The Health Scrutiny Committee met to discuss the provision of life after stroke services in Barking and Dagenham, and to consider appointments to the Outer North East London Joint Health Overview and Scrutiny Committee.

Update on Life After Stroke Services in Barking and Dagenham

The committee received an update on life after stroke services in Barking and Dagenham, presented by Charlotte Stone, System Programme Director for Long-Term Conditions. The discussion highlighted that while residents receive six-month stroke reviews within the expected timeframe and these are conducted using standardised assessment tools by trained staff, there are significant challenges. A key issue identified is the absence of a clearly defined referral process from acute care to the Community Rehabilitation Service (CRS), meaning not all eligible residents are being offered a review. Furthermore, data indicates a limited uptake of these reviews by residents, with the reasons for this not always being clear.

Concerns were raised about the potential strain on CRS capacity if referral or uptake levels increase. A wider North East London (NEL) mapping exercise revealed that Barking and Dagenham has a gap in stroke-specific services, such as those provided by the Stroke Association for communication support and recovery, which are available in other NEL boroughs.

Several councillors engaged in a detailed discussion about preventative measures for stroke. Councillor Rice questioned the role of baby aspirin for at-risk individuals, while Councillor Freeborn raised concerns about the six-month review period and the specific risks faced by women during perimenopause and menopause. Councillor Robinson highlighted the borough's low healthy life expectancy and the importance of early preventative work, particularly for younger individuals and those at risk due to ethnicity or lifestyle.

The discussion also touched upon the importance of culturally appropriate communication and education regarding stroke prevention and management. Councillor Lumsden and Councillor Rice specifically asked about ensuring information is accessible in various formats and languages, and how to reach hard-to-reach communities. The need for a more holistic approach, involving families and trusted community figures, was repeatedly emphasised.

Charlotte Stone explained that a five-year plan for commissioning intentions, including stroke services, is being developed. She acknowledged the need to improve communication and literacy around stroke reviews and highlighted ongoing work to standardise community stroke services across NEL. Initiatives include a NEL-wide referral pathway for six-month reviews and a review of Stroke Association services to reduce variation. The potential for sharing specialist workforces across boroughs was also discussed as a way to address national shortages in areas like speech and language therapy.

The Barking Community Diagnostic Centre's role in stroke diagnostics was clarified, with most diagnostics currently occurring in acute settings, though opportunities for integration with community services are being explored. The committee also discussed the performance of Early Supported Discharge (ESD) services, noting that Barking and Dagenham's 47% uptake is comparable to London averages but still significantly below the national target of 67%.

The conversation extended to broader public health issues, including childhood obesity and its link to long-term conditions, and the challenges of engaging working-age individuals who may struggle to take time off for health checks. The importance of a toolbox of engagement methods, including working with the voluntary sector and linking with other outreach services, was stressed.

The concept of neighbourhood health and integrated neighbourhood teams was a significant theme, with Matthew Cole, Director of Public Health, explaining how this approach aims to provide holistic care by bringing together health, social care, and the voluntary sector to address the wider determinants of health, such as housing and income. The aim is to identify at-risk individuals and prevent hospital admissions through community-based support.

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. It was noted that the Chair and Deputy Chair of the Health Scrutiny Committee are typically appointed. Therefore, Councillor Michel Pongo (Chair) and Councillor Donna Lumsden (Deputy Chair) were nominated. The committee agreed to proceed with these two appointments and would appoint a third member at a later meeting.

Other Business

The committee noted the minutes from the previous Joint Health Overview and Scrutiny Committee meeting and the Health & Wellbeing Board and ICB Sub-Committee meeting. The work programme for 2025/26 was also presented for noting.