The Health and Wellbeing Board met on Thursday 25 January 2024 to discuss the Harrow Borough Partnership Winter Improvement Plan, the North Central London Start Well Programme consultation, an update on the Health and Wellbeing strategy's Healthy People - start well domain, and the North West London Child Death Review Annual Report. The Board noted the progress on the Winter Improvement Plan, discussed the ongoing consultation for significant changes to maternity, neonatal, and children's surgical services in North Central London, endorsed an integrated model for children and young people's services, and received an update on child mortality data for North West London.

Harrow Borough Partnership Winter Improvement Plan and System Pressures Metrics Report

The Board received an update on the Harrow Borough Partnership Winter Improvement Plan, which aims to support community care, prevent hospital admissions, and ensure safe and efficient discharges. Lisa Henschen, Managing Director of the Harrow Borough Based Partnership, reported that the plan was being implemented and that the system was coping with pressures, with no need to declare a major incident. She noted that the first week of January had been the most pressurised, partly due to increased demand and industrial action by doctors. Jason Antrobus, Deputy Chief Operating Officer of London North West Health Care Trust, detailed ongoing work with the London Ambulance Service and other partners to improve patient flow in and out of hospitals. The Board noted the report.

North Central London Start Well Programme Consultation

The Board was presented with a report on the North Central London Start Well Programme consultation, which proposes changes to maternity, neonatal, and children's surgical services across North Central London. Anna Stewart, North Central London Start Well Programme Director, emphasised that no decisions had yet been made and that feedback was being sought through a consultation running until 17 March 2024. Option A of the proposals includes the closure of maternity and neonatal services at the Royal Free Hospital, which would affect approximately 124 Harrow residents. Option B would see the closure of services at Whittington Hospital, with only one Harrow resident projected to be affected. The Board was also informed of a separate consultation regarding the closure of Edgware Birth Centre. Members raised questions about the impact on Harrow residents, and Anna Stewart undertook to investigate if any specific communities within Harrow would be disproportionately affected. The Board noted the report and presentation, with the Chair requesting that information about the proposals be included in the weekly newsletter.

Health and Wellbeing Strategy Update: Healthy People - start well

Sebastien Baugh, Consultant in Public Health, introduced a report detailing work on the healthy people domain of the Health and Wellbeing Strategy, with a focus on children and young people. Ayo Adekoyo, Associate Director for Integration at Harrow Borough Based Partnership, presented the case for change in Children and Young People Services, outlining plans for integrated Family Hub Networks. Andrea Lagos, Public Health Strategist, and Mathilde Kerr, Health Improvement Officer, highlighted the success of the Healthy Schools London and Healthy Early Years London programmes, noting Harrow as a high-achieving borough. The Board resolved to note the work completed to support integrated services for children, young people, and families, and to endorse the integrated Children and Young People model and its roadmap to implementation.

North West London Child Death Review (CDR) Annual Report 2022/23

Chris Miller, Chair of the Harrow Children Safeguarding Board, introduced the North West London Child Death Review Annual Report 2022/23. Tanya Nanuwan, Child Death Review Team Leader, explained the team's role in reviewing child deaths across North West London to identify trends and learning. The report highlighted that Harrow's performance in this area had moved from being a top performer to being more in the middle. The Board noted the report, with the Chair requesting that borough-based breakdowns on deprivation and ward details be circulated. Laurence Gibson, Consultant in Public Health, advised caution regarding local perspectives and expressed interest in geographical hazards. Clarification was sought regarding intravenous line deaths and discharges to the community, with the Chair of the Harrow Children Safeguarding Board confirming that recommendations from a previous review were being addressed and that a review of intravenous line deaths was underway nationally. The Board noted the report.