The North Central London Joint Health Overview and Scrutiny Committee was scheduled to discuss the implications of the NHS 10 Year Health Plan and Neighbourhood Health Delivery, as well as receive an update on the merger of the North Central London (NCL) and North West London (NWL) Integrated Care Boards (ICBs). The committee was also set to review its work programme for the upcoming year.

NHS 10 Year Health Plan and Neighbourhood Health Delivery

The committee was due to consider and comment on the NHS 10 Year Health Plan and its impact on future service provision, with a particular focus on Neighbourhood Health Delivery. The report pack outlined the national context for the plan, noting an ageing population, an increase in years lived in poor health, and significant unmet social needs.

The NHS 10 Year Health Plan proposes three key shifts:

• From hospital to community: Aiming to provide better care closer to home, including enhanced neighbourhood health services, improved dental care, quicker specialist referrals, convenient prescriptions, and better community mental health support.
• From analogue to digital: Enhancing the patient experience through digital innovation, including a unified patient record to reduce repetition, self-referrals via the NHS App, and improved online booking for equitable access.
• From sickness to prevention: Shifting the focus to preventative healthcare by making healthy choices easier and supporting individuals before they become ill.

Feedback from local residents, gathered through the Change NHS consultation and subsequent community conversations, highlighted several key themes. Residents expressed the need for clear points of contact for community-based care, ensuring services are well-staffed, visible, inclusive, and responsive. They also stressed the importance of involving carers and families, and that while technology can enhance care, it should not replace human interaction, with offline options always being available. Concerns were raised about ensuring resources genuinely follow need, particularly for prevention and voluntary, community, and social enterprise (VCSE) groups, and the need for adequate staffing and skills to support both patients and unpaid carers. Clear and consistent communication was identified as crucial for residents to understand neighbourhood care offerings, and there was a call for data to be used intelligently without losing nuance or lived experience, particularly for neurodivergent residents who noted that data-led pathways can overlook fluctuating needs and communication differences.

The report detailed how the plan is being implemented through digital improvements, such as the London Care Record and the London Secure Data Environment, which aim to bring health and care information together for better patient care, planning, and research. Data will be used to identify communities at greatest risk, enable earlier diagnosis and proactive treatment, and reduce health inequalities.

Neighbourhood health is being organised at a local level through dedicated multidisciplinary Integrated Neighbourhood Teams (INTs) working alongside existing services to improve access, experience, and outcomes, particularly for those with complex needs. The role of strategic commissioner is seen as enabling better support for individuals with long-term conditions, with a focus on proactive, ongoing support, earlier intervention, and promoting self-management through education, health coaching, and community-based approaches.

The report highlighted the role of Integrators in driving Neighbourhood Health forward, with plans to engage residents and the voluntary sector. Specific examples of local delivery were mentioned, including Enfield's Health Hearts Service and Haringey's MACCT service. A pioneering multi-purpose neighbourhood mental health centre in Haringey, named in honour of Roger Sylvester, was also noted as a key development.

The report also touched upon the West and North London approach, which involves a newly merged Integrated Care Board (ICB) with a significant budget and a focus on reducing health inequalities. This approach aims to reshape investment and proactively support those with greater needs.

NCL & NWL ICB Merger & Change Update

The committee was scheduled to receive an update on the reconfiguration of the North Central London (NCL) and North West London (NWL) Integrated Care Boards (ICBs). This update was expected to cover the merger of these two organisations, which was legally set to occur on 1 April 2026, forming a new entity named West and North London ICB.

The report indicated that ICBs were asked in March 2025 to reduce running costs by approximately 50%, with an operating budget of £19.00 per head of population, and to shift to a new role as strategic commissioners. This merger and cost reduction necessitate substantial changes to how the organisations operate and work with partners.

The Model ICB blueprint was outlined, reinforcing the role of ICBs as strategic commissioners, moving away from clinical delivery and provider management. Its core functions include understanding local context, developing population health strategy, delivering strategy through commissioning and resource allocation, evaluating impact, and fulfilling governance and statutory duties.

The challenge and opportunity presented by the merger were discussed, noting that across West and North London, approximately £12 billion is spent annually on health and care for around 4.5 million people. The report highlighted that most of this expenditure is currently directed towards hospitals and crisis services, which is unsustainable and does not deliver equitable outcomes, with a significant variation in healthy life expectancy across neighbourhoods. The new ICB aims to reshape investment and proactively support those with greater need.

The process of setting up the new organisation was underway, with an interim CEO appointed. The report detailed the proposed priorities and future strategy for West and North London ICB, including reducing inequalities, investing strategically to prevent ill health, better supporting those with the greatest needs, making care more local and accessible, and empowering local people.

The value the ICB aims to add includes understanding population needs through data and engagement, making decisions on resource allocation and commissioning, and shaping the provision of healthcare services through transformation and innovation. The report also outlined where the ICB fits within the broader health system, interacting with NHS England and providers.

The definition of the ICB's changing role was presented, distinguishing between what the ICB would continue to hold tightly (strategy, resources, governance, system enablers) and what it might hold more loosely (operational work, detailed service design, delivery of partnership programmes). The governance structure for West and North London ICB was also proposed, including a Board of Members. The report confirmed that the ICB would retain its statutory responsibilities post-transfer, with plans to ensure continued quality for residents, although staff reductions were anticipated.

The approach to Neighbourhood Health within West and North London was detailed, with plans for approximately 50 neighbourhoods serving over 4.5 million people. Integrators have been established in each of the 13 boroughs to deliver neighbourhood health in partnership with local areas. Certain services in Haringey, Hillingdon, and the Bi-Boroughs were noted as moving faster towards neighbourhood health due to existing foundations for integrated working. The merger was seen as a major opportunity to accelerate the development of neighbourhood work and a shift towards equitable, proactive, integrated, and person-centred care. Stakeholder feedback was also summarised, addressing questions about place-based work, clinical leadership, statutory duties, and the focus on reducing inequalities. An indicative timeline for these changes was also provided.

Work Programme

The committee was scheduled to review its work programme for the 2021-22 municipal year. This item would have provided an outline of the planned activities and focus areas for the North Central London Joint Health Overview and Scrutiny Committee.