The Health, Wellbeing and Adult Social Care Scrutiny Committee met to discuss the North London NHS Foundation Trust's annual performance, review witness evidence related to life expectancy, and review the Quarter 4 performance report for public health. The committee noted the North London NHS Foundation Trust (NLFT) annual performance report and discussed actions to improve performance against key performance indicators. The committee also discussed strategies for reducing drug-related deaths and alcohol-related harm, and reviewed public health performance against targets, including vaccination rates and access to smoking cessation services.

North London NHS Foundation Trust Annual Performance

Prosper Mafu, Managing Director for the Islington Division in North London NHS Foundation Trust, presented the North London NHS Foundation Trust Annual Performance Update, highlighting that the NLFTKPIs) related to access to talking therapies, memory services, crisis services, and bed occupancy. The committee noted the report.

Key discussion points included:

• Talking Therapies: Councillor Tricia Clarke raised concerns about staffing shortages and the effectiveness of talking therapies, questioning whether two sessions were sufficient to assess success. Mafu clarified that two contacts were a minimum, and the trust was working with NHS England to increase the number of trainees.
• Discharge Delays: The committee discussed challenges in discharging patients who are clinically ready, with Councillor Janet Burgess MBE, Carers Champion, highlighting delays related to court of protection processes and the appropriateness of supported accommodation.
• Crisis Response: Councillor Toby North inquired about variations in crisis response times, and Mafu attributed this to staffing levels and the complexity of cases.
• Children and Young People's Mental Health Services: North also asked about children and young people's mental health services, and Mafu explained that these services in Islington are run by the Whittington Hospital.
• Memory Assessments: Burgess noted that while the Alzheimer's Society says Islington is one of the best in the country for assessments, the report's statistics seemed to indicate otherwise. Mafu clarified that the report focused on the responsiveness of assessments, particularly follow-up assessments.
• Data Specific to Islington: Councillor Asima Shaikh, Deputy Business Manager, Independent and Green Group, requested Islington-specific data, particularly on neurodevelopmental and dementia assessments. Mafu agreed to provide this data if requested by the chair.
• Trust Merger: The committee discussed the impact of the trust merger and the integrated care board (ICB) merger on the trust's work. Mafu stated that the merger had been positive, with learning between different services, and that the trust was committed to working at a borough level.

Scrutiny Review: Life Expectancy

Jonathan O'Sullivan, Director of Public Health, presented witness evidence for the scrutiny review on life expectancy, avoidable mortality, and healthy life expectancy. He explained that life expectancy is a long-term measure of the overall health and wellbeing of the population, linked to deprivation and income inequality.

Key points from the presentation:

• Life expectancy in Islington is higher for females than males, and has narrowed the gap with national life expectancy, but remains lower than London averages.
• The gap in life expectancy between the most and least deprived areas in Islington has narrowed for females but increased for males.
• Cancers, circulatory disease, and respiratory disease are the largest contributors to the gap in life expectancy.
• Avoidable mortality is concentrated in the most deprived parts of the borough.
• White and black communities have higher mortality linked to preventable deaths, while black and Bangladeshi communities have higher mortality from treatable deaths.
• The underlying trend in healthy life expectancy is positive for both males and females.

Councillor Tricia Clarke noted that Bunhill and Finsbury Park are the two most deprived boroughs in Islington, and that air quality and alcohol consumption are contributing factors to respiratory and liver diseases.

Miriam Bullock, a public health consultant, presented on drug-related deaths and alcohol-specific mortality, noting that drug-related deaths typically occur in people in their 40s, contributing to reduced life expectancy. She noted that Islington is around the middle of inner London boroughs in terms of numbers of drug-related deaths.

Key points from the presentation:

• Synthetic opioids are an emerging risk, and the council has a preparedness plan in place.
• Sexualised drug use (chemsex) is a concern, and the council is working with Antidote, an LGBTQ+ charity, to provide support.
• The council has improved its local drug information system and is hosting a new partnership panel to consider drug-related deaths.
• Being in drug treatment is protective, and the council has expanded its treatment offer.
• Alcohol-specific deaths have increased, and the average age of death is 57.2 years.
• Islington has a high proportion of adults drinking over 14 units of alcohol a week.

The committee discussed the data presented and the interventions in place to address drug and alcohol-related harms.

Public Health Performance Report

O'Sullivan and Sarah Hyde presented the Quarter 4 Performance Report for Public Health, highlighting that the council met or exceeded targets across nine of eleven indicators.

Key achievements included:

• Meeting targets for uptake of Healthy Start Vouchers.
• Exceeding targets for NHS Health Checks.
• Meeting targets for provision of Long-Acting Reversible Contraception (LARC).
• Achieving high coverage for New Birth Visits.
• Surpassing targets for the number of people accessing stop smoking support.

Challenges remain in increasing the uptake of childhood immunisations.

Councillor Toby North asked how the council was benchmarking take-up of the Good Start programme, and Hyde explained that there had been issues with the national data set, but that the council was using information on income to target the offer.

Clarke asked about the swap to stop scheme, where people are offered vaping starter kits to stop smoking, and whether this was just encouraging people onto vaping. O'Sullivan explained that it was one of the most effective ways to help people stop smoking, and that the council would monitor the scheme.

Work Programme

The committee noted the work programme for 2025/26. The next meeting was scheduled for 16 October 2025, to discuss Healthy Weight, London Ambulance Service, Adult Social Care Quarter 1, and a 12-month update on last year's scrutiny review.