The Health and Wellbeing Board of Harrow Council met on Thursday 12 March 2026 to discuss rising tuberculosis (TB) rates, homelessness prevention strategies, and the future of the Mount Vernon Cancer Centre. Key decisions included endorsing a TB needs assessment, agreeing to partner with the Northwest London Integrated Care Board on TB screening, and endorsing a request to London Northwest University Healthcare NHS Trust to enhance TB services. The Board also noted an update on early homelessness prevention activities and endorsed ongoing work on the Joint Strategic Needs Assessment (JSNA).

Tackling Tuberculosis in Harrow

The Board received a comprehensive update on the rising incidence of tuberculosis (TB) in Harrow. Ben Allen, a registrar in the public health department, presented findings from a needs assessment, highlighting that between 2022 and 2025, Harrow saw an average of 105 new TB cases per year, an increase from previous years. The assessment revealed that approximately 95% of active TB cases in Harrow occurred in individuals born outside the UK, with India being the most common country of origin. A significant proportion of those diagnosed had been living in the UK for less than five years. The presentation also noted an increase in residents with medical conditions that predispose them to TB, such as diabetes and chronic kidney disease.

The analysis suggests that the rise in TB incidence is largely due to the reactivation of latent TB infection among new migrants. A critical finding was that while over half of individuals who developed active TB would have been eligible for latent TB screening, only 9% received it. Across the London Northwest Integrated Care Board (ICB), it is estimated that in 2024, the opportunity to prevent approximately 600 people from developing TB was missed due to low screening and treatment uptake.

To address this, three requests were made and endorsed by the Board:

• Endorsing the TB needs assessment.
• Agreeing to partner with the Northwest London ICB to explore supplementation of the latent TB infection screening programme.
• Endorsing a request to London Northwest University Healthcare NHS Trust to work in partnership with public health to ensure sufficient secondary and community-based resources to address TB challenges in Harrow.

Potential solutions discussed included employing community outreach workers, developing targeted public health campaigns, promoting GP registration for access to screening programmes, and developing alternative screening routes through the ICB. The Board also discussed the importance of community engagement, addressing stigma, and ensuring adequate capacity within secondary care for TB treatment.

Homelessness Prevention Strategies

Brian Biko, Housing Needs Operational Manager, and Ellen, a Project Manager from the Business Transformation Outreach Team, presented an update on Harrow's Homelessness and Rough Sleeping Strategy. The strategy, which is reviewed every five years, aims to build community resilience and provide consistent housing advice and services at an early prevention stage. A significant concern highlighted was the council's expenditure on nightly paid accommodation, projected to be £21 million for the current year.

The presentation detailed the main reasons for homelessness in Harrow, with the end of private rented accommodation being the most common, followed by family exclusions and domestic abuse. Data segmentation revealed specific high-risk profiles, including individuals from other Asian ethnicities aged 35-45, who were five times more likely to be evicted, often due to issues within the private rented sector. The presentation also noted that a significant number of people facing homelessness are in employment, with rising rental costs being a major factor.

Technological solutions are being implemented to improve prevention, including the LIFT platform, which identifies families at risk of homelessness by analysing data from housing benefit and council tax records. Lightning Reach is another initiative, designed to match individuals with relevant grants, benefits, and support services. The team is also working on co-tailored advice leaflets and a pre-prevention housing booklet. The expansion of family hubs to include housing officer appointments was also mentioned as a way to improve access to advice and support. The Board noted this summary of early homelessness prevention activities.

Future of Mount Vernon Cancer Centre

Jessamie presented an update on the public consultation regarding the future of the Mount Vernon Cancer Centre. An independent clinical review in 2019 identified concerns about the site's sustainability due to the lack of on-site acute support, critical care, and other essential medical facilities. This limitation restricts the treatments that can be offered and necessitates the transfer of patients to other hospitals, such as Watford General Hospital, Hillingdon Hospital, or Northwick Park, which can fragment care and increase travel times.

The proposals, developed in conjunction with patients and staff, aim to secure the future of specialist cancer care by moving services to an acute hospital site. While Watford General Hospital is considered the most central option for the population served, other sites including Northwick Park, Hillingdon Hospital, Wexham Park, Stoke Mandeville, and Luton and Dunstable are also being considered. The consultation is seeking feedback on these proposals, as well as exploring options to bring care closer to home.

Key proposals include:

• Moving the main cancer centre to Watford.
• Adding chemotherapy chairs at Northwick Park.
• Establishing a chemotherapy unit at Hillingdon Hospital.
• Expanding chemotherapy at home options.
• Developing a radiotherapy unit in the north of the catchment area, potentially at Luton and Dunstable or Lister Hospital, to reduce travel times.

The consultation is actively engaging with the community through over 30 events, a survey, and a micro-grant scheme for community and voluntary organisations to run their own conversations. The analysis of consultation feedback will inform a decision-making business case, expected to be complete in July. The Board was encouraged to review the proposals and participate in the consultation.

Joint Strategic Needs Assessment (JSNA)

Sandy provided an update on the Joint Strategic Needs Assessment (JSNA), also known as the Health and Wellbeing Profile. The JSNA is a legal requirement under the Health and Social Care Act 2012 and serves as a single source of truth about the borough's health needs. The process has moved from triennial, lengthy reports to a rolling programme, overseen by a local steering group and smaller working groups. An interactive web platform for the JSNA has recently been launched. The current work programme includes assessments on various health issues, with tuberculosis noted as a current focus. The Board was asked to note the update and endorse the ongoing work to develop the JSNA.

Community Equipment Service Update

James, Chief Operating Officer, provided an update on the community equipment service following the collapse of the previous provider, NRS, into administration. A consortium of eight councils, including Harrow, has partnered with Provide, a social enterprise that originated from the NHS, to establish a new equipment provider. The service is nearing business-as-usual, with significant improvements noted in the collection and recycling of equipment, leading to faster pick-ups for residents, environmental benefits, and cost savings for the council. Discussions are ongoing regarding the funding split for equipment between the ICB and councils, with a focus on maintaining a joint service for the benefit of residents and prescribers. The Board noted the update on the community equipment service.