Agenda item

Report of the Managing Director, Harrow Borough Based Partnership.

The Managing Director of the Harrow Borough Based Partnership provided an update on the activities of the Harrow Borough-Based Partnership over August and September.  She highlighted the partnership's role in integrating health and care services across Harrow, this involved key stakeholders such as CLCH (Central London Community Healthcare), CNWL(Central and North West London), Harrow Council, Northwest London ICB (Integrated Care Board), London Northwest University Hospital Trust, and local voluntary sectors.

Winter Plan:

·                 The winter plan was finalised and mobilised, incorporating lessons learned from the previous year.

·                 Initiatives focused on reducing hospital admissions through vaccination programs, warm hubs, support for urgent community response, and safe discharge processes.

·                 Discharge funding was allocated to expand bridging services and increase bed capacity for individuals with dementia and delirium, as well as to pilot a 24-hour home care service.

Preventing Admissions:

·                 The Preventing Admissions Steering Group, utilising data insights, had implemented measures to address high admission rates in Harrow.

·                 Admissions from Ambulatory Care Sensitive conditions have begun to plateau, and efforts were ongoing to support vulnerable residents through proactive care planning and multidisciplinary team involvement.

Strategic Planning:

·                 The partnership was evaluating the impact of its three-year plan and beginning to draft a new strategy and delivery plan set for April.

·                 The upcoming NHS 10-year plan would influence priorities. Current efforts were focused on assessing public needs and improving system performance.

Integrated Neighbourhood Team:

·                 Development of integrated neighbourhood team had progressed, with Harrow's three neighbourhoods (West, Central, and East) confirmed.

·                 Emphasis was placed on aligning health and social care services within these neighbourhoods, with frontline staff receiving support to collaborate and deliver coordinated care.

Performance and Outcomes:

·                 Positive trends were noted in reducing the number of children under five with tooth decay and in patient-reported access to general practice services.

·                 Admissions, although still high, were showing signs of plateauing for ambulatory care sensitive conditions.

Risks:

·                 Ongoing challenges included occupational therapy provision for children, discharge capacity, and gaps in children’s continence services.

The Chair thanked the Managing Director of the Harrow Borough Based Partnership for the comprehensive update and acknowledged the ongoing efforts to address the outlined challenges.

The Board asked the following questions and discussed the following:

The Board raised concerns regarding the termination of discharge funding on 1 November 2024 and sought clarification on mitigation strategies to address the impact.  The Managing Director of the Harrow Borough Based Partnership confirmed that additional funding had been secured to continue services through to March 2025.  Although a long-term solution was still under development, immediate risks over the winter period were mitigated. Additionally, an action plan existed to reduce non-elective admissions for ambulatory conditions, this focused on conditions like asthma, diabetes, and kidney disease.  Efforts included IV antibiotic management within the community and increased asthma reviews in primary care.

The Board discussed difficulties in arranging safe hospital discharges, especially for elderly patients.  It was noted that services like the Voluntary Home and Settle program were available but may not be sufficiently communicated.  The Board also raised the need for improved support for dementia care, particularly for ethnic minorities.  A detailed report on available dementia services, including the memory clinic and post-diagnosis support, was requested for the next meeting.

The Board expressed a need for clarity on leadership and oversight of child mortality reporting.  It was noted that despite investments in the child death overview panel, local follow-up actions may need further attention.  The Board agreed to follow up on this and confirm the Governance and oversight of this area.

The Board highlighted the importance of preventive care, particularly in partnership with the voluntary sector, as demonstrated during COVID-19. The Board requested a report to further formalise and enhance collaboration with community groups to strengthen preventive measures.

RESOLVED:  That The Board reviewed and noted the updates on the winter plan and the work of the Borough-Based Partnership.