The Health and Wellbeing Board met on Wednesday 18 March 2026 to discuss progress on the draft Joint Health and Wellbeing Strategy and the Better Care Fund Plan for 2026/27. The Board also received updates on integrated health and wellbeing performance, the occupational therapy service, and reviewed future agenda items.

Draft Joint Health and Wellbeing Strategy 2026-2031 Update

The Board received an update on the consultation and engagement process for the draft Joint Health and Wellbeing Strategy 2026-2031. The strategy, developed by Hillingdon Health and Care Partnership (HHCP) on behalf of the Board, aims for a fairer, healthier, more integrated Hillingdon and is structured around four life-course outcomes: Best Start in Life, Live Well, Age Well, and Healthy Places. Seven high-impact programmes have been identified, including neighbourhood proactive care and mental health early intervention. The consultation approach involved online surveys and engagement with existing resident groups. The Board noted the consultation process and the proposed final strategy approval arrangements. The results of the consultation are to be reported back to the Board in June 2026, at which point the final strategy will be presented for approval.

2026/27 Better Care Fund Plan Update

The Board was presented with an update on the planning requirements for the 2026/27 Better Care Fund (BCF). The report highlighted that the BCF aims to support integrated and preventative care, particularly for those with complex health and social care needs. The framework for 2026/27 includes reforms focused on joint commissioning, support for people with frailty, and alignment with neighbourhood health services. The total minimum value of the BCF for 2026/27 is £43,482,688, an increase from the previous year, with contributions from both the NHS and the Council. The report detailed the national conditions and metrics for the BCF, which remain largely consistent with the previous year, focusing on reducing emergency admissions, discharge delays, and long-term care home admissions for older people. The Board was asked to note the content of the report and endorse the plan approval arrangements.

Integrated Health and Wellbeing Performance Report and Service Update

The Board received a comprehensive update on the integrated health and wellbeing performance and progress across key programmes. The report indicated that the system was stabilising with measurable improvements, particularly in discharge performance, frailty management, and mental health crisis response. Specific achievements included reduced attendances and improved waiting times at The Hillingdon Hospitals NHS Foundation Trust's Emergency Department, a reduction in No Criteria to Reside (NC2R) delays, and improved throughput at the Lighthouse mental health crisis service. The Reactive Care Coordination Hub was live, simplifying access to urgent community response.

However, the report also highlighted areas where performance remained off-track, including emergency demand and bed days, which were still above operational targets. Key risks identified included workforce fragility and the challenge of scaling new models. The forward plan for the next three months focused on consolidating gains, accelerating delivery, and addressing remaining gaps.

Updates were provided on specific programmes:

• Neighbourhoods (Live Well & Age Well): Integrated Neighbourhood Teams (INTs) are fully operational, with progress in frailty case management and the Healthy Heart campaign to tackle hypertension. The development of Neighbourhood Hubs is also progressing.
• Reactive Care (Urgent & Crisis Response, Hospital Discharge): The Reactive Care Coordination Hub is operational, and a pilot for mobile diagnostics is underway. The Lighthouse mental health service has seen a significant reduction in length of stay. Progress has been made in reducing NC2R delays, and the Discharge to Assess (D2A) Pathway 1 is being integrated.
• Best Start to Life (Children & Young People): Work is progressing on Child Health Hubs, integrated paediatric clinics, and a CYP Neighbourhood Dashboard. The expansion of Mental Health Support Teams (MHSTs) in schools is underway, and efforts are being made to address the significant demand for neurodevelopmental assessments.

The report also outlined cross-cutting system risks, including high ED attendances, potential NC2R relapses, workforce constraints, the growth of long-term conditions, and the surge in demand for CYP neurodevelopmental assessments. Mitigation strategies for these risks were detailed.

Occupational Therapy Service Update

The Board was briefed on the challenges faced by the Occupational Therapy (OT) service in meeting statutory contact hours for children with Special Educational Needs and Disabilities (SEND) as outlined in their Education, Health, and Care Plans (EHCPs). It was reported that approximately 400 children did not receive their full allocation of OT contacts in the academic year 2024/25 due to national recruitment and retention challenges for OTs. Central and North West London NHS Foundation Trust (CNWL), the service provider, has been working with the Council to develop a recovery plan. This plan includes commissioning additional capacity from the independent therapy market and ensuring that all affected children receive their agreed therapy by the end of the Spring term 2026. The Board noted the content of the report, with discussions also touching upon the sustainability of performance and the potential impact of new legislation on demand.

Board Planner & Future Agenda Items

The Board considered its business for the forthcoming cycle of meetings, reviewing the draft Board Planner for 2026/2027. It was agreed that the SEND Joint Strategic Needs Assessment (JSNA) and the Place Operating Model (to be considered in Part II) would be added to the agenda for the meeting on 9 September 2026. The SEND reforms, plans, and funding will be discussed on 2 December 2026. The Board also noted that an update on the review of early intervention and prevention services would be provided at a future meeting.