The Joint Health Overview and Scrutiny Committee was scheduled to discuss updates on the Start Well Paediatric Surgery Programme and the merger of Royal Free London NHS Foundation Trust and North Middlesex University Hospital NHS Trust. The committee was also set to review the progress and outcomes of the NCL Inequalities Fund.

Paediatric Services Review Update

The committee was scheduled to receive an update on the Start Well Paediatric Surgery Programme, which aims to review and improve maternity, neonatal, and children's surgical services across North Central London. The programme has involved extensive engagement with patients, staff, and partners since November 2021. The update focused on proposed changes to paediatric surgical pathways, including the transfer of very young children requiring emergency surgery to specialist centres such as Chelsea and Westminster Hospital, St Mary's Hospital, or The Royal London Hospital. Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) would continue to treat medically and surgically complex children. The NHS North Central London Integrated Care Board (NCL ICB) approved a revised care model on 30 September 2025, and implementation planning was underway with the North Thames Paediatric Network. The report detailed the case for change, consultation and engagement processes, the approved care model, and the benefits and enablers of the new model. An Integrated Impact Assessment (IIA) was also provided, outlining potential impacts on travel times and costs for families, with proposed mitigations.

North Middlesex & Royal Free Hospital Merger Update

An update was scheduled regarding the merger of the Royal Free London NHS Foundation Trust (RFL) and North Middlesex University Hospital NHS Trust (North Mid), which officially came together on 1 January 2025. The report provided an overview of the structure, service changes, and performance during the first year post-merger. Improvements were noted in emergency department performance, cancer pathways, and virtual ward capacity. Specific achievements highlighted included a decrease in the cancer backlog at North Mid, improved Faster Diagnosis Standard performance, and significant improvements in 31-day radiotherapy performance. The report also detailed capital funding allocated for redeveloping the urgent treatment centre at North Mid and improvements in maternity services. Performance indicators pre- and post-merger were presented, showing improvements in most metrics, although some areas like Long Length of Stay (LOS) exceeding 21 days and Diagnostic Waiting Time and Activity (DM01) performance saw slight downturns. The update also covered front-line service changes, including the accreditation of Edgware Community Hospital as a surgical hub, consolidation of complex colorectal work at the Royal Free Hospital, and recruitment to joint medical oncology posts. Research and development functions were integrated, leading to improved financial sustainability and increased study recruitment at North Mid. Emergency care at North Mid also saw performance improvements, with a new urgent treatment centre planned for spring 2026.

NCL Inequalities Fund

The committee was scheduled to review the NCL Inequalities Fund, a £5 million per year investment aimed at funding innovative partnerships to address the root causes of health inequalities. The fund focuses on prevention, early help, and wider determinants of health through co-production with communities. Funding is allocated to individual boroughs based on deprivation levels, with a portion retained in an 'NCL pool' for non-geographical projects and specific borough needs. The report detailed the allocation of funding based on the Indices of Multiple Deprivation 2019 and the implications of the recent update to IMD 2025. It outlined the selection process for schemes through Borough Partnerships and provided a summary of the fund's achievements in 2025-26, including over 20,000 people supported across 45 projects. The report included an overview of the Population Health Outcomes Framework, thematic evaluations of project outputs and outcomes, and an economic evaluation estimating the programme's impact on the health and care system, projecting a return on investment of £1.47 for every £1 spent. A summary of the evaluation by borough was also presented, highlighting net positive cost-benefit analyses across all participating boroughs. The report concluded with learning from the fund and next steps, including aligning the programme with strategic priorities and strengthening neighbourhood development. Several project highlights were detailed, including initiatives in Barnet, Camden, Enfield, Haringey, and Islington, focusing on areas such as cardiovascular disease prevention, mental health support, diabetes management, childhood immunisations, and learning disability health checks.