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Inner North East London Joint Health and Overview Scrutiny Committee - Tuesday, 13th May, 2025 7.00 pm
May 13, 2025 View on council website Watch video of meetingSummary
The Inner North East London Joint Health and Overview Scrutiny Committee (INEL JHOSC) met to discuss a health update, financial performance, cancer services and the committee's work programme. Councillor Richard Sweden was scheduled to chair the meeting. Councillors were expected to review progress against outstanding actions and recommendations.
Cancer Services in North East London
The committee was scheduled to discuss a report on cancer services in north east London from Femi Odewale, Managing Director, and Angela Wong, Chief Medical Officer, of the North East London Cancer Alliance.
The North East London Cancer Alliance works with NHS acute providers, GPs, local authorities, public health, voluntary organisations and the local population. The report pack states that the North East London ICB continues to support the North East London Cancer Alliance, which aims to ensure everyone has equal access to better cancer services to help:
- prevent cancer
- spot cancer sooner
- provide the right treatment at the right time
- support people and families affected by cancer.
The report pack included data on cancer incidence, referrals and screening in north east London. In 2023-24, 7,735 people in north east London were diagnosed with cancer, compared to 8,133 in 2022-23. The most common types of cancer were prostate (18.4%), breast (14.8%) and lung (11.4%). The total number of people living with cancer in north east London in 2025 was 52,979, compared to 51,588 last year. In the first nine months of 2024-25, 66,118 people were referred via the Faster Diagnosis Standard for suspected cancer, of whom 63,794 (96.5%) were given the all clear.
The report pack also included data on performance against national cancer standards. In December 2024, NEL's Faster Diagnosis Standard (FDS) performance was 74.84%, below the 75% target. Performance against the 31-day decision to treat-to-treatment standard was 97.20%, above the 96% standard. NEL recorded a performance of 72.82% against the 62-day combined standard in December 2024, above the 70% target.
Screening rates for bowel, cervical and breast cancer were also included in the report pack. The report pack stated that uptake of lung cancer screening, a free scan of the lungs for 55-74 year olds who have ever smoked, has remained very positive in north east London. The lung health check attendance rate was approximately 61%, which is above the national average. Since going live, the programme has diagnosed over 100 lung cancers, with 77% in stages 1 or 2.
The report pack highlighted a number of initiatives to raise awareness, increase uptake of screening and reduce health inequalities, including:
- The You Need to Know campaign, which has expanded to focus on ovarian cancer as well as womb cancer.
- Support from Hackney Wick FC to take forward the Its Not a Game campaign.
- A pan-London cervical screening campaign with Olympic athletes.
- Cancer Awareness in Schools, which has engaged with over 5,000 pupils in the last 2 years.
- Breast Screening for Women with an SMI, in collaboration with the North East London Foundation Trust (NELFT).
- A campaign with CoppaFeel!, the UK’s only breast cancer awareness charity for young people.
- Interventions with the Turkish and Turkish Cypriot communities.
- Cancer awareness sessions delivered by Achienu Cancer Support (ACS) with supporting literature in Yiddish.
- Engagement with Gypsy and Roma Traveller (GRT) communities.
- Delivering Grass Roots Awareness projects.
The report pack also highlighted a number of initiatives to improve diagnosis and treatment, including:
- Use of Artificial Intelligence in Chest X-Rays, which has reduced the wait time for chest X-ray results from three weeks to just three days for scans with significant findings.
- Treatment clinical animations, which empower patients to understand their treatment options.
- Teledermatology at the Homerton Hospital.
- Histopathology Improvements.
- Progress to improve Multidisciplinary Team Meetings (MDT).
- A NEL Breast Pain Pathway.
- A new pathway in NEL to support patients who have unscheduled bleeding whilst on HRT.
The report pack also highlighted a number of initiatives to provide personalised cancer care, including:
- All NEL Trusts now have operational Personal Stratified Follow Up for Breast, Colorectal and Prostate.
- A Remote Monitoring System is live at BHRUT and Barts, with Homerton expected in Q4.
- Prehabilitation services have been sustained at BHRUT, Maggies and Barts Health.
The report pack also highlighted a number of initiatives to support the cancer workforce, including:
- An Oncology Workforce Review in NEL.
- Cancer MDT Enhancement.
- A Pan-London Cancer Clinical Nurse Specialist Development Lead (CDL).
- Cancer workforce scoping and mapping.
The report pack also highlighted a number of initiatives to improve communications and engagement, including:
- Attending over 80 community events in 2024 to 2025.
- A Patient and Carer Community of Practice.
- Support for Patients and Carers.
- Podcasts.
- HSJ Awards.
- Website & Social Media.
The report pack set out the priorities for 2025 to 2026, including:
- Operational performance against national cancer standards.
- Early diagnosis.
- Uptake of screening programmes, including lung cancer screening.
- Reducing health inequalities in cancer diagnosis, treatment and care.
- Improvements to priority cancer pathways: urological, gynae, breast and skin.
- Optimise the use of artificial intelligence in cancer diagnosis.
- Implement national priority recommendations from clinical audit/GIRFT reports to reduce variation in treatment in trusts not meeting the NHS-wide target.
- ACCEND: Supporting patient care, performance and productivity through enabling recruitment, retention and upskilling in key roles.
- Maintain a comprehensive approach to community and public engagement.
Health Update
Zina Etheridge, Chief Executive, NHS North East London, was scheduled to present a health update. The update included information on a new careers hub, medication shortages, staff survey results and changes to Integrated Care Boards (ICBs).
The new careers hub provides access to a range of tools and resources, including:
- Skills assessments
- Guides to the skills and qualifications needed for different roles
- Employment opportunities for students with learning difficulties, disabilities and/or Autism
- Guidance on becoming a volunteer or an ambassador.
The report pack stated that NHS North East London is aware that some people are currently affected by supply issues of some medications, including medication for the ongoing management of ADHD, and access to pancreatic enzyme replacement therapy (PERT) medicines. NHS North East London is working closely with local pharmacies, GPs, and hospitals to ensure patients can get the medicines they need, providing advice to prescribers in GP practices on alternative brands or treatments where needed, working with a regional procurement centre to import PERT from other countries, and working with specialist teams and pharmacy services in hospitals to ensure prescribers in GP practices, and community pharmacies can access the support they need to help the patients they prescribe PERT for.
The report pack included some highlights from the staff survey results, including:
- The number of staff having appraisals has increased by nearly 20% (from 46% to 65%)
- The number of staff recommending the organisation as a place to work has increased by 7% (from 32% to 39%)
- There is an increase in the number of staff who feel their team has shared objectives (increasing from 55% to 65%)
- Staff have a more positive view of managers with scores improved across several areas, ranging from 70% to 79%.
The report pack stated that NHS England (NHSE) will reduce in size by half and be merged into the Department of Health and Social Care (DHSC), and that Integrated Care Board (ICB) resource will need to be reduced by half as well, by quarter 3 2025/6 (October-December).
The report pack also included good news from NEL, including:
- Transforming diabetes care for young adults in north east London
- NEL shortlisted for award by Student Nursing Times
- Delivering more cutting-edge treatments for our patients at BHR Hospitals
- Quick procedure could cure high blood pressure at Barts Health NHS Trust
- ELFT colleagues recognised as ‘Amazing Social Work Leaders’
- New crisis support service launches in Redbridge at NELFT
- Homerton’s Research and Innovation capabilities are set to grow thanks to a share of £4.75m in funding
The report pack included operational performance data from Homerton Healthcare NHS Foundation Trust and Barts Health NHS Trust.
The report pack also included collaborative updates from the Mental Health, Learning Disability and Autism Collaborative and the Community Healthcare Collaborative.
The Mental Health, Learning Disability and Autism Collaborative is a partnership between the NEL Integrated Care Board (ICB), East London Foundation Trust (ELFT), North East London Foundation Trust (NELFT), and the seven place-based partnerships. The aim of the Collaborative is to work together to improve outcomes, quality, value and equity for people with, or at risk of, mental health problems and/or learning disability and autism in north east London.
The North East London NHS Community Collaborative (NELCC) aim is to improve community health services by working collaboratively across NHS trusts, local authorities, and other healthcare providers including, East London NHS FT, North East London NHS FT, Homerton Healthcare NHS FT and Barts Health NHS Trust.
The report pack included updates on dementia improvement, NEL Adult Neurodiversity Services Review, Mental Health, Learning Disability and Autism in 2025/26 and Specialised Commissioning Delegation.
The report pack included key updates from Community Healthcare Collaborative Improvement Networks, including:
- Children's Community Nursing
- Musculoskeletal (MSK)
- Children's autism services
- Community inpatient beds
- Rapid Response
- Community and Intermediate Care Beds
- Dietetics
- Procurement
The report pack also included key updates from other programme areas, including:
- Reducing Waiting Times
- Joint Planning for 2025/26
- Promoting the Impact of Community Services (PICS)
- Performance and Data Quality
The report pack included local developments, including:
- Redbridge ‘Well House’ opened in February with seven beds to support people experiencing a mental health crisis safely out of hospital.
- Extending opening hours to 24/7 by end of March for the Mental Health Crisis Assessment Hub at Goodmayes Hospital with four new treatment areas co-designed with service users.
- Mental health crisis café is now out to tender in Barking and Dagenham and due to go live May 2025. Havering, Redbridge and Waltham Forest also due to go out to tender shortly.
- Capital bid submitted to support the creation of additional acute mental health beds at Goodmayes Hospital.
The report pack included information for information only from Barking, Havering and Redbridge University Hospital NHS Trust, including urgent and emergency care, reducing waiting lists, cancer targets in February, finance, 24/7 service for stroke patients and other news.
Financial Overview
The committee was scheduled to discuss a report from Henry Black, Chief Finance Officer, NHS North East London, providing a financial overview of the North East London Integrated Care System (NEL ICS).
The report pack stated that at month 11, the year-to-date ICS deficit is £91.5m, with a variance to plan deficit of £86.1m. This consists of providers deficit to plan of £91.5m breakeven for the ICB. The forecast deficit was £125m, but NHS England have provided additional resource of £45m to support providers, reducing the expected month 12 deficit to £80m.
The key pressures at a system level are:
- Efficiency and cost improvement
- Run rate pressures
- Pay costs
The report pack set out the 2025/26 operating plan resource and application of funds principles. The ICS has a significant underlying deficit and the operating plan assumptions support financial recovery. The cost uplift factor (CuF) is a gross 4.15% uplift, with a 2% efficiency requirement leaving a net 2.15% inflation increase. NHS Providers will be funded for the 2.15% cost uplift factor.
The report pack stated that trusts are required to plan for a breakeven position and develop cost improvement plans (CIP) including service changes to meet this requirement. As a minimum, system plans must include at least the operating plan requirements for a 40% reduction in agency spend and a 15% reduction in bank staff.
The report pack included a summary of the 2025/26 system financial plan. After applying the required planning assumptions, every Provider with the exception of the Homerton, submitted a break-even plan for the year ahead. To deliver the plan (after the additional allocations), requires efficiencies of £367.69m to be delivered, of which £79.01m remains unidentified and a risk to plan delivery.
Scrutiny Report
The committee was scheduled to review the scrutiny report, which provides an update on the committee's work programme, action tracker and recommendations tracker.
The action tracker captures all actions required of officers by the committee at the previous scrutiny meeting and provides an update on progress. The recommendation tracker captures all recommendations made by the committee at the previous scrutiny meeting.
The forward plan included items for future meetings, including:
- Health update (to include complaints backlog)
- Big Conversation – the way forward
- Maternity review – next steps
- Finance
- Specialised Commissioning
- Primary Care
- Long Term Conditions
The forward plan also included items suggested by members, including:
- The impact of the CASS Report on the ICB Review
- An update from Sexual Health Partners outlining their provisions and campaigns
- The 10-year plan and the impact on NEL
- Royal London's implementation of a new discharge policy following the safeguarding review and coroner's report on the JL case
- Funding of Enhanced Primary Care Services across NEL from 26/27
- Services which will be transferred to the ICBs for local commissioning, which were previously commissioned at a national or regional level
- Improving outcomes for black women in maternity services
- Improving outcomes for black men in prostate cancer treatment
- NEL Community Health Services
- Update on the constitutional status of INEL and ONEL
- Response on the takeover of Operose Practices which was raised at the last meeting
- NHS Talking Therapies, for anxiety and depression programme Review (formerly known as Improving Access to Psychological Therapies, IAPT)
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Meeting Documents
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Reports Pack