The Brent Health and Wellbeing Board met on 24 July 2025, noting the positive findings of the recent Special Educational Needs and Disability (SEND) inspection, discussing primary care transformation, and receiving an update on the Joint Health and Wellbeing Strategy. The board also discussed upcoming changes to the Integrated Care Board (ICB) and ratified the Better Care Fund (BCF) year-end report.

SEND Inspection Outcome and Action Plan

The board noted the findings of Brent's January 2025 Local Area SEND Inspection, which concluded that SEND arrangements in the borough typically lead to positive experiences and outcomes for children and young people with SEND.

Councillor Gwen Grahl, Brent Council Cabinet Member for Children, Young People & Schools, highlighted the rising number of Education, Health and Care Plans (EHCPs) and financial pressures on the high needs block, as well as a shortage of provision for children with Autistic Spectrum Disorder (ASD). Councillor Grahl noted that while targets for processing initial EHCP applications had been met, improvements were needed in the timescale for processing annual reviews.

Nigel Chapman, Corporate Director, Children and Young People, Brent Council, noted that Brent was one of only 14 out of 59 local areas nationally to receive the best outcome from their SEND inspection.

A key challenge identified was the timeliness of mental health provision and neurodevelopmental assessments within the NHS. Robin Doran, Brent Integrated Care Partnership Executive, noted that 70% of young people and children referred to Child and Adolescent Mental Health Services (CAMHS) in Brent are referred for neurodevelopmental assessments, compared to an average of 35% in North West London. Doran suggested that there was something going on in Brent around over wanting to pathologise children, many of whom are traumatised due to poverty and domestic violence.

Jackie Allain, Brent Integrated Care Partnership Executive, announced that funding had been secured to deliver a continence service for children.

Councillor Fleur Donnelly-Jackson, Brent Council Cabinet Member for Housing, raised concerns about areas highlighted in red in the action plan, where no funding is currently available . She also sought clarification on neurodevelopmental diagnostic assessments, asking whether by neurodevelopmental diagnostic assessments, we're talking about things like ADHD, neurodivergence, autism .

It was clarified that the neurodevelopmental assessments referred to assessments for autistic spectrum disorder and Attention Deficit Hyperactivity Disorder (ADHD), and that the waiting list for assessment was 30 months.

Councillor Promise Knight, Brent Council Cabinet Member for Customer Experience, Resident Support and Culture, asked about recruitment and retention of specific skills, particularly occupational therapists (OTs). It was noted that there is a national shortage of OTs, and that Brent was working with adult social care to address this. It was also noted that occupational therapy is a very white profession, and that work was being done to recruit more locally, including through apprenticeships.

The board agreed to note the findings of the SEND inspection, the proposed action plan, and the news about the continence service. They also requested an update on the potential partnership with Imperial College London around an audit of CAMHS waiting lists.

Primary Care Transformation Update

The board received an update on the Brent Integrated Care Partnership (ICP) Transformation Executive Group's progress. The report outlined the challenges facing general practice and aligned with national policy on modernising general practice and improving primary care. Priorities included scaling up activities across the seven primary care networks in the borough and working closely with communities to tackle health inequalities.

Initiatives included child health hubs, local enhanced schemes, and extended access hubs. The report highlighted a 93% utilisation rate for extended access hubs and increased registrations on the NHS app. It also noted challenges in cervical screening uptake, with 33 practices remaining below the 60% target.

Councillor Grahl welcomed the child health hub initiative and asked about the scaling up of access in primary care to a neighbourhood delivery model. She also suggested that the council assist with a communications campaign regarding cervical screening tests. She also raised concerns about low uptake figures for Covid-19 vaccinations and underperformance in paediatric phlebotomy and level 2 diabetes monitoring.

It was noted that the child health hubs are currently primary care network based, but that the intention is to map them against the five neighbourhood areas in the future.

In response to the question about Covid-19 vaccinations, it was explained that recommendations have been pared down to focus on those in whom the consequences of infection are more severe.

Councillor Neil Nerva, Chair of the Health and Wellbeing Board in Brent, raised concerns about variations in workforce composition across primary care networks and asked whether residents had been asked what they might find useful. He also asked about work being done to harmonise primary care networks and GP localities.

It was agreed that work would be undertaken to ensure a standard offer for healthcare practitioners working in the hubs and that services would be delivered on a neighbourhood basis.

Joint Health and Wellbeing Strategy Progress Update

The board received a progress update on the Joint Health and Wellbeing Strategy, which has a wide-ranging program of activities delivered by the council, NHS, and voluntary sector. The refreshed strategy focuses on the social determinants of health and takes a community-centred approach.

Agnieszka Sprudz, Strategy Lead – Policy, Brent Council, noted that the current strategy shifts away from purely health and care-focused objectives and focuses more on the social determinants of health. She also highlighted the development of a new social progress index, which brings together ward-level data.

Councillor Knight asked why a target related to the Music Mile project was only partially achieved. She also asked about plans to develop a council-wide food strategy and the uptake of the Couch to 5K running program.

It was explained that the food strategy would be a food strategy for the borough, developed and delivered by the community.

Councillor Donnelly-Jackson asked whether some of the projects that have met their targets would be continuing, such as the oral health bus. It was confirmed that the vast majority of projects are ongoing.

Councillor Suresh Kansagra, Leader of the Conservative Group, noted low numbers of service users recorded from the Roma, Gypsy and LGBTQ+ communities and requested support for the formation of a cross-organisational working group.

The board noted the progress made and looked forward to a presentation on the social progress index.

Social Progress Index Presentation

A presentation was given on the social progress index, a public-facing data tool that measures outcomes in Brent at a ward level. The index organises data into three themes: basic human needs, foundations of well-being, and opportunity. It is designed to help the council become an insight-led borough and inform service planning and resource allocation.

It was noted that the index could be used to identify areas where referrals for autism and ADHD are high, and to look at the social determinants in those areas.

Councillor Nerva asked about the possibility of getting data below ward level and whether health indicators such as take-up of vaccinations and screening could be included.

It was agreed that health would seek to have certain indicators included in the index and that the council would share the tool with its social partners.

Joint Health and Wellbeing Strategy Report

The board noted the report, and made a recommendation that work is undertaken to ensure that there is a standard offer for healthcare practitioners working in the hubs and welcomed the work being undertaken to ensure that services are delivered on a neighbourhood basis.

Integrated Care Board Reforms

The board received an update on the integrated care board reforms, which follow budget announcements and the NHS plan. Jonathan O'Sullivan, , discussed the 50% cuts to ICB operating costs, the NHS 10-year plan, and the proposed merger of North West London and North Central London ICBs.

Robin Doran explained that the ICB as it is known will no longer exist, and that functions will be devolved locally to a system integrator at place level, likely to be one of the community or mental health trusts.

Councillor Grahl said that she found the paper completely bewildering and asked about the impact on children's safeguarding.

It was confirmed that safeguarding responsibilities would stay the same for the moment, as changes to the act would be needed to change this.

The board noted the report and highlighted the need for the merged ICB and local system integrators to treat local government as a key partner.

Better Care Fund

The board ratified the Better Care Fund (BCF) 2024-25 year-end report and plans for 2025-26. Elena Maxwell, Better Care Fund Lead for Brent, presented the report, noting that it had been submitted and signed off by relevant parties.

Antoinette Jones, Head of Place, Brent Borough Brent ICP, discussed the plan for 2025-26, noting that the growth received has been lower than in previous years.

The board noted the report and thanked officers for their hard work.

Other Business

The board discussed agenda items for future meetings, including ongoing updates on the changes to the ICB and system integrator, and the development of a food strategy.