The Health and Wellbeing Board met to discuss updates from the North London Foundation Trust and the Better Care Fund, as well as a review of the Board's strengths and areas for future development in the context of Neighbourhood Health. The meeting's agenda focused on strategic planning and service delivery across health and social care.

Update from North London Foundation Trust

The Board was scheduled to receive an update from the North London Foundation Trust (NLFT). The NLFT provides mental health services across North London and has recently merged with the Tavistock and Portman NHS Foundation Trust. The report pack indicated that the NLFT was facing significant financial challenges, requiring a substantial reduction in clinical and corporate headcount. The Trust's strategy included a major redesign of acute, community, and rehabilitation pathways, alongside embedding a new operating model with five new Clinical Care Groups.

Key service developments planned or underway included:

• The creation of a Mental Health Hub for Haringey residents at the Roger Sylvester Centre, aiming to co-locate services such as the NLFT Crisis Prevention House, the Safe Haven Crisis Hub provided by Mind in Haringey, and the Clarendon Recovery College provided by Haringey Council. This initiative is intended to provide joined-up mental health care in a recovery-focused environment.
• The expansion of mental health expertise through the development of Haringey Integrated Neighbourhood Teams, with an increased capacity to support adults with co-morbid complex conditions.
• The introduction of specialist crisis care at home for older adults in Haringey for the first time, aiming for admission avoidance and early discharge support.
• The introduction of Intensive Outreach Pathways into core Haringey Mental Health Teams to support service users with psychosis who find it difficult to engage with community mental health services.
• Measures to reduce waiting times to access specialist mental health support, including the introduction of a Single Point of Access for non-urgent referrals and a digital mental health tool called 'Be Seen'.

The report also highlighted a concern regarding the number of Haringey residents who were clinically ready for discharge from older adult mental health wards but were unable to be discharged, with Haringey having the highest number of such cases in London. Weekly Multi-Agency Discharge Events and a workshop to improve the interface between NLFT, the Integrated Care Board (ICB), and Haringey Mental Health Leads were planned to address this.

Better Care Fund Update

The Board was scheduled to receive an update on the Better Care Fund (BCF), focusing on its performance in 2025/26 and plans for 2026/27. The BCF is a pooled budget between Haringey Council and the North Central London ICB, totalling £43.9 million for 2026/27.

The 2025/26 year was described as having delivered strong performance across most of the year, particularly in supporting independence and reducing long-term care admissions. However, system pressures in Quarter 4 impacted discharge performance and emergency admissions. The 2026/27 BCF was presented as a transition year, with funding remaining broadly stable but with a national policy emphasis on integration, outcomes, and neighbourhood-based care. More significant reforms were anticipated from 2027/28.

Key objectives for the BCF in 2026/27 were to shift from hospital to community care and from reactive care to prevention and independence. The plan aimed to reduce non-elective admissions, improve discharge performance, reduce long-term admissions to residential and nursing care, and monitor reablement outcomes.

The report detailed the BCF's financial delivery for 2025/26, with an outturn spend of £43,771,970 against a planned allocation of £43,225,531, resulting in an overspend of £546,259. This variance was attributed to increased demand for community equipment and additional cost pressures following the liquidation of NRS Healthcare.

The 2026/27 plan included a slight increase in the total BCF allocation to £43.89 million. Funding adjustments included an uplift to the Multi-Agency Care and Coordination (MAC) Team to support an additional social worker, and the ICB directing its uplift to Community Equipment Provision.

Headline metrics for 2026/27 included targets for reducing non-elective admissions for people aged 65+, improving discharge performance by reducing delays from the Discharge Ready Date, reducing long-term admissions to residential and nursing care, and monitoring the proportion of people aged 65+ discharged into reablement who remain at home after 12 weeks.

Risks to delivery for 2026/27 included pressure on community capacity, discharge delays, financial pressures, risks associated with national reform, and workforce constraints. Mitigation strategies were outlined for each risk.

Discussion was held regarding the 2025/26 end-of-year submission and the 2026/27 planning submission for the Better Care Fund.

Haringey Health and Wellbeing Board: Review of Strengths and Areas for Future Development in Context of Neighbourhood Health

The Board was scheduled to review its strengths and areas for future development in light of the NHS Neighbourhood Framework published in March 2026. This framework outlines enhanced expectations for Health and Wellbeing Board Partnerships in overseeing the development of Neighbourhood systems of Health and Care at a borough level.

The report indicated that the Board had engaged in a Local Government Association (LGA) and Department of Health and Social Care (DHSC) support offer to assess its readiness for the Neighbourhood Health model. This involved a Conditions of Success (CoS) survey, national webinars, and facilitated interviews with Board members.

Key findings from this review were to be presented, focusing on what is working well and providing recommendations for improvement. The recommendations were categorised under three priorities: Influence of the Citizen Voice, VCFSE Representation/Influence, and Shared Agenda With Outcomes. These aimed to embed lived experience in decision-making, position the Voluntary, Community, Faith, and Social Enterprise (VCFSE) sector as a core partner, and establish a co-owned shared agenda with measurable neighbourhood outcomes.

The Board was to discuss its next steps, which included developing a proposal for a community advisory forum, reviewing the role and membership of the Health and Wellbeing Board itself, exploring ways to develop a co-ordinated voluntary sector infrastructure at a neighbourhood level, and reviewing and refreshing the action plan for the Haringey Health and Wellbeing Strategy 2024-29.