The Integrated Meeting of Waltham Forest Health & Wellbeing and Health & Care Partnership Boards was scheduled to discuss a range of important health and wellbeing initiatives. Key topics included the development of the Better Care Fund (BCF) Annual Plan for 2026/27, a strategy for managing long-term health conditions, and updates on the Promoting Wellbeing workstream. The meeting was also set to address the mental health of Black boys and young men in the borough.

BCF Annual Plan 2026/27

The meeting was scheduled to consider the Better Care Fund (BCF) Annual Plan for 2026/27. This plan is a key component of how health and social care services are integrated and funded. The report pack indicated that early planning for the 2026/27 BCF was underway, with a focus on greater board influence. Known requirements for the upcoming year included the confirmation of minimum NHS and local authority contributions, though Disabled Facilities Grant (DFG) amounts were not yet finalised and were expected to be reduced. The BCF is set to be renamed the Integrated Care Funding Framework (ICFF). National guidance was anticipated in mid-February, with a submission deadline expected after the local elections in May 2026. A review of the Northeast London (NEL) BCF had concluded that the BCF was not always an effective strategic commissioning tool due to resources being tied up in block contracts or general local authority funding. Waltham Forest was noted for its efforts to align spend with strategic ambition, but faced constraints. Specific findings for Waltham Forest included the lowest proportion of social care investment from the NHS minimum contribution, the most funding tied to recurrent commitments/block contracts, the second-highest BCF spender on mental health and learning disabilities, and ongoing community equipment budget pressures. Recommendations from the review included further action to understand service line reporting in NHS contracts and greater transparency in local authority spend. The review of 2025/26 BCF priorities included progress on the Integrated Discharge Hub, which was transforming into a Transfer of Care Hub, and work on Step-Down Provision, Re-enablement Offer, Integrated Equipment Services, Assistive Technology, and End-of-Life Services. Shaping priorities for 2026/27 involved aligning neighbourhood health plans with BCF plans. The report pack also detailed discussions from breakout groups on the relevance of 25/26 priorities for 26/27, potential new priorities, alignment with neighbourhood health delivery, and methods for better evidencing the impact of BCF work. Key discussion points from these groups included the need for service design to be better aligned to varying levels and types of need, financial realism regarding available funding, the importance of reviewing current spend, and the significant influence of housing on health and care outcomes. There was also a recognition of limited additional investment, reinforcing the need for reprioritisation. Practical challenges of reviewing existing schemes, the difficulty of making evidence-based decisions without sufficient time and data, and concerns that discussions might focus solely on investment priorities rather than overarching strategic priorities were raised. Opportunities were identified to make better use of population health management approaches and existing frameworks. The importance of learning from the current planning cycle to avoid repeating discussions was also highlighted. The need to align current priorities within a neighbourhood health strategic context, particularly in relation to prevention and proactive care, was emphasised. Ambitions around health inequalities were felt not to be clearly articulated within BCF documentation and should be made more meaningful. The importance of being clear about how the wider system contributes to prevention and better connecting with the wider determinants of health was stressed. Carers were identified as a key group that should be more clearly reflected within priorities and planning. Next steps included further stakeholder workshops, with feedback from the meeting shaping these sessions, and the opportunity to bring the work back to the committee prior to final submission. Working drafts could also be shared earlier with the Health and Care Partnership Board. The Chief Executive noted a potential lack of alignment across breakout groups, with some focusing on consolidating existing activity and developing an overarching vision, while others appeared to add new elements. It was clarified that the overarching message was consistent: the need to reframe existing activity under a consolidated strategic vision, clearly linked to neighbourhood health, prevention, and proactive care. Practical issues relating to engagement, including provisional workshop dates and the potential for a survey or written feedback mechanism, were discussed. There was strong agreement that workshops should be grounded in realism around resources and deliverability, ambitious but achievable, and involve the right individuals with appropriate expertise.

Update on the Mental Health of Black Boys and Young Men

The meeting was scheduled to receive an update on the Mental Health of Black Boys and Young Men project. This project aims to improve the mental health and wellbeing of Black boys and young men in Waltham Forest, as well as their aspirations, life opportunities, and educational experiences. The work brings together partners from across the Council, NELFT (North East London NHS Foundation Trust), and the voluntary and community sector (VCS), with an aim to develop a community-centred, non-hierarchical, transparent, and inclusive way of working. Recruitment for the project's Board was complete, with the first meeting scheduled for 16 April 2026. The report highlighted significant inequalities in mental health outcomes for Black boys and young men, noting that in Waltham Forest, residents from a Black ethnic group have double the diagnosed rate of serious mental health issues compared to those from White or Asian backgrounds. Furthermore, people from Black ethnic groups are four times more likely than White ethnic groups to be detained under the Mental Health Act. Despite these disparities, Black residents are less likely to receive mental health support, with Black children representing 19% of the Waltham Forest population but only 13% of children receiving a CAMHS (Child and Adolescent Mental Health Services) referral in 2023. The project identified five workstreams: Education and School Exclusions, Support for Parents and Families, Mentoring and Role Models, Access and Quality in Mental Health Services, and Mental Health Promotion and Prevention. Opportunities identified included exploring representation in the teaching workforce and a potential expansion of the partnership between Community Psychology and Waltham Forest College. A resident insight survey was also being considered for expansion to specifically target the demographic of Black Men aged 25 and under. The project had also shaped and launched the most recent iteration of Community Chest funding, with grants for projects addressing the mental wellbeing of Black boys and young men. Planning for outcome measures was underway, with proposed measures including racial disparities in school suspension rates, fair access panel referrals, exclusion rates, access data for mental health support services, and the Warwick-Edinburgh mental wellbeing scale. Following the first Board meeting, plans were underway to develop forums for wider community voice and participation, led by Spark2life, a Black-led organisation.

Long Term Conditions Strategy and NEL Outcomes Framework

A significant portion of the meeting was dedicated to discussing the Waltham Forest Long Term Conditions (LTC) Strategy and the North East London (NEL) Outcomes Framework. The report highlighted that approximately 97,000 residents in Waltham Forest have a diagnosed LTC, impacting their physical and mental health, as well as social determinants of health such as employment and financial circumstances. This situation is potentially exacerbated by delayed diagnosis and suboptimal management, particularly when complications and comorbidities arise. The strategy, developed in response to a data deep dive and requested by the Chairs of the Waltham Forest LTC Delivery Group, is designed to be high-level, with a detailed action plan to follow. The draft NEL LTC Framework aims to deliver a consistent, outcomes-driven model of care to enable residents with, or at risk of, long-term conditions to live longer, healthier, and more independent lives, improve population health, reduce inequalities, and support financial recovery. The Boards were recommended to endorse the Waltham Forest LTC Strategy, provide steer on the delivery of the NEL LTC Outcomes Framework locally, considering changes in Integrated Care Board (ICB) roles, ICB staffing capacity, the development of Integrated Neighbourhood Teams, and new population health management tools. They were also asked to endorse future engagement plans and support requests for input from partner organisations, including nominating lead collaborators and agreeing accountability mechanisms. The issue of LTCs was framed as a significant challenge, with a third of the local population living with one or more long-term physical health conditions, and many developing preventable conditions at an earlier age. The strategy focuses on four key areas: prevention and early detection, improved treatment and management, pathway development and integration, and proactive care and self-management. The draft NEL LTC Outcomes Framework sets out a delivery approach for the NEL LTC Proactive Care Service, including expected care processes and quality standards, with a defined set of indicators. A 'Year of Care' approach is advocated, offering quality care tailored to need rather than solely focusing on completing metrics, with funding apportioned by need rather than registered list size. The strategy acknowledges wider policy developments, including the NHS Neighbourhood Health Framework and the NHS ten-year plan, and aims to strengthen partnership working. The report also detailed specific commitments and indicators for chronic respiratory conditions (asthma, COPD), cardiometabolic conditions (hypertension, diabetes, chronic kidney disease), and comorbidities. For chronic respiratory conditions, commitments include supporting prevention through local programmes, improving access to diagnostic tests, increasing awareness of COPD, ensuring access to pulmonary rehabilitation, reducing variation in asthma reviews, improving post-COPD exacerbation reviews, developing a standardised COPD pathway, reducing ill health due to cold homes, and ensuring patients have access to education and support. For cardiometabolic conditions, commitments focus on community-based awareness campaigns for high blood pressure, raising awareness of hypertension and supporting its prevention and early detection, reducing unwarranted variation in care and optimising treatment for hypertension, supporting neighbourhood health services, and proactively promoting referrals to Public Health commissioned lifestyle services. For diabetes, commitments include raising awareness and supporting prevention and early detection of type 2 diabetes, ensuring young people at high risk of complications are proactively managed, ensuring care pathways for the eight annual care processes are in place, developing a standardised diabetes and foot pathway, identifying and addressing barriers to structured education programmes, co-designing and delivering local early onset diabetes education, and increasing access to diabetes peer-to-peer support. For chronic kidney disease (CKD), commitments focus on increasing opportunities for earlier detection through annual reviews, reducing unwarranted variation in CKD care and optimising treatment, ensuring the CKD pathway is operating effectively, and proactively promoting referrals to Public Health commissioned lifestyle services. For comorbidities, commitments include preventing long-term conditions associated with comorbidities, supporting a whole systems approach to prevention to reduce obesity, expanding and strengthening the personalisation approach of proactive care, co-designing and implementing a Tier 3 weight management service, and increasing referrals for patients with long-term conditions and their carers into local mental health support services. The report also highlighted the importance of wider determinants of health, such as housing, employment, and green spaces, in influencing long-term conditions.

Update on the Promoting Wellbeing Workstream

The meeting was also scheduled to receive an update on the Promoting Wellbeing workstream, which aims to promote preventative approaches and reduce health inequalities through collaboration between the local authority, NHS, and VCS partners. The report included a status report detailing progress in five priority areas: strengthening the partnership with the VCS and faith groups, the Borough of Sanctuary (BoS) initiative, employment and health, housing and health, and mental health promotion. Progress in strengthening the VCS partnership included the transition from the VCS Leadership Group to the Waltham Forest Health & Wellbeing Alliance, which will coordinate VCS involvement in neighbourhood delivery. The Borough of Sanctuary programme had seen progress in submitting a response to a government consultation on changes to Earned Settlement rights and the launch of the 'Patients Not Passports' exhibition. The Employment and Health workstream focused on programme transition and system strengthening, with the 'Individual Placement and Support in Primary Care' programme concluding and 'Connect to Work' gaining momentum. The Housing and Health priority area explored the relationship between housing and health, with a focus on the borough's key housing challenges and opportunities for closer collaboration between housing services and the wider health and care system. In mental health promotion, progress included establishing a board to oversee work on the mental health of Black Boys and Black Young Men, and continued work in schools, including Youth Mental Health First Aid training. The report also covered updates on Locality Hubs and Primary Care Spaces, with progress on the Coronation Square project and the development of a revenue case. Consultation feedback from residents was being incorporated into decision-making, particularly concerning locality hubs and women's health hubs. Key risks identified across the workstream included fragmentation and coordination of VCS provision, sustainable funding and resourcing, embedding population health and prevention approaches, clarity of the VCS and Neighbourhood model, under-engagement from healthcare partners on Safe Surgeries principles, and the impact of ICB changes on leadership for children's mental health boards.

The meeting was also scheduled to review the findings from a recent Joint System Workshop series held in preparation for the development of three neighbourhoods in Waltham Forest, as well as more detailed updates on current focuses in the Housing and Health priority area. The Joint System Workshop series involved over 60 organisations and highlighted recurring themes such as the need for stronger partnership and trust, concerns about short-term funding, calls for shared intelligence and feedback loops, opportunities to embed VCS neighbourhood teams, and the importance of equity and inclusion. Participants also discussed the NHS 10-year plan and its implications for Waltham Forest, with a strong call for a local covenant between VCS, NHS, and local authority partners. Prevention and localities were discussed, with an emphasis on resident-led design, community insight, and local assets. Commissioning for community-led prevention was also a focus, with participants highlighting a gap between commissioning intent and lived experience, and a desire for clearer communication, transparency, and earlier involvement. Recommendations for the Promoting Wellbeing Board included endorsing the emerging prevention-focused way of working, escalating this approach to the Health & Care Partnership Board, and supporting the development of enabling conditions such as shared data, joint commissioning models, and equitable partnership with the VCS. The Housing and Health update detailed the council's efforts to tackle the housing crisis through various approaches, including reducing households in temporary accommodation, early intervention for those at risk of homelessness, increasing the supply of affordable housing, and improving the quality of privately rented homes. The Promoting Wellbeing Board was exploring further partnership work to address the housing crisis and its health impacts, with a focus on prevention and early intervention. Training for frontline health staff on housing issues, including early intervention to prevent homelessness, providing consistent housing advice, and supporting residents experiencing damp and mould, was also planned. The report also highlighted the need for system support to prevent homelessness and manage resident expectations, noting the significant waiting times for social housing and the potential placement of residents in temporary accommodation outside of Waltham Forest or London. The health system partners were asked to support the delivery of the NEL homeless health strategy and work with housing partners to establish a functioning notification system for GPs and Health Visitors when individuals move into temporary accommodation. The report also raised awareness of Awaab's Law and the support available for patients experiencing damp and mould at home, encouraging healthcare professionals to consider housing as a contributory factor to chronic respiratory issues and to raise awareness of the links between damp and mould and poverty.

The meeting was also scheduled to review the BCF Annual Plan 2026/27, which included a draft numerical template and narrative return.