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)

·       Tom Shakespeare (Brent Integrated Care Board Director)

·       Claudia Brown (Director of Adult Social Care, Brent)

·       Dr Rammya Mathew (Vice Chair, ICP)

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.

None declared.

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

RESOLVED: That the minutes of the previous meeting, held on 16 April 2026, be approved as an accurate record of the meeting.

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

None.

This report sets out the goals and expectations of the NHS Neighbourhood Health Framework and how it will be delivered as part of Brent’s overall approach to ‘Working in Neighbourhoods’ (WIN), highlights progress to date in Brent, outlines the role of the Health and Wellbeing Board in shaping, overseeing and championing neighbourhood working, and provides timelines and next steps.

The Board received a report from the Brent Integrated Care Partnership (ICP) Executive setting out the goals and expectations of the NHS Neighbourhood Health Framework and how it will be delivered as part of Brent’s overall approach to ‘Working in Neighbourhoods’ (WIN), highlighting progress to date in neighbourhood working in Brent and outlining the role of the Health and Wellbeing Board in shaping, overseeing and championing neighbourhood working. Robyn Doran began the presentation and highlighted the following key points:

·       She highlighted the importance of neighbourhood work both because Brent had been passionately working towards this for several years and because it was now part of a framework in terms of the NHS 10-Year Plan which cited the importance of Health and Wellbeing Boards in the shaping of neighbourhood geographies and overseeing how the work was implemented locally.

·       The framework set out how local areas should move away from the hospital-based treatment that had been traditionally delivered for many years to a community-based model, towards prevention and away from treatment, and towards a digital approach, away from analogue. The principle should be care as close to home as possible, wrapping services for health and social care, and the voluntary sector, around where people lived.

·       In recognising those aims, the ICP also acknowledged the differences across neighbourhoods in Brent. Neighbourhood working had been piloted in Harlesden for the past 18 months which she had advised had been a successful way of working, asking the community what mattered most to them.

·       As the ICP had tested and learned from that model, it would look to roll it out wider across the whole borough, with a programme overseeing that and neighbourhoods agreed by the Health and Wellbeing Board. The ICP would report regularly to the Board on the progress of the programme.

Dan Shurlock then outlined the Health and Wellbeing Board’s role in supporting working in neighbourhoods, highlighting the following key points:

·       There were some significant decisions and roles for the Health and Wellbeing Board in supporting the implementation of Working in Neighbourhoods, including to confirm the neighbourhood geographies.

·       There was an expectation for an action plan to be signed off for each of the agreed neighbourhood areas in Brent, with those action plans aiming to deliver some of the key NHS targets around health services going forward. Brent should identify the local priorities specific to Brent communities that the system wanted to work together on and identify opportunities to bring in additional funding and resources to deliver those priorities.

·       The ICP was opening up a conversation with key stakeholders to ask for their views on geographies. That evidence would be gathered for the Board and the ICP would return to the Board in September 2026 outlining that engagement work, the findings and recommending a way forward for neighbourhood geographies.

Subash Jayakumar then provided further details of the pilot work conducted in Harlesden, highlighting the following key points:

• Subash Jayakumar began by introducing himself as a GP based at the Stonebridge practice and the  ...  view the full minutes text for item 5.

This report presents the LGA peer review report and action plan in response to the findings and recommendations.

Councillor Liz Dixon (as Cabinet Member for Community Safety and Public Health) introduced the item, which presented the LGA independent review of Brent Health Matters (BHM), and Brent’s response to the review. In introducing the report, she commended the work of BHM and was pleased that the review had recognised the success of the programme and what it had achieved in practice. The health checks in factories and health events in community spaces such as the Pakistani Community Centre were particularly emphasised as good practice in community engagement and tackling health inequalities. She provided a brief history of the establishment of BHM in response to COVID-19 and its now ongoing programme tackling health inequalities and thanked all who contributed to the review. She then invited Dr Debbie Frost to present further information who highlighted the following points:

·       Dr Debbie Frost had been asked to facilitate reviews by the LGA as a retired Deputy Medical Director at NHSE, a Barnet GP and Chair of the then Barnet CCG, and she had been facilitating reviews for around 10 years. The LGA attended reviews as a group of multiple professionals to discuss the delivery of health programmes with local stakeholders. The feedback that the LGA gave came from local people.  

·       In Brent, the LGA spoke to over 30 people and then presented the report at a workshop of senior stakeholders in April. She presented the positive comments heard about BHM which was treasured within the community and did well in reaching communities that were often not engaging with services.

·       Within the feedback received from the review, respondents felt that BHM was running alongside the system rather than within it and it was clear that not enough integration between mainstream primary care and BHM was happening. There was also a feeling that some of the activity was already being commissioned in primary and community care. She advised that a relationship was essential between BHM and primary care so that when BHM made successful interventions the practical steps, such as booking an appointment for a vaccination at the GP, could be undertaken quickly and seamlessly.

·       Feedback also highlighted that the real impact of BHM’s work was not being captured and it was not clear that some of the outcomes, which were very clinical in nature, were as the result of BHM interventions. For Dr Debbie Frost, the most compelling narrative was successful individual stories, such as when the BHM team visited a family who needed help for asthma and also supported that family in applying for benefits and school places for three children who were not in school and arranged a dentist appointment all within the same visit, which was not possible to quantify but which made a big difference to that family. She felt that some of this community working could be better communicated when reporting the impact of BHM.

·       Further feedback suggested that upstream prevention ambition was unfinished and that the programme had focused too much on health access and clinical interventions instead  ...  view the full minutes text for item 6.

To provide an overview of the Better Care Fund (BCF) and the Health and Wellbeing Board’s role in ratifying the BCF.

Eleanor Maxwell provided an overview of what the Better Care Fund was and its mechanisms to new Board members before they were asked to ratify the end of year position and plan for 2026-27. In outlining the purpose of the Better Care Fund, she highlighted that it underpinned the services residents relied on, particularly in relation to the move between hospital and the place the patient called home. There were many strands of governance to the Better Care Fund (BCF), for which the Health and Wellbeing Board provided strategic oversight and democratic accountability. Every area in England was required to produce a BCF which then acted as a joint agreement between the local authority and ICB and was supported by a Section 75 Agreement. Whilst based on guidance, every BCF was local to the area it sat within, meaning Brent had the ability to chose how BCF funds were spent in the borough and there was a good amount of flexibility within that. In terms of the purpose of the BCF, she advised that it enabled the local authority and ICB to jointly plan services by bringing funding together to focus on shared priorities based on the needs of residents.

Over the last three years, she had helped to significantly strengthen the way Brent managed the BCF with stronger monitoring of metrics and stronger governance. A full corporate audit had been undertaken with all recommendations now implemented and a dedicated BCF Board had been established to improve financial monitoring and scheme management. The stronger, more robust approach to measuring performance and outcomes had strengthened partnership working, giving greater visibility of where the investment was having the greatest impact and enabling partner to move much faster where gaps needed to be addressed.

Eleanor Maxwell flagged that, over the next two years, there would be a need to respond to significant national changes, including the ICB restructuring, the development of a system integrator role, and the transition following the abolition of NHSE who currently owned the BCF. Whilst this would present challenges, she felt that there would also be opportunities to strengthen local partnership working to further align services around neighbourhoods.

Looking ahead, the BCF would continue to play a central role in supporting the shift towards neighbourhoods, and the key existing metrics were likely to remain unchanged. Whilst reducing hospital admissions and improving discharge were still priorities, there was an increasing focus on prevention, early intervention and supporting people to remain independent in their own communities. The BCF would increasingly align with the development of neighbourhood working, meaning using shared resources and flexibility, designing services around people’s needs rather than organisational boundaries and making greater use of shared data and joint decision making. Success would increasingly be measured not only by how quickly people leave hospital but whether they were able to live healthier and more independent lives and avoid unnecessary escalation into intensive services. In practical terms, she flagged that the greatest challenge would be balancing the need to sustain  ...  view the full minutes text for item 7a

This report presents the End of Year (EoY) report for the Better Care Fund (BCF) 2025-26, which was submitted to the BCF Team at NHSE on 5 June 2026, and seeks formal ratification from the Health and Wellbeing Board for the Corporate Director Service Reform and Strategy to sign off the report to meet the national submission deadlines.

Rachel Crossley introduced the BCF end of year report for 2025-26 which sought formal ratification from the Health and Wellbeing Board. She noted that, due to tight timescales, she had signed off the End of Year report under delegated authority from the Health and Wellbeing Board in order to meet the national submission deadlines.

In considering the report, the following points were raised:

• Councillor Butt noted the Section 75 agreement presented and agreed at Cabinet on Monday 27 July 2026, which ensured discharge and support elements were in place for residents moving out of hospital. He noted that there previously was more funding coming through in this area, and highlighted issues going forward if the level of funding was not in line with demand, need and the opportunities and commitments required of all partners.
• In response, Eleanor Maxwell agreed that there was a need for stability of funding. The previous year, local areas had only been notified of funding 2 weeks before the national deadline for completion, meaning a budget of stability was set, and this year, due to national and regional structural changes to the system, another budget of stability had been set, but every scheme had been re-costed and looked at in depth. She highlighted if the funding did not keep pace with inflation for a further year then that risked devaluing what the scheme could do and it would not be possible to deliver new innovative schemes. She expected that going forward the new merged ICB would look for consistency in funding across the 13 boroughs.

As no further points were raised, the Chair drew the item to close and the Health and Wellbeing Board approved the 2025-26 Better Care Fund End of Year report.

This report provides an update on the planning process for the Better Care Fund (BCF) Plan for 2026-27 and seeks formal ratification for the BCF 2026-27.

Eleanor Maxwell then presented the proposed BCF Plan for 2026-27 and an update on the planning process, which had been developed jointly with the WNL ICB and submitted to NHSE by the deadline of 14 May 2026. She highlighted that the plan allocated £57m of joint funding covering 60 schemes spanning discharge, reablement, community therapies, equipment, carer support, adaptations and services for independence. £19m was set aside for community health services commissioned by the ICB, £30m for Adult Social Care commissioned services, £7m for the Disabled Facilities Grant and around £1m for some wider Council and voluntary services, which she highlighted was a reflection of the breadth of the number of partners and services in Brent. Success of the scheme would be measured through key system metrics such as fewer hospital admissions, faster hospital discharges, more people supported safely at home and fewer long term residential admissions to care homes. The performance of every scheme was closely monitored through local KPIs, financial monitoring and regular performance reviews, and the data on these metrics was reported to NHSE. Performance monitoring ensured value for money and continuous improvement. She highlighted that she had developed a good system of tracking these metrics over the three years she had been in post as the dedicated Better Care Fund Project Officer as she felt it important to have a strong hold on whether the schemes were delivering what they set out to and identify where there were gaps that needed addressing. 

In considering the report, the Board highlighted the following points:

• In considering the papers as a whole, the Board highlighted it would be useful to have further financial details in the reports in future as well as the outcomes of the schemes.
• The Board asked for further details regarding the £1.3m overspend attributed to community equipment. Eleanor Maxwell highlighted that the community equipment provider had stepped back from the contract, which left boroughs where they worked in a difficult position as it meant additional costs, including legal challenges and finding alternative suppliers. Whilst the ICB funded 62% of the contract, the ownership, commissioning and management sat with the local authority which resulted in an overspend. In addition, the budget setting from the ICB was not as accurate as it could be and was limited by funds available in the BCF. She highlighted that the community equipment budget had been overspent every year and she believed the budget set by the ICB needed to be reviewed. Rachel Crossley added that the new provider were delivering much better data and stronger contractual management since mobilisation.

As no further issues were raised, the Board resolved to formally approve the BCF Plan for 2026-27.

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.

In terms of future items, it was proposed that a joint paper between the ICP and Housing on the effects of housing on healthcare and health outcomes in the borough was brought to a future meeting, including proposed actions for the new neighbourhoods model and BHM, and linking this with the Council’s air quality strategy. Nigel Chapman agreed to bring an update on progress towards Best Start in Life to a future meeting. Rachel Crossley agreed to bring a progress report on the Carer’s Strategy to a future meeting.

The Board also requested that, where possible, residents and service users were invited to the meeting to share their experiences.

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.