Brent Council's 'Working in Neighbourhoods' health plan pilot is set to expand, with learnings from its initial phase informing a borough-wide rollout. The strategy, designed to shift healthcare towards community-based prevention and digital services, aligns with the national NHS Neighbourhood Health Framework.
The initiative aims to integrate health, local government, and voluntary sector partners to improve health outcomes and reduce inequalities. A pilot in Harlesden, running for approximately 18 months, has established an Integrated Neighbourhood Team (INT) with a multidisciplinary team (MDT). This team comprises representatives from council services, the NHS, and various community organisations, offering coordinated support for residents facing issues such as homelessness, financial hardship, and school readiness.
During a Health and Wellbeing Board meeting, councillors heard that the Working in Neighbourhoods
programme is progressing, with established neighbourhood leadership arrangements and early development of draft action plans. The Harlesden pilot was highlighted as a key example of integrated multidisciplinary working.
Councillor Gwen Grahl, Chair of the Health and Wellbeing Board, emphasised the initiative's importance in shifting healthcare from hospital-based treatment towards community-based prevention. Dan Sherlock, Head of Place Leadership at Brent Council, explained that the board would have a role in signing off neighbourhood action plans later in the year and would also review proposed neighbourhood geographies.
The proposed neighbourhood geographies for Brent are: Kilburn (population 47,913, projected growth to 53,600 by 2041), Willesden (population 54,787, projected growth to 66,800), Harlesden (population 56,965, projected growth to 74,200), Kingsbury & Kenton (population 75,663, projected growth to 92,000), and Wembley (population 104,487, projected growth to 165,600). The criteria used to define these areas are not explicitly stated, but the report notes that current footprints vary significantly in size, with some already operating close to the national neighbourhood model and others being substantially larger. There are also differing views on which neighbourhood the Cricklewood & Mapesbury Ward fits best, and the Wembley neighbourhood area is at the upper edge of guidance due to its growing population. The Health and Wellbeing Board is recognized as the appropriate strategic forum to oversee this process, ensuring neighbourhood boundaries align with local population need, wider public service reform, and national expectations.
Subash Shekumar, a GP and clinical lead for the Harlesden neighbourhood, described how residents often struggle to navigate multiple organisations and repeat their stories. He highlighted the formation of a strong neighbourhood team involving health, council, and voluntary sector partners to break down organisational barriers.
Anita Silberbauer, Director of Skylight at Crisis, emphasised the importance of preventative solutions to reach those most in need before they reach a crisis point. She noted that the hyper-local focus on neighbourhoods and communities was exciting and that the health planning offered an opportunity to address interconnected issues like health inequalities, safety, housing, and homelessness.
The Harlesden pilot's success is measured by several targets, including a 10-20% reduction in non-elective admissions, a 10% improvement in evidence-based clinical outcomes for chronic conditions, and a 10% increase in diabetes patients receiving all 8 care processes. The pilot also aims for a 10% reduction in bed days over one day and more people dying in their preferred place. Key findings from the pilot indicate that it has built trust in communities that statutory services have previously failed to reach. The program has also helped narrow the bowel cancer screening health inequalities gap from 13% to 9% and improved hypertension identification in Black communities through outreach. The Children and Young People team has shown success in reducing hospital attendances and admissions through joint home visits with housing officers on asthma outreach. The pilot has also facilitated support for disadvantaged families with wider determinants of health. The Harlesden Neighbourhood Action Plan aims for a 10-20% reduction in non-elective admissions and improved patient experience, with a target of more people dying in their preferred place and fewer ambulance conveyances.
For the expanded rollout, the 'Working in Neighbourhoods' programme aims to scale the Harlesden model across other Brent neighbourhoods. The INTs will be supported by neighbourhood leadership arrangements and will work with population health data, resident insight, and partner engagement to identify local priorities. The report also mentions the development of a 'Neighbourhood Operating Model' for wider rollout, with ward members playing a pivotal role in shaping work in their neighbourhoods. The INT executive group is operating to support decision-making, and there are plans for co-location of services within community hubs.
The 'Working in Neighbourhoods' programme emphasizes collaboration through Integrated Neighbourhood Teams (INTs) that bring together health, local government, and voluntary sector partners. The Harlesden pilot has established a multidisciplinary team (MDT) that includes representatives from council services, the NHS, Crisis, Sufra, and grassroots organizations, meeting weekly for joined-up discussion and decision-making. The report also mentions the establishment of a joint partnership leadership group with senior leads from Brent Council, ICP, CNWL, CLCH, and VCFSE representatives to oversee the transition and implementation of recommendations. This group reports into the overall ICP and Health and Wellbeing Board governance. The programme also aims to strengthen connections with other community-based roles, such as social prescribers, and to co-develop strategies with the VCFSE sector for running events. Furthermore, the Better Care Fund (BCF) is highlighted as a mechanism that forces partners to come together around the same table to experience one coordinated system, rather than separate NHS or council services.
The report indicates a phased decision-making process for neighbourhood geographies and action plans during Summer and Autumn 2026, culminating in formal Board approval in September 2026. The 'Working in Neighbourhoods' programme aims to scale the Harlesden model across other Brent neighbourhoods. Key milestones include the development of neighbourhood-specific action plans, which are being developed and will be brought through governance. The LGA peer review of Brent Health Matters has led to an action plan with key actions to be delivered over specific timeframes: team changes and extending neighbourhood working from July-September and September-March; workforce plan agreement by August-October and first phase implementation from November-March; co-development of VCFSE role for events from September-December; and agreeing new strategic priorities for BHM clinical resources from July-September. A senior partnership group is already in place to deliver recommendations and report to relevant boards.
The 'Working in Neighbourhoods' plan aims to shift from analogue to digital services. While the report acknowledges the importance of digital inclusion, it does not detail specific mechanisms to ensure equitable access for those with limited digital literacy or access. However, it does mention that the Universal Care Plan (UCP) is being promoted, and training has been completed to allow Adult Social Care staff to securely view Advance Care Plans and other shared care information. Further work is ongoing to enable full read/write functionality once national information governance requirements are resolved. The Age-Friendly Brent initiative also advises Council services to include a phone number alongside digital contact information and highlights that hubs are a resource for teaching digital skills.
The report mentions that work is underway to enable Adult Social Care staff to access Universal Care Plans (UCP) and that training has been completed for secure viewing of Advance Care Plans and other shared care information. Further work is continuing to enable full read/write functionality once national information governance requirements are resolved. The 'Working in Neighbourhoods' programme aims to improve information sharing and digital infrastructure. The Harlesden pilot has developed IT tools for communication, though these could be further developed. The report also notes that the 'Brent Health Matters' review identified a need to enhance data sharing and communication. The LGA peer review recommendations include mapping roles across the wider system to bring the wider system together. The Better Care Fund also emphasizes making greater use of shared data and joint decision-making.
The Board is expected to make a decision on proposed neighbourhood geographies for the borough and timelines for developing action plans in September. Public reports pack Thursday 30-Jul-2026 18.00 Health and Wellbeing Board.pdf
