The Joint Health Overview & Scrutiny Committee (JHOSC) met to discuss several key areas of healthcare provision across North West London. Scheduled topics included an update on urgent and emergency care delivery, the implementation of a same-day access model in primary care, and the application of continuing healthcare criteria. The committee was also set to review the SEN continence service and track the progress of previous recommendations.

Urgent and Emergency Care Delivery

The committee was scheduled to receive an update on urgent and emergency care across North West London, focusing on performance, system resilience, and preparations for winter 2025/26. The report highlighted significant progress in strengthening urgent and emergency care, with a move towards a more integrated system across acute, community, mental health, primary care, the London Ambulance Service (LAS), and local authority partners. Key achievements noted included the launch of the Integrated Care Coordination Hub (ICC), record levels of Same Day Emergency Care (SDEC) activity, and strengthened community and mental health alternatives. The report also detailed improvements in ambulance handover and Emergency Department (ED) performance, with evidence of positive impacts for high-need and underserved groups. Challenges remain, particularly concerning rising demand, mental health waits, community workforce fragility, and virtual ward utilisation, which are being actively managed. Winter plans have been stress-tested, and the system is described as having the strongest resilience in recent years, though it remains finely balanced. Future work will focus on maturing the ICC, strengthening neighbourhood-based urgent care pathways, standardising virtual ward models, and consolidating winter learning.

Implementation of the Same Day Access Model in Primary Care

A report was scheduled to detail the progress in improving access to primary care, aligned with the 10 Year Plan and national planning guidance. The strategy aims to embed Modern General Practice principles and reduce system pressure by optimising GP capacity and targeting resources where they will have the greatest impact. Key priorities include enhancing the role of Dentistry, Optometry, and Community Pharmacy (DOPs) in delivering integrated care, building on Neighbourhood Health, expanding digital access via the NHS App, and utilising existing pathways while maintaining continuity of care. The Access Programme has evolved through several phases since 2023, with extensive engagement shaping the revised 2025/26 Access specification. From October 2025, all practices are required to offer Online Consultations throughout core hours. Performance metrics indicate that 82% of calls are answered within 10 minutes, and 88% of e-submissions are responded to by the next working day. Continuity of care for high-risk patients is being addressed through PCN-led initiatives and audits. Patient engagement is ongoing, with a focus on co-design and feedback-driven improvement, and access plans are targeting underserved populations to reduce health inequalities. The programme supports integration across DOPs and urgent care, with pilots and new services expanding access beyond general practice. Future focus includes a 2-year contract extension for the NWL Enhanced Services Single Offer, ongoing monitoring, and a Task & Finish Group to oversee further development, with a strong emphasis on health equity, digital access, and continuous engagement.

Application of the Continuing Healthcare Criteria

The committee was scheduled to receive a report on All Age Continuing Care (AACC) services managed by the North West London (NWL) Integrated Care Board (ICB), which supports approximately 4,400 individuals. The report highlighted that NWL ICB funds more CHC-eligible individuals than any other ICB in London. Referrals and funded patients have exceeded pre-pandemic levels, and efforts have been made to ensure consistency of approach across all boroughs, reflected in changes to conversion rates and numbers of individuals funded. Conversion rates for adult CHC remain above the London average, with some borough variations. Fast Track referrals are also above London and national averages. A significant increase in individuals with learning disabilities and/or autism eligible for CHC has been noted and is being investigated. The report detailed the definition of Adult Continuing Healthcare (CHC), which is funded by the NHS for individuals aged 18 or over with a 'primary health need'. Eligibility is based on assessed needs, not means-testing, and care can be provided in various settings. Fast Track CHC is the primary route for eligibility, with a streamlined digital process planned. Standard CHC referrals are often initiated by social care, GPs, or care homes, and involve a checklist to determine the need for a full assessment. The report also provided data on CHC caseload numbers, referral activity, and conversion rates, noting a gradual increase in the overall NWL conversion rate for standard CHC assessments since pre-pandemic levels, attributed to greater consistency in assessment processes and decision-making across local CHC teams.

SEN Continence Service

A review of continence services for children and young people with special educational needs and disabilities (SEND) across North West London was scheduled. The report aimed to highlight current service models, identify gaps, and support the development of more equitable and person-centred care. Continence issues for this group can significantly impact their dignity, independence, and educational experience, yet are often inconsistently supported. The report noted variations in commissioning, delivery, and access across North West London, with families commonly experiencing long waiting times and unclear referral pathways. Effective continence services are crucial for improving quality of life, reducing hospital admissions, supporting school attendance, and alleviating pressure on families. The report detailed the ERIC Children's Continence Pathway model, outlining Level 1 (universal services), Level 2 (community bladder and bowel services), and Level 3 (medical assessment) provision. Contributions from Parent-Carer Forums across North West London were included, highlighting both positive examples of co-production and areas of concern regarding blanket policies in schools and lengthy waits for specialist support. The report also detailed the current provision and integration between health, education, and social care in each borough, with a summary of the 0-25 population profile. NWL ICB is working to codesign and implement a common offer for bladder and bowel services for children and adults across all boroughs, aiming to provide all-age support and reduce unwarranted variation. Future opportunities include standardising Level 1 services and exploring productivity improvements for Level 3 continence offers.

North West London JHOSC Recommendations Tracker

The committee was scheduled to review the latest recommendations and information requests trackers for 2023/24, 2024/25, and 2025/26. These trackers provide an overview of scrutiny recommendations made to NHS bodies and the progress on their implementation. Updates from the previous meeting were to be highlighted, offering the committee oversight of ongoing actions and responses from NHS colleagues. Key items included ongoing updates on capital funding for acute beds, progress on the New Hospitals Programme, details on the standardisation of ophthalmology services and its impact on health inequalities, and baseline data for ophthalmology service performance. The tracker also covered information on musculoskeletal (MSK) services, palliative and end-of-life care, mental health provision for children and young people, alternative provision to accident and emergency services, and plans for supporting people and communities in deprived areas. Updates on the ICS structure, communications with residents regarding planned care, and the operation of the Elective Orthopaedic Centre were also to be presented.

North West London JHOSC 2025/26 Work Programme

The committee was to review its work programme for the 2025/26 municipal year. This programme outlines the health policy areas the committee plans to scrutinise, focusing on the implementation plans of the North West London Integrated Care System and its Integrated Care Board. The work programme is designed to be flexible, allowing for the review of emerging items and adjustments to meeting schedules as needed. Confirmed meeting dates and the specific agenda items scheduled for each were to be presented, including discussions on maternity provisions, adult mental health, ICB reconfiguration, dentist commissioning, special school nursing, urgent and emergency care, primary care access, continuing healthcare criteria, SEN continence services, cancer screening, digital health, and weight loss drug supply. The process of prioritising items for the work programme, based on a set of criteria, was also to be highlighted.