The North West London Joint Health Overview and Scrutiny Committee is scheduled to meet on Tuesday, 9 December 2025, to discuss urgent and emergency care, primary care access, continuing healthcare criteria, and special educational needs (SEN) continence services. The meeting will also include updates on the committee's recommendations tracker and work programme.

Urgent and Emergency Care Delivery

The committee will be given an update on urgent and emergency care (UEC) across North West London. The report pack highlights progress in integrating acute, community, mental health, London Ambulance Service (LAS), primary care and local authority services. Key achievements that may be mentioned include:

• The launch of the Integrated Care Coordination Hub (ICC). The ICC is intended to provide senior clinical decision-making to improve patient routing and reduce avoidable ambulance conveyance.
• 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.

The report pack notes that challenges remain, including rising demand, mental health waits, community workforce fragility and virtual ward utilisation. Winter readiness plans, stress-tested across demand and capacity scenarios, may also be discussed. The report pack states that next steps involve embedding the ICC, strengthening neighbourhood-based urgent care pathways, standardising virtual ward models and maturing digital tools.

Implementation of the Same Day Access Model in Primary Care

The meeting will include a discussion of the implementation of the Same Day Access Model in Primary Care. The report pack states that improving access to primary care remains a top priority, aligning with the NHS 10 Year Plan¹ and national planning guidance. The aim is for general practice to manage primary care presentations, with resources targeted where they will have the greatest impact.

The report pack notes that from 1 October 2025, online consultations must be available throughout core hours, with no caps or restrictions. The report pack also notes that the NWL ICB has submitted its Post-1 Oct GP Contract Compliance Return to NHS England.

The report pack states that NWL continues to improve access to Primary Care, with a focus on at-scale services across all 45 PCNs, ensuring full population coverage. In 2025/26, all 45 PCNs submitted PCN-led Improvement Plans to meet the agreed Access Specification targets.

The report pack also notes that there is borough variation in the percentage of GP appointments seen on the same or next day, and that NWL ICB is committed to reducing unwarranted variation.

Application of the Continuing Healthcare Criteria

The committee will consider a report on All Age Continuing Healthcare (AACC) in North West London. The report focuses on adult Continuing Healthcare (CHC) and Funded Nursing Care (FNC) provision.

The report pack states that North West London ICB is the largest ICB in London and funds more CHC eligible individuals than any other ICB in London. The number of referrals and patients funded have exceeded pre-pandemic levels. The report pack also notes 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.

The report pack notes that the overall NWL conversion rate for standard CHC assessments has shown a gradual increase since the pre-pandemic period, reaching 25% in Q2 2025/26.

SEN Continence Service

The committee will discuss a report on SEN Continence Services. The report pack notes that children and young people with special educational needs and disabilities (SEND) often face complex health and care challenges, including continence issues. The report pack also notes that there is notable variation in how these services are commissioned, delivered, and accessed across North West London.

The report pack states 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 pack describes the model for children's continence services as:

• Level 1: Universal services provided by health visiting and school nursing teams, and sometimes GPs.
• Level 2: Children's Community Bladder and Bowel Service Nurse-led multi-disciplinary team.
• Level 3: Medical assessment Paediatrician-led services.

The report pack notes that experiences of families is variable across NWL, and that there is a need to reduce unwarranted variation in level 1, level 2, and level 3 services.

Other Items

The committee will also review the North West London Joint Health Overview Scrutiny Committee 2025/26 Work Programme and the North West London Joint Health Overview Scrutiny Committee Recommendations Tracker.