Agenda and minutes

For Members of the Board to note any apologies for absence.

Apologies for absence were received from the following:

·       Kim Wright (Chief Executive, Brent Council)

·       Councillor Grahl, substituted by Councillor Butt

Members are invited to declare at this stage of the meeting, the nature and existence of any relevant disclosable pecuniary or personal interests in the items on this agenda and to specify the item(s) to which they relate.

Personal interests were declared as follows:

·       Councillor Nerva – Councillor Member of the North West London Integrated Care Board (NWL ICB)

To approve the minutes of the previous meeting as a correct record.

RESOLVED: That the minutes of the previous meeting, held on 28 October 2024, be approved as an accurate record of the meeting.

To consider any matters arising from the minutes of the previous meeting.

The Chair advised the Board that a letter to the ICB had been sent, signed by himself as Chair and Dr Rammya Mathew as Vice Chair of the Health and Wellbeing Board, in relation to the NWL Forward Plan. They awaited feedback from that letter and looked forward to further engagement.

To provide the Health and Wellbeing Board with an update regarding the Better Care Fund planning process for 2025-26.

Steve Vo introduced the report, which provided an update regarding the Better Care Fund planning process for 2025-26. In providing an update, he highlighted the following key points:

·       The national deadline for the plan to have been completed, agreed and submitted to NHSE was 31 March 2025, but, due to factors outside of the borough teams’ control, including waiting for NWL ICB to review the finance and proposals, there was no agreement to submit.

·       Brent had received an extension to submit their plan by 4 April 2025 which officers were aiming for.

·       Members attention was drawn to the challenge of the ICB asking for a 50% reduction in additional ICB funding allocated to the Brent local authority, resulting in a decrease of £864k. The Board were advised that this would have an impact on winter planning and the Brent Borough Based Partnership were undertaking detailed analysis to assess the risk posed by the reduction and identify potential measures to achieve a balanced budget.

·       As a result of the reduction in funding, decisions had been made to remove the Discharge to Assess physio service, which had been a pilot programme providing fast-tracked physio access to residents.  This service was in addition to the existing Community Physio service and work was ongoing with CLCH to support those changes and reduce any risks as a result.

·       Rachel Crossley added that she had delegated authority from the Board to sign the BCF off so that it was submitted on time. Unless there were major changes from the ICB then she would use that delegated power on 4 April 2025 to sign off and submit the plan.

The Chair thanked the presenters and invited contributions from those present. The following points were made:

·       The Board acknowledged that the 50% reduction in additional funding would have an impact and asked how officers would make decisions about what schemes to take forward. Steve Vo advised there had been 3 additional schemes under review which all had a direct impact on hospital discharges, and one would impact step-down beds. The review had found that changes to the reablement service would have the least impact as it was a pilot scheme that had no established funds. Tom Shakespeare added that the Integrated Care Partnership (ICP) was looking to undertake a comprehensive review of the rehab and reablement service over the next few months to understand productivity and where the most impact could be made with the remaining resource regarding managing hospital flow and achieving good outcomes. He advised that, whilst the ICP were having to make rapid decisions driven by the ICB’s financial position, there were plans to do an extensive piece of work to mitigate the impact of that reduction throughout the year.

·       The Board asked how they could be assured that the planning process laid out met the needs of the community. Steve Vo advised that the majority of the plan was a rollover of activity of the previous year which was assessed and evaluated every year.  ...  view the full minutes text for item 5.

Will Holt introduced the report, which provided an update on progress and next steps to develop Integrated Neighbourhood Teams (INTs) as well as ongoing work to develop a Radical Place Leadership (RPL) approach in Brent. He began his introduction by explaining that RPL focused on shifting power away from organisations towards communities and encouraged consideration of how services could be redesigned with residents as the clear focus so that services were being built around residents’ multiple interconnected needs. The RPL approach aimed to empower partner organisations, neighbourhood groups and communities to take greater ownership of decision making and saw residents as collaborative partners in the process. To take the work forward, the Council had established an RPL Steering Group which brought together a range of colleagues across the local authority, health, education, police and VCS. The steering group had now agreed a model for RPL and agreed to initially start testing the approach in Harlesden, which was chosen due to the health outcomes, employment outcomes and deprivation levels there as well as the strong VCS presence in the area and willingness and energy of partner organisations. The steering group had identified 3 key pillars which were seen as fundamental to the vision which were; Health INTs; establishment of INT pilots in Harlesden on the wider determinants of health; and community power to empower communities to take ownership of local placemaking.

Josefa Baylon then provided information on the neighbourhood health aspect of INTs, reminding the Board of the extensive resident engagement that had been done with residents from 2022 and presented to the Board regularly. She emphasised that the priority areas identified had been done in collaboration with communities through face-to-face neighbourhood forums, online ‘have your say’ surveys and virtual forums. She added that, due to the nature of the localised approach, there would be differences in terms of specific neighbourhood hyperlocal priorities. Of the 5 neighbourhood areas, the programme was very active within Harlesden and Willesden, where Harlesden aligned closely with the RPL vision focusing on the wider determinants of health such as homelessness, financial hardship and housing. She explained that the aim was for all 3 elements to eventually come together as one, i.e. the health INT and wider determinants of health INT through an RPL approach.

In relation to the INT for the wider social determinants of health, some initial key priorities specific to Harlesden had been established around financial hardship, homelessness risk and increasing school readiness. The INT would bring together colleagues from a range of Council services and partner organisations in a co-located collaborative space in Harlesden to work with residents in need and prevent escalations to crises. The team would operate on a case worker model with one member of an INT being the primary point of contact for a specific resident, and the INT may involve children’s and adult’s social workers, representatives from the VCS including Crisis and Sufra, debt advisors, employment support workers, colleagues from CNWL and social prescribers. The team should be  ...  view the full minutes text for item 6.

To update the Health and Wellbeing Board on the activity being undertaken within the adult mental health workstream of the Brent Integrated Care Partnership (ICP) / Borough Based Partnership.

Sarah Nyandoro introduced the report, which provided an update on the data of mental health performance in Brent, the delivery of the mental health programme, plans for further work on cultural competence within the mental health and wellbeing priority programme, and a deep dive into data regarding mental health patients from the private rented sector. Matt Henshaw added that the NW2 and NW10 pilots linked with the Integrated Neighbourhood Team (INT) work discussed in the previous item and was a good example of collaboration with other services. The pilots had worked well, with an improved presence at Northwick Park Hospital and the project had enabled a focus on those communities and a place-based approach.

The Chair then invited questions and comments, with the following points raised:

• In relation to children and young people accessing specialist mental health support in the way they wanted to, the Board asked whether Kooth online was being used as one of the options. Sarah Nyandoro confirmed that the Kooth online service was used across all 8 NWL boroughs, with the highest numbers accessing the service being children and young people from Brent. The highest outcomes in terms of children and young people’s needs being met was also from Brent. The ICP was looking at a more preventative approach and one way of doing that was through increasing mental health support teams in schools and the number of schools being supported. The ICP Exec was also looking at the services they would like to develop as part of the transformation programme.
• The Board highlighted concerns that the data was lacking in relation to mental health and the Private Rented Sector, as a large proportion of Brent residents were private renters, and asked what would be done to obtain that data. Rachel Crossley advised that obtaining that data depended on what people recorded and what people disclosed, and with the private sector so broad and unregulated getting that data sharing in place was a challenge. There were other routes to that information, such as through GPs, but she was doubtful that person level data providing the full picture would ever be obtained. The ICP was working with services about what was collected and how to use that data to get a better understanding of residents.
• The Board asked whether there were any updates on whether funding for children and young people neurodiversity assessments would continue. Sarah Nyandoro advised that the funding had only been in place until September 2024 and current discussions were underway with NWL ICB regarding continued funding because demand continue to increase. There was no firm response on that, but the ICP had been told they were likely to receive the same non-recurrent funding. Nigel Chapman added that young people with acute mental health need continued to wait longer in Brent for services compared to other areas of NWL, and an area for priority and action arising from the recent local area SEND inspection was around reducing waiting times for specialist mental health services.  ...  view the full minutes text for item 7.

To update the Health and Wellbeing Board on the activity of the Brent Children’s Trust (BCT).

Nigel Chapman introduced the report, which detailed the activity of the Brent Children's Trust (BCT) over the reporting period. He highlighted that the areas of priority for BCT were listed, some of which clearly linked to existing subgroups in the ICP such as health inequalities, immunisations and mental health and wellbeing. Key Performance Indicator reporting went directly to the ICP Exec as referenced in the attached Governance Appendix. He highlighted that there was a need for BCT to obtain more holistic data across the whole partnership which had been asked for ahead of the next meeting. The local area SEND inspection outcome was published on Thursday 27 March 2025 which gave a good overview of the strengths of the local area partnership and showed there was good, effective, on the ground work and good partnership activity with parents and carers, but still areas to improve, particularly related to waiting times. Overall, the outcomes showed that professionals were working hard to mitigate a system which was seen as not working particularly well for children with SEND nationally. Despite waiting times, inspectors found that children were not disadvantaged as mitigations were put in place whilst children were waiting.

The Chair thanked Nigel Chapman for his introduction and invited input from those present, with the following issues raised:

• The Board asked whether the new Autism Strategy and Autism Working Group would be co-produced with people with autism. Nigel Chapman confirmed that every strategy and piece of work implemented was co-produced alongside the Parent and Carer Forum.
• The Board asked how the development of the Welsh Harp Skills Resource Hub was going. Nigel Chapman replied that the Council was aiming to build the post-16 skills centre for young people with SEND there and were partnering with Woodhill School which was beside Welsh Harp. The capital required had been identified and the building was in its design stages. The intention was for that building to be operational by 2027 and progress on the hub would be presented to Cabinet.
• A new Travel Policy and Travel Training Policy had been agreed, co-produced with parents and carers, to enable those who were capable to undertake independent travel. It was highlighted that it would not be mandatory but offered to those able to travel independently to give them that opportunity. The policy was in its early stages, but the implementation was being monitored and going well.

As no further issues were raised, the Chair drew the discussion to a close and asked members to note the report.

To present the Healthwatch Brent draft 2025-26 work programme to the Brent Health and Wellbeing Board, outlining priorities for the year and seeking feedback and strategic input to ensure alignment with health and care priorities in Brent.

Patricia Zebiri (Healthwatch Manager) introduced the report, which presented the draft plan of priorities for Healthwatch during 2025-26 and requested feedback and strategic input from the Health and Wellbeing Board to ensure alignment with health and care priorities. In introducing the report, she highlighted the following key points:

• Healthwatch Brent was delivered on 2.2 whole time equivalents, so the need to be careful and precise in where capacity and energy was spent was highlighted in order to demonstrate improvement and impact.
• One of Healthwatch’s main objectives was to work with the community to drive the Healthwatch agenda with what mattered to residents, helping residents to have their voices heard so that changes and improvements could be made from a bottom up perspective.
• Healthwatch had an Advisory Board made up of local residents and people living, working or running businesses in Brent, where these priorities would be shared and monitored.
• Healthwatch continued to work with Adult Social Care and had looked at dementia care, autism and learning disabilities and carried out mystery shopping. Now Healthwatch were doing some independent customer service, ringing random customers who accessed Adult Social Care to understand their experience. Healthwatch had also gone back into the community to close the loop on their feedback, informing residents where their feedback had made a difference  in order to encourage people to stay engaged.
• Healthwatch assisted with the engagement for Brent’s Pharmaceutical Needs (PNA) assessment., helping to increase the level of engagement.  Following that, work would be done to raise awareness of pharmacy services in Brent to improve access to the right places.
• Healthwatch continued to look at GPs and GP access. It was recognised that services were stretched and finances were challenging, making it difficult to deliver services, but GP access continued to be the biggest issue raised to Healthwatch. Healthwatch continued to build on that work focusing on GP complaints and raising issues with GPs.
• Part of the Healthwatch service was signposting and supporting other community units, and currently the service was working with the Brent safeguarding team and the breast screening team to see how they could raise awareness of those particular issues from a health inequalities lens.

The Chair thanked Patricia Zebiri for the introduction and invited comments and questions from those present, with the following points raised:

• In terms of community engagement, the Board asked whether Healthwatch worked with Brent Health Matters (BHM) and whether there were any opportunities to collaborate to avoid duplication. Patricia Zebiri responded that Healthwatch worked closely with BHM and attended their events, but highlighted the importance of Healthwatch as an independent organisation that needed to remain impartial. She acknowledged that BHM was very good at sending information which Healthwatch ensured its grassroots partners were aware of so they could inform their residents.
• Dr Melanie Smith thanked Healthwatch on behalf of the Pharmaceutical Needs Assessment (PNA) Steering Group, as there had been a much improved response to the consultation as a result of their support.
• Noting the report stated that Adult  ...  view the full minutes text for item 9.

To discuss and agree any future agenda items for the Health and Wellbeing Board.

The Chair gave members the opportunity to highlight any items they would like to see the Health and Wellbeing Board consider in the future. Future items included the Children and Young People’s Mental Health Transformation Programme, an update on Integrated Neighbourhood Teams, a review of the impacts of welfare benefits reforms and a care home sector update.

Notice of items to be raised under this heading must be given in writing to the Deputy Director – Democracy Services or their representative before the meeting in accordance with Standing Order 60.

None.