This meeting of the Inner North East London Joint Health and Overview Scrutiny Committee was scheduled to receive reports on a variety of topics affecting the NHS in North East London. It was also scheduled to receive an update on the work of the Best Start in Life programme, which is currently looking at how maternity and neonatal services could be delivered in the future. It should be noted that this summary is based on the documents provided to the attendees for the meeting and does not describe what was actually discussed, or whether any decisions were actually made.

Maternity and Neonatal Services

The Committee was scheduled to hear an update on the Best Start in Life programme. This programme has been set up to consider potential changes to maternity and neonatal services in North East London. The programme is currently in the early stages of development and no decisions about future services have been made.

The report pack provided to attendees for the meeting includes a summary of the public engagement that was carried out on the Case for Change document, which was published earlier this year. This document explains the challenges and opportunities facing maternity and neonatal services in North East London.

The engagement summary notes that the most common issues raised were around matching demand and capacity across the system, delivering neonatal care in the appropriate setting, and strengthening antenatal and postnatal care pathways. The Committee was scheduled to hear more about how the engagement feedback will be used to inform the next stage of this work, which is the development of potential models of care.

The Committee was also scheduled to be reminded about the demographic challenges that face the service in North East London. Birth rates in Barking and Dagenham are projected to increase by 36% over the next 18 years, while birth rates in Havering are projected to decrease by 2%. It was also noted that the fertility rate in Barking and Dagenham is 64.4 per 1000 women of child bearing age, which is the highest in London.

Specialised Services

The Committee was scheduled to be provided with an update on specialised services in North East London. The report pack explains that specialised services are a diverse portfolio of around 150 services that are typically accessed by people with rare or complex conditions. The cost of providing these services is rising, and demand is growing faster than the rate of population growth. It is noted that the budget for specialised services in North East London represents around 20% of the total NHS commissioning budget.

The Committee was scheduled to hear about the benefits and opportunities of Integrated Care Boards (ICBs) taking on the responsibility for commissioning specialised services. The report highlights that ICBs will be able to pool specialised budgets and non-specialised budgets to meet the needs of their local population and tackle inequalities in their area. It also notes that ICB-led commissioning should lead to better joined up care, as ICBs and providers will be able to work together more closely to improve communication and the sharing of information. The report pack includes several case studies from across North East London which are given as examples of where good work is already taking place. These examples include work on HIV and Hepatitis, Cardiology, Neonatal services, and Respiratory problems.

The report pack provided to attendees of this meeting contains a detailed description of the challenge of Human Immunodeficiency Virus in North East London. The Committee was scheduled to hear that:

All NEL ‘places’ have been identified as having a very high number of HIV diagnoses (>5/1000) and on average one in 12 people living with HIV do not know they have it.

The Committee was scheduled to hear that work is taking place with local communities and charities to tackle stigma and to raise awareness of the importance of getting tested.

Health Update

The Committee was scheduled to hear a general update on the work of the NHS North East London Integrated Care Board.

The report pack notes that Jacqui Smith, who was the Chair in Common of Barts Health NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust, has stepped down from this position to take up a governmental position. The Boards of these two Trusts are recruiting new Chairs.

The Committee was also scheduled to hear about the opening of several new health centres in North East London, including the Beam Park Health Centre in Rainham, the Lower Clapton Health Centre in Lower Clapton, and the Ilford Exchange Health Centre in Ilford.

The Committee was scheduled to be provided with an update on the review of elective surgery contract specifications. It is noted that the ICB is reviewing the specifications used to accredit providers of surgical services for ear, nose and throat, gastroenterology, general surgery, gynaecology, ophthalmology, trauma and orthopaedics, and urology. The report pack explains that this review is taking place to:

ensure services provide high-quality care, follow best practice guidelines, reflect the changing needs of our population, reduce health inequalities and represent value for money.

The Committee was scheduled to hear about the public engagement that is taking place as part of this review. A survey is open until 17 October 2024, and workshops are taking place with clinical and service providers.

The Committee was scheduled to be provided with an update on NHS North East London's plans for winter. The report pack explains that planning for winter is underway and is being aligned with the Urgent and Emergency Care (UEC) Transformation Plan.

Finance Overview

The Committee was scheduled to hear a report on the current financial position of the NHS in North East London. The report pack explains that the year to date deficit for the NHS North East London Integrated Care System (ICS) is £87.2m. This is made up of a £9.1m deficit for the ICB and a £78.1m deficit for provider trusts.

The Committee was scheduled to hear about the key drivers for overspends at a provider level, including pressures caused by increased demand for services, slippage on efficiency savings, and the impact of industrial action.

Provider Updates

The Committee was scheduled to hear reports from the Chief Executives of Barts Health NHS Trust, Homerton Healthcare NHS Foundation Trust, and East London NHS Foundation Trust.

The report pack explains that Barts Health has treated almost 18,000 people who had waited for more than 65 weeks for a planned appointment in the last six months. This has reduced the number of people waiting for more than 65 weeks for treatment to 590. The Committee was scheduled to hear that the Trust's emergency departments at The Royal London, Newham, and Whipps Cross hospitals remain busy.

The report pack notes that the Homerton has reduced its spending on agency staff by £6.3m in the first six months of this financial year.

The Committee was scheduled to hear from Lorraine Sunduza OBE, Chief Executive of East London NHS Foundation Trust, about the work of the North East London Mental Health, Learning Disability and Autism Collaborative, and the North East London Community Health Collaborative.

Scrutiny Work Programme

The Committee was scheduled to review and approve the minutes of its previous meeting which was held on 24 April 2024.

The Committee was also scheduled to review and approve its Forward Plan for the rest of the 2024-25 municipal year. The forward plan included in the report pack for this meeting indicates that the Committee was scheduled to consider a Primary Care report at its meeting on 05 March 2025, and that this report would include updates on two previously agreed actions:

• Officers to bring a case study to a future meeting which demonstrates how a practice could reduce its waiting time for non-urgent appointments to two weeks.
• NHS to report on performance monitoring data for those practices that have implemented new telephony systems.

The Committee was also scheduled to review its Action Tracker and Recommendations Tracker. The Action Tracker includes a request for an update on the role of Community Pharmacy services in primary care, which is expected to be provided at a future meeting. The Committee was also scheduled to be provided with an update on the constitutional status of the Inner North East London and Outer North East London Joint Health and Overview Scrutiny Committees.

The report pack for this meeting also includes a list of suggested items for future meetings, including services that will be transferred from NHS England to local ICBs, improving outcomes for Black women in maternity services, improving outcomes for Black men in prostate cancer treatment, and NHS Talking Therapies.