The Hounslow Health and Wellbeing Board met to discuss a range of topics, including updates on domiciliary care, extra care housing, and a hospital discharge pilot. The board was also scheduled to discuss the Better Care Fund, the Health and Wellbeing Strategy Progress Report, and the Joint Strategic Needs Assessment.

Domiciliary Care Update

The Hounslow Health and Wellbeing Board was scheduled to receive an overview of Hounslow Homecare (HHC), which provides support to residents who are having difficulties managing at home. The services that HHC provides includes:

• Personal care
• Household support
• Outdoor activities
• Support for carers

According to the report, residents can access the service through a referral from a social care assessment, which may require a financial assessment, or residents can self-fund homecare services.

Hounslow Council commissions several homecare providers, divided into main providers and select list providers. Main providers include Care Outlook, Eleanor Care, Healthvision, Nation Care Agency, TC Care, and Westminster Homecare. Select list providers include Thames Homecare, Avant, AMI Homecare, Open Heart, and Haven Care. The report pack stated that these providers are not recommended or endorsed by the council but are contracted to deliver services.

The report pack also included information on Key Performance Indicators (KPIs) that are split into critical and non-critical, and measured monthly through CM2000¹. These KPIs cover all aspects of a quality service, such as call durations, punctuality, continuity, quality alerts, use of the system and acceptance of work.

The report pack stated that all main providers and all of the Select List that London Borough of Hounslow commission from are now rated 'Good' by the Care Quality Commission (CQC).

The report pack also highlighted the following services:

• Medications Administration (contracted) - This service, commissioned by the Integrated Care Board (ICB), is delivered by all of the providers and referred to as level 2 medication support, avoiding the need for district nurses.
• Out of Hours Service (contracted) - A service operated over weekends and public holidays to facilitate the discharge of patients from hospital.
• Bridging Care (new initiative) - Operated with all HHC providers, this initiative also facilitates hospital discharge, providing 5 days of care and preventing assessment related hospital discharge delays.
• Hospital at Home (new initiative) - Working collaboratively with health partners to provide a 'hospital bed and support' within the residents usual place of residence, facilitating hospital discharge and providing service users an alternative to extended stays in hospital maximum of 10 days.

Extra Care Housing Update

The Hounslow Health and Wellbeing Board was scheduled to receive an update on extra care housing in the borough. Extra Care Housing supports vulnerable residents with long-term conditions and/or disabilities to live independently in their own home with care and support on-site. It is traditionally for older people 55+, but there is one innovative 18+ scheme. Care and support is tailored to needs and flexible, so the likelihood of having to move when needs change is reduced.

The report pack stated that the schemes are part funded through the Better Care Fund² and keep vulnerable adults independent for longer, avoiding or delaying the need for residential care, preventing hospital admissions and supporting fast discharges. Health integration includes:

• Dedicated scheme GPs under enhanced contract
• Support from West London Trust (WLT) Care Homes team, Integrated Community Response Service (ICRS) and Pre-hospital Ambulance Support Team (PhAST)
• Healthy Hounslow visits

Hounslow has 201 units across four schemes, all rated CQC Good.

Hounslow Cabinet has agreed to the development of up to another 200 units over ten years and are developing the first new scheme with a specialist Registered Provider at Nene Gardens in Hanworth due to open in 2028/29. It will be an older persons 55+ scheme of 50 flats. The preferred model is an integrated scheme where a specialist provider delivers both the housing support and the care, which may include step down/short stay beds to support hospital discharge.

The council is also exploring a second scheme of around 70 flats in Hounslow, which will be a mixed age 18+ scheme similar to Bristol Court. It is expected to open around 2030/31. The council is also exploring developing smaller Mental Health and Learning Disability supported living schemes for those with more complex needs.

Linking Hospital to VCS Hospital Discharge Pilot

The Hounslow Health and Wellbeing Board was scheduled to receive an update on the Linking Hospital to Voluntary and Community Sector (VCS) Hospital Discharge Pilot. The pilot facilitates early and timely discharges for patients to ensure bed flow and prevent social re-admission. It also collaborates with other appropriate services that support people to develop long term holistic solutions by tackling the root causes of problems including, but not limited to, housing stability including healthy homes, health and lifestyle and income maximisation/entitlement.

The pilot tackles three problems:

• Non-medical delays to discharge
• Health inequity
• Lack of awareness of voluntary & community services by hospital staff.

The report pack stated that a single officer works with hospital teams, Hounslow Council housing services, and local VCSE organisations to provide in-person discharge support followed by longer-term, preventative help in the community by a dedicated Floating Support Worker.

The inclusion criteria for the pilot are:

• 18+
• Primarily Hounslow residents. If capacity allows, advice will be provided for out of borough residents.
• Residents who are not receiving Adult Social Care / Care Act Assessment (Package of Care); likely support will be P0 and P1³.
• Residents who have an identified support need that can be met by this service to maintain independence.

The support provided by the pilot includes:

• Social isolation by referring to relevant services
• Financial support e.g. benefits and claims
• Access to health and wellbeing services (including Healthy Homes)
• Maintaining home environment (including referrals for blitz clean/de-cluttering)
• Emergency provisions e.g. food, heating
• Onwards referral for Floating Support to promote on-going stability

Better Care Fund

The Hounslow Health and Wellbeing Board was scheduled to approve the Better Care Fund (BCF) Quarter 1 2025/26 template submission.

The BCF is one of the government's national vehicles for driving health and social care integration. It is a joint plan between the council and North West London Integrated Care Board (NW London ICB) for using pooled budgets to support integration, governed by an agreement under section 75 of the NHS Act (2006).

The Health and Wellbeing Board (HWB) is responsible for ensuring compliance and the strategic direction of the BCF and other jointly funded projects as outlined in the Section 75 Agreement and is therefore required to sign off submissions to NHS England.

The board was asked to confirm that the National Conditions continue to be met, share Q1 metric performance and update the annual plans if required, and provide high-level Q1 spend against plans.

Health and Wellbeing Strategy Progress Report

The Hounslow Health and Wellbeing Board was scheduled to receive the Health and Wellbeing Strategy Progress Report for Quarter 1 2025/26.

In March 2024, a new Health and Wellbeing Board governance framework was agreed to provide oversight and assurance through delegated Senior Responsible Officer (SRO) Board members. SROs are responsible for the delivery of the Health and Wellbeing Strategy 2023-2026 priorities and quarterly reporting to demonstrate progress.

The report presents each thematic area with information submitted by each Strategy delivery group. The relevant SRO has agreed to this information.

The report included updates on the following:

• Improve pre-pregnancy, maternity and early years health and care and target pregnant women and new mums with the poorest child health outcomes.
• Halt the increase in obesity prevalence of children at school Year 6.
• Increase the number of children who are healthy, ready, able, and willing to learn at the end of reception year.
• Support parents and carers to be more informed about childhood illnesses, and when and where to access the right support.
• Improve mental health for our children and young people through more effective universal services.
• Improve the overall number of our children who achieve five or more GCSEs and 3 A Levels or equivalent.
• Increase the number of children 16-17 who maintain engagement and achieve positive education, employment, and training outcomes.
• Improve oral health and reduce visually obvious decay in 0– 5-year-olds.
• Provide information, education and guidance that supports our communities to be healthier and enabled to self-care.
• Increase the uptake of NHS Health checks and referrals to lifestyle services for those identified as at risk.
• Halt the increase and reduce the number of residents reported as obese.
• Reduce the number of people who die early from respiratory conditions, for example asthma and Chronic Obstructive Pulmonary Disease (COPD).
• Increase the uptake of universal and targeted vaccinations to reduce avoidable health risk and emergency hospital admissions.
• Reduce the number of people smoking.
• Identify residents with high blood pressure through outreach case finding, reducing the risk of myocardial infarction and stroke.
• Reduce the number of people diagnosed with cancer at a late stage of disease through increasing cancer screening coverage.
• Transform services to improve preventative health and wellbeing outcomes.
• Improve outcomes for those with mental health needs.
• Provide effective prevention, treatment and recovery services for residents experiencing problematic drug of alcohol use.
• Ensure carers are recognised, supported, and valued.
• Support our older and frail residents to maintain independence and when required be assessed as at risk of frailty and increased likelihood of falls.
• People are supported to express preferences and make decisions about their end-of-life care inc' planned care in emergency, medical situations.
• Ensure co-produced proactive and personalised care is planned for residents, including in care homes.
• Recognise the first priority of health and wellbeing is that our residents live in safe, warm, affordable homes.
• Deliver our commitment to tackling climate change and greening the borough, collaborating with communities, and supporting the aim toward carbon neutral neighbourhoods.
• Work with businesses and the community to increase job creation opportunities.
• Reduce the level of serious and nuisance crimes in the borough through engaging with communities to keep the borough safe.
• Encourage community connectors to be active across the borough.

Joint Strategic Needs Assessment (JSNA) Update

The Hounslow Health and Wellbeing Board was scheduled to receive a State of the Borough update as part of the Joint Strategic Needs Assessment (JSNA). The State of the Borough 2025 report for Hounslow, offers a comprehensive and thematic overview of life in the borough. The complete report can be viewed via the Hounslow Data Hub.

Healthwatch Update

Peter Goulding from Healthwatch Hounslow was scheduled to provide a verbal update on the organisation's activities. In Quarter 2 (July–September), Healthwatch Hounslow carried out visits to General Practitioner (GP) Practices across the Borough to gather residents' experiences. They focused on how easy it was to get through to someone on the phone and difficulties in booking and securing appointments. As part of the 0-4 Accident and Emergency (A & E) attendance project, they heard about people's experiences with GP access and how it influences their decision to attend A & E.