The Health and Wellbeing Board met on Tuesday 2 December 2025 to discuss the Integrated Health and Wellbeing Performance Report, the draft Joint Health and Wellbeing Strategy, and updates on Childhood Obesity, Health Protection, and Occupational Therapy services. Key decisions included noting the progress on the Integrated Health and Wellbeing Performance Report, approving the draft Joint Health and Wellbeing Strategy for public engagement, and agreeing to establish a Health Protection Committee.

Integrated Health and Wellbeing Performance Report and Service Update

The Board received an update on the progress of Hillingdon's five strategic priorities: Best Start in Life, Live Well, Age Well, Healthy Places, and Equity & Inclusion. Sean Bidewell, Joint Borough Director at North West London Integrated Care Board (NWL ICB), presented the report, highlighting that while emergency demand remains high, there are early signs of improved hospital flow, particularly with a 27% reduction in No Criteria to Reside (NC2R) delays. All three Integrated Neighbourhood Teams (INTs) are now fully operational, contributing to proactive community care. Frailty management is showing positive results, with around 50% of the severe frailty cohort under enhanced case management, leading to a 36% reduction in emergency admissions for these patients. Hypertension outcomes are strong, with a prevalence of 13.8% and 77% of known patients achieving blood pressure control, which is among the best rates in North West London. The Reactive Care Programme is maturing, with the Coordination Hub set to launch in December 2025, and the Best Start in Life programme is progressing, particularly in expanding mental health support in schools. However, challenges remain, including sustaining improvements in the face of high A&E demand, the growth in long-term conditions, neurodevelopmental demand in children, and winter pressures.

Councillor Jane Palmer highlighted the upcoming borough-wide hypertension campaign planned for February, linking it with the British Heart Foundation's Heart Month and the Pan-London programme on healthy hearts. She emphasised the importance of education around self-care and lifestyle changes for those with high blood pressure. Amanda Carey-McDermott supported this, stressing the need for clear signposting to services and the value of data in identifying at-risk individuals. Gary Collier noted that future reports would include performance against three national metrics for the Better Care Fund: emergency admissions for those aged 65 and over, discharge delays, and permanent admissions to care homes for those aged 65 and over. Tony Zaman raised a philosophical point about measuring the impact of transformation against baselines and the need for clearer communication to residents about service pathways. Keith Spencer agreed, emphasising the importance of articulating the overall picture in plain English to gain public buy-in.

The Board noted the report, with an action to discuss transformation capacity, capability, and execution.

Draft Joint Health and Wellbeing Board Strategy 2026-2031

Gary Collier presented the draft Joint Health and Wellbeing Strategy for 2026-2031, which aims to replace the current strategy and represents the first fully integrated, life-course strategy for Hillingdon. The strategy is structured around four life-course outcomes: Best Start in Life, Live Well, Age Well, and Healthy Places, and identifies seven high-impact programmes. It is underpinned by Hillingdon's Place Operating Model, which includes Integrated Neighbourhood Teams (INTs), Family Hubs, a Borough-wide Reactive Care Service, and the new Hillingdon Hospital. Mr Collier stated that a plain English version of the strategy has been produced for public and stakeholder engagement, which will run from January to February 2026.

Sharon Stoltz, as the new Director of Public Health, expressed her pleasure at the focus on maternity services and children within the strategy, highlighting the importance of the 1001 days from conception to age two. She also raised the need for clear governance arrangements for the child health agenda, particularly regarding public health-related issues. Claire Eves from Central and North West London NHS Foundation Trust (CNWL) agreed on the need for stronger relationships between the local authority and CNWL, and for a strong strategic direction for children and young people's services. Councillor Jane Palmer raised the point about a social contract approach, questioning whether the system was brave enough to expect more from the population in terms of self-care. Councillor Susan O'Brien stressed the importance of representation from children's services when discussing children's health and highlighted the ongoing issue of domestic abuse. Keith Spencer acknowledged the points raised, particularly regarding communication and the need to articulate the strategy in plain English.

The Board approved the draft Joint Health and Wellbeing Strategy for public and stakeholder engagement, with the results of the consultation to be presented at the meeting on 9 June 2026.

Childhood Obesity Update

Sharon Stoltz presented an update on childhood obesity, highlighting its long-term impacts on health and life chances. She noted that while Hillingdon's rates of overweight and obesity in Reception and Year 6 children are similar to or slightly better than London and England averages, there has been a slight increase in Reception-aged children since the previous year. The report detailed progress in areas such as school food provision, increasing uptake of universal free school meals, the Healthy School London programme, parent information sessions, and partnerships with The Felix Project. Free access to physical activity in the community, including Parkrun at Stockley Park, was also highlighted.

Stoltz expressed her view that Hillingdon currently lacks a clear strategic direction for tackling excess weight in children, suggesting a need for a whole-system approach. She proposed that a future agenda item focus on developing a strategic approach to excess weight for all ages. Councillor Susan O'Brien and Councillor Jane Palmer expressed strong support for this, with O'Brien stating, Hallelujah comes to mind. Amanda Carey-McDermott also supported the call for a strategic approach, emphasizing the link between child and family health. The Board noted the report, with an action for the Director of Public Health to develop a strategic excess weight programme as part of the health and wellbeing strategy and delivery plan.

Hillingdon Health Protection Committee

Sharon Stoltz proposed the re-establishment of a Health Protection Committee, which had previously been a Health Protection Board that had not met for some time. The aim is to create a doing group chaired by the Director of Public Health to address health protection risks, including vaccination and screening uptake, infectious diseases, and preparedness for emerging pathogens or pandemics. The committee would report annually to the Health and Wellbeing Board, with interim reports possible for significant risks. Tony Zaman raised a question about the constitutional arrangements for discharging the council's statutory duty for health protection. Nikki O'Halloran confirmed that this would be looked into, noting that in other local authorities, such committees typically report to the Health and Wellbeing Board.

The Board approved the establishment of the Hillingdon Health Protection Committee, with draft terms of reference and membership to be finalised. An annual health protection report will be received, with interim reports possible for urgent issues.

Occupational Therapy Service Update

Alex Coman provided an update on the challenges in delivering Occupational Therapy (OT) statutory contacts for children with Special Educational Needs and Disabilities (SEND) as outlined in their Education, Health, and Care Plans (EHCPs). Approximately 400 children did not receive their full allocation of OT contacts in the academic year 2024/25, although over half of all contacts were delivered. This was attributed to a national shortage of OTs, recruitment and retention challenges faced by Central and North West London NHS Foundation Trust (CNWL), and a reduced workforce due to maternity leave and other factors. A recovery plan is in place, with funding secured until March 2026 to address the backlog. CNWL is commissioning additional capacity from the independent therapy market and aims to have appropriate OT provision delivered by the end of Spring term 2026.

Claire Eves from CNWL explained that savings from staff vacancies had been used for agency staff, but this was not a long-term solution. She confirmed that permanent job offers had been made and OT technicians were now available in schools. Councillor Susan O'Brien noted concerns raised by residents and hoped that funding and workforce issues would be resolved before the next academic term. Amanda Carey-McDermott suggested that the issue could be considered as a commissioning gap by the new West and London ICB. The Board noted the report and agreed to receive an update at its meeting on 9 June 2026.

Reports Referred from Cabinet / Health and Social Care Select Committee: GP Coverage in Hillingdon Single Meeting Review

Nikki O'Halloran presented an update on the implementation of recommendations from the Health and Social Care Select Committee's review of GP coverage. The committee had made recommendations regarding future GP surgery needs, IT systems, the expansion of champions roles, awareness of changing community care, and online booking systems. Amanda Carey-McDermott provided an update on the implementation of these recommendations, noting that online booking is now a requirement under the standard GP contract and that most practices are complying. She also clarified the role of champions and the status of IT system improvements. Councillor Susan O'Brien sought clarification on specific recommendations, and it was agreed that Nicky O'Halloran would seek further clarification to ensure the plans met the committee's requirements.

The Board noted the plans for updates and agreed to seek clarification on the requirements of the Health and Social Care Committee.

Board Planner & Future Agenda Items

Nikki O'Halloran presented the Board Planner for 2025/2026. It was agreed that the following items would be added to future agendas: the results of the consultation on the Joint Health and Wellbeing Strategy 2026-2031, an update on the 2026/27 Better Care Fund Plan, and an update on the occupational therapy service. The Board also noted the proposed meeting dates for 2025/2026.

The Board agreed to the amended Board Planner.