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)

·       Rachel Crossley (Corporate Director Service Reform and Strategy, Brent Council)

·       Simon Crawford (Deputy Chief Executive, LNWT)

·       Gina Aston (HealthWatch)

·       Tom Shakespeare (Managing Director, Brent Integrated Care Partnership)

·       Dr Rammya Mathew (Vice Chair)

·       Sarah Law (Nursing and Residential Care Sector)

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)

·       Councillor Donnelly-Jackson – was involved in the Kilburn State of Mind and Music Mile projects in her previous portfolio role and was under discussions to become a trustee.

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

RESOLVED: That the minutes of the previous meeting, held on 2 April 2025, be approved as an accurate record of the meeting.

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

None.

To provide the Health and Wellbeing Board an update on the outcome of Brent’s recent (January 2025) Local Area SEND Inspection, outlining the key findings, agreed action plan, and progress made against the actions to date.

Councillor Gwen Grahl (in her role as Cabinet Member for Children, Young People and Schools, Brent Council) introduced the report, advising members that the conclusion of the local area SEND inspection that took place in January 2025 was that SEND arrangements in Brent typically led to positive experiences and outcomes for children and young people with SEND. In introducing the report, she highlighted the following key points:

·       She provided national context that local areas were operating in a challenging landscape, with the number of Education, Health and Care Plans (EHCPs) rising approximately 10% per year over the last 10 years. This in turn caused significant financial pressure on the High Needs Block (HNB) and there was shortage of provision in some areas, for example children with an Autistic Spectrum Disorder (ASD).

·       She felt that the inspection conclusion was very positive for Brent and commended those staff in the Inclusion Service, those supporting young people in schools and health colleagues. She thanked health colleagues for providing support with prompt anti-natal checks for learning and development needs, enabling needs to be identified as early as possible.

·       Whilst there was good progress identified, resulting in a good outcome, she highlighted that inspections were also an opportunity to recognise areas for improvement.

·       She felt that Brent as a local area partnership had worked hard to meet targets for progressing initial EHCPs but needed to improve on annual reviews to ensure the right support was in place for each young person. She highlighted challenges in that, as reviews required professional input from many different agencies including schools, parents and health.

·       There was work to be done on cross-organisational working to streamline the EHCP review process.

·       In relation to the timeliness of mental health provision and neurodevelopmental provision, she advised that those challenges were deeper and widespread, and she felt government oversight and spending would be needed to comprehensively address those issues.

Nigel Chapman provided further information by way of introduction, highlighting the following key points:

• He advised that Brent had been on a journey over the last 8 years following the inspection in 2017 concluding that Brent required a written statement of action. That had been dealt with quickly, as evidenced by a revisit in 2019 where Brent and inspectors had been assured that improvements had been made. He felt that the outcome of the 2025 inspection showed that those improvements had been consolidated and built upon.
• In terms of the inspection process, he explained that, nationally, there had been 59 published joint CQC Ofsted inspections of local areas, with a possible grading across 3 numbers. 30 of those published inspections had an average middle grading, 15 had the lowest grading, and 14 had the best outcome, of which Brent was one.
• He felt that, throughout the inspection, Brent had been able to demonstrate that the work being done was mitigating the impact of the challenges in the overall system for SEND that was felt did not work as well as it could. This was  ...  view the full minutes text for item 5.

This report provides the Health and Wellbeing Board with an update on the progress of the Brent Integrated Care Partnership (ICP) Transformation Executive Group.

Zaid Dowlut introduced the report, which provided an update on the projects being progressed within the primary care programme covering general practice. In introducing the update, he highlighted the following key points:

·       The recently published NHS 10-year plan had now been published, which set out significant changes due to take place moving forward from the current way of working to a more neighbourhood health approach. Primary Care was at the core of the model and would be asked to work closely with communities to tackle health inequalities and deliver better access and co-ordination of services locally.

·       The national General Practice Improvement Programme (GPIP) also introduced a focus on health inequalities and the wider determinants of health in 2023 in light of growing challenges.

·       The Brent Primary Care Transformation Executive Group (PCTEG) was responsible for overseeing the delivery of primary care transformation and change priorities relevant to the local partnership and system, and aimed to align primary care with both national policy and local plans, including the NWL Joint Forward Plan and the Council’s Borough Plan 2023-25.

·       The next steps that the PCTEG was looking to implemented was to move to a neighbourhood level approach for primary care, which would require a different way of funding. 

·       Locally, colleagues across the ICP and primary care were working together to look at models of multi-disciplinary working and the report set out that approach, including Child Health Hubs, local enhanced services, population cohorts with specific needs and improving access to primary care.

·       In relation to access to primary care, a new access model had reduced pressure on other parts of the system, including urgent and emergency care, and the report detailed the 9 extended access hubs now available offering a range of face to face and telephone appointments. These additional appointments had achieved an overall utilisation of 93% across Brent.

·       Registration of patients on the NHS had increased, and Brent, compared to NWL, had higher rates of appointments being booked through the NHS app, showing a good indication of engagement with the new digital environment.

·       The paper set out key progress since the previous year and some of the challenges for some services. It was hoped that with better access, capacity and transition planning that performance would have improved by next year.

·       In relation to cancer screening and early detection, 33 GP practices across Brent remained below 60% uptake for cervical screening, below the national efficiency standard of 75%. It was hoped that with the new integrated approach the performance would strengthen. A new HPV self-referral approach was being deployed, and cervical screenings were now being offered at enhanced access hubs, and a local cancer improvement programme was in development to reach communities with low uptake of screening.

·       Child Health Hubs were due to come on stream in July, running initially at PCN level with the aim to scale that up to a neighbourhood level, working as multi-disciplinary teams supporting children and young people with complex needs in the community without them having to  ...  view the full minutes text for item 6.

This report provides a progress update following the approval of the refreshed Health and Wellbeing Strategy in July 2024.

Agnieszka Spruds introduced the report which provided a progress update against the refreshed Health and Wellbeing Strategy priorities. In presenting the update, she highlighted the following key points:

• Covid-19 had highlighted deep health inequalities in Brent, leading the Board to rethink its Health and Wellbeing Strategy in 2020 to look beyond health and care services and focus on the wider determinants of health and wellbeing. At the time of the rethink, a three-stage consultation process bringing in a broad range of community voices had shaped that strategy and its commitments.
• Most of the original commitments of the 2020 strategy had been delivered, but many were narrative in nature. This had been right at the time, but made it difficult to measure progress, leading the Board to ask for clearer, data-based commitments and a refresh of the strategy to incorporate that. The refresh had been approved by the Board the previous year and included 49 commitments each with specific KPIs to track delivery.
• She felt that the work happening across the programme with the refreshed commitments was wide-ranging and ambitious, with lots of good examples of innovation and strong partnership working.
• One of the new commitments led to the creation of a Social Progress Index (SPI) which was a new tool bringing together ward-level data and enabling partners to take a more data-informed approach when setting priorities.
• The Board heard that both the Joint Health and Wellbeing Strategy and the Borough Plan were due to end at the same time, allowing their next versions to be developed in parallel and strengthening the links between them. Officers proposed to return to Board in January 2026 with a process and timeline for developing the next strategy in line with the national 10-year health plan.

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

• Noting that the report marked the Music Mile project as partially achieved, the Board asked why that was, considering the target for number of residents enrolled on the project had been met, which they considered a strong achievement. Officers explained that, due to lack of data, it was unclear how many of those who had enrolled had actually attended the project and therefore this had been marked as partially completed.
• The Board highlighted that there was no current formalised Food Strategy in place for Brent, but felt there was scope to develop one. Members felt it would be helpful to develop an approach across departments, including residents’ services, and asked whether there were plans to develop a Council-wide formalised Food Strategy. Dr Melanie Smith replied that there was a plan to develop a Food Strategy in consultation with the community, as a borough-wide strategy instead of a Council-owned strategy. This reflected the fact that there were many organisations and individuals who were knowledgeable in this area, so a steering group had been established to drive this forward with the community leading the project. She highlighted that the process had been very positive and felt owned by the  ...  view the full minutes text for item 7.

This report provides the Health and Wellbeing Board with an update on the reconfiguration of the ICB and potential implications on services.

Jonathan Turner introduced the report which set out the reconfiguration of Integrated Care Boards (ICBs) and potential implications on services. In introducing the report, he highlighted the following key points:

• In March 2025, NHS England provided notice that ICBs would face 50% reduction in costs in the 2025-26 financial year and a directive to reduce operating costs by 50%, which included people and estates.
• The government also announced a 10-year plan for the NHS and a merger of NHSE with the Department of Health and Social Care, followed by the publication of a Model ICB Blueprint, which set out ICBs’ role as a strategic commissioners rather than a deliverers of services.
• NWL ICB submitted a draft operating model to NHSE in May 2025, working within the new remit of ICBs, and received feedback in June 2025 which steered the ICB to develop an options appraisal on clustering NWL ICB with North Central London (NCL) ICB, considering both a full merger and viability to continue as individual organisations.
• Following this directive, NCL and NWL ICBs had received options appraisals to their Boards and endorsed on Tuesday 22 July 2025 and Wednesday 23 July 2025 the full merger option.
• The appraisal had identified benefits of merging, including reducing duplication and allowing more efficient use of resources given the reduction of funding now available. The operating model supported the shift to focusing on neighbourhood health, digital access to healthcare and early prevention and intervention.
• The main focus of attention for the ICB going forward would be on delivering population health and reducing health inequalities and, at a later stage, delivering neighbourhood health centres.
• The borough-based aspects of ICBs would no longer exist and would transfer to a provider organisation. Some other functions would also transfer, for example strategic workforce planning, which would transfer to regional teams, and continuing healthcare and infection control, which would transfer to providers to make the ICB more focused on the commissioning element of its functions.
• The borough-based partnership team were now looking at the modelling options and their impact locally for the integrator, looking at how providers could take on some of the functions of the borough-based partnership where there were duplications of roles, but there was currently no specific allocation of resource for that.

Robyn Doran provided further information:

• Many functions of the current ICB would be devolved locally to a system integrator at place level, which was likely to be one of the community or mental health provider trusts. Local authorities across NWL had fed back that they did not wish to be the integrator, there was no coherent federation of GPs to take on that role, and acute services did not wish to take on that role.
• Some functions would need to continue to be delivered by the ICB until legislation changed, such as SEND provision and safeguarding.
• She reiterated that there was no blueprint yet for ICBs to follow, so the ICB was taking things day by day operationally.

The Chair thanked colleagues  ...  view the full minutes text for item 8.

This report presents the Better Care Fund (BCF) 2024-25 which was submitted to the BCF Team and NHS England (NHSE) on 6 June 2025, and seeks formal ratification for the end of year report, and an update on the planning process for BCF 2025-26.

Eleanor Maxwell introduced the item, which presented the End of Year Better Care Fund (BCF) submission for 2024-25. In introducing the report, she highlighted the following key points:

• The end of year report had been submitted to NHSE on 6 June 2025, having been through the relevant governance stages, and been signed off by the Corporate Director of Service Reform and Strategy under delegated authority, pending ratification of the Health and Wellbeing Board. It has been signed off by NWL Integrated Care Board (NWL ICB), Brent’s Chief Finance Officer, and borough-based partners in health, Adult Social Care and Finance.
• The end of year report presented a balanced financial year with one exception – an overspend on community equipment – which had been funded from additional ICB contributions.
• The balanced position was seen to represent strengthened governance and financial monitoring processes and the variances were advocated to the system’s responsiveness to local need.
• Brent Council had implemented improved processes for budget allocation and tracking in 2024-25 which had resulted in enhanced financial oversight and forward planning into the new year.

Antoinette Jones then presented the BCF Plan for 2025-26, highlighting the following key points:

• The BCF Plan for 2025-26 had been signed-off by the Corporate Director of Service Reform and Strategy under delegated authority on 4 April 2025. The Board was asked to formally ratify the plan.
• There had been a lower than usual NHS Minimum Contribution for 2025-26, which had increased by 3.9% compared to the historical 5.66% uplift.
• This meant Brent as a system was dealing with lower levels of income, which, taking into account the increase in expenditure due to operational costs and cost-of-living, meant 2025-26 would be a challenging period. As such, the new plan delivered no new opportunities but maintained the current rollout of programmes.
• The Health and Wellbeing Board had discussed the reduction in additional funding from the ICB at its meeting on 2 April 2025, where a service reduction in the scheme with the least impact on discharge had been agreed – rapid access to physio in CLCH.
• There was now a programme lead in post looking at rehabilitation and reablement and officers hoped for an interim solution in the short term in mitigating those risks as well as a long-term solution by April 2026 where the funding for reablement and step-down would come to an end.
• Partners had been improving BCF processes over the past 2 years with improved oversight, regular reporting, and improved accountability by heads of service and programme leads.
• She concluded that due to the reduction in funding and income there was a need to manage the budget tightly to ensure the BCF could balance needs and demand against the funding constraints.

The Chair thanked officers for the introduction asked the Health and Wellbeing Board to note the 2024-25 end of year position and ratify the 2025-26 BCF Plan.

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 Food Strategy and ongoing updates relating to the ICB reforms and statutory functions.

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

None.