The North Central London Joint Health Overview and Scrutiny Committee (JHOSC) convened to discuss several key healthcare initiatives, including an update on the St Pancras Hospital Transformation Programme, the North Central London Integrated Care System (NCL ICS) finance, and the proposed reconfiguration of the NCL ICB. The committee also reviewed its action tracker and work programme for the upcoming year.

NCL ICB Reconfiguration

The committee reviewed the NCL NWL Case for Change and Options Appraisal for Merger, which proposes a full statutory merger between the North Central London (NCL) and North West London (NWL) Integrated Care Boards (ICBs). The merger aims to create a single, unified commissioner to address pressures such as a nationally imposed running-cost ceiling, rising demographic demand, and significant health inequalities.

The report considered four structural scenarios:

1. Stand-alone ICBs
2. Clustering
3. Merger, partial integration
4. Merger, full integration

The recommendation was for option 3b, a full merger with fully integrated teams, which achieved the highest composite score in an options appraisal.

The merger is expected to lead to:

• coherent strategy
• investment
• data-driven decision-making across eight boroughs
• accelerated programmes in cardiovascular disease, mental-health access and children's services
• reduction in unwarranted variation across North and West London

The merger is projected to save money by reducing staff numbers by 50%.

The report also identified risks, including:

• meeting timelines for the 2026 merger
• managing the complexity and risk of change
• integrating different cultures and ways of working
• ensuring fair share convergence in funding

A member of the public asked how all 13 local authorities would scrutinise health decisions from one merged ICB, and if there would still be JHOSCs or other overview committees carrying on this function. The ICB responded that:

It is also clear that democratic oversight and accountability remains critical and will evolve alongside the NHS and reforms to local government. Health Overview & Scrutiny Committees remain in place and ICBs will continue to engage accordingly. We continue to be committed to working closely with local authorities, including with Joint Health Oversight and Scrutiny Committee colleagues, whatever decision is made.

NCL ICS Finance Update

The committee received a finance update for the NCL ICS, which included the overall strategic direction of travel and the 2025/26 figures for the NCL ICB and for NHS Trusts that provide services to NCL patients.

Key points from the report:

• The NCL system's 2025/26 plan is a balanced position, with a planned improvement in the underlying position of £63m.
• The system is heavily reliant on non-recurrent measures to achieve financial break-even.
• 2025/26 plans are underpinned by approximately £318m of efficiency savings to be delivered.
• NCL have identified approximately £0.25bn of gross risks in the 2025/26 plans. Almost 50% of the risk relates to the delivery of the Cost Improvement Plans¹.
• The 2025/26 Core Capital allocation for NCL ICS is £249.4m.
• The ICB is required to achieve a surplus of £27.2m.

The report also noted that the latest government announcements about reducing ICB costs have not yet been factored into this plan.

St Pancras Hospital Transformation Programme

The committee received an update on the NHS's engagement and involvement approach to the St Pancras Hospital Transformation Programme. The primary aim of the programme is to transform and improve the mental and physical healthcare services that patients in North Central London receive. The proceeds from land sales have already started to deliver new healthcare facilities for patients across Camden and Islington.

The report set out the NHS's approach to the involvement of, and engagement with, patients, service users, their carers, and wider stakeholders around the programme. There are several NHS organisations that run services which are proposed to move off the St Pancras Hospital site as part of the programme. The services are commissioned by NHS North Central London Integrated Care Board (NCL ICB), which is also a partner in the programme.

The report described the services run by each organisation, the engagement and involvement activity that they have conducted to date, and next steps. It set out how the insights from this work are having tangible and meaningful impacts on decision-making.

The services that are proposed to move are:

• CNWL long term conditions, including:
  • Camden community heart failure service
  • Camden COPD and home oxygen service
  • Camden podiatry service and surgical procedures
  • Camden community diabetes service
• NLFT services, including:
  • Neurodevelopmental disorders
  • Psychodynamic psychotherapy
  • Rivers Crisis House
• RFL services, including:
  • Dialysis and renal outpatient services
  • Ophthalmology outpatient service

The committee was asked to support the targeted and focused service-based involvement approach outlined in the report, and to provide any feedback or additional suggestions to help shape the future engagement and involvement activity described.

Deputations

The committee was scheduled to hear a deputation from Haringey Keep Our NHS Public (KONP). According to the supplementary agenda, Haringey KONP planned to raise concerns about changes in health and care in NCL, particularly the planned merger of NCL and NWL ICBs, and the limited public engagement by the ICBs on their plans for the future. It is not clear from the minutes if this deputation took place.

Action Tracker and Work Programme

The committee reviewed the NCL JHOSC Action Tracker 2025/2026 and discussed items scheduled on the 2025-26 work programme.