Hillingdon Council is facing a projected overspend of £6.5 million in health and social care for the 2025/26 financial year, primarily driven by escalating demand for services.
The Health and Social Care Select Committee reviewed the council's budget monitoring position on Thursday, March 26, 2026. The report, available in the Budget Spending Report, indicates an adverse movement of £0.8 million from the previous quarter's forecast.
The significant overspend is attributed to a combination of factors, including increasing client demand volume and complexity and market pressures.
The council's front door services are managing a substantial volume of contacts, with a significant proportion requiring timely triage, assessment, or onward action to manage risk and prevent escalation. Specifically, 63% of these contacts relate to physical support needs, followed by support with memory and cognition, mental health, learning disabilities, and social support needs. Safeguarding activity also represents a considerable component of this demand.
Within Adult Social Care & Health, the forecast overspend of £6.5 million is comprised of £8.0 million in pressures. These are partially offset by a £1.5 million underspend in SEND transport and £2.0 million in savings achieved through effective vacancy management. The overspend is largely due to ongoing growth in demand across all service areas, particularly in Learning Disabilities and Mental Health services, where client numbers continue to rise above budgeted assumptions. Support with memory and cognition, reflecting increased dementia prevalence, is a significant driver of this growth.
To address the projected overspend, Hillingdon Council is implementing several measures. Mitigations of £2.0 million have been achieved through effective vacancy management. The underspend in SEND transport is attributed to more economical procurement of personal assistants and maximising efficiencies through a mix of delivery options. Furthermore, Adult Social Care operates robust financial controls to manage demand-led expenditure and ensure resources are targeted appropriately in line with statutory duties under the Care Act 2014. A spending control process initiated in June 2025 has reportedly led to improvements in care provisioning and the adoption of a strengths-based approach to supporting residents in the community.
The council's agenda for the Health and Social Care Select Committee meeting on March 26, 2026, can be found here.
