The Health and Wellbeing Board meeting scheduled for 25 January 2024 was set to discuss a range of critical public health issues, including winter pressures on health and care services, a consultation on significant changes to maternity and neonatal services in North Central London, and an update on the local Health and Wellbeing Strategy with a focus on children and young people. The meeting also included a review of the North West London Child Death Review Annual Report.

Harrow Borough Partnership Winter Improvement Plan and System Pressures Metrics Report

The board was scheduled to receive an update on the Harrow Borough Partnership Winter Improvement Plan, which was developed to prepare the local health and care system for the winter period. The plan's actions aim to support high-quality community care, prevent hospital admissions, and ensure safe and efficient patient discharge. The report also contained system pressure metrics designed to indicate demand on Harrow's health and care system and the effectiveness of the system's response. Early indications suggested a severe impact on services due to a surge in demand and the Junior Doctors' Strike. The report highlighted longer-term trends, including a significant increase in A&E attendances and a rise in the number of people receiving social care support after hospital discharge.

North Central London Start Well Programme Consultation

A key item on the agenda was the consultation on proposed changes to maternity, neonatal, and children's surgical services in North Central London, as part of the Start Well programme. This programme aims to ensure these services are best set up to meet population needs and improve outcomes, particularly for pregnant women, babies, and children. The consultation presented two options for maternity and neonatal services, both involving the consolidation of services into four units, with the closure of either the Royal Free Hospital's maternity and neonatal unit (Option A) or the Whittington Hospital's maternity and neonatal unit (Option B). The proposals also included the closure of the birthing suites at Edgware Birth Centre. For paediatric surgical services, the proposed model involves consolidating care into two centres of expertise: one at Great Ormond Street Hospital (GOSH) for emergency and planned inpatient care, and another at University College London Hospital (UCLH) for day case surgery. The report detailed the potential impact on Harrow residents, with approximately 124 Harrow residents potentially affected by Option A and one by Option B regarding maternity services. The consultation aimed to gather views on these proposals, their potential impacts, and any suggested mitigations.

Health and Wellbeing Strategy Update: Healthy People - Start Well

The board was set to receive an update on the Healthy People domain of the Health and Wellbeing Strategy, with a specific focus on children and young people and starting well in life. This included an overview of work to integrate services for children, young people, and families in Harrow, and to promote healthy early years and school settings. The report highlighted the need for joined-up services to support families effectively, particularly during the early years of a child's life. Key programmes of work included Early Help for the Under 5s, Family Hub Networks, the Harrow Family Front Door, and the Team Around the Family (TAF) model. The report also detailed progress on the Healthy Schools London and Healthy Early Years London award schemes, which recognise and celebrate schools and early years providers for their health-promoting activities.

North West London Child Death Review (CDR) Annual Report 2022/23

The meeting was scheduled to review the North West London Child Death Review Annual Report for 2022-23. This report detailed the work of the NWL Child Death Review Team and highlighted issues relating to child mortality across NWL, which were also applicable to Harrow. The report noted that some small population areas in Harrow had higher child mortality rates than others, presenting an opportunity for focused action. The report also discussed ethnicity and deprivation in relation to child mortality, noting that while Black and Asian women had poorer outcomes in childbirth nationally, this was not consistently the case in NWL. The report identified specific Local Super Output Areas (LSOAs) within Harrow that had a higher number of child deaths over a four-year period, suggesting these areas could benefit from targeted health promotion and interventions.