The Health Scrutiny Committee meeting on 1 October 2025 focused on an update on life after stroke services in Barking and Dagenham, with discussions also touching upon appointments to the Outer North East London Joint Health Overview and Scrutiny Committee and the council's work programme. Key concerns raised included the need for improved referral pathways for stroke survivors, equitable access to specialist services, and the challenges of engaging diverse communities in preventative health measures.

Update on Life After Stroke Services in Barking and Dagenham

The committee received an update on the provision of life after stroke services in Barking and Dagenham from Charlotte Stone, System Programme Director for Long-Term Conditions. While acknowledging that people are generally seen for their six-month reviews within the expected timeframe and that standardised assessment tools are used, significant challenges were highlighted.

A major concern is the absence of a clearly defined and agreed referral process from acute care to the Community Rehabilitation Service (CRS), meaning not all eligible residents are being offered the crucial six-month review. Furthermore, data indicates limited uptake of these reviews when offered, with the reasons for this not always being clear. The capacity of the CRS could also be strained if referral or uptake levels increase.

Councillor Irma Freeborn questioned the six-month timeframe for reviews, suggesting it might be too long for some individuals, particularly considering factors like perimenopause and menopause which can increase stroke risk in women. Ms. Stone explained that national guidance recommends a six-month review, but that teams are expected to follow up earlier with those identified as higher risk or not progressing as expected.

The discussion also revealed a gap in stroke-specific services within Barking and Dagenham compared to other North East London boroughs. While general support services are available, residents have limited access to stroke-specific support for communication difficulties, exercise groups, mood management, and return-to-work programmes. Ms. Stone outlined a plan to develop a five-year strategy for community stroke services, with changes anticipated from 2027/28. In the interim, a task and finish group is working on a London-wide referral pathway for six-month reviews, and a review of Stroke Association services across North East London is planned by April 2026 to address variations in provision.

Councillor Paul Robinson raised concerns about the lowest healthy life expectancy in North East London and the implications for stroke prevention, particularly for those with high blood pressure. He also highlighted the importance of supporting individuals who have experienced a mini-stroke (TIA) and the need for preventative work. The discussion touched upon the role of community pharmacies, dental practices, and optometrists in offering blood pressure checks, and the vital role of voluntary organisations like the West Ham Foundation in reaching communities.

Several councillors emphasised the need for culturally appropriate communication and education, particularly for communities with language barriers. Ms. Stone acknowledged this, stating that the current approach of relying heavily on leaflets is insufficient and that more accessible formats, including verbal communication and potentially video, are being explored. The importance of family involvement in care and support was also stressed.

The Barking Community Diagnostic Centre's role in stroke services was discussed, with Ms. Stone noting that most stroke diagnostics currently occur in acute settings, but opportunities exist to integrate services into community diagnostic centres and integrated neighbourhood teams in the future.

Regarding early supported discharge, it was noted that approximately 47% of stroke survivors in Barking and Dagenham receive this service, which is comparable to London averages but still considered low, with a national target of 67%.

The committee also explored the biological understanding of stroke and the importance of preventative education from a young age. The analogy of a car engine was used to explain the need for clarity on how the body functions and how to maintain it. The importance of a family and community approach to tackle issues like childhood obesity and type 2 diabetes was reiterated.

Concerns were raised about engaging hard-to-reach residents, including those with severe mental health conditions, learning disabilities, or autism, who may not leave their homes. Ms. Stone acknowledged the complexity and the need for tailored approaches, working with mental health providers and specialist teams.

The discussion concluded with a call for greater collaboration between the council and health services to deliver integrated care, with Matthew Cole, Director of Public Health, highlighting the government's 10-year plan for neighbourhood health and the move towards integrated neighbourhood teams that will work across traditional organisational boundaries.

Appointments to the Outer North East London Joint Health Overview and Scrutiny Committee

The committee was asked to confirm the appointment of three members to the Outer North East London (ONEL) Joint Health Overview and Scrutiny Committee (JHOSC) for the 2025/26 municipal year. As a matter of practice, the Chair and Deputy Chair of the Health Scrutiny Committee, Councillor Michel Pongo and Councillor Donna Lumsden respectively, were nominated. The committee agreed to proceed with these two nominations and would appoint a third member at a future meeting.

Work Programme

Members were asked to note the work programme for the Health Scrutiny Committee for 2025/26, which included future discussions on GP performance, the public health grant, the rollout of weight loss injections, the impact of healthy weight commissioning, and sexual health services, with a particular focus on HIV.