The Health and Wellbeing Board met on Tuesday 10 March 2026 to discuss updates on the Health Determinants Research Collaboration (HDRC) programme and the Careline service. The Board noted the progress of the HDRC initiative, which aims to build research capacity within local government, and received a report from Healthwatch Ealing on the experiences of Careline service users and staff.

HDRC Year 2 Update

Vaishnavee Madden, Consultant in Public Health Medicine, presented an update on the Health Determinants Research Collaboration (HDRC) programme, which has been renamed Evidence and Learning for Health. The programme, funded by the National Institute for Health Research, is in its second year of delivery and focuses on building research capacity within local government concerning the wider determinants of health. The first two years have concentrated on establishing governance, performance, and financial frameworks, alongside developing collaborative working relationships with three universities – Imperial College London, London School of Hygiene and Tropical Medicine, and the Institute of Development Studies – as well as community sector partners and the Council.

During the second year, the HDRC team expanded with new roles, including a research capacity lead, communications lead, participatory research specialist, evaluation specialist, and research data scientist. Efforts have been made to improve communication about the programme's purpose and progress, including the launch of a new website and communications materials. A significant aspect of the programme involves building community research capacity. In collaboration with the Institute of Development Studies, 22 community researchers from diverse communities across the borough have received training in participatory action research. These researchers have gathered narratives from residents about factors influencing their lives and wellbeing, which have been analysed to identify pathways contributing to positive and negative health outcomes.

Six action research groups have been formed, focusing on themes such as access to green spaces and wellbeing, youth activities and antisocial behaviour, the impact of temporary accommodation on mental health, domestic violence and substance use, and language barriers affecting employment. Council and voluntary sector staff are now collaborating with these groups to co-develop potential actions.

The programme is also enhancing data linkage and accessibility. A pilot project, in partnership with Imperial College, is linking children's social care and education data with NHS data across North West London. This initiative is expected to support future analytical work, including the development of tools such as school health profiles and strategic outcomes frameworks. Developmental evaluation, conducted in partnership with the London School of Hygiene and Tropical Medicine, is ongoing to support learning and improvement. Furthermore, a training and capacity-building programme has been developed for both Council and voluntary sector staff, offering online resources, communities of practice, and opportunities to engage with the HDRC team on practice-based work. Intensive work is also underway with early adopter teams in climate, children and young people, and housing services.

Vaishnavee Madden noted that the programme has prioritised building strong collaborative foundations and embedding equality, diversity, and inclusion, particularly through the community researcher model. Challenges have included communicating the programme's purpose, as research is a relatively new concept in local government compared to the NHS, and the limited capacity of staff to engage due to competing pressures.

For the third year, priorities include strengthening the role of community researchers, expanding engagement with council directorates and communities of practice, developing data dashboards for children and young people, and establishing research governance processes such as ethics and data governance frameworks. The programme also aims to define research priorities aligned with the Council Plan and national priorities, and to secure further external research funding.

In response to questions, Vaishnavee Madden indicated that there are opportunities to support neighbourhood health initiatives and the integrated neighbourhood model, including embedding evaluation within neighbourhood projects. She also highlighted the potential to better map existing research activity across the borough to identify overlaps, gaps, and opportunities for collaboration, particularly concerning community champion and link worker roles.

Anna Bryden, Director of Public Health, added that feedback from partners suggests the programme has strengthened local relationships and collaboration between the Council, voluntary sector organisations, and academic partners. She noted that the work has advanced elements of the Health and Wellbeing Strategy and enabled developments such as data linkage in children's services, which had been a long-standing discussion. She emphasised that the programme provides valuable expertise and resources, and that future updates will help demonstrate the long-term impact of the work.

The committee RESOLVED to note the update and agreed to receive an annual update on the HDRC programme.

Careline Report from Healthwatch and Verbal Update

David Crawley, Project Officer at Healthwatch Ealing, presented findings from a review of the Careline service. He noted that recent information from the Department of Health and Social Care indicates that Healthwatch's statutory functions relating to social care will transfer to local authorities, while healthcare functions will move to Integrated Care Boards, with no clear timeline provided yet. Healthwatch Ealing is expected to continue operating for at least another year.

Healthwatch spoke with 22 Careline service users and four staff members. Nineteen respondents reported that the service helps them feel safe and independent, with no respondents indicating otherwise. The only neutral response came from a carer providing information on behalf of a service user. Most respondents had used the service for over four years. Those who had experienced incidents found the service very helpful, with one individual describing how staff supported them during a distressing situation. In non-emergency situations, most users reported being connected to an operator within minutes, with only one person experiencing a longer wait. The most common equipment used was a pendant alarm or fall alarm, though some also had pull alarms.

Regarding the transition of the service from Ealing to Harrow, most respondents reported no issues. Only one service user experienced difficulties related to equipment collection and payment due to miscommunication between the councils. Most respondents did not notice any change in service provision, and one individual felt the service had improved. However, some concerns were raised about communication during the transition, with several users reporting they were unaware of the change until after it had occurred.

Staff reported high job satisfaction despite working in a fast-paced environment and felt supported by colleagues and management. However, it was noted that while employee support programmes exist, the interviewed staff were unclear about how to access them.

Management reported that Harrow Careline had led the digital to analogue switchover in London since 2019, which facilitated the transition in Ealing. Equipment costing less than £1,000 is funded by the local authority under the Care Act, meaning there is no charge to service users. Ealing Council does not intend to introduce charges for callouts or monitoring, and any future changes would be subject to consultation. Additional engagement activities include birthday calls, annual surveys, and eight-week follow-up calls after installation.

Healthwatch recommended improving communication with residents about service changes, using multiple communication channels such as letters, SMS messages, and phone calls. They also recommended continued service user engagement, prioritising staff wellbeing due to the demanding nature of the work, and increasing promotion of the Careline service to enhance public awareness. David Crawley noted that during community engagement, many residents were unaware of the service's existence.

Overall, Healthwatch reported that the service is performing well, with no major concerns identified from discussions with service users, staff, and the Council.

Kerry Stevens, Director of Adult Services, thanked Healthwatch for its independent review and highlighted its role in holding services to account. He explained that the transfer of the service to Harrow Council in April 2024 followed safeguarding concerns within the previous Council-run provision and the need to meet national standards. He noted that the partnership with Harrow had enabled improvements, particularly in digital technology, and had introduced performance monitoring data that was not previously available. He added that while communication with residents could have been improved, the fact that many users had not noticed the transition suggested the transfer had been managed smoothly.

Robert South, Strategic Director for Children's Services, emphasised the need to increase awareness of the service across the borough, suggesting that awareness-raising could also consider links with support for young carers and early intervention services. Members noted that Careline is available to residents eligible under the Care Act through social care pathways rather than as a commercial service, and officers agreed to explore how awareness could be strengthened among social workers and relevant services.

In response to questions from the public, David Crawley explained that the research used qualitative engagement methods to ensure independence. Healthwatch attended community events across the borough and spoke with approximately 100 individuals, though only 22 were service users or carers. While acknowledging the small sample size, he noted that the service user population is relatively small and difficult to reach. Despite resource limitations, he considered the engagement valuable in ensuring that service users' experiences were heard and reflected independently.

The committee RESOLVED to note the update.

Better Care Fund Verbal Update

Kerry Stevens, Director of Adult Services, reported that national guidance for the Better Care Fund had been issued, with a deadline for sign-off in May. He advised that the overall financial position was expected to be similar to the previous year, with continued financial rollover arrangements. However, there were stronger national expectations to move towards a neighbourhood health model and to develop neighbourhood strategies.

He explained that officers intended to present the proposal to the Health and Wellbeing Board in May. However, due to the timing of elections, this might not be possible in a public meeting, and approval might need to be sought outside of the formal meeting process.

Members noted that the Better Care Fund enables partners to pool resources to support integrated working across health and social care. It was highlighted that, alongside financial considerations, it would be important to demonstrate the benefits and outcomes of the funded activity for residents, including work relating to reablement and hospital discharge support.

In response to questions, Kerry Stevens noted that the Council's commitment to the London Living Wage had significantly benefited lower-paid workers in the health and social care sector in the borough, increasing earnings for over 2,500 workers and contributing to workforce stability and improved public health outcomes. He highlighted that the workforce is predominantly female and highly diverse.

He also noted the Council's disappointment that Minster Care Group had stopped paying the Real Living Wage to some staff within PFI care homes. While not a contractual requirement, the issue had been raised formally with the provider. Any potential reinstatement of the London Living Wage across those services would have financial implications for the Council's Medium Term Financial Strategy.

Councillor Kamaljit Kaur Nagpal, Cabinet Member for Decent Living Incomes, added that the Council continues to champion the London Living Wage, noting that while some organisations have struggled to maintain accreditation, others are newly adopting it, recognising the benefits for staff morale, recruitment, retention, and organisational reputation.

In response to public questions regarding the future of the Michael Flanders Centre, Kerry Stevens clarified that proposals do not involve reducing day services but expanding provision across the borough to four sites, improving accessibility and reducing travel times. A nearby service at Sycamore Lodge will continue to serve the Acton area, while Elm Lodge will provide improved access for residents in the west of the borough. He emphasised that the proposals are not driven by cost reductions but aim to improve local access and meet growing demand, particularly from residents with dementia, and are expected to increase service capacity and accessibility.

The committee RESOLVED to note the update.