The Joint Health Overview & Scrutiny Committee met on Thursday 23 October 2025 to discuss improvements in primary care access, updates from local healthcare trusts, and the financial position of the North East London Integrated Care Board (ICB). Key decisions included a deep dive into innovative GP access models and a review of healthcare provider performance and financial challenges.

Improving GP Access at Maylands Healthcare

Dr. Atul Aggarwal, a GP partner at Maylands Healthcare, presented a case study on how his practice has transformed primary care access. The practice implemented the X-on Health cloud-based telephone system to manage call demand and reduce patient waiting times, alongside the AI-based triage tool, Klinik. This dual approach has led to a significant reduction in missed calls, improved patient satisfaction with waiting times (rising to 68% in the 2025 survey), and a 20% reduction in overall workload. Dr. Aggarwal highlighted that the system ensures patients are directed to the most appropriate care, whether that be a GP, a pharmacist, or a physiotherapist, and that clinician-led triage remains central to the process. The practice also ensures that patients who are less digitally able are still supported through traditional phone access and staff assistance. The presentation noted that this model already meets the NHS England requirement for all GP practices to offer always-on digital access during core hours from October 2025.

Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) Update

Professor Andrew Deaner, Chief Medical Officer at BHRUT, provided an update on the trust's performance. He reported that BHRUT was close to its 80% target for urgent and emergency care performance, having achieved it in the previous week and ranking 22nd out of 121 trusts nationally. However, he noted that Tuesday of that week was the busiest day ever recorded at Queen's Hospital, highlighting significant ongoing demand. Professor Deaner also shared that over 70% of patients were seen within 18 weeks of referral, and the trust was meeting cancer targets for diagnostic speed. Financially, the trust is facing challenges, with a deficit greater than anticipated, though efforts to reduce agency staff costs have been successful. Maternity services are under scrutiny as part of the Baroness Amos inquiry, despite recent improvements noted by the Care Quality Commission. A significant upcoming development is the introduction of an electronic patient record (EPR) system on 8 November, which is expected to improve patient safety and data collection, though potential delays during the transition are anticipated.

North East London Collaborative Updates

Carol White, Deputy Chief Operating Officer for North East London Foundation Trust (NELFT), presented updates on the Mental Health, Learning Disability and Autism (MHLDA) Collaborative and the Community Healthcare Collaborative.

Mental Health, Learning Disability and Autism (MHLDA) Collaborative: The Collaborative aims to improve outcomes, quality, value, and equity for individuals with mental health issues, learning disabilities, and autism across North East London. Despite increased investment in areas like home treatment teams and a new mental health A&E (Integrated Crisis Assessment Hub), the rise in mental health crises continues, with a 200% increase in referrals since pre-COVID. The Integrated Crisis Assessment Hub, opened in March, has seen nearly 800 patients, with only 20% requiring hospital admission. A significant focus is on reaching individuals not currently known to mental health services who present at A&E. The Collaborative is also working to increase bed capacity, with plans for 30 new adult mental health beds and the development of crisis houses in various boroughs. The report also addressed concerns raised by the Mental Health Action group regarding the quality of Talking Therapies services, with NEL and ELFT providing responses to themes such as drop-out rates, therapy types, and access inequalities.

Community Healthcare Collaborative: This collaborative focuses on improving community health services through partnerships between NHS trusts, local authorities, and other providers. Key updates include the standardisation of community nursing core offers, high performance in urgent community response teams, and efforts to reduce waiting lists for musculoskeletal services. Joint work between BHRUT and NELFT aims to streamline A&E processes, improve falls prevention, and enhance stroke and diabetes care pathways. A one-stop shop for dementia diagnosis at St George's Hospital is also in development.

Finance Overview

Samuel Thacker, Director of Finance and Partnership Services at NEL ICB, presented the financial position as of August 2025. The Integrated Care System (ICS) was planning for a break-even position by the end of the financial year, but at month five, a deficit of £59.5 million was reported, an adverse variance of £30.2 million against the plan. This is largely attributed to slippage in cost improvement plans, particularly at BHRUT and Barts Health. A financial recovery plan has been submitted to NHSE, forecasting a year-to-date deficit of £54.8 million. Regarding efficiencies, the system's planned cost improvement programme for the year was £367.7 million, with £103.6 million delivered by month five, leaving a £21.8 million gap. The full-year forecast indicates a £19.6 million slippage in efficiencies. The ICB itself reported a £1.5 million positive variance against its planned deficit, contributing to a £2.5 million surplus, which was committed in the operating plan to offset provider deficits.

Other Discussions

The meeting also included a brief update on the North East London Collaborative, with a mention of the upcoming launch of an electronic patient record system at BHRUT on 8 November. Zina Etheridge, Chief Executive of the ICB, announced her departure and introduced Ralph Coulbeck as the interim Chief Executive. Discussions also touched upon the financial pressures facing the NHS, with a mandated 50% reduction in ICB running costs and concerns about its impact on frontline services. The committee noted the ongoing legal process for NELFT regarding a health and safety breach.