The North West London Joint Health Overview & Scrutiny Committee met to discuss place-based partnerships, special school nursing and the committee's work programme. The meeting was scheduled to take place at Harrow Council Hub. Councillor Lucy Knight, Chair of the Adult Social Care and Health Select Committee was in attendance.

Place Based Partnerships

A report titled, The Future of Place Based Partnerships Delivering Health and Care Services, written by David Williams, Programme Director, Integrated Care, NHS North West London ICS, was prepared for discussion. The report set out a maturity model for Place-Based Partnerships¹ (PBPs) in North West London (NWL). It outlined a framework to help local authority, health and voluntary sector partners in each place to:

• assess the PBP's current state
• identify development needs
• plan its journey towards greater maturity

The aim was to enable consistency while respecting the diversity of local contexts and the strengths of individual partnerships. The report outlined a process to confirm roles and responsibilities within each partnership.

The report noted that the NHS 10 year Plan and the ICB reforms set PBPs and neighbourhood development as central to improving healthcare. The merger of NWL and NCL ICBs, moving from 8 to 13 boroughs, makes the development of PBPs even more important in the new organisation.

The report stated that by April 2026, every borough in NWL should be operating as a mature PBP with:

• Shared strategic priorities rooted in population need
• Integrated neighbourhood teams at the heart of delivery
• Clear accountability and inclusive governance arrangements (across health and local authority)
• Coordinated infrastructure and resources to deliver effectively

The maturity model defines what 'good' looks like across six key domains:

• Leadership & Governance
• Vision & Strategy
• Service Delivery & Integrated Care Models
• Population Health Management
• Patient and Community Engagement
• Workforce Development

The report sought to answer the following questions:

• What has North West London's journey been to developing its Place-Based Partnerships?
• What successes have been achieved to date?
• What is the future direction of travel for place?
• What does a fully mature model for place look like in NWL?
• What are the roles of partners to support system success?
• What are our next steps in this process to enable system success?

The report noted that partnerships have played a vital role in managing the health and social care system, keeping people out of hospital, driving prevention, supporting discharge, improving health and well being of residents, developing relationships and supporting improved joint working.

PBPs are expected to:

• Operate as borough-level alliances
• Integrate care around residents' needs improving access, experience, and outcomes whilst coordinating the flow of activity as part of reactive services and promoting the shift from hospital-based care to community care as a promotion of proactive care.
• Coordinate budgets and delivery across partners.
• Lead on reducing inequalities, developing neighbourhood working, and embedding preventative care.
• Develop neighbourhood teams to be the delivery vehicle for health and social care within populations of 50,000-100,000

The report stated that there was a clear commitment across the system that Place is not a passive recipient of system priorities, but an active partner in shaping and delivering them.

The report also noted some ongoing challenges:

• There is a lack of a consensus around the core responsibilities of Partnerships and, by extension, the Managing Director agreement
• Legacy CCG structures continue to blur accountability, especially between ICB Borough Directors and PBP MDs.
• Current arrangements have facilitated varying degrees of Local Authority involvement

The report stated that the ambition is that by April 2026, all Places will operate with clear accountability, robust governance, and equitable infrastructure.

The report gave examples of what NWL PBPs have already achieved:

• Hillingdon: Integrated Neighbourhoods Driving Proactive Care
• Brent: Tackling Inequality and Delivering Outcomes
• Hammersmith & Fulham: Rebuilding Trust and Integration
• Ealing: Better Discharge, Better Lives
• Hounslow: Driving Change Through Joint Leadership and Targeted Investments
• Harrow: Better Discharge, Better Lives
• Bi-Borough: From Fragmentation to Focused Delivery

The report described how a mature PBP should function, stating that it will require behavioural change to ensure that there is a coordinated approach to address core needs of local population, working beyond organisational boundaries in a way that promotes sustainability across the partnership as a whole.

The report also described the roles of different partners:

• Integrated Care Board (ICB)
• Lead Provider
• All Providers
• Local Authorities

The report described the role of the Place-based 'Integrator' function, stating that there is recognition that these are future aspirations for Integrators, which will need to build and evolve over time as Place and neighbourhood working matures.

Special School Nursing

A report titled, Special School Nursing, written by David Williams, Programme Director, Integrated Care, NHS North West London ICS and Ross Graves, Chief Strategy and Digital Officer Central and North West London NHS Foundation Trust, was prepared for discussion. The purpose of the report was to provide an update on the current position of Special School Nursing provisions across North West London.

The report stated that a Core Offer for community services is a key contributor to improving outcomes and reducing variation for the NWL ICS. It also stated that Community Providers, through the collaborative have committed to developing a consistent core offer for any place to reduce unwarranted variation and drive service consistency across North West London.

The report outlined a review process:

• Collective review of the clinical model of each service historically commissioned across 8 NWL boroughs
• Core model proposal agreed at high level for each service
• Subject specific work stream informed by subject matter experts to progress from high level outline to full specification
• Review of best practice to further inform model
• Engagement with stakeholders including local authorities, primary care, acute trusts, plus other partners as appropriate to each service to inform model to inform model
• Impact analysis on service users and stakeholders/partners to inform model and implementation plan
• Gap analysis by each borough of current to proposed model to identify scale of change
• Demand and capacity review for each borough to identify:
  • Productivity opportunities
  • Investment or resource reduction position per borough
• Sign-off off by Collaborative COOs/CMOs/CNOs and NWL Clinical Advisory Group
• Implementation/mobilisation plans and timeframes agreed with partners

The report summarised changes and boroughs affected:

• Service specification outlines delegation model in line with national guidance in Children and Families Act 2014, with delegation of tasks to healthcare assistants and school staff.

• All boroughs will be affected to some extent, most significantly in Ealing where large proportion of work will be moved to school staff.

The report also outlined a Special Schools Engagement Work Plan, with the following priorities:

• Designated Clinical Officers for SEND
• Directors of Childrens Services and Local Authorities – e.g. Directors of Education
• Special Schools
• All partners and stakeholders including JHOSC

North West London JOHSC Recommendations Tracker

The North West London JOHSC Recommendations Tracker was also scheduled for discussion. The tracker included recommendations and information requests from previous meetings, including:

• Acute beds
• Ophthalmology
• Musculoskeletal (MSK)
• Palliative and end of life care
• Mental health provision for children and young people
• Alternative provision to accident and emergency
• Proposals on the future of The Gordon Hospital
• ICS Workforce Strategy and Programme Update
• NWL Elective Orthopaedic Centre
• ICS Updates: ICS Running Costs Reduction
• Primary Care Access And Same Day Access Model
• NWL Adult Community based Specialist Palliative Care (CSPC)
• NWL Involvement Strategy
• Integrated Care System Update
• North West London Planned Care Strategy
• Maternity Provisions in North West London
• Reconfiguration of the ICB and implications on services
• Adult Mental Health