The Hammersmith and Fulham Health and Wellbeing Board met to discuss a range of issues, including the Better Care Fund, adult safeguarding, palliative care, the 10-year health plan, and the Central London Community Healthcare (CLCH) organisational strategy. Due to the meeting being held online, all decisions were deferred to the next in-person meeting.

Hammersmith and Fulham Safeguarding Adults Board Annual Report 2024/25

Fiona Bateman, the independent chair of the Hammersmith and Fulham Safeguarding Adults Board (SAB), presented the board's annual report for 2024/25. She highlighted the importance of partnership working between various agencies, including public health organisations, the local authority, housing, adult social care, community safety, and the police.

Bateman explained that the SAB is not an operational body, but it works to improve connections between organisations and individuals to address risks for adults with care and support needs. She noted that one of the challenges is determining when an adult with care and support needs becomes a statutory responsibility in the context of safeguarding.

The report focused on the core functions of the safeguarding board, with a particular emphasis on safeguarding adult reviews (SARs). Bateman noted that the rise in referrals for SARs is a sign of a healthy partnership that wants to explore and learn from cases where the outcome hasn't been what people wanted.

Bateman highlighted the importance of cultural competency and cultural literacy in safeguarding, noting that the board had held lunch and learn sessions on the topic. She also mentioned the need to make safeguarding services more accessible to local residents who may be fearful of them.

Councillor Natalia Perez, Chair of the Health and Adult Social Care Policy Accountability Committee, asked about the steps taken to empower adults to make decisions, particularly in light of the case of Hussein, where there was over-reliance on his family to make decisions. Bateman explained that the board looks at whether advocates were involved when they should have been and whether the adult was asked what outcome they wanted from the intervention. She said that the key message the partnership wants to get across is that raising a concern is not where you step away, but when you step up.

Jackie McShout, Executive Director of People, welcomed the emphasis on the role of the partnership rather than individual agencies. She asked how performance data is used to surface early any potential practice issues in any agency across the partnership. Bateman responded that the quality in practice subgroup scrutinises data from local agencies very carefully. She noted that adult social care had been very open about sharing data and identifying areas for improvement.

Catherine Wilmette, Director of Adult Social Care, added that historically the data has been very local authority-focused, but the new approach looks across the piece and requires partners to own their data.

Councillor Alex Sanderson, chair of the meeting, raised the issue of councillor representation on the Safeguarding Board. Bateman said she would be emailing Councillor Perez to re-establish that link. Councillor Sanderson also asked whether Bateman's attendance at the Health and Wellbeing Board more frequently might be useful. Councillor Sanderson welcomed a more active role of safeguarding on the board.

Improving Adult Community Specialist Palliative Care Services for Residents in North West London

Sue Roosten, the Borough Director for Hammersmith and Fulham and who works for North West London ICB, presented an update on adult community specialist palliative care services. She announced that the ICB had approved a business case to increase investment in these services across North West London.

For Hammersmith and Fulham, this means:

• The palliative care team will increase its hours from 9am-5pm, seven days a week, to 8am-8pm, seven days a week.
• A new hospice at home service will be provided.
• Residents will be able to access specialised hospice care from all of the North West London hospices.
• Funding has been allocated for five new enhanced end-of-life care beds.
• The specialist palliative care telephone line will be expanded to be accessed by anybody, including people that care for those residents.
• Enhanced services in bereavement support.

Roosten said that there would also be improved training to offer cultural competence across the services and reduce inequalities by making the care much more personalised.

She noted that the process had started in December 2021 and had taken until July 2025 to get to this stage. The plan is to have new contracts with providers in place by 1 October, and a workshop will be held in mid-October to engage with residents on the enhanced end-of-life care bed locations.

Hammersmith and Fulham Health and Care Partnership 10 Year Health Plan Update

Caroline Farrah, managing director of the Hammersmith and Fulham Health and Care Partnership, provided an update on the 10-year health plan. She said that the plan was published because services are increasingly becoming unsustainable and taking a greater share of the tax burden on society. The plan calls for a shift towards more integrated delivery of health and care services, a shift from hospital to community, a shift from sickness to prevention, and a shift from analogue to digital.

Farrah noted that there are significant reductions in staffing and changes to the operating model for the whole of the NHS, and many staff are at risk of their roles. She also said that while there is a 10-year health plan, there is not yet a delivery plan.

Farrah said that it will take at least the rest of this financial year to solidify thinking and understanding of what this means for the partnership and to develop plans. She added that it may be necessary to revisit the joint health and wellbeing strategy in light of these developments.

Jackie McShout asked what attention will be given to children, young people, and services to adolescents in the new model. Farrah responded that the plan is intended to be a whole population approach, and the partnership is interested in making this shift across the whole of the population, including children and young people.

Councillor Natalia Perez asked how the transition from analogue to digital will be managed. Farrah said that there is a lot of focus on the NHS app, but it will be necessary to focus on digital exclusion and ensure that people are not left behind. She also mentioned new technologies like ambient voice technology and broader AI, as well as the use of data and analytics.

Sue Spiller commented on digital exclusion, saying that it can feel as if the service people get if they're not digitally included is somewhat less than the quality of services that other people might be able to access. Farrah responded that if people can't use or can't access systems which could really make a positive benefit to their lives, they should be supported in being able to access those.

Central London Community Healthcare (CLCH) Organisational Strategy

Navneet Willoughby, the director of ops for the inner boroughs at Central London Community Health, presented the organisation's strategy. She said that there is a real focus on four key areas: improving outcomes in population health, tackling inequalities in outcomes, enhancing productivity and value for money, and helping the NHS for broader economic development.

Willoughby said that the strategy is centred around three key points: developing a core offer that improves outcomes and reduces unwarranted variation, co-developing integrated models with partners and communities to improve population health, and creating an integrated workforce through leadership in education and development.

She also discussed the three layers within the strategy: doing things well, doing things better, and doing better things, and said that the strategy demonstrates a commitment to system working, collaboration, and partnership.

Jackie McShout reflected that her organisation's interactions with CLCH have been very constructive and solution-focused. She said that there has been a mutual desire to come to a solution, and some of those solutions have been very effective.

Work Programme

Councillor Sanderson said that one of the positive conversations earlier in the week with CLCH was about having external partners suggest items for the health and wellbeing board agenda, particularly health. She welcomed those ideas. She also thanked outgoing Healthwatch member Nadia Taylor for her years of service and welcomed Diane.