The Health and Wellbeing Board met on Thursday 03 July 2025 to discuss the Better Care Fund, the progress of Integrated Neighbourhood Teams, and the findings of the Oral Health Needs Assessment. Key decisions included the noting and approval of the 2024/25 Better Care Fund End of Year Report and the formal approval of the 2025/26 Better Care Fund Plan. The Board also received an overview and discussion on Integrated Neighbourhood Teams and heard the findings of the Oral Health Needs Assessment.

Better Care Fund Review and Submission

The Board received an update on the 2024/25 Better Care Fund (BCF) and the submission for the 2025/26 BCF plan. The 2024/25 review indicated that Harrow was on track to meet its target for discharges to a normal place of residence, though data quality issues persisted for other metrics. Harrow was noted as being one of the lowest-funded boroughs in North West London for BCF, but this was not impacted by the recent announcement of a 50% reduction in additional BCF contributions for other boroughs. The 2025/26 plan, which had been submitted to the Department of Health and Social Care, focused on reducing emergency hospital admissions for those aged 65+, reducing hospital discharge delays, and minimising long-term admissions to residential and nursing care homes. The Board noted and approved the 2024/25 Better Care Fund End of Year Report and formally approved the 2025/26 Better Care Fund Plan.

Integrated Neighbourhood Teams

An overview and discussion took place regarding Integrated Neighbourhood Teams (INTs), also referred to as Neighbourhood Health. This initiative is a national and regional priority, with the NHS 10-Year Plan and the London Region 'Target Operating Model' highlighting its importance. North West London's Joint Forward Plan also prioritises establishing integrated neighbourhood teams with primary care at their heart. The presentation detailed the six core components of a Neighbourhood Service Model, including Population Health Management, Modern General Practice, Standardising Community Health Services, Neighbourhood Multidisciplinary Teams, Integrated Intermediate Care, and Urgent Neighbourhood Services. Harrow has three INTs, each with a leadership group comprising representatives from primary care, adult social care, public health, mental health services, the voluntary sector, and other partners. Progress in Harrow includes the rollout of the 'Harrow Way' communication framework, a pilot for proactive care for older people with frailty and dementia, and a focus on children's health, aiming to reduce A&E admissions and improve public health outcomes. Challenges identified include existing organisational barriers, conflicting priorities, differing professional cultures, lack of capacity, and varying levels of development across the INTs. The Board was asked for comments and questions regarding how to support the shift to prevention, how the Board can remain involved in the development of neighbourhood health, and how Board partners can support the ambition for neighbourhood health in Harrow. It was agreed that neighbourhood health would become an ongoing agenda item for future Board meetings.

Oral Health Needs Assessment

The Board received a summary of the draft Oral Health Needs Assessment for Harrow. The assessment indicated that while oral health in Harrow is improving, with falling rates of tooth decay, hospital admissions, and tooth extractions, poor oral health remains prevalent across all ages and particularly affects vulnerable communities. Reasons for poor oral health are multi-faceted, influenced by behaviours, environments, and challenges in accessing NHS dental care. Key findings highlighted variations in oral health behaviours, prevalent risk factors for oral cancer, unhealthy food environments, and inconsistent oral health messaging. Access to NHS dental care was noted as variable, with challenges for vulnerable groups. The report made several recommendations, including enhancing integration and collaboration, extending oral health promotion, addressing risk factors and wider determinants of oral health, improving and optimising NHS dentistry access and delivery, advancing intelligence and research, and advocating for change beyond the scope of the assessment, such as supporting water fluoridation and dental reform. The Board was asked to note and comment on the draft findings and identify areas of collaboration for implementing the recommendations.