The Inner North East London Joint Health Overview and Scrutiny Committee (INEL JHOSC) meeting on 06 November 2024 included a scheduled discussion of a range of topics relating to the provision of healthcare in the boroughs of Newham, Hackney, Waltham Forest and Tower Hamlets by the NHS North East London Integrated Care Board. The meeting was scheduled to include a discussion of the ongoing transition of responsibility for commissioning specialised services from NHS England to the Integrated Care Board, and a discussion of some proposed changes to the way that maternity care and neonatal care are provided. The committee was also scheduled to receive an update on the financial position of the NHS in North East London, which is reporting year-to date deficit of £87.2m (ICB £9.1m, providers £78.1m), which is a variance to plan of £53.2m.

The agenda for the meeting also included the following items:

Best Start in Life: shaping future maternity and neonatal services

A report pack, the Best Start in Life: shaping future maternity and neonatal services report, was provided to the committee, which included an analysis of the projected increase in births across the four boroughs, and contained the findings from a recent public engagement exercise on the topic. The report suggested that the key themes that emerged from the public engagement included ensuring that there was sufficient capacity to meet an anticipated increase in demand for maternity services, delivering neonatal care in the most appropriate clinical setting, and addressing variation in quality, access and experience of maternity services.

Focus on Specialised Services

The committee was scheduled to receive a presentation on the subject of Specialised Services, entitled Focus on Specialised Services. The report explained that:

Specialised services are a diverse portfolio of c150 services generally accessed by people living with rare or complex conditions.

The report highlighted that the commissioning of these services was in the process of being devolved from NHS England to the Integrated Care Board, and that

Unless upstream programmes, improving productivity, encourage joint working and scoping consolidation, there will be significant growth and financial challenges with specialised services across NEL.

The report identified a number of clinical areas where improvements in the way that care is provided had resulted in better outcomes for patients and reduced demand for specialised services. For example the report described how:

Pharmacist led hypertension review project with Black patients [in Newham, Hackney and Tower Hamlets] ... demonstrated (48%) were not taking their medication as prescribed. In the short-term, patients adhered to their medicine and reduction in systolic blood-pressure and longer-term, we aim for patients to continue to manage their LTC proactively and not progress onto specialised services for stroke, cardiology and renal

Provider Updates

The committee was scheduled to receive updates from the Barts Health NHS Trust, the Homerton Healthcare NHS Foundation Trust and the East London NHS Foundation Trust, which is part of the North East London NHS Foundation Trust (NELFT)

Finance Overview

The committee was scheduled to be provided with a Finance Overview for the first six months of the financial year.

Health Update - November 2024

The committee was also scheduled to receive a Health Update - November 2024. This report was to include an update on the Integrated Care Board's progress on developing a plan for winter, which was described as maintaining a focus on:

1) Prevention, keeping people well 2) Supporting people to get urgent care in the community 3) High quality and efficient support in an emergency 4) Timely and supported discharges

The report also mentioned that the NHS England had recently published an assessment of the NEL ICB's performance. It is unclear whether this assessment was included in the meeting pack.

The Scrutiny Report

The committee was scheduled to receive The Scrutiny Report, which included the action tracker, and the forward plan. The forward plan contained a list of suggested items for future meetings:

1. Services which will be transferred to the ICBs for local commissioning, which were previously commissioned at a national or regional level. The list
    of potential services is here [https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-annex-a-final-spa-lists.pdf](https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-annex-a-final-spa-lists.pdf).
        a. What plans are in place to prepare for local delegation?
        b. How has the amount of money been calculated?
        c. What are the implications of transfer of specialist commissioning from NHSE to ICBs – notably HIV treatment and care commissioning.
2. Improving outcomes for black women in maternity services.
3. Improving outcomes for black men in prostate cancer treatment.
4. NEL Community Health Services.
5. Update on the constitutional status of INEL and ONEL.
6. Response on the takeover of Operose Practices which was raised at the last meeting.
7.  NHS Talking Therapies, for anxiety and depression programme Review (formerly known as Improving Access to Psychological Therapies, IAPT)