The Health and Adults Scrutiny Sub-Committee met to discuss accident and emergency (A&E) waiting times, winter planning, and the committee's draft work programme. The committee heard that Royal London Hospital A&E is performing well, and discussed ways to improve performance further. They also scrutinised the Tower Hamlets winter plan, and agreed to add the Care Quality Commission (CQC) inspection findings to their work programme.

A&E Hospital Waiting Times

Dan Northam Jones, Deputy CO, Bath NHS Trust, Royal London and Mylan Hospital, gave an overview of A&E performance and transformation work. He reported a 6% increase in patients seen within four hours in the main emergency department in July, which he called a significant jump . Changes to initial assessment processes, with senior decision makers reviewing patients quickly (ideally within 15 minutes of arrival), have helped direct patients to the appropriate care setting, such as the urgent treatment centre (UTC) or same-day emergency care.

Key points raised:

• Performance Data: Overall performance in July, combining A&E and the Stepney Way urgent treatment centre, was 77%, close to the national target.
• Patient Feedback: Patient feedback is gathered through the friends and family test, with 75% recommending the service in July.
• Transformation Initiatives: A reset week with interventions to help patients get home from hospital quicker, and the REACH community emergency medicine service (delivered with the London Ambulance Service) are helping to manage demand.
• Impact of the Elizabeth Line: The opening of the Elizabeth Line has contributed to a steady increase in attendances, alongside population growth and an ageing population.
• GP Access: There were questions about how many A&E patients are attending because they cannot get a GP appointment.
• Urgent Treatment Centre: 45-50% of patients attending A&E are then sent to the UTC. There were questions about how many of these patients return to A&E because their needs were not met.
• Staffing: The hospital adheres to nationally mandated nurse staffing ratios, and provides support to staff to ensure they feel valued and supported.

Councillor Iqbal Hossain, Chair of Development Committee, noted that the A&E department was only achieving 62% against the four hour target, below the national average of 78%. Dan Northam Jones, Deputy CO, Bath NHS Trust, Royal London and Mylan Hospital, clarified that the 78% target includes both main A&E and type 3 performance, and that the overall performance in July was 77%.

Councillor Gulam Kibria Choudhury, Chair of the Health & Adults Scrutiny Sub-Committee, requested that data be provided again at the end of the year to assess progress.

Tower Hamlets Winter Plan 2025

The committee discussed the Tower Hamlets winter plan, which aims to prepare vulnerable residents for the winter season and ensure strategic coordination and resourcing are in place.

Councillor Sabina Akhtar, Cabinet Lead for Health, Wellbeing and Social Care, expressed disappointment in the quality of information provided by the North East London Integrated Care Board (ICB). She said that the report lacked crucial details about the support residents will receive during the winter months, and that it was difficult for elected members to scrutinise the delivery of health services and make recommendations.

Julie Dublin, Senior Program Manager on Planned Care and Aging Well Integrated Commissioning Division, and Paul Swindles, one of the service heads in adult social care, presented the plan, highlighting key ambitions, actions, and schemes.

Key discussion points:

• Funding: There is no additional funding for winter, but physical capacity funding has been received for specific schemes.
• Priorities: Key priorities include vaccinating staff, eliminating corridor care, and improving ambulance response times.
• Key Actions: The ICB is working to ensure patients are seen in the right place at the right time, with minimal delays.
• Winter Priority Cohorts: Focus is on older people, vaccinations, primary care, and children and young people.
• Winter Schemes: Existing commissioned services include social prescribing and community pharmacy. Proposed schemes through physical capacity funding aim to improve patient flow.
• Local Authority Perspective: The local authority has secured over £400,000 to support the discharge pathway through additional posts across hospital-based teams.
• Community Equipment Service: Following the insolvency of Nottingham Rehab Services (NRS), the council has set up a business continuity emergency service to provide community equipment.
• Vaccinations: There were concerns raised about the secondary school flu vaccination programme, particularly regarding the ingredients of the vaccine and addressing myths.

Councillor Amy Lee asked what information was missing from the report. Councillor Sabina Akhtar, Cabinet Lead for Health, Wellbeing and Social Care, responded that a more detailed breakdown of dedicated funding and how the effectiveness of its use will be evaluated would be helpful.

Councillor Leelu Ahmed asked about step-down provisions. Paul Swindles, one of the service heads in adult social care, explained that there is a range of step-down offers across the region, including local options like the four step-down units at Sue Starkey House, an extra care sheltered scheme.

Councillor Marc Francis requested a written update on the community equipment service within the next month.

The committee agreed that collaborative planning between the council and health partners is essential to manage winter pressures, support vulnerable residents, and ensure frontline staff are resilient.

HASSC Draft Work Programme

The committee considered the draft work programme and agreed to add the CQC inspection findings and responses from the council once available. They also discussed the importance of having time and space to discuss the CQC inspection as a committee.

Councillor Abdul Mannan offered an update from his children and education subcommittee, explaining that they would be figuring out the causes of school bullying, which he said was high across inner cities, and that this would turn to a lot of mental health issues. He said that he would like to take that as an outreach work, similar to what they did last year. Councillor Gulam Kibria Choudhury, Chair of the Health & Adults Scrutiny Sub-Committee, responded that they would have to think about whether it was related to their agenda.

The committee agreed to consider the draft learning disability strategy and the introduction of the neighbourhood health team at their next meeting on 11 November 2025.