The Hillingdon Health and Wellbeing Board met to discuss strategic priorities and funding. The board approved the Hillingdon Joint Health and Wellbeing Strategic Priorities, Dashboard and Progress Update, which sets five strategic priorities for 2025-2028, and also approved the 2025/26 Better Care Fund Plan, which details how funding will be allocated to support health and social care integration.

Hillingdon Joint Health and Wellbeing Strategic Priorities, Dashboard and Progress Update

The board approved the Hillingdon Joint Health and Wellbeing Strategic Priorities, Dashboard and Progress Update. The report set out five strategic priorities for 2025–2028, which aim to integrate current strategic plans and respond to worsening population health trends, increasing system health and social care pressures, and health inequalities.

The five priorities are:

1. Start Well: Improve early years outcomes, reduce child obesity, and promote readiness for school and life.
2. Live Well: Prevent and/or delay the onset of long-term conditions, particularly hypertension, improve mental wellbeing, and enhance access to early intervention and support for carers.
3. Age Well: Implement 'at scale' proactive frailty management, and better end-of-life care that enable people with multi-morbidity to maintain independence for as long as possible in order to avoid non-elective presentations, admission to long-term care and to promote early discharge.
4. Healthy Places: Tackle housing, environment, employment, and social isolation.
5. Equity and Inclusion: Target resources and interventions where inequalities are greatest using Core20PLUS5¹: specifically Hayes, Yiewsley, and West Drayton.

For the first two years, the focus will be on priorities 2, 3 and 5: Live Well, Age Well and Equity and Inclusion.

Keith Spencer, Managing Director at Hillingdon Health and Care Partners, explained that these priorities would be delivered through the implementation of a seven-day place operating model, with two key transformation schemes: integrated services focused on preventing crisis, and integrated services focused on responding to crisis.

The report included a dashboard of key metrics to measure progress against the priorities. Key metrics include:

• Reducing urgent treatment centre (UTC) attendances to a daily average of 180 or less by 2025
• Reducing emergency department (ED) attendances to a daily average of 164 or less by 2025
• Reducing non-elective admissions to hospital by 10% over 2019/20 baseline
• Increasing the percentage of people on the carers register over 2021 census
• Enabling The Hillingdon Hospitals NHS Foundation Trust (THH) to operate within a target bed base of 412 beds or fewer by reducing patients without criteria to reside to a daily average of 34 or fewer by 2025 and reducing discharge delays across all pathways to national norms by 2025
• Delivering a 30% reduction in associated non-elective admissions/long-term care for hypertension over the 2019/20 baseline by 2028

The report also provided a progress update on neighbourhood development, noting the implementation of three integrated neighbourhood teams and the alignment of community and mental health services at neighbourhood team level.

Councillor Jane Palmer, Cabinet Member for Health and Social Care, said that the report was a fantastic start and thanked the people that have sat round the table to make this possible".

Sandra Taylor, Corporate Director, Adult Social Care and Health, supported the five priorities, noting that they dovetailed appropriately from an adult social care perspective, particularly the hypertension points.

Lesley Watts, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust, said that it was important to be clear where responsibilities lie for delivering each bit of the plan, including where the acute unit needs to step in.

Lynn Hill raised concerns about the increasing use of A&E services by under-ones, and asked what the position was in Hillingdon regarding this.

Professor Ian Goodman said that the priorities had been discussed in the medical model, and that there needed to be more discussion about what can be done outside the medical model to achieve the targets of living well and ageing well.

The board agreed to accept the priorities as being what is needed, and moved the recommendations as in the report.

Better Care Fund Plan Submission

The board approved the 2025/26 Better Care Fund (BCF) Plan. Gary Collier, the Council's Health and Social Care Integration Manager, explained that the BCF is a national initiative to support the shift from sickness to prevention and to support people to live independently and the shift from hospital to home.

The proposed value of the BCF for 2025/26 is £74,160,938, comprising a council contribution of £44,729,879 and an Integrated Care Board (ICB) contribution of £29,431,059.

The main priorities reflected in the 2025/26 BCF plan include:

• Continuing to embed a Population Health Management (PHM) approach across the health and care system.
• Further developing three Integrated Neighbourhood Teams (INTs) and the neighbourhood working approach to deliver care and support closer to home.
• Establishing fewer, larger integrated teams aligned to the INTs that cover seven days and have a single leader.
• Expanding a targeted care coordination programme within the INTs that utilises digital innovation and focuses on risk stratification and early intervention, particularly for the 4,400 people who are high users of health services.
• Reviewing the technology enabled care (TEC) offer and exploring alignment with the INTs to maximise opportunities for need escalation prevention.
• Implementing a single Borough-wide Reactive Care Service that maximises the 'Homefirst'[2] approach and delivers community-based urgent responses.
• Implementing the outcomes of competitive tenders for third sector provided preventative services, e.g., information, advice and guidance, support for carers, and early intervention support for adults with mental health needs.
• Implementing the outcomes of the Northwest London Integrated Care System (ICS) BCF review to achieve greater alignment of approaches across the sector.

Vanessa Odlin asked about any impact on mental health from the plan, and Gary Collier confirmed that there was nothing in 2024/25 that is actually coming out in 2025/26.

Lesley Watts said that the 1% improvement target for the metrics is unlikely to get the council to where it needs to be for the new hospital, and that there needs to be more challenging of each other about what works and what doesn't work.

Professor Goodman said that Hillingdon was at the forefront of digital support for its citizens and residents, and asked how much the council is going to be able to use digital innovations in the planning to actually manage the BCF in a more efficient way.

Sandra Taylor responded that the council is in the process of proposing a digital tech-enabled strategy, with two sections: how staff work and how they manage the business and the huge demand, and how people can help themselves with normalised technology.

Amanda Carey-McDermott said that there are active discussions about mobile diagnostics, which would be small sets of diagnostics that can go on the back of a moped or something, and that they were initially talking about whether that could be used in a care home setting.

The board approved the 2025/26 Better Care Fund Plan as described in the report, including the proposed financial arrangements and proposed targets for the national metrics, and noted the position regarding Equality and Health Impact Assessments as set out in the report.

Proactive Care Developments Update / Neighbourhood Health

Keith Spencer said that he had covered this item in the health and wellbeing priorities, and that there was no need for further discussion unless the board would like it. The board did not request further discussion.

Board Planner and Future Agenda Items

The board considered the board planner and future agenda items. The board agreed to accept it, and Vanessa Odlin seconded it.

[2]: Home First is an approach to hospital discharge that prioritises returning people to their own homes as quickly and safely as possible, with support and assessment taking place there rather than in hospital.