The Health Scrutiny Committee meeting on 10 December 2025 focused on improving GP performance and addressing financial concerns within public health spending, alongside updates on a new interim health facility. Key decisions included noting progress in GP appointment accessibility and a revised approach to managing the public health grant, with a significant potential repayment to the Department of Health and Social Care averted.

GP Performance and Development

The committee received a comprehensive report on GP performance and development in Barking and Dagenham. Simon Clark, Head of Primary Care for Barking and Dagenham Place, and Dr. Kanika Ray, Place Clinical Lead for Primary Care, presented the findings. A significant achievement highlighted was the 10% growth in same-day GP appointments over four years, the largest increase in North East London (NEL), which facilitates timely access to services. In August 2025, GP practices saw over 106,000 patients, a 30% increase compared to August 2019, despite a similar number of GPs. Additional support includes over 25,000 appointments annually from commissioned hub sites and a recommissioned acute respiratory hub providing over 3,000 appointments during winter months.

The report also noted that five practices in Barking and Dagenham are ranked in the top 10 percentile for improvement in the GP Patient Survey across NEL, making the borough the second most improved. Immunisation rates have also seen significant improvement, with Quality and Outcomes Framework (QOF) achievement for vaccinations and immunisations more than doubling between FY 2021/22 and 2023/24. Furthermore, ten practices were among the top 26 in NEL for flu vaccination coverage among over-65s, making Barking and Dagenham the best-performing borough in this category. Other achievements include leading London for data quality in GP records and national recognition for health inequalities work.

Regarding population growth, the borough's GP-registered population has increased by 16% over the past decade, with forecasts predicting a further 25% rise by 2040, making it the fastest-growing borough in NEL. This growth, particularly in areas like Bean Park and Barking Town Centre, necessitates proactive planning for healthcare provision.

During the discussion, Councillor Chris Rice raised concerns about delays in specialist referrals and communication between primary and secondary care. Dr. Ray clarified that while primary care referrals are not delayed, waiting lists exist within secondary care, a nationwide issue. She also confirmed that cancer referrals are prioritised. Councillor Irma Freeborn inquired about the basis of same-day access appointments and the availability of walk-in appointments for patients less reliant on digital or telephone access. Dr. Ray explained that practices prioritise and navigate appointments based on the reason given, directing patients to the most appropriate professional, which could include pharmacists or social prescribers. She also confirmed that all practices should offer walk-in, telephone, and online options.

Councillor Paul Robinson questioned the plans to sustain service delivery given the increasing patient numbers and static GP numbers. Simon Clark explained that while the Integrated Care Board (ICB) has limited influence on GP recruitment, they are investing in programmes like the GP fellowship programme with Queen Mary University to attract and retain GPs. However, he acknowledged that retaining GPs in the area is challenging due to high workload and the lack of London weighting for salaries.

Councillor Donna Lumsden enquired about the incident at King Edwards Medical Centre due to a burst water main. Simon Clark confirmed that the ICB offered support, including temporary space, and that the practice is currently operating from alternative sites with IT infrastructure support. He offered to provide a more up-to-date update outside the meeting.

Councillor Paul Robinson also asked about ensuring patient safety with remote appointments. Dr. Ray explained that patients have a choice of appointment type, and triage processes are in place to determine if a face-to-face consultation is necessary. Safety features, such as red flag alerts in online consultation systems, are also utilised.

Councillor Donna Lumsden raised concerns about the electronic healthcare record system and the ability to feedback results between hospitals and primary care. Dr. Ray acknowledged that Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) is experiencing glitches with their new electronic system, causing delays in receiving results and letters, but the trust is aware and working to resolve these issues.

Agnes, representing Healthwatch, highlighted feedback from the community regarding difficulties in booking GP appointments, particularly the long phone queues and lack of online platforms in some practices. Dr. Ray acknowledged the challenge, stating that mandatory online consultations are an attempt to reduce the morning rush, but many residents prefer to phone. She noted that workforce issues contribute to delays and advised practices to encourage online consultations, which can streamline the triage process.

Councillor Lumsden also asked about the tactics used by the top-performing practices for flu uptake and the expected coverage uplift for the next season. Simon Clark stated that successful practices often have focused teams and robust call and recall processes. He also mentioned the make every contact count approach, where vaccinations are offered during other appointments. Matthew Cole, Director of Public Health, added that a task force has been established to improve coverage for priority immunisations like flu, COVID-19, and RSV, and also MMR due to rising measles cases. He highlighted the importance of community engagement and addressing hesitancy, particularly on social media.

Councillor Robinson questioned how Barking and Dagenham compares to other NEL boroughs on key survey measures and the timeline for reaching the NEL median. Simon Clark stated he would provide this detailed analysis outside the meeting.

Financial Review of Public Health Spend

Councillor Maureen Worby, Cabinet Member for Adults, presented a report on the financial review of public health spending for 2022/23 and 2023/24. The review, prompted by an independent assessment and an LGA peer review, identified potential non-compliance with the eligibility criteria for the ring-fenced public health grant. A forensic review concluded that approximately £1.8 million of the grant may have been used inappropriately, with £1.238 million relating to 2022/23 and £0.565 million to 2023/24. This included £0.675 million allocated to support General Fund savings in 2022/23 and unreported underspends.

However, Councillor Worby announced that the Department of Health and Social Care (DHSC) has confirmed that a repayment of £1.8 million is not required. This decision was based on the council's agreement to repay the identified monies internally from the General Fund to the Public Health grant and the high level of cooperation and transparency demonstrated by the council in addressing the issue.

To strengthen financial management, a Public Health Grant Executive Assurance & Oversight Board has been established, chaired by the Strategic Director Children and Adults. Budgetary responsibilities have been clarified, with the Director of Public Health now having clear oversight of all public health grant spend. Monthly monitoring meetings, quarterly reviews of spend against budget, and detailed budget reconciliations are now in place. Memorandums of understanding are being signed by heads of service to ensure compliance.

Looking ahead, from April 2026, the public health grant will be consolidated, and councils will undergo mandatory peer reviews every five years. Matthew Cole, Director of Public Health, explained that while the consolidation of grants will make management more complex, the council is preparing for these changes. He also noted that the council's healthy life expectancy is among the lowest in the country, and future commissioning will be reviewed to ensure alignment with government outcomes frameworks and to target areas that will make a significant difference.

Councillor Irma Freeborn asked about delivering best value and reducing health inequalities. Matthew Cole stated that a stronger focus on impact and value for money is being implemented, and the council is reviewing its investments to demonstrate this. He also highlighted the strong relationship with partners, including the ICB, and the potential for pooling prevention monies.

Councillor Paul Robinson enquired about internal and external audit arrangements and the value received for preventative programmes. Matthew Cole confirmed that external auditors Grant Thornton are involved, and internal audits are conducted regularly. He also noted that while smoking cessation is performing well, challenges remain with new communities driving up smoking rates, necessitating investment in enforcement against illegal tobacco. He also highlighted the need to focus on the 0-5 age group and young working-age adults to improve healthy life expectancy.

Councillor Worby added that measuring outcomes for some preventative programmes can be challenging, but this does not mean they should be unfunded. The focus is on ensuring robust governance to guarantee funds are spent as intended.

Regarding the miscellaneous spend category, which has been flagged nationally for review, Matthew Cole stated that the council details its miscellaneous spend and provides memorandums of understanding to the regional team to demonstrate compliance. He expressed confidence that the council's position is strong due to the work undertaken over the past year.

Councillor Chris Rice asked about a strategy to encourage residents to use the new dental seats at Queen Mary University. Matthew Cole confirmed that arrangements are in place, with capital fitting out underway. He mentioned existing programmes for children's dental health and the need for more adult-focused campaigns. Councillor Worby added that the new dental facility will offer later evening and Saturday appointments, and there is a hope to retain students from Queen Mary University to practice in the borough. Agnes asked if community dental services would be offered for people with disabilities, which was confirmed.

Interim Health Facility Barking Riverside Update

Kelvin Hankins, Deputy Director of Barking and Dagenham Place Team, provided an update on the interim health facility at Barking Riverside. The development is planned for up to 50,000 residents, with approximately 5,000 currently residing there. A new health centre is under development, but an interim solution is needed. Barking Riverside Limited (BRL) has offered a unit on The Circus, covering fit-out costs and some operational subsidies. The initial budget of £650,000 has increased to an estimated £950,000 due to the need for specific healthcare ventilation and other requirements. BRL is seeking additional funding from the Strategic Community Infrastructure Levy (SCIL) fund.

A significant challenge has been procuring a fit-out contractor due to the building's high-risk building status under the Building Safety Act 2022, which has deterred specialist contractors. BRL is exploring options with the ICB, including utilising the expertise of NHS Property Services or Community Health Partnerships. A new procurement for the fit-out is expected in January, with the process taking approximately three months.

The procurement for the primary care GP service provider is underway, with a contract award targeted for July 2026 and a contract start date of 1 October 2026. An interim solution, involving commissioning a local GP practice to provide sessional GP clinics, will be in place if the building is ready before the new provider is mobilised.

Councillor Irma Freeborn suggested informally approaching the regulator for advice on dealing with high-risk buildings, as this is likely not an isolated issue. Kelvin Hankins confirmed that BRL is consulting with experts and that a regulator's recommendation would de-risk the process for contractors.

Councillor Paul Robinson questioned the future-proofing of the facility, noting the limited space for five clinical rooms. Kelvin Hankins explained that this is a standard GP practice, primarily for GPs and nurses, and that non-clinical services might be delivered in other spaces on the Barking Riverside site. The facility is estimated to serve a list size of around 8,000 residents. He also acknowledged that if a larger health centre is not achieved, another interim facility may be needed at the other end of the site as the development progresses.

Councillor Ajanta Deb Roy asked about access for vulnerable people. Kelvin Hankins stated that the practice would operate a vulnerable persons list and have access to the same services as other GP practices, with adjustments made for individual needs.

Councillor Irma Freeborn inquired about community input into the interim and long-term practice. Kelvin Hankins confirmed significant engagement with Barking Riverside residents, led by BRL, with support from Dr. John, who runs GP pop-ups in the area. A joint communications strategy is in place, and a national neighbourhoods programme is engaging residents.

Councillor Paul Robinson asked if the joint task and finish group is the only mechanism for accountability and if updates are provided to the public. Kelvin Hankins explained that updates are provided at major step changes, and a joint communication to residents about the current status and next steps is due in the next month.

Regarding the cost increase for fitting out the temporary unit, Kelvin Hankins explained that the initial £650,000 was an estimate, and the £950,000 figure reflects more detailed assessments of necessary modifications, such as ventilation systems. The open tender process will provide a clearer understanding of final costs.

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

The committee was asked to appoint one further member to the Outer North East London (ONEL) Joint Health Overview and Scrutiny Committee (JHOSC) for the 2025/26 municipal year. Councillors Michel Pongo (Chair) and Donna Lumsden (Deputy Chair) were already appointed as standard practice. The report outlined the role of JHOSCs in scrutinising health matters that cross local authority boundaries and noted that the ONEL JHOSC comprises representatives from Barking & Dagenham, Havering, Redbridge, and Waltham Forest.

Work Programme

The committee noted the work programme for 2025/26, which includes topics such as the rollout of weight loss jabs, the early impact of healthy weight commissioning, and sexual health clinic services, with a focus on HIV.