The Health and Wellbeing Board of Hillingdon Council met on Wednesday 09 September 2026 to discuss the Integrated Health and Well-being Performance Report and Service Update, the Joint Health and Wellbeing Strategy, and gambling harm prevention. The Board noted the progress made in stabilising the health and care system, with improvements in discharge performance and frailty management, while also acknowledging ongoing challenges in emergency demand and length of hospital stay.

Integrated Health and Wellbeing Performance Report and Service Update

Sean Bidewell, from the West and North London Integrated Care Board (WNL ICB), presented a comprehensive report on the progress of Hillingdon's strategic priorities and transformation programmes. The system is showing clearer signs of stabilisation and measurable improvement, particularly in discharge performance, frailty management, and mental health crisis flow. Key achievements include a significant reduction in No Criteria to Reside (NC2R) patients, with daily averages falling from approximately 50 to 41. The redesigned Lighthouse model for mental health crisis response has also seen success, with 78% of patients discharged within 24 hours, a substantial increase from 55%.

However, challenges remain. Emergency Department (ED) attendances are still above the operational target, with an average of 182 patients per day in July compared to a target of 164. Length of stay for non-elective patients also remains above target, at 9.6 days on average, compared to the target of 8.5 days. The report highlighted that while admissions are reducing, patients who are admitted are staying for longer.

Priorities for the next six months include sustaining NC2R numbers at or below 34 per day, scaling up the frailty programme across all three neighbourhoods, and fully mobilising the reactive care hub for physical health needs, with plans to integrate mental health needs subsequently. The Hospital to Community Transformation programme, also known as left shift, is also being prioritised.

The Better Care Fund (BCF) Quarter 1 reporting indicated that while emergency admissions and permanent admissions to care homes for those aged 65 and over are on track, discharge delays are not. Specifically, 90.3% of people aged 18 and over were discharged on their discharge-ready date, against a target of 92.3%.

Joint Health and Wellbeing Strategy 2026-2031 Update

Gary Collier, Hillingdon Council's Health and Social Care Integration Manager, provided an update on the development of the Joint Health and Wellbeing Strategy. The strategy, which sets out the direction for improving the health and wellbeing of Hillingdon residents, has undergone public consultation. Feedback highlighted concerns about joined-up care, communication, inconsistent access to timely help, digital exclusion, and the quality of care home providers. Residents were supportive of the proposed hubs but raised questions about accessibility and public transport. The Board noted the outcomes of the consultation and approved proposed amendments to the strategy. Authority was delegated to the Corporate Director of Adult Social Care and Health to approve the final version of the strategy in consultation with the Co-chairs, the NHS West and North London representative, and Healthwatch Hillingdon. An audit will be undertaken in two years to assess residents' ease of access to services.

Gambling Harm Prevention

Nick Sinclair, from Public Health, and Lucy Hays, from GamblingHarmUK, presented on the issue of gambling harm and the prevention activities being undertaken in Hillingdon. The introduction of a statutory gambling levy has provided ringfenced funding for research, prevention, and treatment. Hillingdon has received £65,585 for gambling harm prevention activities, which will be used for a needs assessment, frontline staff training, and awareness-raising campaigns. The Board was asked to support the development of gambling harm prevention activity by committing to its inclusion in relevant local strategies, joining a local steering group, and participating in the needs assessment. The Board was also encouraged to recognise the risks associated with gambling harm, including its link to suicide and its impact on families, and to consider local measures to restrict access to gambling.

SEND Joint Strategic Needs Assessment Update

Andy Kimber, Senior Public Health Manager, informed the Board that scoping work for a Joint Strategic Needs Assessment (JSNA) for Special Educational Needs and Disabilities (SEND) has begun, with a completed assessment expected in the autumn and winter of 2026. This JSNA is a requirement of the recent SEND reforms, aimed at ensuring children with SEND receive timely and consistent support. The assessment will identify needs and provision across health, education, and social care, incorporating data analysis and the voices of children, young people, and their families. The proposed timescale is challenging given the scale of data involved, but mitigations include a comprehensive reference document and the use of AI for data importation.

Board Planner & Future Agenda Items

The Board considered its business for the forthcoming cycle of meetings. It was agreed that the draft SEND Joint Strategic Needs Assessment and the complete Place Operating Model would be considered at the meeting on 09 September 2026, with SEND reforms, plans, and funding to be discussed on 02 December 2026. The Board also noted that an update on the review of early intervention and prevention services would be provided at a future meeting.