The Health and Adults Scrutiny Sub-Committee met to discuss improvements in adult oral and dental health, and the proposed approach to the next Health and Wellbeing Strategy. Key decisions included the commitment to explore how the committee and council can support the call for additional funding for dentistry, and the agreement to align the new Health and Wellbeing Strategy with the Our Tower Hamlets vision.

Improving Adult Oral and Dental Health

The committee received an update on the state of adult oral and dental health in Tower Hamlets. Kelly Nizer, Regional Lead for Primary Care Commissioning, Dentistry and Optometry Services, and Huda, an Optal Consultant, presented information on dental access, commissioned services, and oral health promotion.

It was highlighted that London, and specifically North East London, has returned to pre-pandemic levels of dental activity, with practices operating at 96-98% capacity. Additional funding of £447,000 has been allocated to 16 practices in Tower Hamlets, providing an additional 13,360 Units of Dental Activity (UDAs). The urgent care service is accessible via NHS 111 and operates 24 hours a day for triage, with dental appointments available from 5 pm to 2 am. The practice Align and Smile was identified as the provider for urgent care in Tower Hamlets.

Discussions also covered the historical basis of dental contracts, which are largely determined by activity levels from 2004, rather than current population needs. Councillor Abdul Mannan raised concerns about the contract value in Tower Hamlets being lower than in comparable boroughs like Newham and Redbridge, despite similar population sizes. Officers explained that this is due to the historical nature of the contracts and that additional funding is directed to areas of high need, such as Newham and Tower Hamlets, when available.

Councillor Marc Francis raised concerns about the lack of a centralised waiting list, stating, If waiting lists are held by practices and not monitored, how are we monitoring anything? Officers clarified that while practices hold their own waiting lists, the overall access and demand are monitored through regular communication with practices, patient complaints, and feedback from Healthwatch.

The committee also discussed the upcoming dental contract reform from April 1st, which will focus more on pathways for high-needs patients and potentially a longer duration of treatment. However, the primary concern for North East London remains access to routine dental care rather than urgent care.

A key action point agreed upon was to explore how the committee and the council can support the argument for additional funding for NHS dentistry, potentially through a public statement or by encouraging local MPs to advocate for it. Healthwatch's work on resident experiences was also highlighted as a valuable resource for making this case.

Regarding performance indicators, it was confirmed that additional funding for dental access has been secured for three years. Performance data, including the range of treatments provided by practices, will be shared with the committee at regular intervals.

Approach to the Next Health and Wellbeing Strategy

Councillor Sabina Akhtar, Cabinet Lead for Health, Wellbeing and Social Care, George S. Simbani, Corporate Director of Health and Adult Social Care, and Suman Banerji, Director of Public Health, presented the proposed approach to developing the Tower Hamlets Health and Wellbeing Strategy 2026-2030.

The strategy development is occurring within a challenging context of financial constraints, persistent health inequalities, and increasing demand on health and care systems. It will be aligned with the Our Tower Hamlets vision for 2025-2035, which aims to break the cycle of poverty and inequality.

Key themes emerging from discussions with the Health and Wellbeing Board and residents include:

• Housing and Integrated Neighbourhood Teams: A focus on these areas as a common priority, with close collaboration between local authorities and partners.
• Measurable Priorities: A desire for 5-10 clear and actionable priorities to ensure accountability.
• Seamless Experience of Services: Simplifying processes, reducing duplication, and ensuring accessibility and responsiveness.
• Prevention and Early Intervention: Understanding local needs and adapting services accordingly.
• Community Engagement and Inspiration: Building strong relationships and involving residents in shaping services.
• Accountability and Governance: Establishing clear reporting lines and measurable commitments.

The committee discussed the importance of integrating health and care systems, addressing wider determinants of health such as housing and employment, and reducing duplication of efforts between different boards and committees. Councillor Amy Lee highlighted the need for the Health and Wellbeing Board to be more accessible and understandable to all members.

Councillor Marc Francis raised concerns about specific service areas, including home care, access to services for individuals with dementia and Alzheimer's, and the timeliness of mental health support linked to housing issues. He also questioned what aspects of the previous strategy had been successful and what could have been included.

The committee was assured that resident experience would be a key metric for monitoring the strategy's success, with a focus on both population-level health improvements and individual experiences of care. The strategy is planned to launch in May 2026.

Action Log and Performance Dashboard

Councillor Marc Francis raised concerns about outstanding actions related to the home care contract and the community equipment service. Officers confirmed that while some information had been provided, further updates on medium to long-term solutions for community equipment provision would be brought to the next meeting.

Regarding the ASC Performance Dashboard, Councillor Francis inquired about the performance on safeguarding concerns and inquiries, noting that targets were not being met. Officers explained that performance reporting for safeguarding would be disaggregated by service area to identify bottlenecks and improve timeliness. They committed to providing a detailed note on the trajectory of improvement in safeguarding performance.

Councillor Francis also requested a note on the Meals on Wheels service, including the number of recipients and plans for its rollout. Clarification was sought on whether this service still exists in its traditional form, as officers indicated that the council had not provided meals on wheels for some time, with current provisions potentially being lunch clubs or similar. This will be investigated further.

The committee also noted the ongoing work to address hospital discharge delays, with Tower Hamlets performing well nationally and regionally in terms of patients being discharged on their discharge-ready date. However, a reduction in performance was observed from May onwards, and further analysis on the reasons for these delays will be provided.