The Merton Council Health and Wellbeing Board was scheduled to meet on 24 June 2025 to discuss a number of topics, including an update from the Integrated Care Board (ICB), the Better Care Fund, a Pharmaceutical Needs Assessment, the Merton Story, and the board's terms of reference.

Health and Wellbeing Board Terms of Reference and Strategy Monitoring

The Health and Wellbeing Board was scheduled to review its terms of reference and discuss how the board will monitor the Merton Health and Wellbeing Strategy 2025-2030.

The report pack included a draft of the revised Terms of Reference, which were scheduled to be reviewed by the Governance Standards and Audit Committee, followed by the Cabinet. The proposed changes to the terms included:

• Updated core principles to reflect those within the current Health and Wellbeing Strategy.
• Updated responsibilities to include new statutory responsibilities of the Health and Wellbeing Board, including publishing and maintaining a Pharmaceutical Needs Assessment, and links to the Joint Local Health and Care Plan.
• An updated membership list to reflect current roles and organisations.
• Details of the link to the Health and Wellbeing Strategy, the outcomes dashboard and monitoring process.
• The agenda setting process and how this will reflect the priorities within the Health and Wellbeing Strategy on a rolling 12-month basis.

The report pack also detailed a proposed reporting process to ensure the Health and Wellbeing Board receives updates on all year one actions, in a rolling 12-month period. The proposed reporting process included:

• A Health and Wellbeing Actions Highlight Dashboard, to be submitted at each Health and Wellbeing Board meeting.
• A Health and Wellbeing Actions Report, to be submitted on the Health and Wellbeing Strategy Action Report template.
• A Look-back Look-forward process, to enable the Health and Wellbeing Board to assess what has been implemented, what works, and what needs to be modified or changed to inform future action.

The report pack also contained an outline of the Health and Wellbeing Strategy outcomes dashboard, designed to provide a mechanism against which the strategy can be monitored using the outcome measures included in the strategy.

Better Care Fund

The Health and Wellbeing Board was scheduled to discuss and approve the Better Care Fund (BCF) plan for 2025/26, as well as the performance and financial outcomes for 2024/25. The BCF is a pooled fund, managed jointly by the council and the South West London Integrated Care Board, aiming to reduce barriers created by separate funding streams¹. The report pack noted that the value of contributions to the fund in 2025/26 is £26,885,638, which is made up of:

• Local Authority Disabled Facilities Grant: £1,801,974
• Local Authority Better Care Fund Grant: £6,180,261
• NHS Minimum Contribution: £18,903,403

The report pack stated that the national conditions of the Better Care Fund are:

• Jointly agreeing a plan
• Implementing the objectives of the BCF
• Complying with the grant conditions and the BCF funding conditions
• Complying with the oversight and support processes

The report pack also stated that the policy direction for the Better Care Fund has been focussed this year towards two over-arching objectives:

• Reform to support the shift from sickness to prevention
• Reform to support people living independently and the shift from hospital to home

The Merton BCF plan sets out detailed plans across 50 individual schemes, all of which are designed to deliver on the national conditions and objectives of the BCF. The plan continues to build on previous plans and the local success.

The Policy Framework requires local areas as usual to agree how spending will improve performance against the BCF metrics for 2025/26 and requires specific local goals to be set against these metrics. For 2025/26 there are three headline metrics:

• Metric 1 Emergency admissions to hospital for people aged over 65 per 100,000 population
• Metric 2 Average length of discharge delay for all acute adult patients derived from a combination of proportion of patients discharged on their discharge ready date and, for those not discharged on their discharge ready date, the average number of days from that date to the actual date of discharge; and
• Metric 3 Long-term admissions of people aged 65 and over to residential and nursing care per 100,000 population

The report pack included a summary of the 2024/25 Year End BCF return, stating that the BCF produced a balanced financial outturn, with a Disabled Facilities Grant carry forward as per previous years and 3 of 4 metrics where achieved, while the Avoidable Admissions target was slightly missed.

ICB Update

Mark Creelman, Place Executive, Merton and Wandsworth – SWL ICB, was scheduled to present an update on the plans for new Mental Health Crisis Teams (MHCT) Local Plan, and restructures at the Integrated Care Board.

The report pack included a presentation on the national NHS changes and the new Model ICB. The presentation noted that in March 2025, ICBs were asked to reduce their running costs by around 50% and shift to a new role as strategic commissioners. Some ICB functions currently managed by ICBs may move to local providers, regional teams or national bodies. These changes aim to improve how care is organised locally.

The presentation stated that the core ICB functions are:

• Understanding local context
• Developing Population Health Strategy
• Delivery of the strategy through payor and commissioning functions and resource allocation
• Evaluating impact
• Governance and core statutory functions

The presentation also included a summary of the functional changes from the 'Model ICB document', grouping functions into those to grow, selectively retain and adapt, and transfer.

The presentation noted that neighbourhood-level integration is a key national priority, and that the Target Operating Model for London for Integrated Neighbourhood Health has now been published. It sets out how care will be delivered at neighbourhood level across London and supports the direction of travel set out in the blueprint — where, over time, some ICB functions may move to integrators as they become more established, helping to create a more joined-up, community-based approach to care.

The presentation also included an update on local neighbourhood estate developments, noting that the business case process for both the Wilson Hospital and Rowan Park are ongoing.

Pharmaceutical Needs Assessment

The Health and Wellbeing Board was scheduled to discuss the collaborative approach being taken to refresh the Pharmaceutical Needs Assessment (PNA). The PNA is a key evidence informed tool for identifying current and future needs at a local level and to explore the potential for and to improve the quality and effectiveness of pharmaceutical services². The report pack stated that from 1 April 2015 it became a statutory requirement that Health and Wellbeing Boards publish a Pharmaceutical Needs Assessment (PNA) and they publish a revised assessment within 3 years.

The report pack noted that Health and Wellbeing Board members had been invited to participate in a briefing with Public Health and Soar Beyond on 17th June 2025, to share more about the PNA and to provide an opportunity to review the draft PNA before it goes out to a statutory 60-day consultation, which will take place between from 7th July to 7th September 2025.

The report pack stated that due to the tight deadline associated with the publication of the PNA, it was being recommended that the approval of the final PNA be delegated to Councillor Peter McCabe, Cabinet Member for Health and Social Care, and Russell Styles, Director of Public Health.

Merton Story Summary

The Health and Wellbeing Board was scheduled to review and endorse The Merton Story Summary Infographic 2024/25, and to agree to promote the use of the Merton Story Infographics and other resources.

The Merton Story is an annual high-level assessment of Merton's population providing a snapshot of the local health and care needs and priorities of residents. It forms part of the Joint Strategic Needs Assessment (JSNA).

The report pack stated that the Merton Story consists of sub chapters, data dashboards and summary infographics. The summary infographics are a series of infographics and visuals that have been pulled together and consist of summaries which include key messages and priorities based on the chapters. These are:

• The Merton Population
• Health Protection and Screening
• Start Well
• Live Well
• Age Well
• Healthy Place

The report pack noted that the Merton Story Summary Infographics are not a comprehensive collection of all possible information and data on a given topic of interest but is based on insights from chapter leads who have worked with their key stakeholders involving colleagues from NHS SWL ICB, the Voluntary and Community Sector, and wider stakeholders to identify key issues based on partners' insights.