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Health and Wellbeing Board - Thursday 3 July 2025 2.00 pm
July 3, 2025 View on council website Watch video of meeting Read transcript (Professional subscription required)Summary
The Harrow Health and Wellbeing Board met to discuss the Better Care Fund, integrated neighbourhood teams and an oral health needs assessment. The board approved the 2024/25 Better Care Fund end of year report and formally approved the 2025/26 Better Care Fund plan.
Better Care Fund
The board reviewed the 2024/25 Better Care Fund (BCF) plan and gave formal approval to the 2025/26 plan. The Better Care Fund was established by the government to provide funds to local areas to support the integration of health and social care.
Ayo Adekoya, Head of Delivery for the Haro Barra in ICB, reported that for two of the four key metrics in the 2024/25 plan, data quality issues had impacted the measurement of performance. For discharges to a normal place of residence, Harrow missed the target by 0.4%, and the board heard that Harrow performs well on residential care home admissions when measured against other local authority areas.
For the 2025/26 BCF plan, there are three new headline metrics:
- Emergency admissions to hospital for people aged 65+ per 100,000 population
- Average length of discharge delay for all acute adult patients
- Long-term admissions to residential care homes and nursing homes for people aged 65+ per 100,000 population
The BCF is used to fund the following areas that contribute to Harrow's efforts in meeting the metrics:
- Disabled Facilities Grants to support capital spend to enable people to remain in their own homes
- Assisted technology to support self-management and retain independence
- Short term homecare to support hospital discharge processes
- Short term step-down beds to support discharge from hospital whilst decisions are made on longer term care options
- Long term care services, to support people at home or in care home placements
Andrew Davies, Assistant Director, commissioning, raised concerns about challenges ahead, particularly around discharges, and issues with the community equipment contract that Harrow is part of. He noted some uncertainties to the viability of the current contract and that they were looking at contingencies.
Councillor John Higgins, Chief Officer, Voluntary and Community Sector, asked about patient experience measures, and what percentage of the budget is spent within the voluntary and community sector. He suggested that it would be helpful to see data that shows people's experience of discharges and of being supported at home.
Councillor Norman Stevenson, Portfolio Holder for Business, Employment & Property, asked if best practice had been shared with other boroughs, and about stats on avoidable admissions.
Councillor Pritesh Patel, Portfolio Holder for Cleaner Streets & Public Safety, asked about discharge rates across the weekend time period. Simon Crawford, from the NHS, responded that they don't have as many discharges at the weekend as they would like, and that care homes often won't accept at the weekends. He offered to share the average discharges every day of the week, split down by Harrow and Brent.
Councillor Hitesh Karia, Portfolio Holder for Children’s Services, raised concerns about equipment and how it's been managed, and about weekend discharges. He also asked about funding, and whether the discharge funding that's been amalgamated elsewhere has also had an incremental 1.7% increase.
James Mass, Director of Adult Social Services, Harrow Council, said that one of the ways to speed up care home discharges and get care homes to accept at the weekends is to pay them more. He added that the work they're doing jointly with hospital staff and the social work teams is around trying to change behaviours so as few people as possible go to a care home.
Gazzanthar Ali, a Councillor, asked if the discharge data is based on a particular hospital like Northwick Park, and about the equipment challenges.
The board then approved and noted the 24-25 Better Care Fund End of Year Report.
Integrated Neighbourhood Teams
The board were given a presentation on integrated neighbourhood teams by Jackie Allain, Director of Operations, Outer North-West Division, CLCH, and Shaun Riley, Assistant Director of Health and Well-Being Services, Harrow Council.
Integrated neighbourhood teams aim to provide coordinated care that addresses medical, social, and mental health needs together by reducing fragmented services. They bring together people and services to improve population health and well-being.
In Harrow, there are three integrated neighbourhoods, each of which has a leadership group with representatives from primary care, adult social care, public health, adults with mental health services, the voluntary sector and other partners.
Achievements include the launch of the HARA Way, which is a way of communication across partners, and using integrated neighbourhood teams as a delivery vehicle for proactive care for older people.
Jackie Allain said that the neighbourhoods had identified issues that they wanted to tackle, and that they were working on engagement with residents. She noted that barriers still exist, and that they were working to manage how they can work not in the siloed organisations that they have, but as a collective, looking at the Harrow way.
Councillor Hitesh Karia said that children's services have a responsibility until the age of 25, and that he wanted to make sure that care leavers are incorporated in there. He also asked how they measure their success within the 10 year timeline.
Parmjit Chahal, Director of Children's Services, Harrow Council, said that a two day diagnostic by Mark Riddell, the national lead for care leavers, highlighted that mental health for young carers and care leavers was a gap.
Councillor Pritesh Patel asked if the three integrated neighbourhood teams are adequately resorted, and where the shortfalls might be.
James Benson, from the NHS, said that community health services in Harrow are under-resourced when compared to some of the other areas in northwest London.
Councillor Norman Stevenson said that there are concerns about how effective this is going to be, and wondered whether they're just going through a painful change, which could be to the detriment of those residents where they're going to be providing care.
Lawrence Gibson, Director of Public Health, said that one of the challenges for the INTs is to understand risk, and that from a preventative point of view, for the INTs, it's just getting a core set of messages produced and available.
Councillor John Higgins urged that the voluntary sector are seen as an equal partner, and not as a cheap alternative.
The board then discussed what more they can do to support the shift to prevention, how they can keep the board involved, and how the board partners might support the ambition for neighbourhood health in Harrow. It was agreed that this should be an agenda item on every one of the board meetings.
Oral Health Needs Assessment
The board then discussed the oral health needs assessment.
Councillor Jean Lammiman, Portfolio Holder for Adult Services & Public Health, said that prevention is becoming absolutely key to the way they regard the neighbourhood health, older people, and babies.
Lawrence Gibson introduced Jamie Harkness, public health consultant trainee, who gave a presentation on the Harrow oral health needs assessment. He noted that oral health is already recognised as a priority in Harrow, and that poor oral health has huge consequences for people of all ages.
Key findings from the needs assessment were that oral health in Harrow appears to be improving, but that poor oral health is still a substantial issue, particularly affecting some communities such as those from more deprived areas. NHS dental care access rates are relatively high in Harrow compared to other northwest London boroughs, but access can still be challenging, and experiences of NHS dental care are generally positive, but this is variable. Oral health messages across the health and care system are inconsistent, and support and training on oral health is limited.
Recommendations were summarised around expanding oral health promotion work, addressing oral health risk factors more specifically, and increasing NHS dentistry access and optimising delivery.
Councillor Ghazanfar Ali asked if the discharge data is based on a particular hospital like Northwick Park, and about the equipment challenges.
Councillor Pritesh Patel asked how many schools are participating in the supervised toothbrushing program, and if there are any penalties for those dental practices that are not using up their allocated UDAs1.
Councillor John Higgins said that he struggled very much to get an NHS dentist, and asked if there has been any progress on being able to access data on the numbers of young children who are registered with NHS dentists.
Aisha Coombes, said that in terms of the UDA, they will only pay for activity that has been delivered.
Councillor Lammiman asked if there were any recommendations for how they can improve things for adults with a learning disability.
Councillor Hitesh Karia asked if it was possible to enable someone from the dental board to have a representation at the meetings.
It was also suggested that the INTs should promote oral health.
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Units of Dental Activity, used to measure the amount of work done by an NHS dentist. ↩
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