The Health and Social Care Scrutiny Subcommittee meeting addressed the rising incidence of tuberculosis (TB) in Harrow, the findings of the Healthwatch Harrow Annual Report, and the introduction of a new Frailty Hospital at Home service. Decisions were made to endorse the approach to tackling TB, agree actions to ensure local TB services are appropriately designed and resourced, and review relevant policies. The committee also noted the Healthwatch Harrow Annual Report and the new Harrow Frailty Hospital at Home model.

Tuberculosis Health Needs Assessment

The committee received a report highlighting the increasing incidence of tuberculosis (TB) in Harrow, which now has the second highest rate in England. The Director of Public Health, Laurence Gibson, presented findings indicating that 95% of active TB cases in Harrow involve individuals born outside the UK, with 69% of these born in India, and 58% having lived in the UK for less than five years. This suggests many infections occurred before arrival in the UK. The report also detailed low uptake and completion rates for the latent TB screening programme across North West London, with only 35% of eligible individuals screened and 10% completing treatment.

Future recommendations are expected to focus on increasing screening and treatment completion, raising awareness, promoting GP registration, and advocating for alternative screening pathways. The committee endorsed the proposed approach to addressing TB challenges, agreed to actions ensuring local TB services are appropriately designed and resourced, and committed to reviewing relevant policies, including those on housing, homelessness, and high-risk groups. An action plan is anticipated to be presented to the subcommittee in approximately six months.

Healthwatch Harrow Annual Report 2024-2025

Alison Davies, Chief Executive Designate at Community Connex, presented the Healthwatch Harrow Annual Report for 2024-25. The report detailed how Healthwatch Harrow engaged over 4,100 residents to gather feedback on health and social care services, analysing approximately 70,000 items of feedback to inform service improvements. Overall resident satisfaction with health and care services stood at 83%, an increase from the previous year, with positive feedback on the quality and compassion of care received.

However, concerns were raised regarding GP access, waiting times, and appointment booking processes, with satisfaction down by 12% on online booking and 2% on waiting times. Hospital satisfaction also saw a significant decrease of 15%. Targeted engagement with South Asian communities highlighted issues with language barriers and cultural understanding in social care access, while work with the Romanian community and refugees aimed to improve understanding and access to NHS services. The committee noted that Healthwatch Harrow operates with one of the lowest funding levels nationally and in London, impacting its capacity. The report also mentioned the proposed abolition of Healthwatch England and local Healthwatch organisations, with functions potentially transferring to the Department of Health and local authorities, pending legislative changes. The committee noted the report and presentation.

Harrow Frailty Hospital at Home Service

Patrick Laffey, Deputy Director of Operations at Central London Community Healthcare NHS Trust (CLCH), presented the newly commissioned Harrow Frailty Hospital at Home Service. This service, funded by the North West London Integrated Care Board (ICB), aims to provide hospital-level care in patients' homes for up to 14 days, supporting up to ten patients at a time. The service will focus on preventing hospital admissions and facilitating earlier discharge.

The model involves a multidisciplinary team, including GPs, nurses, and pharmacists, and will work closely with existing services like Urgent Community Response and Discharge to Assess. The service is expected to improve patient experience, support independence, and enhance system flow by reducing unnecessary hospital admissions and readmissions. Recruitment is underway, with the service anticipated to begin accepting patients in early April. The committee noted the report and presentation.

Community Equipment Update

Andrew Davies, Assistant Director, Strategy and Commissioning, provided an update on the Community Equipment Service. The service, which provides essential equipment to support independent living, faced disruption following the compulsory liquidation of its previous provider, NRS Healthcare, in July 2025. Harrow, as part of a 21-borough consortium, worked with seven other North London councils to commission a new provider, Provide Healthcare Solutions, which became operational in September 2025.

Despite initial challenges in mobilisation, including staff recruitment and stock recovery, the service has improved. In December 2025, over 642 equipment deliveries and 270 collections were made in Harrow, with a recycling rate of 94% by value across the partnership. The committee noted the report. Concerns were raised regarding the funding split for the service, with Harrow contributing 45% of costs compared to the ICB's 55%, a disparity noted as significantly higher than in some other boroughs. Discussions with the ICB regarding a more equitable split are ongoing.