The Health and Adult Social Care Scrutiny Commission met to discuss hospital pressures, alcohol harm, and the council's work plan. Key decisions included noting submissions on hospital pressures and confirming the intention to examine reablement, step-down, and discharge support in a future meeting. The commission also agreed to note reports on alcohol harm and inequalities, with observations and recommendations to be recorded.

Hospital Pressures and Close to Home Initiatives

The commission reviewed the current landscape of acute care pressures in Newham, focusing on how health and care partners are working to keep residents' care closer to home. Tom Ellis, Director of Strategy at Newham Hospital, highlighted significant pressures, noting that the Emergency Department (ED) was built for 250-300 attendances daily but regularly sees over 450, with peaks of over 500 during winter. This overcrowding contributes to corridor care, a situation the hospital is actively working to reduce, having experienced three consecutive days without it recently.

Delayed discharges were also a significant concern, with an average of 20-30 patients ready for discharge daily facing delays due to issues such as a lack of appropriate housing placements, particularly for homeless patients or those awaiting nursing or residential home places. The cost of delayed discharges nationally was estimated at £1.89 billion in 2022/23.

Charlotte Pomery, representing NHS North East London Integrated Care Board (ICB), discussed the national NHS 10-year plan, which emphasizes a shift from sickness to prevention, from analog to digital, and from hospital to community care. While welcoming these shifts, she noted a lack of clarity on available funding. The ICB is undergoing a significant restructure to reduce running costs by 50%, which will impact its operating model and lead to a reduction in place delivery teams.

Concerns were raised about the future of Healthwatch Newham, which has been discontinued as part of the NHS reforms. The ICB acknowledged the loss of its independent voice and committed to finding solutions jointly with local authorities to ensure resident experience is represented.

The commission also heard about the East London Foundation Trust's (ELFT) work on community mental health services. Michael Jones, Joint Head of Strategic Planning and Programmes at ELFT, explained that while acute mental health admissions have decreased, the average length of stay has increased significantly, with housing issues being the primary driver of delayed discharges.

Alcohol Harm, Inequalities, and Local Response

The commission examined alcohol misuse in Newham, focusing on inequalities and the local response. Fiona Hackland, Assistant Director of Commissioning for Adults and Health, highlighted that alcohol harm extends beyond dependency, contributing to cancers and negatively impacting mental health. She noted the alcohol harm paradox, where individuals in more deprived areas experience greater harm from alcohol even with lower consumption levels. Disproportionate effects were also noted in some global majority communities, with Sikh men experiencing higher rates of liver cirrhosis.

The data presented indicated that while White ethnicity had the highest rates of alcohol-specific deaths, there were concerns about under-reporting and lower service uptake among global majority communities. The report highlighted that 76% of those in treatment for alcohol misuse are male, and Newham has the seventh highest number of residents in treatment for alcohol in London.

Edward King, Assistant Director of Licensing and Regulations, detailed the Licensing Act 2003 and Newham's approach to regulating alcohol sales, focusing on the four licensing objectives. He explained the Newham Integrated Enforcement Model (NICE) and weekly GRIP meetings, which use intelligence to target premises of concern. Successful work has been done to reduce street drinking by engaging with businesses to remove high-strength, low-price alcohol from sale.

Mike Ward from Alcohol Change UK discussed innovative approaches, including the Dry January challenge and the Blue Light Approach, which supports complex dependent drinkers who frequently use public services. He highlighted that 85% of dependent drinkers nationally are not engaged with treatment services. Lauren Mulligan from Change Grow Live (CGL) Newham Rise, the borough's alcohol support service, reported an increase in the complexity of needs among those accessing treatment, particularly concerning poor physical health. CGL works with over 30 access points across the borough and collaborates with community groups to reach underrepresented populations.

The commission discussed the potential impact of Minimum Unit Pricing (MUP) for alcohol, noting evidence from Scotland showing reductions in alcohol-specific deaths and hospital admissions. While Newham does not have the power to implement MUP, it was suggested as a potential area for political campaigning.

Work Programme

The commission reviewed its work plan for 2025-26, which includes ongoing scrutiny of emerging issues, a review of leisure inequalities, updates on CQC assurance for adult social care, and further examination of Close to Home initiatives. Future substantive items will include detailed scrutiny of reablement, step-down, and discharge support, as well as the implementation of the Mental Health Action Plan and learning from a pilot community mental health service in Tower Hamlets. The commission also plans to assess local trends in alcohol-related harm and the system's response.

The meeting concluded with the confirmation of the next meeting date as Tuesday, 11 November 2025.