The Adult Social Care & Health Select Committee met on Tuesday 29 April 2025 to discuss cancer screening outcomes, supported accommodation for older people, and the committee's work programme. Key discussions included the challenges in cancer screening uptake within the borough and plans to address these, as well as the growing demand for specialist accommodation for older residents.

Cancer Screening and Outcomes

The committee received an update on cancer screening participation and outcomes in the Royal Borough of Kensington and Chelsea (RBKC). It was noted that London, in general, has the lowest cancer screening participation rates in the country, and RBKC, despite its affluence, has the lowest rates in England. This is attributed to factors such as population mobility, higher rates of private healthcare, and a significant proportion of residences being second homes or occupied by residents who spend extended periods outside the UK.

Despite these challenges, there have been some improvements. Bowel cancer screening coverage in RBKC increased by 12% between 2019 and 2024, though it remained unchanged between 2023 and 2024. Cervical cancer screening saw a decline of 3% but increased by 1% between 2023 and 2024. Breast screening coverage declined by 10% overall between 2019 and 2024, but saw a significant increase from 34% to 46% between 2023 and 2024. However, RBKC remains below the North West London (NWL) and London averages for breast, cervical, and bowel screening coverage.

Various initiatives are underway to improve participation and reduce inequalities, including partnership working, data analysis, community engagement, improved access to screening, and transforming screening services. NHS England London has committed to eliminating cervical cancer by 2040 through improved screening and HPV vaccination rates, with plans to introduce self-screening in selected practices in 2025.

The committee was asked to note the report and consider further actions to address low uptake and inequalities, and how partnership working could be optimised.

Supported Accommodation for Older People

The committee discussed the provision of specialist accommodation for older people in RBKC. Population projections indicate a significant increase in the older population, leading to a greater need for support services, including specialist accommodation. There is an existing waiting list for extra care housing, and a predicted increase in demand necessitates the provision of new units, such as the planned 65 units at Lots Road.

While demand for care home placements is returning to pre-pandemic levels, the complexity of needs is increasing, with a majority of demand being met by out-of-borough services. The report highlighted the need to assess the cost and quality effectiveness of increasing in-borough care home provision and to consider alternative commissioning approaches, including out-of-borough options. Factors such as demographic projections, digital solutions, and medical advancements will also influence future provision.

The report noted that the average age of residents in extra care provision is 79, and in care homes is 83. The council's focus on supporting residents to live independently for as long as possible is reflected in an increase in homecare services and technology-enabled care. However, the rising demand for placements for older residents with severe mental health conditions or challenging behaviour related to advanced dementia is changing the profile of services and the skills required for social care staff.

The council is progressing plans to increase specialist accommodation, collaborating with the West London Commissioning Alliance for out-of-borough access, and encouraging market development. The report also acknowledged the challenges of high land prices in RBKC, the scarcity of available land, and the impact of staffing shortages and costs on the provision of care. The viability of developing or block-funding out-of-borough offers, particularly for residents who wish to retire to the country or coast, was also raised.

Work Programme Report

The committee reviewed its work programme for the municipal year 2024/2025 and began considering items for the following year. Proposed items for the meeting on 18 June 2025 include discussions on dentistry and oral health, an update on community pharmacies, and a report from Public Health on the forthcoming pharmaceutical needs assessment. A scrutiny workshop for all non-executive and Select Committee members is scheduled for 3 June to discuss priorities and agenda items for the new municipal year. The report also noted potential implications for the North West London ICB due to anticipated reductions in Integrated Care Board running costs.