This meeting was scheduled to include a review of the feedback from the public consultation on the Start Well programme, which is looking at maternity, neonatal and children’s surgery in North Central London. In addition, there were scheduled updates on access to primary care and dental services in the area.

Start Well

A recent public consultation sought views on the Start Well programme’s proposals for changes to maternity and neonatal services at hospitals in the area, as well as changes to provision of children’s surgery. The Committee was scheduled to hear a summary of the feedback, which included a preference for retaining services at Whittington Hospital and a call for improvements to maternal medicine, interventional radiology and antenatal and postnatal pathways.

Across all engagement activities, a substantial majority agreed that changes are needed to address current challenges facing services, with 67% of questionnaire respondents either strongly agreeing or tending to agree.

The interim feedback from the public consultation suggests there was broad recognition amongst consultees of the challenges to services. Consultees generally agreed that all neonatal units should offer the same minimum level of neonatal care. Consultees were less in favour of the proposal to consolidate maternity and neonatal care from 5 sites to 4, but tended to support Option A of the two options presented which proposed the closure of services at the Royal Free Hospital. The Committee was scheduled to hear about the reasons given for these views, as well as the fact that many consultees living near the Royal Free preferred the alternative Option B, which proposed closing services at Whittington Health.

The Committee was also scheduled to hear about the interim feedback on the proposed closure of the birthing suites at Edgware Birth Centre, whilst retaining the antenatal and post natal services that are provided at the site. The report suggests that about three-fifths of respondents agreed with this proposal, but that there was higher disagreement amongst those living closest to the site.

The interim feedback on the proposed consolidation of surgery for young children (under the age of 5) and low volume specialties at two ‘centres of expertise’ was also scheduled to be summarised for the Committee. This included proposals for a centre for emergency and planned inpatient care at Great Ormond Street Hospital for Children (GOSH), and a centre of expertise for planned day case surgery at University College London Hospitals (UCLH).

The Committee was scheduled to hear that most participants in the consultation agreed that changes should be made to improve children’s surgical services and that there was majority agreement from residents and patients that the proposal to create two new centres would benefit babies and young children.

The Committee was also scheduled to hear about the feedback from the GOSH Executive Team, which suggests that whilst they remain committed to addressing the challenges related to emergency surgical pathways, they believe the proposal for a new emergency and planned inpatient care at GOSH requires further design. They believe the ‘centre of expertise’ would be better delivered at a site with an adjacent paediatric A&E department.

Primary Care Access

The Committee was scheduled to be updated on access to primary care services in North Central London, in particular the implementation of the national Delivery Plan for Recovering Primary Care Access, which was published in May 2023.

This two-year programme involves Integrated Care Boards (ICBs) supporting GP practices to move towards the ‘modern general practice’ operating model. This includes operational and technical changes to the way GP practices work, as well as improvements to the way they interact with patients, aiming to improve patients' experience of accessing services.

The Committee was scheduled to hear about the fact that, despite more appointments being provided in general practice than ever before, patient satisfaction with access has declined nationally and in North Central London.

Dental Services

The Committee was also scheduled to hear an update on dental services in North Central London. This was scheduled to include the strategic challenges faced by the sector, as well as the progress the NCL ICB has made in the first year of being responsible for commissioning these services.

The Committee was scheduled to hear that, despite the challenges faced by the sector, the NCL ICB has increased access to primary dental services, including an increase in activity from 67% of the plan in April 2023 to 87% in March 2024.

The Committee was also scheduled to hear about the importance of the Community Dental Services, which is provided by Whittington Health NHS Trust.

All referrals for more specialist care are triaged via the CDS and result in only 8% of all referrals being sent on for treatment in Acute Care.

This was scheduled to include a summary of the work the Community Dental Services has done with rough sleepers and asylum seekers, as well as a description of their work to improve outcomes for young people with special educational needs by revising the screening programme currently undertaken into a programme of supervised tooth brushing (STB).

Work Programme

The Committee was scheduled to review its work programme for 2024/25. The next meeting of the JHOSC is expected to be held on 9 September 2024. The Committee was scheduled to consider what topics to include on its work programme for the coming year. The Committee was also scheduled to note its previously stated aim to dedicate at least one meeting per year to discussion with a wide range of community groups.

The Committee has already scheduled discussion of a finance update, the NCL Estates Strategy, and a proposed merger between the Royal Free London NHS Foundation Trust and North Middlesex University Hospital NHS Trust at its next meeting on 9 September 2024, and an update on workforce issues in November 2024. The meeting in February 2025 is scheduled to include an update on the St Pancras Hospital Transformation Programme.