The North West London Joint Health Overview and Scrutiny Committee met to discuss urgent and emergency care, primary care access, continuing healthcare criteria, and special educational needs continence services. Councillor Ketan Sheth, Chair of the Community & Wellbeing Scrutiny Committee, was scheduled to chair the meeting. The committee was also expected to review its recommendations tracker and work programme for the 2025/26 municipal year.

Urgent and Emergency Care Delivery

A report on urgent and emergency care across North West London was prepared by Melissa Mellett, Associate Director UEC. It noted that North West London was operating as a single integrated system across acute, community, mental health, London Ambulance Service (LAS), primary care and local authorities.

The report stated that key achievements included:

• The launch of the Integrated Care Coordination Hub (ICC).
• Record levels of Same Day Emergency Care (SDEC).
• Strengthened community and mental health alternatives.
• Improved handover, response and ED performance.
• Evidence-based impact for high need and underserved groups.
• Digital front door and Optica roll out.
• Discharge performance and flow improvements.

It also noted that challenges remained around rising demand, mental health waits, community workforce fragility and virtual ward utilisation.

The report stated that winter plans had been stress tested across multiple demand and capacity scenarios and were jointly owned across acute, community, mental health and social care partners.

Implementation of the Same Day Access Model in Primary Care

The committee was scheduled to discuss the implementation of the same day access model in primary care, referencing the Integrated Care Board's (ICB) revised strategy for improving access and how online consultations support same day access.

The discussion was expected to cover:

• An overview of the access programme and access specification.
• Specification progress across key targets.
• Performance metrics across North West London.
• A vision for change management during surges.
• Continuous improvement in access into wider primary care.
• Building on neighbourhood health and value for money initiatives.
• Findings from engagement activities, including the GP Patient Survey, and 2024/25 patient and staff feedback.
• ICB communication with residents and practices on access plans.
• Primary Care Network (PCN) led approaches to engage patients and communities.
• The General Practice Action Plan to tackle unwarranted variation.
• Ongoing work to ensure equitable access provision across North West London.
• Next steps and proposed changes to access services and specifications.
• Key risks and mitigations.

The report noted that from 1 October 2025, online consultations must be available throughout core hours (8:00am - 6:30pm, weekdays excluding holidays) with no caps or restrictions. It also noted that any patient making contact with the practice should know on the same day how their presenting issue would be handled.

Application of the Continuing Health Care Criteria

The committee was scheduled to discuss All Age Continuing Healthcare (AACC) in North West London. The report focused on adult Continuing Health Care (CHC) and Funded Nursing Care (FNC) provision.

The report noted that North West London ICB manages several services under AACC with an active caseload at any time of around 4,400 individuals. It also noted that North West London ICB is the largest ICB in London and funds more CHC eligible individuals than any other ICB in London.

The report stated that conversion rates for adult CHC funded care remain above the London average across North West London, with some borough variations, and that Fast Track referrals are above London and national average. It also noted that the number of individuals with learning disabilities and/or autism eligible for CHC funded care has increased significantly over the past couple of years.

SEN Continence Service

The committee was scheduled to discuss continence service provision for children and young people with special educational needs and disabilities (SEND). The report noted that children and young people with SEND often face complex health and care challenges, including continence issues that can significantly affect their dignity, independence, and educational experience.

The report stated that across North West London, there is notable variation in how these services are commissioned, delivered, and accessed, and that families commonly report long waiting times and unclear referral pathways.

The report noted that all children in North West London have access to a range of continence services, ranging from advice to parents as a usual part of child development, through to specialist medical assessments.

The report referenced the Education & Resources for Improving Childhood Continence (ERIC) Children's Continence Pathway, describing the model for children's continence services as:

• Level 1: Universal services.
• Level 2: Children's Community Bladder and Bowel Service Nurse-led multi-disciplinary team.
• Level 3: Medical assessment.

The report also included comments from Parent-Carer Forums, highlighting the need to reduce unwarranted variation in level 1, level 2, and level 3 services.

Recommendations Tracker and Work Programme

The committee was also scheduled to review the latest recommendations tracker, providing a summary of scrutiny recommendations made during the previous and current municipal years.

Finally, the committee was expected to confirm its work programme for the 2025/26 municipal year.