The North Central London Joint Health Overview and Scrutiny Committee (NCL JHOSC) met to discuss community pharmacy services, the North Central London (NCL) estates and infrastructure strategy, and the committee's draft terms of reference and work programme.

Community Pharmacy Update

The committee was scheduled to receive an update on the impact of community pharmacy services on patient care in NCL.

The update included the following points:

• Patient experience:
  • 33% of NCL patients chose to have their flu vaccination in a local pharmacy, and 60% selected pharmacy as the location for their Covid-19 vaccination.
  • 94.6% of people found pharmacies easy to access, with only 5% reporting difficulty.
  • Pharmacies were seen as the most accessible healthcare setting by 37% of people who reported difficulty accessing GP services.
  • 85% reported an overall positive experience with staff and convenience.
  • 60% were aware of the Pharmacy First scheme[^1]. [^1]: The Pharmacy First scheme allows pharmacies to give advice and NHS medicines for certain conditions without a GP appointment.
  • Of the 10,998 patients in NCL using the Self-Care Medicines Scheme (SCMS)[^2] in the last 12 months, 84% reported they would have gone to their GP if not for the scheme. [^2]: The Self-Care Medicines Scheme (SCMS) allows participating pharmacies to provide eligible patients with selected free medicines.
  • 25% of patients reported having ever delayed or skipped medications due to cost.
  • 15% had concerns about privacy during consultations.
• Community pharmacy services:
  • Essential services, such as dispensing medicines, repeat dispensing, disposal of unwanted medicines, support for self-care, and signposting.
  • Advanced services, such as flu vaccination, Pharmacy First, hypertension case-finding, New Medicine Service, and smoking cessation.
  • Enhanced services, such as the London Vaccination Service and Covid-19 vaccination.
  • Locally commissioned services, such as needle exchange, supervised self-administration, stop smoking service, emergency hormonal contraception, supply of end-of-life medicines, and the Self-Care Medicines Scheme.
• Pharmacy First service:
  • 95% of pharmacies in NCL offer the Pharmacy First service.
  • The service includes NHS referrals for minor illness and urgent medicine supply, as well as clinical pathways.
  • The two most common conditions presented to community pharmacies as part of Pharmacy First are sore throat and urinary tract infection.
• NCL Self-Care Medicines Scheme (SCMS):
  • The service is available to patients under 16 with an eligible parent, those receiving Universal Credit or other benefits that give them eligibility for free prescriptions, young people aged 16-18 in education or training, and homeless people.
  • Conditions and medicines included in the SCMS cover a range of ailments such as athlete's foot, back pain, constipation, diarrhoea, earache, fever, hay fever, head lice, minor injuries, nappy rash, ringworm, scabies, teething, threadworm, vaginal thrush, and warts and verrucas.
  • As of June 2025, 238 pharmacies were signed up for SCMS.
  • There were 10,998 consultations between June 2024 and May 2025, with 84% being self-referred.
  • 44% of patients were under 16.
• NHS blood pressure check service:
  • Free NHS blood pressure checks are available to people aged 40 and over, with general practices also able to refer patients to participating community pharmacies.
  • 89% of pharmacies in NCL are registered for blood pressure checks.
• Pharmacy Contraception Service:
  • Pharmacists can give expert advice about selecting and managing contraceptive pills.
  • Emergency Hormonal Contraception (EHC) was scheduled to be added to the national service from October 2025.
• Vaccinations:
  • Many community pharmacies are involved in providing both Covid-19 and flu vaccinations.
  • A new flu walk-in finder tool was scheduled to launch in October 2025.
• Recent and future developments:
  • The ICB is working with three Urgent and Emergency Care (UEC) settings in NCL to start referring eligible patients to the Pharmacy First service.
  • Newly qualified pharmacists will be joining community pharmacy ready to work as independent prescribers from September 2026.
  • An Independent Prescribing Pathfinders pilot has been commissioned from three NCL pharmacies.
  • NCL is supporting Barts Health with a Pilot of Point of Care testing (PoCT) in Community Pharmacy to check Lipids and calculate QRISK[^3] for selected patients. [^3]: QRISK is a tool used to estimate the risk of having a heart attack or stroke over the next 10 years.
• Your Local Health Team campaign:
  • The campaign has created content showcasing pharmacy services, promoted the NHS App, and supported residents to feel more confident in how they can improve their own health and access services.
• Self-Care Medicines Scheme:
  • Participating pharmacies provide eligible patients with selected free medicines.
  • A poster and leaflet have been translated into 18 languages.
• Free prescriptions for care leavers:
  • Eligible care experienced young people can apply for a free Prescription Prepayment Certificate.
• Sarah Sackman, MP for Finchley and Golders Green, visited Jethro's Pharmacy.

NCL Estates and Infrastructure Strategy 2025

The committee was scheduled to receive an update on the North Central London Local Care Estates 2025.

The update included the following points:

• 2024/2025 was a year of progress.
• It is important to develop a shared primary care baseline.
• Prioritising the investment pipeline and GP leadership is key.
• There is a need to build the return on investment case for 5% investment allocated to Local Care.
• Delivery of strategically important larger projects is being supported.
• A pipeline of smaller, business as usual projects is being developed.
• There is a focus on using the current fit-for-purpose estate harder and limiting voids.
• It is important to secure other sources of funding.
• Challenges exist in continuing to build the case for 5% of NCL capital envelope allocated to Local Care, further refining NCL's Local Care capital plan, supporting estates as an enabler to deliver Neighbourhood Care, further testing the affordability agenda, and continuing to deliver.
• Recent delivery in local care and key achievements include the official opening of The Muswell Hill Practice, the Welbourne Centre, Torrington Park HC Refurbishment Wood Green Community, and Diagnostic Centre – Phase 2.
• Two HSJ awards were won: Bronze award winner 2024: FMH CDC, and Gold winner 2023: Wood Green CDC.
• The Record Rooms Conversions Programme delivered 800 sqm of clinical/clinical support, with a total capital investment of £2.4m.
• The ICB aims to invest in local care infrastructure working with partners.
• NCL has in the past allocated 5% of ICS capital allocation for prioritised local care schemes.
• The 10-year capital pipeline forecast suggests a total capital requirement of £233m.
• A significant gap exists, and the ICB continues to look for additional funding sources.
• Revenue funding continues to be a challenge.
• The ICB has developed plans for primary care estate by borough, including new 'core' general practice premises, improvements to 'Flex One' and some 'Flex Two' sites, consideration of PCN hubs[^4], and consideration of Integrated Neighbourhood Team hubs[^5]. [^4]: PCN hubs are 'core' general practice sites where ARRS staff can see patients and hotdesk in larger meeting rooms and where some primary care 'at-scale' services can be provided. [^5]: Integrated Neighbourhood Team hubs are opportunities to consolidate larger multidisciplinary teams (primary care, mental health, community health, social care, potentially voluntary sector) in line with the Fuller agenda.
• The ICB has developed a comparative assessment of each GP practice across the five boroughs, with data from primary care, finance & estates.
• A correlation emerges between the quality of the estate and the service the general practice can provide.
• 39 practices have closed or merged since 2018, predominantly smaller practices operating from 'tail' premises.
• NCL updated its Infrastructure Strategy, with a strong focus on the current state of the local care estate.
• NCL's commitment to allocate 5% of capital to local care is linked to investment principles.
• The profile of the provider estates and work underway has been raised, to provide balance to wider acute activity.
• Further analysis around capital planning is recognising implications on revenue and PCDs[^6]. [^6]: The report pack does not define what PCDs are.
• There is an ongoing emphasis on the need to demonstrate delivery at both local care and provider level.
• Work is supporting ICB and trust risk management, illustrated by allocating spending to prioritised critical backlog items, as well as emphasis around exiting from tail estate.
• There is a need to optimise what is already available and manage void estate.
• Infrastructure should also align with NCL's neighbourhood care vision.
• Integrated Neighbourhood Teams (INT) build on MDTs[^7] and include NHS providers, Council teams and the VCSE[^8]. [^7]: The report pack does not define what MDTs are. [^8]: The report pack does not define what VCSE is.
• Borough Partnership work to date suggests at least 18 Neighbourhoods in NCL with populations of 60,000 – 130,000.
• Challenges and opportunities include working with national colleagues on capital funding mechanisms for Primary Care and Neighbourhoods, the multi-year nature of Local Care projects, NCL's changing financial context, the need to focus resource and manage expectations on system priorities, the importance of process criteria to differentiate between Business as Usual to manage risk and Transformational, the importance of raising the profile of this delivery to build confidence at trust and council level that allocation can be spent and delivers, the ongoing need to align estates to Neighbourhood Care given current changes, the importance of aligning estate and digital spend, and the continuing need to embed Net Zero, Core20+5[^9] & Population Health Improvement as a driver for investment decisions. [^9]: The report pack does not define what Core20+5 is.

NCL JHOSC - Draft Terms of Reference

The committee was scheduled to consider the draft terms of reference, propose amendments if required, and approve a final version to be adopted by the Committee.

The draft terms of reference outline the purpose and powers of the committee, its relationship with the Health Overview & Scrutiny Committees (HOSCs), the membership of the committee and the protocol for meetings.

The purpose of the JHOSC is to:

• Engage with relevant NHS bodies on strategic area-wide issues in respect of the co-ordination, commissioning and provision of NHS health services across the whole of the area of Barnet, Camden, Enfield, Haringey and Islington.
• Respond, where appropriate, to any proposals for change to specialised NHS services that are commissioned on a cross-borough basis and where there are comparatively small numbers of patients in each of the participating Boroughs.
• Respond to any formal consultations on proposals for substantial developments or variations in health services affecting the North Central London (NCL) area of Barnet, Camden, Enfield, Haringey and Islington on behalf of Councils who have formally agreed to delegate this power to the JHOSC.

The JHOSC is established by the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013.

The Integrated Care Board (ICB) for the NCL area covers the boroughs of Barnet, Camden, Enfield, Haringey and Islington. The JHOSC will comprise of Councillors across the same five Boroughs in order to enable effective scrutiny of the NCL ICB.

The NCL ICB should provide relevant information about any significant forthcoming reorganisation of NHS services in the NCL area to the JHOSC in a timely manner.

The JHOSC will work independently of both the Cabinet and health overview and scrutiny committees (HOSCs) of its parent authorities, although evidence collected by individual HOSCs may be submitted as evidence to the joint committee and considered at its discretion.

The JHOSC will seek to promote joint working where it may provide more effective use of health scrutiny and NHS resources and will endeavour to avoid duplicating the work of individual HOSCs.

The agenda papers of JHOSC meetings will be provided to each of the local authorities in the NCL area for publication on their websites.

The minutes of JHOSC meetings will be provided to the HOSCs for possible inclusion in their agenda papers.

The Committee shall be comprised of up to ten members in total, with a maximum of two members nominated from each of the five NCL Boroughs.

Appointments to the JHOSC will usually be approved at each authority's Council AGM at the beginning of the municipal year and expire at the end of the same municipal year.

Appointments by each authority to the JHOSC will reflect the political balance of that authority.

Members who hold an executive post shall not be appointed to the JHOSC.

It is strongly advisable that one of the members nominated by each Borough is the Chair of their local HOSC as this helps to strengthen the links between the JHOSC and the HOSCs. It may also be beneficial for the second nominated member from each Borough to be the Chair or a member of their main Overview & Scrutiny Committee (OSC).

The Committee shall appoint a Chair and up to two vice-Chairs at the beginning of the first meeting of each municipal year. This will be on a rotation basis and in borough alphabetical order.

The administrative support for each municipal year will be provided by scrutiny officers in the chair's respective borough and they will take forward a handover of work with their counterpart colleague each year between April and June to allow continuity and effective progression of actions and responsibilities.

The quorum for the Committee shall be at least four members of the Committee, and at least one member from at least four of the five Boroughs.

Member substitutes from each authority will be accepted.

The Committee shall reserve the right to consider the appointment of additional temporary co-opted members in order to bring specialist knowledge to inform specific work streams or agenda items. Any co-opted member appointed will not be permitted to vote at meetings.

Meetings of the Committee will be conducted under the Standing Orders of the Local Authority hosting and providing democratic services support and will be subject to these terms of reference.

A schedule of meetings will be agreed by the Committee at the beginning of each municipal year. The Committee shall hold five ordinary meetings of the Committee in each municipal year.

The Committee may also hold up to two further meetings in each municipal year for the specific purpose of scrutinising the draft Quality Accounts produced annually by NHS Trusts in the NCL area.

In addition to ordinary meetings of the Committee, extraordinary meetings may be called from time to time as and when appropriate.

The Committee shall be regularly consulted on the setting of items for the agendas of future meetings through a standing item on the work programme at every ordinary meeting of the Committee.

The Chair and vice-Chair(s) will usually meet with senior representatives from the NCL ICB and any other relevant NHS organisations approximately 6-8 weeks in advance of an ordinary meeting of the Committee in order to determine the agenda for the meeting and the content of the reports.

Ordinary meetings of the Committee will normally be held at 10am and are typically scheduled to last for two and a half hours.

The Committee will normally hold an informal private 30-minute meeting just before the main meeting, in order to allow Committee members to discuss any procedural issues and possible lines of enquiry relating to the reports in the agenda pack.

The venues for meetings of the Committee will normally be rotated regularly across all five Boroughs in the NCL area.

The Committee will usually endeavour to reach its decisions by consensus. However, in the event that a vote is required, each Member present will have one vote. In the event of there being an equality of votes, the Chair of the meeting will have the casting vote.

A deputation may be received by the Committee if a request stating the object of the deputation is received by the Chair and/or committee clerk at least three clear days prior to the meeting.

Work Programme

The committee was scheduled to note the current work programme for 2025-26 and the proposed agenda items for the next meeting, which is currently scheduled to take place on 12 September 2025.

The proposed agenda items for the next meeting are:

• St Pancras Hospital Programme Update
• NCL Finance Update

The JHOSC's work programme for 2025/26 includes some vacant items and a list of standing items that the Committee usually schedules each year, as well as a list of as-yet unscheduled items of which the Committee has previously indicated that it wishes to receive further updates.

Usual standing items each year:

• Estates Strategy Update
• Workforce Update
• Finance Update
• Winter Planning Update

Possible items for inclusion in future meetings:

• Terms of Reference revised version for JHOSC ToR to be discussed/approved by Committee July 2025
• St Pancras Hospital update July 2025
• Health Inequalities Fund
• NMUH/Royal Free merger
• Smoking cessation & vaping
• The efficacy of online GP consultations
• Developing technology and its role in the management of long-term chronic conditions
• Strategic role of GP Federations
• Vaccination initiatives tailored to specific local needs in each NCL Borough including outreach work with community pharmacies
• Paediatric service review
• Primary care commissioning and the monitoring of private corporations operating in this area
• Increases in number of people being charged for services that they were previously able to access free of charge through the NHS (e.g. dentistry/ear wax syringing)
• Mental Health & Community/Voluntary Sector
• Whittington Hospital merger

The 2025/26 meeting dates and venues are:

• 11 July 2025 LB Barnet
• 12 September 2025 Islington Council
• 21 November 2025 Camden Council
• 30 January 2026 Enfield Council
• 9 March 2026 Haringey Council