The Harrow Council Health and Wellbeing Board convened to discuss key issues impacting the borough, including children's services, adult safeguarding, pharmaceutical needs, and preventative health measures. The board approved the Pharmaceutical Needs Assessment for 2025-2028 and resolved to make prevention a flagship action, focusing on a range of interconnected issues. The board also reviewed the inadequate Ofsted rating of Children's Services and discussed plans for improvement.

Children's Services

Following an Ofsted inspection in January 2025, Harrow's local authority children's services received an overall judgement of 'inadequate'. The report, which is included in the Public reports pack, identified several strengths, but was limited by an inadequate judgement in the area of services for care leavers¹. Parmjit Chahal, Strategic Director of Children's Services, presented the council's response to the inspection findings and the resulting improvement plan. She explained that the 'inadequate' rating was a result of failures in the care leavers service, specifically around not meeting statutory requirements to keep in touch with care leavers and a culture of closing cases at age 21.

Despite the overall judgement, the inspection highlighted several strengths:

• Early help services were described as strong.
• The Multi-Agency Safeguarding Hub (MASH) had effectively addressed issues identified in a previous Joint Targeted Area Inspection (JTAI).
• The service for missing children was a real strength, with highly skilled, knowledgeable and committed workers.

Councillor Hitesh Karia, Portfolio Holder for Children’s Services, thanked Parmjit Chahal and her team for their efforts since January. He emphasised that the Department for Education (DfE) is taking a 'light touch' intervention approach due to the good areas identified in the inspection.

Since the inspection, the council has taken the following steps:

• Established a separate leaving care service.
• Reversed a 2020 decision to integrate the care leaver service with children in care services.
• Reviewed and reopened all closed care leaver cases.
• Recruited a permanent service manager and two permanent team managers.
• Sought input from Mark Riddell, the National Implementation Advisor for Care Leavers at the Department for Education, to improve services.

Councillor Karia noted that Mark Riddell had identified the need for more health support for care leavers. He said that this should be minuted, and that there needs to be more input from health, as this is one of the key things he wanted to bring to the attention of the board.

Councillor Ghazanfar Ali asked about the timeline for future Ofsted visits. Parmjit Chahal responded that Ofsted will conduct termly monitoring visits until autumn 2026, followed by a four-week inspection.

Councillor Norman Stevenson asked about the process for communicating legislative changes to local authorities. Parmjit Chahal explained that changes are communicated through the Association of Directors of Children's Services, but acknowledged that the council should also bring briefings to key forums to ensure political leaders are aware of significant changes.

John Higgins, Chief Officer, Voluntary and Community Sector, asked about the involvement of care leavers in the development of the action plan and ongoing monitoring. Parmjit Chahal said that the council has created a culture of engagement and listening to young people, including having care leavers interview senior leaders.

The Board requested to note the contents of the ILACS inspection findings, the report and ILACS Improvement Plan.

Harrow Safeguarding Adult Board Annual Report

Leslie Hutchinson, Independent Chair of the Harrow Safeguarding Adult Board (HSAB), presented the HSAB Annual Report 2024/25, supported by Olga, the safeguarding adult board manager. She drew attention to the executive summary, which was developed for the first time this year to provide a more accessible overview of the board's work.

Councillor Pritesh Patel, Portfolio Holder for Cleaner Streets & Public Safety, acknowledged the significant work done by Leslie Hutchinson and her team to improve the safeguarding board. He asked where the section 42 safeguarding inquiries originate from, and how to access hidden populations who may not come to the attention of services. Leslie Hutchinson responded that concerns can come in from anywhere, and the local authority monitors the sources of concerns to identify any gaps. She added that raising awareness and instilling confidence for people to come forward is a work in progress, and the board needs help from community members to reach hidden populations.

Olga added that the stakeholder engagement and communication plan includes actions around raising awareness for the voluntary sector and the public, with a focus on people with disabilities and those whose first language is not English.

Councillor Patel also raised concerns about the budgetary contributions of different partners, noting that the Metropolitan Police only contributed £5,000. Leslie Hutchinson responded that she is working with the Mayor's Office for Policing and Crime (MOPAC) to address this issue.

Councillor Hitesh Karia asked how the board monitors the impact of trauma-informed practices and contextual safeguarding. Leslie Hutchinson responded that they are still in the early stages of taking that forward, but monitoring the overall impact is one of the things that they need to do to prove that they are making a difference.

Councillor Karia also requested a deeper dive into the variations in types of abuse, particularly domestic abuse, physical abuse, and organisational abuse, to better understand the causes and target support. Leslie Hutchinson agreed to provide more nuanced information and bring it back to the board.

John Higgins asked if the involvement of the voluntary and community sector on the board is sufficient. Leslie Hutchinson responded that they have the right balance at the moment, but welcome involvement from any organisation with a specific interest.

John Higgins also asked how young people leaving care feature in the adult safeguarding statistics. Leslie Hutchinson responded that they have more granular detail in terms of age, and are doing work around transitions.

The Board requested to note the work carried out by HSAB during 2024/2025 and specific areas of focus on delivering the Strategic Plan which was shared with the Health and Wellbeing Board last year, and to identify any areas the Health and Wellbeing Board would like HSAB to consider.

Pharmaceutical Needs Assessment

Laurence Gibson, Director of Public Health, introduced Joel from Healthy Dialogues Ltd, who presented the Harrow Pharmaceutical Needs Assessment (PNA) 2025-2028. Joel explained that the PNA informs decisions on local commissioning of pharmacy services and is used by NHS England to make decisions on market entry.

The PNA concluded that there is good access to pharmaceutical services for all Harrow residents, and no gaps were identified in the provision of services.

Councillor Pritesh Patel asked if there is a list of all the pharmacies and which services they provide, and whether those services are evenly distributed across Harrow. Joel responded that the report contains an appendix with a listing of pharmacies and some key metrics, such as opening hours. Councillor Patel noted that he did not have the appendix. It was agreed that the appendix would be circulated to the board.

Councillor Norman Stevenson noted that many pharmacies now deliver medication, and asked if that could be built into a matrix. Joel responded that the delivery of medications is at the discretion of each pharmacy and is not a commissioned service, so it cannot be addressed directly within the PNA. However, he said that it would be very useful if that was indicated on a chart somewhere.

Councillor Kuha Kumaran asked about the financial viability of pharmacies, given that many are struggling. Joel responded that this did come up in conversations, but it is not something that can be reported directly within the PNA.

Councillor Ghazanfar Ali asked if there is a similar process for dentistry, given the challenges people face in accessing NHS dental services. Laurence Gibson responded that he did not know the answer to that question, but Aisha Coombes said that a paper was due to be presented to discuss plans to invest additional funding into the boroughs for children in high deprivation.

The Board agreed to sign off the Harrow Pharmaceutical Needs Assessment (PNA) 2025-2028 for publication, and to delegate authority to the PNA Steering Group to identify and subsequently report to the Health and Wellbeing Board, if any changes to pharmaceutical services are of a significant extent to require a new PNA within the next three years.

Prevention Approach

Laurence Gibson presented a report on the prevention approach of a Health and Wellbeing Board. He explained that the report sets out an ambition for the board to review the preventative approach for a number of subject areas and to contribute to the approach where relevant.

Laurence Gibson proposed that the board take an interest in the following issues:

• Frailty and protecting residents at winter
• Wellbeing of children
• Weight management and nutrition
• What's the problem? / Surveillance / Insight / 'network' of engagement
• Mental health attendances at A&E
• Economic wellbeing
• Smoking

He suggested that over the course of the next six or seven meetings, the board take each item in turn and work out what they are asking each of the health and wellbeing partners to do, what they could do in terms of primary prevention, and maybe secondary prevention.

Councillor Norman Stevenson suggested that physical activity also needs to be called out from that list.

Councillor Pritesh Patel said that the report is quite generic, and that there needs to be more focus on what's relevant for Harrow, such as diabetes and kidney disorders. He also said that there needs to be more focus on the borough's diversity.

John Higgins said that the tone of the report was more disease orientated and more around reducing demand in certain parts of the health system, whereas the definition that they'd be more going with is that around the wider determinants of health.

Councillor Stevenson suggested that this should almost be the flagship action of this board.

The Board agreed to approve the suggested prevention approach, and to make it a flagship action for this board.

Any Other Business

Councillor Hitesh Karia asked all the people around the table to think about where they can create opportunities for care leavers, whether it's in the voluntary sector, health watch harrow, or other areas. He asked them to engage as much as possible to increase the reach for care leavers. He also noted that some boroughs have adopted care experienced people young people as a protected characteristic, and asked if Harrow does this.

Councillor Jean Lammiman, Portfolio Holder for Adult Services & Public Health, said that this is a whole debate to be had, because if you look at and speak to care leavers, they often don't want to be categorised under that.

The Board agreed that the flagship action for this board will be prevention.