The Overview and Scrutiny Committee were scheduled to meet to discuss air quality, developer contributions, the Lewisham and Greenwich NHS Trust, and the Overview and Scrutiny Work Programme for 2025-26. The meeting was open to the public, who were entitled to record the proceedings.

Overview and Scrutiny Work Programme 2025-26

The committee was scheduled to consider the draft Overview and Scrutiny Work Programme for 2025-26, with a view to recommending its approval at the Full Council meeting on 14 May 2025.

The report pack stated that the council's constitution dictates that the Overview and Scrutiny Committee is responsible for drawing up the scrutiny work programme and making recommendations to the council.

The report pack also stated that good practice guidelines suggest that an effective scrutiny work programme should be:

• Informed by the priorities and concerns of local people
• Led by scrutiny members
• Manageable and realistic
• Integrated effectively with corporate budget-making and strategic planning and policy setting processes and add value in contributing to the achievement of the Council’s corporate objectives.
• Reflect a proactive approach to driving service improvement, rather than being simply reactive in response to decisions of the Executive.

The Overview and Scrutiny Committee were scheduled to be reminded that the Centre for Governance and Scrutiny (CfGS) had previously reviewed and evaluated the council’s scrutiny function in 2023, and that the findings and recommendations from the CfGS highlighted the need to better utilise resources, in order to maximise participation, influence and impact of Scrutiny on the corporate priorities and local issues.

The report pack stated that a consultation exercise for Royal Greenwich residents was carried out from 7 – 20 April, and that residents were asked to share what issues matter to them most, so they could directly inform and influence the council’s Overview and Scrutiny Work Programme for 2025 to 2026. The short survey gave residents the opportunity to highlight what they wanted the committee to focus on in the coming year – from housing and healthcare to the local economy, public safety, and the environment.

The report pack stated that the survey on Common Place had 173 responses and 186 residents have now subscribed to receive further updates on the Overview and Scrutiny Work Programme, and that the priority areas identified by residents were:

• Crime and Community Safety: Anti-social behaviour prevention, domestic violence support, neighbourhood policing.
• Transportation: Road maintenance, buses, and railway services.
• Public Health and Healthcare: GP access improvements, vaccination outreach, health inequality reduction, food poverty programmes.

The report pack stated that a consultation exercise was also conducted with all councillors, who were asked to submit suggestions for the 2025-26 work programme, and that several of these suggestions have been included as standalone items or incorporated into existing ones.

The draft work programme included items such as:

• Questions and recommendations to the Leader of the Council, Councillor Anthony Okereke
• Waste Strategy
• Contract Management and Performance including Social Value
• Medium Term Financial Strategy Dashboards
• Equality and Equity Action Plan
• Carbon Neutral Plan Update
• Housing Revenue Account Medium Term Financial Strategy 2026-27 Budget and Rent Setting
• Medium Term Financial Strategy 2026/27+
• Cross-cutting Borough of Sanctuary
• Cross-cutting Cooperative Council / Cooperative Commission
• Metropolitan Police
• Air Quality Monitoring and Action Plan
• Borough Parks
• Town Centres Review
• Council’s Consultation Process
• Special Educational Needs and Disabilities (SEND) Assessments

Lewisham & Greenwich NHS Trust - Improving the experience of patients and the quality of services

The committee was scheduled to endorse the recommendations of the Health and Adult Social Care Scrutiny Panel regarding the Lewisham & Greenwich NHS Trust.

The report pack included a report from the Health and Adult Social Care Scrutiny Panel which stated that the panel had undertaken a comprehensive investigation into the provision of local hospital services, with particular emphasis on preparations underway for future inspections and improvements specifically within the Queen Elizabeth Hospital.

The report stated that the investigation specifically examined three core service areas at Queen Elizabeth Hospital identified by the CQC as requiring substantial improvement:

• Urgent and emergency care
• Services for children and young people
• End of life care

The report pack included a written submission from the Lewisham & Greenwich NHS Trust which stated that since 2017, the Trust has shown progressive improvement in CQC domains, particularly in caring, effective, and well-led services. The submission also stated that the Trust has a strategic aim to achieve and maintain an outstanding CQC rating across its services.

The report pack also stated that the Trust has implemented a range of completed improvement actions, including:

• The introduction of the Same Day Emergency Care (SDEC) Unit
• Deployment of Omnicell medicine cabinets
• A dedicated end-of-life care space
• Enhanced staff training in learning disability care
• The rollout of a new patient portal

The report pack stated that strategic development continues across the QEH site, with the expansion of diagnostic services and the planned opening of Ward 26 by May 2025 to support patient flow, and that oversight of improvement actions is maintained through robust governance structures including QSIG, QSPEC, and QPC, and further reinforced through regular mock inspections involving senior leaders and patient representatives.

The report pack stated that central to the Trust’s approach is the Patient Experience Strategy 2022–2025, which aims to embed a culture of co-production and patient-centred care, and that this strategy was shaped in collaboration with over 100 stakeholders and is actively supported through patient engagement forums, co-production boards, cultural humility initiatives, and real-time patient feedback mechanisms.

The report pack stated that the 2023 NHS Adult Inpatient Survey shows measurable improvement in 23 out of 38 comparable areas, notably around nursing levels, post-discharge support, and nutritional care, but that areas such as communication, pain management, discharge arrangements, and food and hygiene continue to be priorities for improvement.

The report pack stated that to further embed best practice, the Trust has launched the “Compassion in Care” programme, focused on key care fundamentals and staff accountability, and that a phased rollout is underway, with early evaluation results expected in May 2025.

The report pack included a summary of a visit to Queen Elizabeth Hospital which stated that in the Emergency Department (ED), several significant enhancements have been made since the last CQC inspection, including:

• Patients are now welcomed through a single-point sign-in at the A&E reception, and booking is managed jointly by a Streaming Nurse and Greenwich Health.
• A Triage Nurse is also present to assess patients’ conditions.
• A waiting room nurse has been added to monitor the wellbeing of patients while they await treatment.
• A water fountain has been installed in the waiting area.
• The department also features a designated “green area,” a wait-and-treat space aimed at improving flow and reducing congestion.
• Nurse staffing levels in the ED have been increased by five, now totalling 22 nurses both day and night, in response to high patient volumes.
• The hospital is undertaking infrastructural improvements to the ED streaming process using Section 106 funding. This includes the conversion of existing space into two new streaming rooms and the development of an ambulance offload area. These works are expected to be completed ahead of winter 2025.
• The introduction of Same Day Emergency Care (SDEC) has also streamlined treatment pathways, with the streaming nurse directly identifying and directing appropriate patients to SDEC, thereby avoiding unnecessary triage delays.
• Volunteer engagement in A&E and ED has increased, with volunteers playing an important role in supporting staff and improving patient experience.
• A metal detector has been installed at the ED entrance to enhance safety.
• When the A&E reaches capacity, the Urgent Treatment Centre (UTC) is contacted to review the waiting list and assist with patient intake where possible.

The report pack stated that on visiting the Acute Medical Unit (Ward 22), the task and finish group noted a rise in bed capacity from 58 to 80 over the past year, and that a business case is being developed to formally convert the space into an Administrative Ward.

The report pack stated that for patients temporarily accommodated in corridor spaces, measures have been taken to preserve dignity and comfort, including the provision of a temporary call bell, chair, locker, and portable curtain, as well as an essentials pack containing items such as earplugs, sleep masks, and toothbrushes, and that Martha’s Rule, which enables patients and families to escalate concerns about clinical care, is actively promoted with clear signage throughout the ward.

The report pack stated that in Ward 14, improvements in medical care have been supported by the introduction of the Trust’s “Compassion in Care” initiative, and that this programme, developed with input from the patient participation forum, aims to foster empathy, respect, and positive patient experiences.

The report pack stated that the hospital continues to manage a deficit of 70 beds, with approximately 26 new beds expected to come online in the near future, and that staff training around Alzheimer's and Dementia has seen strong progress, with Tier 1 training completed Trust-wide, and that Tier 2 training is now being rolled out to Band 6 staff, and it will become mandatory for Band 5 staff as part of ongoing capacity building.

The report pack stated that the red tray system, which visually indicates patients requiring assistance with eating and drinking, has been embedded in the hospital’s nutrition and hydration strategy, and that specialist training is also provided to lunchtime volunteers supporting patients during meals.

The report pack stated that overall, Queen Elizabeth Hospital is demonstrating a commitment to addressing previous CQC concerns, with visible efforts to improve care quality and patient safety in key departments, and that the hospital maintains a constructive working relationship with CQC inspectors and liaison officers, which is aiding the trajectory towards improved ratings in future inspections.

The report pack stated that during the visit, it was noted that many patients appeared to bypass the digital check-in system, and no staff were visibly present at that moment to provide guidance, and that while this may reflect a temporary lapse or variation in staffing, it highlights an opportunity to strengthen the consistency of support at the point of entry—particularly for patients who may be less confident with technology or new to the hospital environment.

The report pack stated that no volunteers were observed in the ED at the time of the visit, and that while this may have been due to scheduling or other operational factors, it suggests that volunteer presence may not yet be consistently embedded in day-to-day service delivery across all departments, and that strengthening this aspect could further enhance the overall patient experience.

The report pack stated that the metal detector installed at the Emergency Department entrance was observed to be out of operation, and staff indicated that it had not been functioning for several weeks, and that while this may be a temporary issue awaiting resolution, ensuring the equipment is operational is important to maintain the hospital’s intended security measures and provide continued reassurance for all users of the service.

The report pack included draft recommendations that the Lewisham and Greenwich NHS Trust should:

• Repair or replace malfunctioning security equipment as a matter of urgency and develop a protocol for contingency measures when safety equipment is non-operational.
• Explore opportunities to expand hours of volunteer support in Emergency Department.
• Explore clearer signage or prompts to encourage check-in compliance
• Identify and implement effective measures to protect and preserve the dignity of patients accommodated on corridor beds.

Developer Contributions (Section 106 Community Infrastructure Levy)

The committee was scheduled to consider an update on the borough’s developer contributions (Section 106¹ and Community Infrastructure Levy²) policies and processes.

The report pack stated that developer contributions help to mitigate the impact of development and support the provision of local infrastructure, and that there are two mechanisms by which the Royal Borough can secure contributions from development in the borough: planning obligations secured through a Section 106 agreement, and the Community Infrastructure Levy.

The report pack stated that CIL follows a tariff-based approach, with liable floorspace charged as a rate per sqm, and that CIL applies to any development that creates a new dwelling or creates 100 sqm or more of new or additional floorspace.

The report pack stated that the Royal Borough collects Mayoral CIL (MCIL) on behalf of the Mayor of London (since April 2012), and introduced it’s own borough CIL Charging Schedule (BCIL) in April 2015 - a multi-zone and multi-rate schedule.

The report pack stated that the Royal Borough undertook a review of it Charging Schedule in 2023/24 and adopted a new charging schedule in July 2024 (“BCIL2”) – the Royal Borough is one of seven London Boroughs to have revised their charging schedule, and that the new schedule applies to permissions granted since 24 July 2024, increased the residential charge rates across the borough.

The report pack included a table comparing Greenwich CIL Rates (£/sqm) – BCIL1 and BCIL2:

The report pack stated that the Royal Borough has collected nearly £30m in BCIL and £36m in MCIL receipts since April 2015.

The report pack stated that annual CIL receipts are entirely dependent on the timing of development; which schemes come forward in that financial year; and the instalments policy that applies to each scheme, and that in 2024/25 the borough collected nearly £5.2m in BCIL receipts.

The report pack stated that BCIL2 applies to schemes that gained permission post July 2024, and that due to the lag between sites getting permission, and works starting on site (the trigger for payment), the Borough is yet to see an increase in income from the rate changes, and that in 2024/25 99% of the borough’s CIL receipts were generated from schemes chargeable under BCIL1, with just one permission gaining permission after July 2024, commencing and becoming due in the financial year, and contributing £65k of BCIL2 to the annual receipt.

The report pack stated that overall, the CIL collected in 2024/25 came from 38 liable schemes, with 5 schemes contributing 82% of the pot.

The report pack stated that Section 106 (S106) of the Town and Country Planning Act 1990 (as amended) allows local authorities to seek planning contributions in order to make development proposals acceptable in planning terms, and that obligations are secured through a legal agreement between the applicant and planning authority, which focusses on site-specific mitigation and generally applies to schemes of 10 or more residential units and/or 1,000sqm of other use floorspace, and that obligations are secured for specific infrastructure types and contributions are subject to viability and negotiation with the developer.

The report pack stated that all S106 obligations secured through the planning process are recorded in the Royal Borough’s Excel-based monitoring system, and that contributions are received based on the payment triggers set out in the legal agreement, and are held in an account pending request to draw funds down, and that the team monitor all planning obligations, specifically in relation to any restrictions on use that may apply.

The report pack included a table providing a summary of the obligations secured and received since Borough CIL was adopted in 2015:

* This amount may duplicate obligations if included in a previous FY and then renegotiated

The report pack stated that the Royal Borough secured £9.4m of new planning obligations in 2024/25 within planning agreements, and that planning obligations are secured against defined headings or categories, and that the legal agreement will stipulate the terms under which those obligations will be received and what they should be spent on, including any restrictions.

The report pack stated that in 2024/25 RBG received £10.9m in Section 106 obligations, and that this includes £5.6m that was secured from the Mast Quay scheme as a result of the Royal Borough’s enforcement action.

The report pack stated that the collection of developer contributions is administered by the Royal Borough’s Planning Obligations Team, in the Directorate of Place and Growth, and that the team is currently made up of 3 Planning Obligations Officers and a Head of Service.

The report pack stated that the administration of CIL is managed using a system called Exacom, a specialist software that integrates with the Royal Borough’s planning system and helps to automate some of the workflows allowing for case management with built in triggers and reminders.

The report pack stated that a significant portion of officer time is spent monitoring schemes and chasing applicants for required information, where this is not provided in accordance with the process as set by the CIL Regulations.

The report pack stated that the main challenges that impact the collection of CIL are:

• Applicants failure to submit a Commencement Notice
• CIL Phasing and payments
• Instalments Policy
• Enforcement

The report pack stated that the collection of Section 106 contributions is slightly more straightforward, and that in general developers are aware of their obligations, and are prepared to work closely with officers to ensure payment once the obligations become due, and that if the S106 is not complied with, it is enforceable against the person that entered into the obligation and any subsequent owner, and can be enforced by injunction, and that in case of a breach of the obligation the authority can take direct action and recover expenses.

The report pack stated that the Planning Obligations SPD³ was adopted in 2015, and that since 2015, the planning and development context has significantly changed, with the London Plan being adopted in 2021, many changes to the National Planning Policy Framework, and the partial review of the Royal Borough’s CIL Charging Schedule in 2024, alongside various changes to the CIL regulations, and that the Planning Obligations SPD is consequently somewhat out of date and requires review.

The report pack stated that to update the Planning Obligations SPD, the Royal Borough will need to progress its own Local Plan further, and that there will likely be significant changes to the level and type of obligations required given the changes to the planning context since the SPD was adopted and the new suite of policies being developed in the emerging Local Plan.

The report pack stated that all obligations need to be in accordance with the tests set out in national planning policy and the CIL Regulations, namely that they are:

• necessary to make the development acceptable in planning terms;
• directly related to the development; and
• fairly and reasonably related in scale and kind to the development.

The report pack stated that to determine the level of obligations, viability testing of Local Plan policies must be undertaken to ensure an acceptable level of viability remains to allow development to come forward whilst meeting the policy obligations set out in the Local Plan, and that this is part of the test to ensure a Local Plan is deliverable, will be examined by an independent planning inspector, and that if obligations are set at a level that prejudices the overall viability of the majority of development in the Royal Borough, there is a risk that the Local Plan will be found ‘unsound’.

The report pack stated that once this work has been undertaken, a new Planning Obligations SPD can be drafted alongside the emerging Local Plan, to give further detail and set out the proposed formulae for calculating individual obligations, and that officers consider it is better to undertake this work once the proposed policies in the new Local Plan have been drafted alongside their supporting evidence and subjected to public consultation.

The report pack stated that the Local Plan will require two rounds of public consultation, scheduled for Summer 2025 and Spring 2026, and that after the second stage it will become clear if there are still substantive objections to policies and they will have been further refined, and that this will ensure the obligations arising from these requirements are clear, and that the SPD itself will also require public consultation prior to adoption and cannot be finalised prior to the adoption of the Local Plan, and that this means that the earliest a revised Planning Obligations SPD can be adopted is likely to be late 2027.

The report pack stated that S106 agreements often secure a number of different obligations, some are financial and some are non-financial, for example the provision of affordable housing, and that most have some implications for development viability.

The report pack stated that for major applications there are a number of items which are secured via a formula which is set out in the planning obligations SPD, including money towards GLLaB⁴ and cycle training, and that carbon off-set payments are also calculated using a formula which is a cost per tonne of carbon needed to be saved over a 30 year period to ensure the development is carbon neutral, and that this is set out in the London Plan.

The report pack stated that affordable housing can either be provided by the developer as a ‘fast track’ quantum of affordable housing or it can be negotiated on based on the outcome of a viability review, and that to benefit from a fast track scheme the development must provide a minimum of 35% of homes as affordable with 70% of those being for low cost rent, the other 30% for intermediate housing, and that on public land or industrial sites this threshold is 50% affordable.

The report pack stated that for other obligations not included in the Planning Obligations SPD or set out in London Plan policy such as affordable housing, carbon off-set payments and payments to third parties, these are negotiated on a case by case basis and often as a result of comments from consultees, and that for example, Transport for London often seeks contributions towards bus service improvements, and the NHS seeks contributions towards the delivery of health services in the borough and colleagues in education identify if there is an upcoming shortfall in school places and if so will seek a contribution towards providing new schools, and that often this is based on a formula used by the various consultees broadly based on a cost per additional resident.

The report pack stated that there may be other examples which are bespoke to a local area, for example, Charlton Riverside has quite complex redevelopment challenges in terms of the infrastructure required to serve mixed use developments, and that this includes, amongst other things new roads and upgraded flood defences, and that here, the Royal Borough along with TfL developed a figure to be applied to each new dwelling which would contribute towards the delivery of the East-West route and the Herringham Road route, and that if a developer provides the land for the route, this is then taken off the total cost apportioned to them.

The report pack stated that it is important that general infrastructure is not secured through S106 agreements, as contributions towards this infrastructure will be secured through CIL, which is levied against most developments and deals with the cumulative impact of development.

The report pack stated that where a scheme is unable to meet all of the obligations required of it, including the threshold of affordable housing, a financial viability assessment is required, and that this includes all of the details of the scheme viability such as build costs, site value and predicted profit levels, and that this is then scrutinised by the Royal Borough’s appointed consultant and the GLA viability team where it is a GLA referrable case.

The report pack stated that S106 payments must meet the tests set out in regulation 122 of the Town and Country Planning Act 1990, and that these tests require all obligations to be:

• necessary to make the development acceptable in planning terms;
• directly related to the development and
• fairly and reasonably related in scale and kind to the development

The report pack stated that CIL liabilities are different in that there is no negotiation - essentially CIL is a tax on development charged as £ per sqm of liable floorspace, and that the CIL Charging Schedule is subject to inspection to ensure viability.

The report pack stated that S106 contributions and CIL payments are there to ensure that impacts of developments are properly mitigated and meet the requirements of planning policies, and not to finance ongoing services which would be covered by payments such as council tax and business rates.

The report pack stated that where a planning obligation is required due to policies in the development plan (Local Plan or London Plan), officers must demonstrate to the developer that contributions meet the Regulation 122 tests set out above, and that on the assumption this is robustly demonstrated and it is not a viability tested scheme it would be expected that the developer would agree to the requests.

The report pack stated that where a development is a viability tested scheme and it has been demonstrated that it cannot afford all of the obligations required of it to mitigate its impacts, a decision must be made at officer level as to which ones are prioritised, and that this recommendation is then put forward to the Planning Board who would then, in determining the application, either concur with the officer’s view, defer the items for further consideration of the mitigation, or refuse planning permission if they were of the opinion that the mitigation was insufficient.

The report pack stated that when refusing an application on this basis, there would need to be consideration given to whether this would be a reasonable position to sustain were the developer to appeal against this refusal, and that officers provide advice to Members on this matter during the planning committee meetings.

The report pack stated that the Borough’s CIL rates are subject to the RICS Community Infrastructure Levy Index (published by BCIS), as per CIL Regulation 121C, and that the CIL rates are indexed based on when the CIL rate was set (“Ic”) compared to the date permission was granted (“Ip”), thereby allowing the rate to increase or decrease in line with inflation, and keeps the rates responsive to market conditions, and that larger, longer-term schemes, which are delivered in phases or under separate permissions would be subject to indexation.

The report pack stated that the Royal Borough is required to publish an Annual CIL Rate Summary, which shows how the rates are adjusted each year for inflation.

The report pack included a table showing Borough CIL 1 (adopted 6 April 2015):

The report pack included a table showing Borough CIL 2 (adopted 24 July 2024):

The report pack stated that Section 106 obligations are also often indexed, normally based on the Retail Price Index, and that officers will adjust the amount secured in the agreement by the relevant indexation, to ensure that the amount collected is responsive to market changes and inflation, and that this is important ensure that the value of older obligation remain.

Air Quality Monitoring and Action Plan

The committee was scheduled to consider an update on the Air Quality Monitoring and Action Plan and make recommendations to the Executive, if necessary.

The report pack stated that the report relates to the council’s agreed missions as follows:

• People's health supports them in living their best life
• It is easier, safer and greener to move around the borough and the rest of London
• Development delivers positive change to an area for existing and new communities
• Greenwich plays an active role in tackling the climate crisis and improving environmental sustainability, in line with our commitment of being carbon neutral by 2030
• Our Council is better at listening to communities, and communities feel they are heard
• We develop networks with communities, key partners and businesses to meet need and address challenges together
• We design our services around the needs of our residents

The report pack stated that in July 2024, the Cabinet agreed to proceed with the formal adoption and publication of the borough’s Air Quality Action Plan 2023-2028.

The report pack stated that the commissioned brief for the scrutiny report was as follows:

• Update and progress of the 10 priorities set out in the Plan.
• How is air quality in the Borough being monitored and are we in compliance with legal limits.
• What is the impact of key initiatives such as Low Emission Neighbourhoods, Schools Streets, EV Charging and green infrastructure.
• Have we identified any challenges and barriers to the plan such as funding, policy limitations and external factors like the Silvertown Tunnel.
• What collaboration has there been with stakeholders and are there any adjustments needed to meet AQAP objectives.

The report pack stated that the council maintains an air quality monitoring network of 10 automatic stations (providing real time data) and 56 diffusion tubes (passive monitoring) throughout the borough.

The report pack stated that air quality is improving and in the latest published data (for the 2023 calendar year), only one monitoring location (at Plumstead Road ) was in exceedance of the national objective level (set at 40ugm/3) for nitrogen dioxide and no site was found to be in exceedance of PM10 or PM2.5 (fine particulates) standards.

The report pack stated that the council’s current Air Quality Action Plan outlines the measures that will be implemented to improve air quality between 2023 and 2027, and that this plan is focused on 10 priority areas:

• Cleaner Development
• Increasing EV infrastructure
• Leading by Example
• Collaborating with AQ partners
• Reducing Pollution around our schools
• More active transport and use of public transport
• Energy efficient building stock
• Increasing public awareness (of air quality)
• Enhancing green infrastructure
• Reducing sources of PM2.5

The report pack stated that in June 2025, the council will be required to produce its latest Air Quality Status Report, and that this document will contain the latest monitoring data (for the 2024 calendar year) and we will be required to formally outline the progress that has been made in delivering the measures outlined within our Air Quality Action Plan, and that the council’s Air Quality Status Report is independently assessed and verified by Greater London Authority.

The report pack included a presentation which stated that the Royal Borough of Greenwich has an Air Quality Management Area (covering entire borough) declared in 2001 for exceedances of Nitrogen Dioxide and Fine Particulates (PM10).

The presentation stated that air quality is monitored at 10 Air Quality Stations providing real time data, and 56 Non-Automatic Monitoring Sites (diffusion tubes).

The presentation stated that air quality is improving, and included a table showing pollutant levels of exceedance in 2001 and 2023:

The