The North West London Joint Health Overview and Scrutiny Committee met on Thursday 14 March 2024 to discuss a range of health-related topics. Key areas of focus included the state of obesity and preventative services, primary care access, commissioning of community pharmacy and dental services, and updates on palliative care and other ongoing programmes.

Obesity and Preventative Services

The committee was scheduled to receive a report on the current state of obesity and preventative services across North West London. The report highlighted that nearly two-thirds of adults in England are classified as overweight or obese, with rates in North West London varying by borough. The report also noted that obesity prevalence is higher in areas of greater deprivation and among certain ethnic groups. The current provision of weight management services, which are organised into tiers from universal services to bariatric surgery, was to be reviewed. This includes services provided by local authorities and NHS offerings such as the national diabetes prevention programme and digital weight management programmes. The report also detailed specialist services for severely obese adults and children and young people with complications of excess weight, with plans to develop local treatment options for the latter. The need for a coherent approach linking NHS and local authority services to tackle obesity was emphasised.

Primary Care Access and the Same Day Access Model

A report was scheduled to be presented on the state of primary care access across North West London, particularly in light of recent changes to GP contracts and the announcement of the Same Day Access (SDA) Model. This model, co-developed by primary care networks (PCNs), aims to improve access by introducing 'same day access hubs'. Patients contacting their GP surgery may be directed to these hubs for triage, potentially leading to telephone, online, video, or face-to-face contact with staff who can direct them to the most appropriate service. The report was expected to detail the scope and rationale for the SDA initiative, its timeline, consultation processes, pilot evaluations, and financial, estate, staff, and equality implications. It also aimed to outline identified risks and mitigation strategies. The report referenced the national 'Fuller Stocktake' review of primary care and the 'We Are General Practice' public information campaign.

Commissioning Arrangements for Community Pharmacy and Dental Services

The committee was to receive a report on the current commissioning arrangements for community pharmacy and dental services across North West London. For community pharmacy services, it was noted that these are commissioned by NHS England. Regarding dental services, the report highlighted that children in North West London have the poorest oral health in London, with particular concerns in Brent regarding tooth decay. The report also detailed the national dental recovery plan, which includes additional investment for 2024/25 to promote access and embed oral health awareness programmes for children and young people. It outlined changes to the commissioning of dental services, with responsibilities delegated to Integrated Care Boards (ICBs) from April 2023. The report detailed current arrangements for General Dental Service providers, including the Unit of Dental Activity (UDA) system, and provided performance data by borough. Challenges related to workforce and staffing, including recruitment and retention, were also to be discussed.

Update on Community-Based Specialist Palliative Care Improvement Programme

An update was scheduled on the community-based specialist palliative care improvement programme. This included the publication of a revised model of care for adult community-based specialist palliative care services, developed following extensive engagement with patients, families, carers, and stakeholders. The report outlined five potential implementation options for delivering this new model, ranging from do nothing to full implementation with various scenarios for the Pembridge inpatient unit and enhanced end-of-life care beds. The process for appraising these options, including engagement with the London Clinical Senate and NHS England, was to be discussed. The report also covered an Equalities Health Impact Assessment (EHIA) and refreshed ten-year demand projections for hospice inpatient care.

Update on Potential Change of Control at AT Medics Ltd

The committee was to receive an update on the potential change of control at AT Medics Ltd. NHS North West London, in partnership with other London ICBs, has been conducting a due diligence process regarding this potential change. Engagement webinars for patients and the wider community were held in January 2024, where concerns were raised about the nature of the organisation taking control and its commitment to high-quality patient care. The due diligence process was ongoing, and dialogue with Operose Health Ltd continued. The request for change of control was not expected to be presented to the North West London Primary Care Executive Group meetings in March 2024 as originally planned.

Recommendations Tracker

The committee was scheduled to review the latest scrutiny recommendations tracker for 2022/23 and 2023/24. This tracker provides a summary of scrutiny recommendations made by the committee and tracks the decisions and implementation progress made by NHS bodies.

Work Programme 2023-24

The committee's work programme for 2023-24 was presented for noting. This programme is designed to be flexible and adaptable to the committee's needs.