The Hillingdon Health and Wellbeing Board met to discuss an integrated health and wellbeing performance report, a community equipment service update, and a pharmaceutical needs assessment. The board reviewed performance against key priorities, focusing on integrated neighbourhood teams and reactive care programmes, and agreed to delegate further amendments of the Draft PNA prior to publication to the Public Health team and Business Intelligence team. They also discussed future agenda items, aiming to strategically plan upcoming meetings.

Integrated Health and Wellbeing Performance

The board received an Integrated Health and Wellbeing Performance Report and Service Update which provided an overview of progress against key priorities and transformation programmes within the borough, with a focus on strategic indicators, integrated neighbourhood teams¹ (INTs) and the reactive care programme. Key Priorities: The report highlighted five strategic priorities aligned with the Core20PLUS5 framework², the North West London Integrated Care System (NWL ICS) priorities, the Hillingdon Health and Care Partners (HHCP) strategic plan, and the council's wider policy frameworks:

• Start Well: Improving early years outcomes, reducing childhood obesity, and promoting school and life readiness.
• Live Well: Preventing and delaying long-term conditions, especially hypertension, improving mental well-being and strengthening early intervention and carer support.
• Age Well: Scaling proactive frailty management and improving end-of-life care to help people live independently for longer.
• Healthy Places: Addressing housing, environment, employment and social isolation.
• Equity and Inclusion: Focusing resources where inequalities are greatest, through the Core20PLUS5 framework, specifically in Hayes, Yiewsley, and West Drayton.

For the first two years, the delivery focus is primarily on Live Well, Age Well, and Equity and Inclusion.

Integrated Neighbourhood Teams: All three INTs are now live, covering the borough. 50% of the severe frailty cohort is already case managed, delivering a 36% reduction in non-elective admissions. The aim is to cover the remaining 50% of that cohort by April 2026.

Hypertension Prevention: Hypertension prevalence recording has increased to 13.8% (up from a 10% baseline), with 85% of diagnosed cases under control. The short-term target is to reach 16% by March 2026.

Reactive Care: The design and mobilisation of the Reactive Care Coordination Hub is underway, with an anticipated go-live date of December 2025. The Lighthouse Mental Health Crisis model has been revised and is due to go live within the next four weeks. The Take Home and Settle service was revised and relaunched in July, supporting safer discharges.

Challenges: Despite progress, challenges remain, including:

• Emergency Department (ED) attendances remaining above the target (196 per day versus a target of 164).
• Urgent Treatment Centre (UTC) activity also being above the target (189 versus a target of 180).
• High numbers of patients with no criteria to reside, with discharge pathway delays above the norm.
• Estates and funding constraints potentially delaying the super hubs and the full same-day urgent care rollout.

Proposed Solutions: To address these challenges, several actions are planned:

• Implementation of the new Lighthouse Diversion Model.
• Expanding urgent community response.
• Launching the coordination hub.
• Piloting mobile diagnostics.
• Implementing a No Criteria to Reside (NCR) reduction taskforce and choice policy.
• Scaling hypertension outreach.
• Developing a Neighbourhood Estates Business Case for super hubs.
• Embedding integrated INT leadership.

Councillor Susan O'Brien, Cabinet Member for Children, Families & Education asked about blood-based diagnostics within care homes, and how this would be staffed. Sean Bidewell said that the organisation providing the mobile diagnostic solution would also provide qualified staff. Councillor O'Brien also asked about hospital discharge, and Gavin Fernandez said that partnership working and daily triage calls with partner agencies were essential to planning discharges.

Community Equipment Service Update

The board received a Community Equipment Service Update following the liquidation of NRS Healthcare Limited, the contracted provider. Medequip Assistive Technology Limited has been contracted to ensure continuation of the service. The report summarised actions taken and provided an update on the current position.

The Community Equipment Service (CES) supplies equipment ranging from raised toilet seats to electric profiling beds and hoists, key safes and handrails to support residents of all ages. The service plays a critical role in supporting the continued independence of Hillingdon's residents living with a physical disability and/or a sensory impairment.

NRS Healthcare Limited went into liquidation on 1 August 2025. Medequip Assistive Technology Limited was able to offer a service based on geography as they have a depot already located at Heathrow. The Council's July 2025 Cabinet meeting agreed to award Medequip a contract for two years from 1 August 2025, with the option to extend for one further year.

Medequip is initially providing a limited service focused on equipment deliveries and installations intended to avoid admission to hospital and support discharge, as well as undertaking repairs to equipment already supplied to residents. A temporary reduced equipment catalogue has been introduced, with advice from senior leads from prescribing teams.

Plans are in place for a full service, including equipment supply, installation, collection, recycling, and servicing, to be in place from 8 September 2025.

Pharmaceutical Needs Assessment

The board received a Pharmaceutical Needs Assessment Update. From 1 April 2013, the statutory responsibility to publish and keep up to date a statement of the need for pharmaceutical services for the population in its area transferred to Health and Wellbeing Boards from Primary Care Trusts. A revised PNA should be published by 1 October 2025.

The Draft PNA was signed off for consultation in early June 2025, and a 60-day consultation was hosted on the Council website between 20 June and 19 August 2025. Feedback was received from a member of the public, a Boots branch, the Borough Lead Inequalities Pharmacist, the London Region Pharmaceutical Services Regulations Committee, and the Harmondsworth & Sipson Residents Association.

Feedback is currently being reviewed and integrated into the draft PNA, including changes to opening hours and trading names, more detail on future housing developments within the localities, further details on current and future provision, and the need to reiterate that many pharmacies who responded to the survey said they are willing to provide services if commissioned.

The Board agreed to delegate further amendments of the PNA prior to publication to the Public Health team and Business Intelligence team.

Board Planner and Future Agenda Items

The board considered the Board Planner and Future Agenda Items for the forthcoming cycle of meetings. The Board Planner is flexible and can be updated at each meeting or between meetings, subject to the Co-Chairs' approval. The board also received an update on current and emerging issues.