The Health, Wellbeing and Adult Social Care Scrutiny Committee met to discuss the Islington Safeguarding Adults Board annual report, the public health performance report for quarter 1, and the impact of smoking on life expectancy. Councillors also reviewed the committee's work programme for the upcoming year.

Islington Safeguarding Adults Board Annual Report

The committee reviewed the Islington Safeguarding Adults Board's (ISAB) annual report, which highlighted the board's activities and achievements in safeguarding adults at risk within the borough. The report detailed the ISAB's strategic priorities, emerging issues, assurance activities, and performance data for 2024-2025.

The ISAB strategy places 'PEOPLE' as its core values. The report noted that the Care Quality Commission (CQC) had awarded a rating of Good for Adult Social Care in Islington following the recent CQC assurance process.

The report highlighted several emerging topics:

• Risk management and escalation: The Creative Solutions panel received twenty referrals in the last year for people at risk of harm.
• Right Care Right Person (RCRP): ISAB partners formed a RCRP task and finish group to assure that locally the policy was implemented in a way that protected adults with care and support needs.
• Homelessness and Rough Sleeping: ISAB has strong representation at board level and also within subgroups from local rough sleeper leads, mental health and housing colleagues.
• Learning: The board completed a thematic review into multiple disadvantage and continued to evaluate the impact of the SAR 'Liam'.
• Raising awareness: ISAB continues its focus around the prevention of safeguarding adults abuse.

The report also included a case study of a home care provider that was rated as 'Requires Improvement' by the CQC. Following a Quality Audit, concerns were discussed with the provider and actions were agreed. A contract officer worked closely with the provider and monthly meetings tracked their performance against the agreed action plan. A quality audit was undertaken which found that improvements had been made, staff understood the processes and residents were happy about the service they were receiving. The Quality Improvement Process (QIP) was closed.

The report provided statistics on safeguarding concerns reported, types of abuse, and the level of enquiry. It also included data on the location of abuse, the impact of safeguarding, and the main support need of adults with concerns raised about them.

The report also included information on equality and diversity, including age, gender, and ethnicity.

The report concluded with a look at next steps, including risk management and escalation, trauma-informed practice, a whole system approach to financial abuse, and prisoners and safeguarding.

Public Health Performance Report

The committee reviewed the Public Health Performance Report for Quarter 1 of 2025/26, which set out the performance against targets for the performance indicators that fall within the Health, Wellbeing and Adult Social Care outcome area.

The report indicated positive performance overall, with targets met or exceeded across 10 of 11 indicators.

• Immunisation Coverage: While immunisation coverage remains a challenge, performance in respect of MMR2 has improved and remains within five percent of the target.
• Healthy Start Vouchers: Targets were met in respect of uptake of Healthy Start Vouchers, with 1790 families in Islington taking up the scheme in Q1 2025/26.
• NHS Health Checks: The numbers of NHS Health Checks delivered in Q1 puts the council on course to meet its annual target.
• Sexual Health: The number of residents to whom sexual health services provided Long-Acting Reversible Contraception (LARC) also puts the council on course to meet its annual target.
• Health Visiting: Islington achieved 95% coverage for New Birth Visits in Q1, meeting the local target. Q1 coverage of 6-8 week Health Visitor reviews continues its strong upward trajectory, and at 87% now exceeds the target.
• Smoking: The number of people accessing stop smoking support in Islington in Q1 puts the council on course to achieve its annual target. The council achieved a successful quit rate of 55% in Q1, meeting its target.
• Substance Misuse: In Q1, 2,063 people accessed treatment and support for drug or alcohol use, exceeding the target. Unplanned exits from drug and alcohol treatment are below the target maximum for the year to date.

The report detailed several initiatives to improve public health outcomes, including targeted outreach to communities with lower vaccine uptake, working with schools to promote pre-school immunisations, and funding Empathetic Refutational Interviewing (ERI) Vaccine Hesitancy Training for primary care staff.

The report also noted challenges, including growing vaccine hesitancy, online misinformation, and restructuring within the NHS North Central London Integrated Care Board¹ (ICB).

The report mentioned that as of 1 July 2025, the UK's routine childhood immunisation schedule was updated for children born on or after 1 July 2024. The main changes are an earlier Meningitis B (MenB) vaccine dose and the cessation of the Hib/MenC vaccine at one year. Further changes are due to take place in January 2026, including bringing forward the second dose of MMR from 3 years 4 months to 18 months and combining vaccination against chicken pox into the MMR vaccinations.

The report stated that the council has launched a local scheme to Fill the Gap between when Healthy Start payments for a child end and when free school meals commence.

Life Expectancy and Healthy Life Expectancy: Smoking

The committee discussed a report on the impact of smoking on life expectancy and healthy life expectancy in Islington. The report highlighted that smoking remains the leading preventable cause of illness, disability, and premature death in Islington, contributing significantly to health inequalities and economic costs.

The report noted that while smoking rates have declined, they remain disproportionately high among certain groups. The estimated smoking-related mortality in Islington is 240.4 deaths per 100,000 people, which is higher than London (171.3 per 100,000) and England overall (202.2 per 100,000).

The report stated that people who smoke are 50% more likely to develop cognitive impairment, particularly vascular dementia and Alzheimer's Disease, than people who do not.

The report also discussed the impact of smoking on pregnancy, noting that smoking and exposure to second-hand smoke in pregnancy significantly increase the risk of complications, including stillbirth, miscarriage, premature birth, and sudden infant death.

The report highlighted the importance of preventing smoking initiation, especially among children and young people, and supporting smokers to quit. It noted that people who smoke are three times more likely to succeed in quitting if they access support from a stop smoking service, versus trying to stop unaided.

The report also discussed vaping, noting that it is less harmful than smoking and is one of the most effective quit aids for adults who smoke. However, it is not risk-free and should not be used by non-smokers or young people.

The report mentioned the Tobacco and Vapes Bill, which will prohibit the sale of tobacco to anyone born on or after January 2009, introduce licensing for tobacco retailers, and introduce further restrictions on product formulation and advertising.

The report stated that Islington has the highest rate in North Central London for smoking attributable hospital admissions (1,728 per 100,000) and mortality (240 per 100,000) in persons aged 35 years and above.

The report detailed stop smoking support in Islington, including the community stop smoking service Breathe, provision in primary care through general practice and community pharmacy locally commissioned services, and access to Smokefree, the leading evidence-based stop smoking app, for Islington residents.

The report concluded that continued efforts to prevent smoking uptake and support more people to quit are essential to reduce the impact that smoking has on life expectancy and healthy life expectancy in Islington.

Work Programme 2025/26

The committee reviewed its work programme for 2025/26, which includes a range of topics related to health, wellbeing, and adult social care.