The Health and Wellbeing Board met on Wednesday 10 September 2025 to discuss the Better Care Fund Plan, the Hammersmith & Fulham Safeguarding Adults Board Annual Report, and improvements to adult community specialist palliative care services. Decisions were deferred on the Better Care Fund Plan until the next in-person meeting.

Better Care Fund Plan 2025-2026 and Quarter 1 Report 2025-2026

The Board received an update on the Better Care Fund (BCF) Plan for 2025-2026 and the Quarter 1 report for the same period. The BCF is a joint fund between the Council and the H&F Integrated Care Board (ICB) aimed at supporting community health and social care resources to reduce hospital admissions and facilitate timely discharge. The plan details projected income and expenditure, as well as performance targets against key metrics such as emergency admissions, discharge delays, and residential admissions. A notable aspect of the 2025-2026 plan is the continued ICB discharge funding, which supports improvements to the bridging service and aims to reduce delays for Pathway 1 patients, ensuring more individuals receive timely care at home. The Board was asked to ratify the BCF Plan and Quarter 1 report, with an end-of-year report on scheme outcomes to be presented at a later date. As this was an informal meeting, final approval of the recommendations was deferred to the next in-person meeting.

Hammersmith & Fulham Safeguarding Adults Board Annual Report 2024/25

Fiona Bateman, Independent Chair of the Hammersmith & Fulham Safeguarding Adults Board (H&F SAB), presented the board's annual report for 2024/25. The report highlighted the board's focus on improving practice and addressing significant challenges in safeguarding adults, not only within Hammersmith and Fulham but also regionally and nationally. The H&F SAB operates as a collective partnership, integrating efforts across public health, local authority, housing, adult social care, community safety, and the police. The board is not operational but aims to test and improve connections between various organisations and residents to identify and address risks for adults with care and support needs.

A key focus for the year has been Safeguarding Adults Reviews (SARs). The report detailed the work undertaken on SARs for Alison and Brian and the ongoing review for Hassan . The increase in referrals to the SAR process was seen as a positive indicator of a healthy partnership committed to learning and improvement. The report also touched upon the SAR for Hussain , a young person in transition who required additional support. The review identified significant learning regarding the complexity of systems, delays in diagnosis for neurodiversity, and the need to support individuals while they wait for assessment. The SAR process aims to provide a solid evidence base for policy changes and practice improvements, emphasizing the need for partners to be open and transparent in influencing both frontline practice and strategic decision-making. The report also detailed progress on the SAB's strategic plan, including work on a self-neglect audit and efforts to improve practitioner engagement through Lunch and Learn sessions.

During the discussion, concerns were raised about cultural sensitivity within safeguarding services and the need for better information dissemination to communities, particularly those with a mistrust of safeguarding processes. The importance of simplifying language and making services feel more accessible was also highlighted. The report also addressed the need to empower adults to make their own decisions, with steps being taken to ensure this is implemented and supported. The use of performance data to proactively identify potential practice issues across the partnership was also discussed, with an emphasis on a data-driven approach to inform policy and practice.

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

Sue Roostan, Borough Director for Hammersmith and Fulham at North West London ICB, presented positive news regarding increased investment in community specialist palliative care services across North West London. For Hammersmith and Fulham, this translates to an expansion of services, including:

• Increased hours for the palliative care team: Moving from 9 am to 5 pm, seven days a week, to 8 am to 8 pm, seven days a week.
• Introduction of a Hospice at Home service: This new service will provide enhanced end-of-life care in residents' own homes.
• Expanded access to hospice inpatient care: Residents will have the choice to access specialist hospice care from all North West London hospices, not just those geographically closest.
• Five new enhanced end-of-life care beds: These beds will provide additional specialist palliative care support, distinct from traditional hospice beds.
• Expansion of the specialist palliative care telephone line: This line will become accessible to individuals not already known to the service, including their carers.
• Enhanced bereavement support services.
• Improved training: This will focus on cultural competence and reducing inequalities to provide more personalised care.

The implementation of these changes is planned to commence with new contracts in place by 1st October 2025. Engagement with residents and stakeholders on the location of the enhanced end-of-life care beds is planned for mid-October.

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

Caroline Farrar, Managing Director of the Hammersmith and Fulham Health and Care Partnership, provided an update on the Fit for the Future: 10 Year Health Plan . The plan acknowledges that current health services are becoming unsustainable and proposes a fundamental shift towards more integrated health and care services, moving from hospital to community, from sickness to prevention, and from analogue to digital. The plan emphasizes a neighbourhood-based approach to bring services closer to communities and foster effective partnership working.

Farrar highlighted that the NHS is undergoing significant changes at national, regional, and ICB levels, with ongoing questions about how these changes will be implemented in practice. She noted that while the 10-year health plan sets out ambitions, a detailed delivery plan is still being developed. The plan presents both challenges, such as demographic changes and the need for service sustainability, and opportunities for innovation and improved patient care. The partnership is expected to take at least the remainder of the financial year to solidify its understanding of the plan's implications and develop local strategies. The joint health and wellbeing strategy may need to be revisited in light of these developments.

Discussions during this item also touched upon the importance of a whole population approach, ensuring that children and young people are included in the integrated neighbourhood model and prevention strategies. The transition from analogue to digital services was also discussed, with a focus on addressing digital exclusion and ensuring that all residents can benefit from technological advancements. The role of data and analytics in understanding population health needs and driving service improvements was also highlighted.

Central London Community Healthcare (CLCH) Organisational Strategy

Navneet Willoughby, Director of Operations for the Inner Boroughs at Central London Community Health (CLCH), presented the organisation's strategy. CLCH aims to improve population health outcomes, tackle inequalities, enhance productivity, and contribute to broader economic development. The strategy is underpinned by a commitment to quality, sustainable services, and making a positive difference in the communities served.

A key focus is the development of a Neighbourhood Health Service, aligning with the national NHS 10-year plan. This involves developing a core offer that improves outcomes and reduces unwarranted variation in care, co-developing integrated models with partners and communities, and fostering an integrated workforce through leadership in education and development. CLCH also aims to be an employer of choice and is investing in digital solutions and infrastructure to support its aims. The strategy is structured around three layers: doing things well (business as usual), doing things better (incremental improvement), and doing better things (paradigm shift in local care delivery). The presentation emphasized the importance of system working, collaboration, and partnership in achieving these goals. The constructive relationship between CLCH and the Council was noted, with a mutual desire to address challenges and find solutions.

Better Care Fund (BCF) Plan 2025-2026 and Quarter 1 Report 2025-2026

The Board noted the Better Care Fund (BCF) Plan 2025-2026 and Quarter 1 report. As this was an informal meeting, the final approval of the plan and report was deferred to the next in-person meeting. The BCF is a joint fund between the Council and the H&F Integrated Care Board (ICB) aimed at supporting community health and social care resources to reduce hospital admissions and facilitate timely discharge. The plan details projected income and expenditure, as well as performance targets against key metrics such as emergency admissions, discharge delays, and residential admissions. A notable aspect of the 2025-2026 plan is the continued ICB discharge funding, which supports improvements to the bridging service and aims to reduce delays for Pathway 1 patients, ensuring more individuals receive timely care at home.

Hammersmith & Fulham Safeguarding Adults Board Annual Report 2024/25

Fiona Bateman, Independent Chair of the Hammersmith & Fulham Safeguarding Adults Board (H&F SAB), presented the board's annual report for 2024/25. The report highlighted the board's focus on improving practice and addressing significant challenges in safeguarding adults. A key focus for the year has been Safeguarding Adults Reviews (SARs), with the report detailing work on SARs for Alison and Brian and the ongoing review for Hassan . The increase in referrals to the SAR process was seen as a positive indicator of a healthy partnership committed to learning and improvement. The report also touched upon the SAR for Hussain , a young person in transition, which identified significant learning regarding system complexity, delays in diagnosis, and the need to empower adults to make their own decisions. The discussion also covered the use of performance data to proactively identify practice issues and the importance of cultural sensitivity within safeguarding services.

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

Sue Roostan, Borough Director for Hammersmith and Fulham at North West London ICB, presented positive news regarding increased investment in community specialist palliative care services. For Hammersmith and Fulham, this includes extended hours for the palliative care team, the introduction of a Hospice at Home service, expanded access to hospice inpatient care, and five new enhanced end-of-life care beds. The implementation of these changes is planned to commence with new contracts in place by 1st October 2025, with engagement on the location of the enhanced end-of-life care beds planned for mid-October.

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

Caroline Farrar, Managing Director of the Hammersmith and Fulham Health and Care Partnership, provided an update on the Fit for the Future: 10 Year Health Plan . The plan advocates for a shift towards integrated health and care services, moving from hospital to community, sickness to prevention, and analogue to digital. The plan acknowledges significant changes within the NHS and the need for a detailed delivery plan. Discussions also covered the importance of a whole population approach, addressing digital exclusion, and the role of data in service improvement.

Central London Community Healthcare (CLCH) Organisational Strategy

Navneet Willoughby, Director of Operations for the Inner Boroughs at Central London Community Health (CLCH), presented the organisation's strategy, which focuses on improving population health, tackling inequalities, enhancing productivity, and contributing to economic development. A key aim is the creation of a Neighbourhood Health Service to provide seamless community care, supported by integrated teams, workforce development, and enhanced digital and estates infrastructure. The strategy emphasizes system working, collaboration, and partnership.

The meeting was noted to be informal due to tube strikes, and decisions were deferred to the next in-person meeting in January.