The Joint Health Overview and Scrutiny Committee meeting, held on Thursday, 23 October 2025, focused on improving primary care access and provided updates on the performance of local healthcare providers and the strategic direction of the North East London Integrated Care Board (ICB). Key decisions included the adoption of new digital systems to enhance GP appointment booking and a commitment to further develop community-based healthcare services.

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 through the implementation of two key systems: X-on Health and Klinik. Facing challenges such as long telephone wait times and high demand for appointments, Maylands Healthcare introduced X-on Health, a cloud-based telephony system designed for GP surgeries, which has significantly reduced missed calls and improved staff efficiency. The Klinik system, an AI-based triage tool, allows patients to submit requests online, which are then assessed for urgency by a trained clinical team. This has led to faster, fairer access for patients, with 68% now satisfied with waiting times, a marked improvement from previous years. The practice estimates a 20% workload reduction and potential savings of up to £300,000 per Primary Care Network (PCN).

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. BHRUT is performing well in urgent and emergency care, exceeding the 80% target for patients admitted, transferred, or discharged within four hours in July and ranking 22nd nationally. However, the trust is experiencing unprecedented demand, with July being its busiest month on record. Mental health patients arriving in A&E remain a significant challenge, with an average A&E stay of 20.2 hours for these patients. BHRUT is making progress in reducing waiting lists, with 71.2% of patients receiving their first treatment within 18 weeks of referral. The trust is also meeting cancer targets for faster diagnostics and 31-day standards, though the 62-day standard is not yet being met. Financially, BHRUT is struggling with a deficit, partly due to strike action, but has significantly reduced agency staff spend. The trust is preparing to launch a new Electronic Patient Record (EPR) system, Oracle Millennium, on 8 November, which aims to improve patient safety and experience, though some delays are anticipated during the transition. BHRUT has also seen improvements in its NHS league table ranking, moving to mid-table.

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. The MHLDA Collaborative aims to improve outcomes, quality, value, and equity for individuals with mental health conditions, learning disabilities, and autism. Despite operational pressures leading to some out-of-area placements, the Integrated Crisis Hub at Goodmayes is helping to reduce A&E pressure. A new Neighbourhood Mental Health Centre has opened in Bethnal Green, and funding for two new 15-bedded wards at Goodmayes has been approved. The national funding for Mental Health Support Teams (MHSTs) in schools has fallen short of costs, and discussions are ongoing with NHS England to secure a firmer financial footing. The National Psychiatric Morbidity Survey indicates an increase in mental health conditions, particularly among young adults. The NHS 10-Year Health Plan is expected to drive the development of dedicated mental health emergency departments and 24/7 neighbourhood care models. An update was also provided on the legal proceedings against NELFT concerning a patient's death in 2015, where the trust was found guilty of a health and safety breach.

The Community Healthcare Collaborative focuses on improving community health services through collaboration between NHS trusts, local authorities, and other providers. Key updates include the standardisation of community nursing core offers, urgent community response teams exceeding national targets, and efforts to reduce waiting lists for musculoskeletal services. Joint work between BHRUT and NELFT is streamlining A&E processes and improving discharge pathways. A new dementia diagnostic model is being planned at St George's Hospital, and the phlebotomy booking system transition is complete with positive feedback.

North East London ICB Health Update

Zina Etheridge, Chief Executive of the North East London ICB, provided an update on organisational change and strategic commissioning plans. The ICB is undergoing a significant restructure to reduce running costs by 50% and focus on strategic commissioning, though the exact number of redundancies is yet to be confirmed. The new operating model will clarify responsibilities between the Department of Health and Social Care (DHSC), commissioners, and providers. Ralph Coulbeck has been appointed as interim Chief Executive. The ICB is refreshing its system strategy to align with the NHS 10-Year Plan, focusing on population health outcomes, equitable access, and enhanced productivity. Commissioning intentions are being developed across core health system provision, with providers required to produce integrated delivery plans. Neighbourhood health plans are also being developed, though further guidance is needed. The ICB's overarching mission remains unchanged, with a commitment to the Good Care Framework and tackling health inequalities through the NEL Outcomes and Equity Framework. The ICB has achieved significant savings and secured additional capital and growth allocations.

Finance Overview

Samuel Thacker, Director of Finance and Partnership Services at NEL ICB, presented the financial position as of August 2025. The ICB is currently reporting a deficit of £59.5 million, an adverse variance of £30.2 million against the planned year-to-date deficit of £29.4 million. This is primarily due to cost improvement plan slippage, with BHRUT and Barts Health not delivering their planned efficiencies. The ICB has submitted a financial recovery plan to its regulator, outlining a year-to-date deficit of £54.8 million. The total system efficiency and cost improvement plan for month 5 was £125.4 million, with £103.6 million delivered, leaving a year-to-date gap of £21.8 million. BHRUT is reporting significant efficiency slippage. The ICB itself holds a £2.5 million surplus, which was committed in April to offset provider deficits.