participated in the roundtable : • Healthwatch Birmingham • Healthwatch Brighton and Hove • Healthwatch Croydon • Healthwatch Derbyshire • Healthwatch Dorset • Healthwatch Gloucestershire • Healthwatch Halton • Healthwatch Havering • Healthwatch Kent • Healthwatch Medway • Healthwatch Portsmouth • Healthwatch Richmond • Healthwatch Southend • Healthwatch Surrey • Healthwatch Tameside • Healthwatch Walsall • Healthwatch Wandswort h 2 1. Use of Pharmacy First service How are people using Pharmacy First? To understand how Pharmacy First is being used by patients , we can look at both NHS data and our nationally representative poll. We asked people whether they had sought advice or treatment from a pharmacy for any of the seven conditions covered by Pharmacy First since February 2024. These are self -reported visits that may include informal advice or over -the-counter medication , not just formal consultations , and are therefore significantly higher than the official consultation numbers . Our poll found that 44% of respondents (3,104 people) had been to a pharmacy for help with at least one of the seven conditions since February 2024 . Among this group who had used the service: • 40% sought advice or treatment for sore throats • 28% for urinary tract infections (UTIs) • 17% for earache These percentages broadly align with the proportions in the official consultation data, especially for more specific conditions like UTIs and sinusitis. NHS England data shows that in its first 13 months (February 2024 – March 2025) the Pharmacy First service has delivered around 2.4 million consultations for the seven conditions 2, with a further 1.5 million minor illness and 1.4 million urgent medicine supply consultations . Pharmacies delivered the most consultations for acute sore throats ( 34%, 835,679 consultations ), followed by uncomplicated UTIs (27%, 665,409). The chart below compares the proportion of respondents in our poll who reported using a pharmacy for each condition with the proportion of NHS consultations for the same conditions. The similarities between our poll and national NHS data gives us confidence that the findings we gathered reflects real world use of the service 3. 2 Pharmacies have also handled 1.5 million minor illness consultations following patient referrals (from GP or NHS 111) and 1.4 million urgent medicine supply consultations. These services were previously commissioned as the Community Pharmacist Consultation Service and are now under the umbrella of Pharmacy First. 3 Greater alignment between NHS consultation data and our poll results is seen for more specific conditions, such as UTIs and sinusitis. In contrast, getting help for broader conditions like sore throats or earache may be interpreted in multiple ways. For 3 Geographical disparities Our poll revealed notable regional variation in how people are using pharmacies for the seven common conditions covered by Pharmacy First. Although 44% of respondents reported using a pharmacy for one or more of the conditions, both the proportion of people who did so and the conditions they sought help for varied across regions. example, someone reporting a sore throat visit might have gone to buy over-the-counter remedies rather than having a formal Pharmacy First consultation. This ambiguity may help explain discrepancies between self-reported use and recorded figures. 40% 28% 17% 12% 9% 4% 3% 34% 27% 12% 10% 8% 3% 4% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Sore throat Urinary tract infection (women only) Earache Sinusitis Infected insect bites Shingles Impetigo Reported pharmacy use for the seven conditions in our poll vs NHS consultation data (Feb 2024 – Mar 2025) (n for HW data =4427, total respondents who had used the pharmacy for one of the seven conditions) Healthwatch Poll data NHS Data 4 The chart below shows the percentage of respondents in each region who reported using a pharmacy for each of the seven conditions. For example, 38% of London respondents said they had used a pharmacy for a sore throat , significantly higher than the national average of 26% , while only 17% in the Eastern region reported the same . This means people in London were over twice as likely to report using a pharmacy for sore throats than those in the Eastern region. The table below outlines the percentage of respondents in each region who used a pharmacy for at least one of the seven conditions February 2024 to March 2025 : 17% 22% 24% 25% 22% 24% 30% 24% 38% 7% 11% 11% 12% 9% 10% 12% 13% 12% 12% 12% 11% 11% 18% 15% 9% 14% 15% 7% 7% 8% 8% 6% 7% 8% 8% 9% 6% 6% 4% 5% 5% 5% 5% 6% 8% 2% 2% 4% 2% 2% 3% 3% 4% 4% 1% 1% 1% 1% 1% 2% 2% 3% 3% Eastern South-East Yorkshire & Humberside East Midlands South-West North-West West Midlands North-East London How does reported pharmacy use for the seven common conditions vary across England? Sore throat Earache UTI (women only) Sinusitis Infected insect bites Shingles Impetigo 5 Table 1. Percentage of respondents who self -report accessing pharmacy services by region Region % used pharmacy for one of seven conditions London 56% West Midlands 51% East Midlands 45% North -East 44% Yorkshire & Humberside 43% North -West 42% South -East 40% South -West 38% Eastern 35% We also analysed the data released by NHS England for the three most recent months of Pharmacy First (December 2024 to February 2025) . This data include d all consultations for the seven conditions across all 42 Integrated Care Board s (ICB s). The map on the right visualises the total number of Pharmacy First consultations relative to the population of e ach ICB. The m ap shows that the geographic distribution mirrors many of our poll's findings, with rural and coastal areas such as Eastern and Southeastern England having lower uptake. Meanwhile, Birmingham, London and North West regions with more urban areas showed higher consultations . Our interactive map of this data can be found here . Number of Pharmacy First consultation s by ICB ( per 100 people ) Source: NHSBSA (consultations), NHS England (population) 6 Birmingham and Solihull ICB recorded the highest rate (1.89 per 100 people in the ICB population), while Cornwall and the Isles of Scilly ICB reported the lowest, at 0.97. This represents almost a twofold difference in relative uptake between ICBs . This disparity highlights the need for targeted efforts to promote uptake in underrepresented areas. Recognising that some regions have fewer local pharmacies, any policy that shifts frontline care to pharmacies must be carefully designed to avoid widening existing gaps in regional healthcare provision. Regional differences: Findings on the ground Local Healthwatch teams across the country have been w orking in their communities to help NHS policymakers understand how Pharmacy First is working on the ground. • Healthwatch Nottingham : Only 40% were aware of the Pharmacy First scheme, with confusion surrounding eligibility and scope . • Healthwatch Halton found 39% of people in their survey said that they had not heard of Pharmacy First at all . • Stockton upon Tees : 72% of people said they would now access Pharmacy First before contacting their GP practice with 21% stating they would still access their GP practice first, as they preferred to see a GP. • Healthwatch Solihull : Patients expressed greater confidence in pharmacist referrals when directed by GPs rather than receptionists. • Healthwatch Solihull : Patients expressed greater confidence in pharmacist referrals when directed by GPs rather than receptionists. • Healthwatch Derbyshire found lower awareness of P harmacy First among people from a Black and Minority ethnic background, people under 25 years old and men. • Healthwatch Birmingham found problems with pharmacy facilities, such as lack of proper consultation rooms and soundproofing issues affecting privacy, which have repeatedly been brought up by patients but not addressed. • Healthwatch Dorset : A survey of over 900 residents highlighted challenges in accessing pharmacy services, including limited opening hours. 63% had not heard of Pharmacy First. • Healthwatch Kent and Medway found that some people were being redirected back to GPs because pharmacies can’t complete care due to limitations like needing blood tests. While Pharmacy First is a nationally led policy, its success depends heavily on local implementation. Pharmacies operate independently and vary in their capacity, engagement, staff training, and coordination with GPs. Public awareness also plays a critical role. Insights from local Healthwatch teams highlight how these local factors have shaped the variation in uptake observed across regions. 7 Understanding how people use pharmacy services To understand the role pharmacists currently play in people’s healthcare choices, we asked which services people have used in the last 12 months. As shown in the table below, the most common reasons for visiting a pharmacy remain the core functions – collecting prescriptions or buying over -the-counter medicines . However, a significant proportion of people are using pharmacies to access health advice and support , the key objective of Pharmacy First. One in five people are using pharmacies for advice about symptoms or about medication , and one in six go for advice about general health and wellbeing. Supporting this data , an Ipsos Mori study showed that a majority of the public identify pharmacies as the organisation they would be most likely to go to if they needed information or advice about a minor health condition (58%) . The 2024 GP patient survey data matches our results , with 21% reporting using a pharmacy to get advice . Table 2. Reasons for using the pharmacy/ chemist in last 12 months Reason for using the pharmacy/chemist March/April 2025 To pick up an NHS prescription 75% To get non -prescription shelf medication 39% To get a vaccination 22% To get advice about symptoms 21% To get advice about medication 18% To get advice about general health and wellbeing 14% To check blood pressure 13% To get advice or support about a preexisting/LT condition 5% To get advice about quitting smoking 3% To be weighed 5% Other (please specify) 1% 8 In our March 2025 poll, people from ethnic minority backgrounds were significantly more likely to use pharmacies for general medical and health advice across all three advice categories, suggesting the service may be particularly valued or relied upon by ethnically diverse communities . 20% 28% 16% 27% 12% 22% White Ethnic minority Reasons for using the pharmacy/chemist (2025) To get advice about symptoms To get advice about medication To get advice about general health and wellbeing 9 2. What’s working well What do the national figures tell us? NHS figures show increasing confidence in and capacity of the Pharmacy First service throughout its first year, with monthly consultation numbers nearly doubling between February 2024 and February 2025. Significantly, according to data shared during an NHS England webinar , only 8% of patients using the Pharmacy First service are referred back to their GP practice . This suggest s that pharmacists are successfully managing the vast majority of cases and lightening the clinical load of GPs. These national trends align with what we heard from the public in our own polling. Not only are more people using the service, but they’re also reporting high levels of satisfaction with the care they receive. High patient satisfaction In our poll , we asked people to rate their experience of going to the pharmacy for one of the seven conditions. Almost nine in ten (86%) reported a positive experience . This high satisfaction was broadly consistent across genders, ethnicity, areas of UK and affluence. The most positively rated experience was 86% 77% 80% 83% 86% 87% 87% 88% 72% 74% 76% 78% 80% 82% 84% 86% 88% 90% Overall Average Impetigo Shingles Sinusitis Earache Infected insect bites Urinary tract infection Sore throat How would you rate your experience of getting help from the pharmacist about these conditions? Net Positive 10 getting help for a sore throat (88%), while the least positive were impetigo (77%) and shingles (80%). Getting help for impetigo and shingles also stood out in our 2023 poll as the two conditions that people expressed the most reluctance to use a pharmacist instead of their GP. In that poll, a round three quarters of those who were reluctant said they preferred to see a doctor for these conditions . This suggests that c oncerns we previously raised around confidence, privacy, or sensitivity remain for some around these conditions. Discussing health with pharmacists Our results from this year also show people are generally comfortable discussing health with pharmacist s, with over three quarters ( 76%) overall agreeing they were comfortable. Only 8% reported feeling uncomfortable discussin g their health at the pharmacist in the last year , which is roughly consistent with our poll from November 2023 (5%) . We heard directly from people who appreciated the service as a quick and responsive alternative to going to the GP. “When I couldn’t get a GP appointment, I visited the pharmacy and was offered their Pharmacy First service. The pharmacist was incredibly kind and professional[;] he assessed my symptoms, confirmed I had an infection, and provided the necessary medication.” Story shared with Healthwatch Waltham Forest “I felt that [the] chemist was very knowledgeable, and I would go when unsure about [a] health concern. It was valuable to have someone who knew what regular medication was, who could advise on what would be safe to take. When they can’t help with the problem, they will tell you to go to GP when necessary.” Story shared with Healthwatch Richmond upon Thames We also heard that the service was c onvenient when travelling, or late at night when other services closed : 11 “Being a long way from home and being Sunday, I couldn’t get to the doctors, so I looked up the recommended pharmacy. I was greeted warmly and taken into an examination room where the pharmacist diagnosed Shingles. He gave me some tablets that I have to take 5 times a day for a week. The lovely assistant even took my blood pressure while I was there. All round fantastic service.” Story shared with Healthwatch Birmingham 12 3. Understanding non- users: Barriers and opportunities This section explores the perspectives of people who have not yet used the Pharmacy First service. While national data suggest that uptake remains below target, our polling encouragingly suggests that many non -users are open to using the service in future. We examine the unfulfilled potential and assess the reasons why some people remain hesitant. By comparing responses from two polling waves, we also identify how key barriers , such as awareness and preference for GP care , decline over the year since launch. Missed targets and untapped potential While 2.4 million consultations were delivered for the seven common conditions between February 2024 and March 2025, the Pharmacy First scheme also delivered 1.5 million consultations for minor illness referrals and 1.4 million consultations for urgent med icine supplies. Combined, this means five million consultations 4 were carried out in the first 13 months of the Pharmacy First scheme . However , this represents at most 8% of England’s population , and likely significantly less once repeat users are accounted for . This points to considerable untapped potential . NHS targets 5 aimed to deliver at least 320,000 Pharmacy First clinical pathway consultations per month by March 2025 , yet the February 2025 figure stand s at 246,813 , suggesting they will miss this target . Olivier Picard , chair of the National Pharmacy Association , recently noted that the uptake of Pharmacy First during its first year in England has been lower than the Scot tish Pharmacy First scheme which launched in 2021 . As analysed by the Nuffield Trust, 23% of the Scottish population (1,242,801 people) accessed Pharmacy First Scotland services at least once in its first year (2 021-2022), compared to less than 8% in England . Key differences in the rollout may explain the disparity : Scotland’s Pharmacy First scheme covers a wider range of conditions and grants pharmacists greater clinical autonomy, including the ability to prescribe, which likely contributed to its stronger early adoption . To improve uptake, policy makers in England should take clear lessons from Scotland’s broader and more flexible approach. 4Including 2.4 million consultations for the seven conditions, 1.5 million minor illness and 1.4 million urgent medicine supply consultations. 5Published in April 2024 13 Further underlining the gap , figures recently shared by pharmacy minister Stephen Kinnock show just 13% of £645m Pharmacy First budget was spent in eight months to December 2024 – a significant underspend. Considering this, it is important to focus on those who have not yet used the service. Public receptiveness and hesitations In our poll , we asked those who have not yet used the pharmacy for the common conditions whether they would use a pharmacy over a GP in the future. As seen on the chart below, t he majority were open to the idea , with the greatest hesitation around shingles and UTI infections . 61% 55% 52% 48% 46% 41% 41% 25% 25% 31% 30% 24% 40% 39% Infected insect bite Earache Sore throat Impetigo Sinusitis Shingles Urinary Tract Infection (women only) Very likely + somewhat likely Very unlikely + somewhat unlikely 14 Our poll revealed that across all conditions (excluding UTI), men in this group were less likely than women to choose to see a pharmacist over their doctor . How have barriers shifted over time? In order to u nderstand the barriers to uptake , we asked those who said they unlikely to go to a pharmacy/chemist what the reason for this was in both our November 2023 poll and our March 2025 poll. Table 3 below compares these responses . Th e proportion of people who said they were unaware of the service fell by 6 %, while the number citing a strong preference to see a doctor also fel l. A desire for continuity in service has also become notably more common . Table 3. Reasons people were unlikely to use the pharmacy/ chemist for the seven conditions – comparison between Nov-23 and March/April 2025 Reason 2023 2025 I would prefer to see a doctor 44% 37% I would feel more comfortable accessing care/treatment at my GP 34% 32% I wasn't aware this is something a pharmacy may be able to treat 35% 29% 57% 50% 48% 45% 41% 39% 64% 59% 55% 51% 51% 42% 0% 10% 20% 30% 40% 50% 60% 70% Infected insect bite Earache Sore throat Impetigo Sinusitis Shingles In the future, how likely would you be to go to a pharmacy/chemist for treatment rather than going to your GP if you had: Net Likely: Female Net Likely: Male 15 I feel I would get better care/treatment at my GP 26% 25% I prefer the continuity of seeing my GP 15% 22% I would go online to seek advice instead (not asked) 10% I have been told my pharmacy doesn ’t offer treatment for this 3% 3% I do not have a local or easily accessible pharmacy/chemist 1% 3% Other 3% 6% Prefer not to say 1% 1% These findings reinforce what we found in our previous report: awareness and trust are key drivers of uptake , and the first year of the service has help ed modestly improve both . While there has been progress, the data shows there is still work to do to ensure Pharmacy First can realise its full potential across all groups . This requir es targeted information and further research to identify why certain demographic s may be more hesitant. 16 4. Challenges In our last report on Pharmacy First , we identified challenges the policy would need to overcome to achieve its full potential. One of these challenges was the ingrained preference of a small segment of the population who were less inclined to go to a pharmacy instead of a G P. T he previous section suggested there has been some progress in this area , but to better understand this hesitation we must also consider comfort , privacy and awareness issues . It’s important to recognise that for some, the GP will always be the preferred option. This choice should be respected and accommodated while continuing to improve pharmacy services and access for all. Patient comfort and privacy concerns Despite overall high comfort levels, 8% of respondents felt uncomfortable discussing health concerns in pharmacies , a similar figure to last year . Among those expressing discomfort (n=246), the most common concerns centred around privacy , particularly about discussing health matters in front of other customers. Table 4. Reasons people were uncomfortable using the pharmacy/ chemist – March 2025 Reason % (Total) I had to talk about my health in front of other customers 35% There was nowhere available to have a private conversation 32% I did not feel comfortable talking about my health to someone who is not a doctor 27% I was not confident I would get the right advice and support 24% None of the above 12% Prefer not to say 2% Other /Don't know 5% 17 In our first pharmacy report , we predicted that privacy would be a key issue holding back the rollout of Pharmacy First. Research by Superdrug before Pharmacy First ’s launch found that over 70% of respondents would consider the service only if private consultation rooms were available. While NHS England regulations require almost all pharmacies to have consultation rooms, implementation and quality standards vary significantly. Pharmacy teams may not always inform customers about the private spaces available or prompt customers to ask about them . Our roundtable discussions with 20 local Healthwatch teams , who have been gathering data on the ground over the last 16 months , confirmed that privacy concerns remained a persistent issue . They highlighted several examples of inadequate infrastructure undermining confidentiality, including: • Poor soundproofing that compromises private conversations • Use of screens rather than proper consultation rooms In addition to privacy, participants also raised accessibility concerns , particularly around wheelchair access to private consultation spaces . This creates barriers for people with mobility challenges and undermines equitable access: “There doesn’t seem to be any investment. When GPs need to do extra consultations, they get NHS funding to improve their surgery, but pharmacists did not get any. How easy would it be to get in there if you have a wheelchair? Bearing in mind out of the 7 conditions one is shingles, where you really do need to take your shirt off. People want to do that in a private setting.” Healthwatch roundtable participant We also heard about this issue directly from patients: “I was asked by someone at the till when booking in why I was eligible and then proceeded to ask me some personal questions about my health and allergies in an open environment without taking me to a private room. Also, where I lived and date of birth. “I am not happy with this as I feel this breached my GDPR rights as people could overhear all of this and my ailments, I had to tell her otherwise I couldn’t book in.” Shared with Healthwatch Brighton and Hove 18 Inconsistent service and communication gaps While some level of variation is expected as Pharmacy First continues to embed, patients and Healthwatch teams raised concerns that inconsistent service delivery is undermining trust and access. We heard about cases w here expectation of what the service can provide may have been out of sync with the reality. Some level of ‘teething pains ’ are to be expected while pharmacists gain confidence, experience and skill in providing help for the conditions . But to address this on a national scale , there must be clearer public information on what Pharmacy First can and can’t do. “The last few times I have had tonsillitis I have been sent to the pharmacy. Every time I am sent there, I am told it is just viral and sent home. I am then left suffering with chronic tonsillitis and no medication. I managed to get a doctor to see me, and they were shocked at the state of my throat and have referred me for surgery. I was informed that the pharmacy and GP have different thresholds which I think is awful, everyone should be singing from the same hymn sheet. I could have been referred for surgery a long time ago if it wasn’t for this.” Story shared with Healthwatch Lincolnshire “Pharmacists can treat a few illnesses. I’ve been sent through GP triage system a number of times. Every single time I’ve been told they can't help and need to see a doctor.” Story shared with Healthwatch Barnsley Healthwatch staff at our roundtable also echoe d these concerns : “Patients often expect immediate service at pharmacies due to advertising. Frustration arises when they see pharmacists not attending to them immediately.” Healthwatch roundtable participant 19 Healthwatch team s identified key communication issues that affect understanding and satisfaction : • Medical terms like ‘impetigo’ and ‘ infected insect bites ’ are unclear to the public. • Patients report u ncertainty about distinguishing between ‘complicated ’ and uncomplicated UTIs . • People not reali sing they ’ve had a Pharmacy First consultatio n or being unsure what that means. They also identified broader issues about the lack of clarity around how the service works and what it offers , including : • Issues with awareness among GP teams about the Pharmacy First services available . • Lack of clear triage processes . • Inappropriate referrals, particularly from NHS 111 . “We’re seeing lots of people trying to access the pharmacy or speaking to 111 and being recommended to go to their pharmacy. They are doing that as their first port of call, but they are meeting barriers whereby the pharmacist can’t help them, because they need access to blood results, or they can’t provide certain medications.” Healthwatch roundtable participant Medicine availability and supply chain issues A key f inding from o ur previous report was that medicine shortage s were undermining trust in pharmacies and w reaking havoc on patients . Comparing our 2025 poll to Nov ember 2023 r esults suggest s that structural issues like medicine shortages , problems with prescriptions, pharmacy closures and affordability continue to erode patient experience . 20 In our latest poll, 45% of people had experienced one of these issues. Just under a quarter of people (23%) couldn't get the medicines they needed because the pharmacist had run out , similar to our poll in 2023 . Worryingly, almost one in five (19%) reported that their prescriptions weren’t ready on time (up from 12% last year) . Evidence from Healthwatch Gloucestershire found that pharmacies in their ICB spend one to two hours daily managing medication , similar to figures found nationally by Community Pharmacy England in 2024. On a national scale, this brings with it less capacity to offer advice to patients who are walking into pharmacies and expecting treatment. Greater focus and coordination around stable supply chains would not only improve patient experience and confidence, but also free up pharmacist time to provide the clinical care of Pharmacy First . 3% 5% 9% 18% 19% 23% 1% 2% 7% 14% 12% 24% 0% 5% 10% 15% 20% 25% 30% My pharmacy/chemist has permanently closed I could not afford the medication in the pharmacy/chemist The pharmacy/chemist was unexpectedly closed when I got there A problem with my prescription (e.g., the pharmacy had not received it on time from your doctor or it was incorrect) The pharmacy/chemist had not prepared my prescription on time The pharmacy/chemist had run out of the medicine(s) I needed What problems have people experienced in the last 12 months? Nov-23 Mar-25 21 5. The future of pharmacy services With industry bodies such as the Company Chemists Association (CCA) proposing further expansion of the scheme , we wanted to explore people’s attitudes to using a pharmacy in the future for services beyond those currently offered under Pharmacy First. Overall, o ur poll data in the chart below reveals strong public backing for certain services, with almost three quarters ( 73%) of respondents expressing support for NHS vaccinations delivered through pharmacies, 67% supporting treatment for eye infections and 66% for skin problems. We found l ess enthusiasm for services for dental pain/tooth ache (44%) and menopause advice ( 47%). 73% 67% 66% 65% 64% 57% 47% 44% 12% 16% 16% 15% 17% 25% 29% 38% NHS vaccinations Eye infections Skin problems Management of high blood pressure or asthma Help with indigestion Chest infections Menopause advice (women only) Dental pain/tooth ache Please rate how likely you would be to use the following services from a pharmacy, if they were to offer them in the future (n = 7029) Net likely Net unlikely 22 Growing enthusiasm for pharmacy services When we asked in November 2023 about some future services, opinion was slightly more split , particularly for long term conditions . While we asked the poll question in a different way – this year we asked about likelihood rather than a simple yes/no – it may point to a positive change in perceptions that has been taking place this year. This year , women were generally more open to provision of future services at pharmacies, particularly for eye infections and indigestion. The exceptions to this were chest infection treatment and vaccinations , which men were more open to than women . Table 5. Gender differences in willingness to use pharmacies for future services Service Women net likely (%) Men net likely (%) Dental pain/tooth ache 45% 43% Chest infections 56% 58% Help with indigestion 66% 61% 64% 57% 46% 44% 27% 34% 41% 47% 0% 10% 20% 30% 40% 50% 60% 70% NHS vacccinations other than flu Dermatology service Menopause advice (women only) Management of a long-term condition (e.g., high blood pressure or asthma) Would you get the following services at a pharmacy? November 2023 Net: Yes Net: No 23 Management of high blood pressure or asthma 65% 65% Skin problems 69% 63% Eye infections 75% 63% NHS vaccinations 71% 74% Previous users want more services We found that people who have used the Pharmacy for one of the seven conditions in its first year were much more willing to use them again for the potential health services we asked about . This is particularly pronounced for services that currently have lower overall support . Those who had visited a pharmacy for one of the seven Pharmacy First conditions were 19 percentage points more likely to support treatment for dental pain/toothache (55% vs 36%) and 16 percentage points more likely to support chest infection treatment (66% vs 50%). The pattern holds across all potential services we tested, with users showing seven to eight percentage points higher support for conditions like high blood pressure management, skin problems, indigestion, and eye infections 6. This suggests that positive experiences with Pharmacy First create a virtuous circle: once people experience pharmacy -based care, they become more open to using these services for different health issues in the future. Regional differences in demand for future services Preferences for potential new pharmacy services varied significantly by region, with areas already making greater use of Pharmacy First showing stronger demand for expansion. The data reveals distinct regional patterns in service preferences. Support for menopause advice was highest in London and both Midlands regions (49 -52%) but significantly lower in the Eastern region (38%). A similar pattern emerges for dental pain treatme nt, where the Eastern region shows markedly lower interest (37%) compared to London (52%) and the Midlands regions (42 -46%). These variations suggest differing levels of public trust and familiarity with pharmacy -delivered healthcare across regions, with areas that have embraced existing services showing greater openness to expansion. 6 All differences were statistically significant (p<0.01). 24 Table 6. Regional support for potential future pharmacy services (% likely to use) Region NHS Vaccin ations Eye Infectio ns High BP/Asth ma Skin Proble ms Indigesti on Chest Infectio ns Dental Pain Menopa use Advice (Women only) London 69% 68% 68% 66% 60% 52% 52% 51% Eastern 74% 66% 63% 61% 61% 52% 37% 38% South - East 74% 68% 62% 67% 63% 56% 44% 45% South - West 74% 66% 65% 67% 62% 56% 43% 48% East Midlands 71% 67% 63% 67% 67% 58% 42% 49% West Midlands 71% 68% 65% 65% 64% 61% 46% 52% Yorkshire & Humber 73% 64% 68% 67% 66% 53% 42% 48% North - East 75% 66% 64% 67% 61% 56% 41% 47% North - West 75% 67% 66% 63% 62% 57% 43% 43% 25 Conclusion and recommendations Conclusion Our research shows high levels of satisfaction with Pharmacy First, with people who have used the pharmacy for the seven conditions saying they felt comfortable, and that they valued the quick and convenient care provided. But challenges remain. We’ve found that medicine shortages persist, stopping many from getting the treatment they need and affecting their confidence in pharmacy services. Concerns about sharing symptoms in private have also put some off. The national awareness raising campaign for the scheme has the call to action “Think Pharmacy First ”. But the public will understandably continue to view general practice as their first port of call for most conditions. Although people can walk up to their pharmacy for a consultation, conversations with national pharmacy stakeholders suggest that other access routes are currently more common. This includes signposting from NHS 111 or urgent and emergency services, or through referral from general practice. Given our positive findings on patient experience of Pharmacy First, there is potential to expand the scheme for the benefit of patients, general practice, and pharmacy teams. A future where this is possible should have long -term ambitions to enable more w alk-ups, and support patients to be able to make bookings for Pharmacy First consultations ahead of time. In the short term, there is still a way to go to raise awareness of the scheme , give pharmacy teams the necessary support to deliver services for the seven common conditions , and begin exploring support for further conditions. 26 Recommendations To address the issues highlighted in this report and continue delivery of positive patient experiences, we’re calling on government and NHS decision makers to action the following recommendations. 1. Continue raising awareness of the Pharmacy First Scheme . Recommendation The Department of Health and Social Care to work with Healthwatch and pharmacy stakeholders to update campaign materials ahead of further promotion . Current policy The ‘Think Pharmacy First’ campaign aims to increase public awareness that pharmacies can provide support for some common conditions. Evidence People have told us they would be happy to use their pharmacy for more services in future . However, a lmost three in ten (29%) are not aware that pharmacies can provide treatment and advice for the seven common conditions . How our proposal will help Adjustments to the campaign, including promotion through the NHS App and more targeted communications to certain demographics, would increase awareness of Pharmacy First. Additionally, campaign materials should include details of each service’s age restrictions so people can make informed choices about their care. And to maintain public confidence, details should be provided about the qualifications and expertise of pharmacy staff, and that there are private spaces for consultations. 2. Give pharmacy teams the support and funds they need to deliver patient care . Recommendation Increase funding for pharmacy services, including Pharmacy First , through the Community Pharmacy Contractual Framework (CPCF) Current policy The CPCF provides funding and a framework for the delivery of pharmacy services. Evidence An independent economic analysis of the pharmacy sector in England suggested that current funding does not cover the full cost of delivery of NHS services . 27 How our proposal will help Increased f unding to continue and potentially expand the Pharmacy First scheme will help patients who have shared good experiences of the service, as well as those who could benefit in future. More resources will also provide stability to teams who are working to a funding gap, despite a rise in funding in the last contract. Recommendation The Department of Health and Social Care to ensure that community pharmacies have the appropriate premises for people to wait for a consultation in comfort, and for that consultation to take place in private if requested. Current policy There is a service requirement for pharmacies to have a consultation room . Evidence Nearly one in ten people (8%) felt uncomfortable discussing their health concerns in the pharmacy, citing issues including having to talk in front of other customers and lack of space for priva te conversations. How our proposal will help Ensuring the provision of, and raising awareness o f, private and accessible consultation rooms will ensure that people can feel safe and comfortable sharing details of their condition . This will make the service more accessible to more people, and boost confidence that Pharmacy First and wider pharmacy services can meet their needs. 3. Expand the Pharmacy First scheme to provide consultations for more conditions. Recommendation In consultation with the public and with key pharmacy stakeholders, t he Department of Health and Social Care should work to expand the Pharmacy First scheme to deliver consultations for more conditions. Current policy The Pharmacy First Scheme provides treatments for seven common conditions. Evidence Our report shows high levels of support from the public for the idea of visit ing their pharmacy teams for help with NHS vaccinations, eye infections, skin problems, and support with high blood pressure, asthma, and indigestion. How our proposal will help With the right support to deliver safe, accessible and effective services, community pharmacies could continue to 28 help relieve demand from general practice, while delivering for patients. 4. Formally and regularly collect , publish, and measure patient experience of community pharmacy services, including the Pharmacy First scheme. Recommendation The Department of Health and Social Care should publish a pharmacy data dashboard. This should include patient experience of services and be able to be cut by demographics. Current policy The NHS Business Services Authority publi shes clinical pathways data for Pharmacy First . The London School of Hygiene and Tropical Medicine are leading a national evaluation of the scheme. The GP Patient Survey publishes annual data on people’s experiences of pharmacy services. The ONS Health Insight Survey captures pharmacy access and experience data as ‘official statistics in development’. Evidence Our report has set out what people like about the Pharmacy First scheme, what challenges they face accessing care and how they would like it to change . How our proposal will help Despite clinical data , a national evaluation, and annual satisfaction data, there is no formal experience data available and no national experience targets. And the official statistics in development may not fully capture everyone’s experiences. Expanding on Healthwatch research to develop formal measures of patient experience will aid service improvement by ensuring decision makers and pharmacy teams can learn from what does and doesn’t work for patients. 5. Take action to mitigate the impact of medication shortages. Recommendation The government to continue exploring increased flexibility for pharmacy teams in prescribing and dispensing of medicines. Current policy Pharmacists have flexibility to dispense up to 10% more or less of an eligible product. 29 Evidence Our evidence shows that medicine shortages remain as big an issue for patients as they were last year, with almost one in four people affected. How our proposal will help Where safe to do so, and in consultation with patients, more flexibilities could enable pharmacy teams to dispense generic substitutions and other changes where an initia lly prescribed medicine is affected by supply issues. Recommendation The government and NHS must produce clear and officially branded information and support resources for patients who are experiencing medication shortage s. Current policy There are no official public facing communications or advice on managing medicine shortages. Evidence Our evidence shows that medicine shortages remain as big an issue for patients as they were last year, with almost one in four people affected. How our proposal will help Currently, patients must rely on unofficial sources for advice, including online forums. Official advice would give people trusted help to manage their restricted access to medicine and next steps in the safest way possible. Healthwatch England National Customer Service Centre Citygate Gallowgate Newcastle upon Tyne NE1 4PA www.healthwatch.co.uk t: 03000 683 000 e: enquiries@healthwatch.co.uk @HealthwatchE Facebook.com/HealthwatchE

Children, Families, Health and Care Select Committee – 13 October 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 – 13 October 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 171 Implementation of the Best Start in Life Strategy – Proposed New Family Hubs Delivery Plan 2026- 2031 Following a previous Cabinet approval of the Family Hub Strategy in 2023, which established the transition from a traditional Children's Centre model to a Family Hub approach, Cabinet will consider proposals to implement Best Start in Life Strategy 2026–2031 approved in March 2026. The Best Start in Life is a Government initiated programme and the proposals to be put forward will include changes to the approach and configuration of Family Hub and Children's Centre provision and an expanded outreach model to improve access to services across the borough. They aim to better target support to children and families most in need while ensuring services deliver best value for money. Subject to Cabinet's endorsement of the proposed approach, a public consultation would be undertaken on the proposed changes. The outcomes of that consultation would then be reported back to Cabinet in 2027 before any final decisions are made. All NEW ITEM 22 October Cllr Susan O'Brien Children, Families, Health & Care Antony Madden Julie Kelly Public Consultation / EQIA 146 Contract for Child Health Services – uplifts The Cabinet will consider a variation to the Collaboration Agreement with the NHS provider to account for the national pay award under Agenda for Change for NHS staff together with additional investment into the 0-19 Healthy Child Service to support the delivery of Best Start in Life priorities. Cabinet may also consider related public health matters. N/A 22 October Cllr Susan O'Brien Children, Families, Health & Care Andy Kimber / Sharon Stoltz / Gary Binstead Sandra Taylor Private (3) 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) Decision-Maker Cabinet / Committee Leads & Officers 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 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 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 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 October Cllr Susan O'Brien Children, Families, Health & Care Antony Madden / Vali Danciu / Tehseen Kauser Julie Kelly Public 173 Review of Telecare Service: Consultation Findings and Future Service Model Cabinet will consider the outcome of the public consultation on proposed changes to the Council's Telecare Service and decide the future delivery model. This will include consideration of introducing charges for telecare services, revised arrangements for new referrals, the future provision of services for residents with and without eligible Care Act needs, and any changes to the service model. Cabinet will also consider the findings of the Equality Impact Assessment, financial implications and implementation arrangements. All NEW ITEM 19 November Cllr Susan O'Brien Children, Families, Health & Care Sarah Baker Sandra Taylor Public public consultation / EQIA 137 Supported Living Arrangements for people with Learning Disabilities To consider proposals for the future delivery of supported accommodation services for adults with care and support needs, including plans to replace accommodation that is no longer fit for purpose with more suitable and sustainable provision for residents. All NEW ITEM 19 November Cllr Susan O'Brien Children, Families, Health & Care Susie Mills / Amy Humbly Sandra Taylor Private (3) User consultation 184 Supported Living Commissioning Cabinet will consider procurement decisions in respect of supported living services plans, in particular to extend 4 supported living health & wellbeing service contracts. All NEW ITEM 19 November Cllr Susan O'Brien Children, Families, Health & Care Michael Jones Sandra Taylor Private (3) 187 Sport and Physical Activity Services This report to Cabinet will be asking for a decision on the future commissioning arrangements for public health sport and physical activity services. N/A NEW ITEM 19 November Cllr Susan O'Brien Children, Families, Health & Care Sharon Stoltz / Andy Kimber Sandra Taylor Public NOVEMBER 2026 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 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 19 November Cllr Steve Tuckwell All LGA / Darren Persaud / Alex Coman Tony Zaman / All Public 63 Carers Strategy Update Cabinet will receive a progress report on the Carers Strategy and Delivery Plan and the priorities going forward. N/A 19 November Cllr Susan O'Brien Children, Families, Health & Care Gary Collier Sandra Taylor Public Select Committee 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 19 November Cllr Susan O'Brien Children, Families, Health & Care Philip Hedges Pete Carpenter Public Consultation with clients 148 Pathways for Young People Can will consider an award of contracts for Pathways for Young People (Arrangements for Staying Close and Supported Accommodation Provision). N/A 19 November Cllr Susan O'Brien Children, Families, Health & Care Gary Binstead/ Poppy Reddy/Sally Offin Julie Kelly Private (3) 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 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 DECEMBER 2026 JANUARY 2027 4 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 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 183 Outcome of the Consultation to review Hillingdon Community School Admissions Arrangements Following consultation on proposed changes to Hillingdon's Community School Admission Arrangements for the 2028/29 academic year, Cabinet will consider the outcome of this and make any necessary decisions. All NEW ITEM 18 February Cllr Susan O'Brien Children, Families, Health & Care James Rogers / Laura Baldry Julie Kelly Public Consultation 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 18 February 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 18 February TBC TBC Democratic Services Public TBC 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 FEBRUARY 2027 Schedule of Individual Cabinet Member Decisions that may be taken each month (standard items non key-decisions) 5 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 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 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 Published 23 September 2026 - The Cabinet's Forward Plan is an official document by the London Borough of Hillingdon, UK 6

Children, Families, Health and Care Select Committee – 13 October 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 – 13 October 2026 Part I – Public Legal Implications None at this stage. BACKGROUND PAPERS NIL.

MULTI-YEAR WORK PROGRAMME - 2026/27 2027/28 October November December January February March April May June July August September 13 12 No meeting 12 16 11 20 No meeting 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 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 Health Updates X Quality Accounts (outside of meetings) X Social Care Hillingdon Advice Partnership Update Carers Update X Joint Health and Wellbeing Strategy Social Care Reforms Children & Families Corporate Parenting Panel Update (minutes) X X X Corporate Parenting Panel Membership (annual) X 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) X 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) X GP Coverage (July 2025) X Persistent Absenteeism (September 2025) X Fostering (April 2026) X Children, Famililes, Health & Care Select Committee