The Health and Wellbeing Board met on 29 November 2022 to discuss progress on population health management initiatives, integrated health and care performance, and updates on mental health services. Key decisions included noting progress on falls and frailty projects, approving the delegation of the Hospital Discharge Fund spending plan, and noting the update on the Mental Health Crisis Recovery House.

Population Health Management Update

The Board received an update on the progress of population health management (PHM) initiatives. This included the Optum falls and frailty project, which is implementing interventions to reduce falls and increase physical activity among older adults. A whole-system approach to tackling obesity in the borough is also underway, with a focus on Hayes as an outlier neighbourhood, and a community engagement event is planned. Training sessions have been delivered to build PHM capacity and capability across Hillingdon Health and Care Partners (HHCP) organisations. The Board also noted the opportunities presented by the NHS England health inequalities funding, which will be invested in current and future projects that meet the funding criteria.

• Decision: The Board noted the progress of the Falls and Frailty project and the Whole System Approach to obesity, was aware of the current training focused on building capacity and capability across HHCP organisations, and recognised the opportunities of ongoing investment for current and future planned projects that meet the criteria for NHSE health inequalities funding.

2022-2023 Integrated Health and Care Performance Report

An update was provided on the delivery of the Joint Health and Wellbeing Strategy and the Better Care Fund (BCF) plan for 2022/23. The draft BCF plan had been submitted, and the outcome of the assurance process was awaited. Hillingdon had been allocated £867.5k from the Hospital Discharge Grant, with a further £8.91m allocated to the North West London Integrated Care System (NWL ICS). Due to tight timescales for spending this grant by the end of the financial year, formal approval of the spending plan was delegated to the Council's Executive Director of Adult Services and Health, in consultation with the Board's Co-Chairmen and the Joint Borough Director at NHS NWL.

The report highlighted that Hillingdon had performed well in reducing the percentage of deaths occurring in hospital. However, concerns were raised about the average waiting times for surgery for older people, which had increased to 166 weeks. The Board requested further investigation into these waiting times.

• Decision: The Board agreed that the formal approval of the Hospital Discharge Fund spending plan be delegated to the Executive Director, Adult Services and Health in consultation with the Health and Wellbeing Board Co-Chairmen and the Joint Borough Director, NHS North West London on behalf of the Board.

Mental Health Crisis Recovery House Update

An update was given on the Mental Health Crisis Recovery House, known as The Retreat, which opened in August 2022. The house aims to provide an alternative to A&E for individuals experiencing a mental health crisis, with the goal of reducing A&E attendances and short inpatient admissions. The service is a partnership between Comfort Care Services, Central and North West London NHS Foundation Trust (CNWL), the Council, and NWL ICB. Feedback from guests has been generally positive, highlighting the welcoming and calm environment. However, further work is needed to promote the service to potential users and professionals, and to streamline the referral process. The Board noted that the Hillingdon model had been marketed and adopted by Surrey.

• Decision: The Board noted the report.

Children and Young People's Mental Health - Verbal Update

Tina Swain, Service Director for CAMHS and Eating Disorders at CNWL, provided an update on Child and Adolescent Mental Health Services (CAMHS) in Hillingdon. CNWL works with young people aged 0-25, providing services in schools and focusing on early help and wellbeing. The organisation is embedding the Thrive methodology to ensure children receive help and advice at the earliest opportunity, focusing on their needs rather than solely on diagnosis. Significant progress has been made in reducing waiting times for specialist CAMHS assessments, with only one young person waiting over 18 weeks. Five additional posts have been created to enhance the therapeutic offer, and the urgent care service has been expanded.

Kelly O'Neill, the Council's Interim Director of Public Health, emphasised the importance of prevention and early intervention, noting that CAMHS is often seen as the default option. She highlighted the need to promote preventative services and for public health to extend its scope in this area. Councillor Nick Denys announced that the Health and Social Care Select Committee would be undertaking a review into CAMHS and children's mental health services, focusing on prevention, referrals, and communication. Vanessa Odlin mentioned a grant scheme to enhance the third sector offer for children and the establishment of a Parents Advisory Board and a forum for young people to help them navigate services.

• Decision: The discussion was noted.

Board Planner & Future Agenda Items

The Board reviewed the Board Planner for future meetings. It was noted that updates on the progress of the Health Checks and Obesity projects would be presented at the meeting on 7 March 2023.

• Decision: The Board Planner, as amended, was agreed.