The Adults and Health Overview and Scrutiny Sub-Committee met on Tuesday 02 June 2026 to review the Quality Accounts of three healthcare providers: North London Hospice, Central London Community Healthcare NHS Trust, and Royal Free London NHS Foundation Trust. The committee also received an update from Barnet Public Health and discussed changes to the Health and Wellbeing Board's operating model.

Quality Accounts Reviewed

The committee heard presentations and discussed the Quality Accounts for three key healthcare providers serving Barnet residents.

North London Hospice

Dr. Sam Edwards, Medical Director, and Gemma, Head of Quality, presented the North London Hospice's Quality Account for 2025-26. They highlighted a year of sustained delivery of palliative and end-of-life care, despite challenges in the healthcare network and financial backdrop of the charitable sector. Key initiatives included the launch of a care coordination service, a palliative advice line, and the development of their governance framework, including a weekly medicines incident group and patient safety partners. Priorities for the upcoming year include piloting ambient voice technology and improving patient and user experience feedback. The hospice is also undertaking a significant redevelopment of its inpatient unit, Building for Tomorrow, with DHSE funding.

Councillor Alison Cornelius inquired about the ambient voice technology, specifically regarding consent and data security, and the transition from paper to digital records. Dr. Edwards explained the cautious pilot approach for the technology and confirmed that the hospice predominantly uses digital records, with ongoing work to digitise prescribing. Councillor Archibald raised concerns about the increase in medicine safety incidents, noting a rise from 55 to 213 over three years. Dr. Edwards clarified that this increase reflects a high reporting culture and improved processes, with the majority of incidents being no-harm events, often related to procedural errors rather than wrong medication. Gemma added that simplified reporting mechanisms and training have empowered staff to report issues, and they do not expect the exponential growth to continue. Councillor Cornelius also asked about the rationale for not making medicine safety a priority for 2026-27, despite the increase in numbers. Dr. Edwards assured the committee that medicine safety remains an absolute priority and is embedded in their governance structure.

Councillor James Esses and Councillor Cornelius also asked about the hospice's CQC rating, which was good across all areas, and the introduction of cuddle beds to allow physical closeness between patients and loved ones. Councillor Cornelius also inquired about the food service, noting a past preference for Barnet Hospital's Steamplicity system. The hospice confirmed that while systems differ across sites, they are committed to improving food quality.

Councillor Archibald also raised concerns about the increase in medicine safety incidents, noting a rise from 55 to 213 over three years. Dr. Edwards explained this reflects a high reporting culture and improved processes, with the majority of incidents being no-harm events. Gemma added that simplified reporting and training have empowered staff. Councillor Cornelius questioned why medicine safety was not a priority for 2026-27, and was assured it remains a priority.

Councillor Cornelius also asked about the increase in clinical complaints, which rose from 14 in 2024-25 to 26 in 2025-26, with most being upheld. This was attributed to issues with a new community scheduling system, which has since been withdrawn. The hospice is also fundraising for a £10.5 million redevelopment of its inpatient unit, aiming to improve facilities and ensure sustainability.

Central London Community Health Trust (CLCH)

Kay Isaac, Director of Operations for CLCH North Central Division, and Sean Hader, Deputy Director of Operations, presented CLCH's Quality Account for 2025-26. They highlighted CLCH's rating of Good by the CQC across all five domains, with Outstanding in well-led for adult community services. They also achieved Prospective Advanced Foundation Trust status. Key achievements included exceeding targets for positive patient experience, preventing harm, and achieving all KPIs for smart effective care. The new campaign on population health and inequalities is focusing on narrowing the gap in appointment attendance between deprived areas and the rest of the population.

Councillor James Esses inquired about the analysis of health inequalities and the time taken to identify and address these gaps. Kay Isaac explained that CLCH analyses data by postcode and deprivation, and has identified specific postcodes with high non-attendance rates for their MSK service in Barnet, leading to investigations into accessibility and community links. Councillor Anne Hutton asked about proactive measures to prevent missed appointments, such as leaflets in GP surgeries and multilingual information. Sean Hader detailed efforts including evening and weekend clinics, working with GP practices, and the use of the NHS app.

Councillor Caroline Stock raised concerns about CQC findings in the safe domain for community health services for children, young people, and families, which required improvement. Kay Isaac acknowledged historic challenges with commissioning and staffing levels in outer northwest services and detailed ongoing work with the ICB to address these.

Councillor Stock also asked about the National Diabetes Foot Care Audit and National Obesity Audit, with Kay Isaac offering to provide further details outside the meeting. Regarding the National Respiratory Audit, she stated she would provide a comparison to last year. On the 21,227 safety events, Kay Isaac explained this was a small percentage of over 4 million patient contacts and each is reviewed. Councillor Stock also noted a decrease in the Friends and Family percentage of staff recommending CLCH, which Kay Isaac attributed to staff being tired and overwhelmed, but expressed confidence in improvement next year.

Councillor James Esses also asked about abandoned clinical audits and plans for ensuring compliance with the Equality and Human Rights Commission guidance on same-sex spaces. Kay Isaac stated she would take these away and provide updates.

Royal Free London NHS Foundation Trust

Dr. Julian Smith, Chief Medical Officer, presented the Royal Free London's Quality Account for 2025-26, highlighting progress following the merger with North Middlesex University Hospital. Key achievements included reducing waiting times for cancer patients, improving performance against national cancer targets, and reducing long waits for elective care. They also reported significant improvements in patient experience, though acknowledged more work is needed in areas like food and nutrition. Martha's Rule pilots have been introduced across acute sites, and improvements have been made in end-of-life care and communication with families.

Councillor James Esses congratulated the Trust on the merger and inquired about its progress. Dr. Smith described it as a challenging but successful process, with staff commitment driving improvements. He noted ongoing challenges in integrating digital systems and the electronic patient record. Councillor Esses also raised concerns about health inequalities, which Dr. Smith acknowledged as deeply ingrained, but highlighted improved data understanding through an inequalities dashboard.

Councillor Anne Hutton asked for clarification on electronic patient records and whether they would be interoperable with other systems. Dr. Smith explained the aspiration for a seamless system and confirmed that updates on progress would be provided. Councillor Caroline Stock inquired about the care after death pillar and the green blob graphic, which Dr. Smith clarified related to recognition of final admissions. She also raised concerns about low Wi-Fi availability and food quality scores. Dr. Smith acknowledged these as priorities for future improvement.

Councillor Cornelius asked about the Steamplicity system and food quality, and also about an increase in bullying and harassment cases. Dr. Smith stated he was unsure about Steamplicity but would provide information on food. He explained the bullying and harassment figures related to an update on a quality priority and were monitored through governance. He also addressed the merger with North Middlesex, stating the Trust now has four hospitals and is focused on providing care for the populations they serve.

Councillor James Esses raised concerns about maternity care CQC findings and patient survey results, asking for plans to improve. Dr. Smith detailed actions implemented following the CQC inspection and ongoing work with external teams and patient engagement. He also discussed referral to treatment timescales, acknowledging that while improving, hundreds of patients still wait over two months for urgent suspected cancer referrals. Councillor Cornelius followed up on maternity staffing shortages, which Dr. Smith stated are monitored daily.

Councillor Richard Barnes asked about communication with bereaved families, noting a dip at the Royal Free. Dr. Smith stated he could provide more detail if helpful. Councillor White raised concerns about maternity care, particularly regarding hazardous substances and training, and also about referral to treatment timescales for cancer patients. Dr. Smith acknowledged the numbers are too high but not out of keeping with other trusts.

Public Health Update

Councillor Alison Moore, Cabinet Member for Adult Social Care and Health, provided an update on changes to the Health and Wellbeing Board and the increase in deprivation levels in Barnet.

Health and Wellbeing Board Changes

Councillor Moore outlined changes to the Health and Wellbeing Board's operating model, including a move towards more workshop-style discussions and a division into formal public and informal non-public parts. This aims to allow for more expansive discussions while maintaining statutory functions and public accountability. The membership will also evolve with changes in ICB representation and increased inclusion of the GP Federation.

Deprivation Levels in Barnet

Councillor Moore discussed the implications of increased deprivation levels in Barnet, as detailed in ONS reports. This has led to an additional £30 million in funding allocation and may influence future inequalities funding from the ICB. The data is being reflected in the local Joint Strategic Needs Analysis (JSNA) to inform strategic work on health inequalities.

Councillor Caroline Stock requested that someone from the Department of Health and Social Care or the newly merged organisations come in person to discuss the funding calculations, as previous written requests had not yielded straight answers. Councillor Richard Barnes questioned the allocation of only 10% of funding to staffing, asking if there were hidden staffing costs. Councillor Moore and Dawn Wakeling, Executive Director, Communities, Adults and Health, explained that staffing costs are included in commissioned services and that managing public health budgets is challenging, particularly with nationally set pay increases.

Councillor Haskew raised concerns about a developing culture of pathologising and self-diagnosis among young people regarding mental health. Councillor Moore clarified that children's mental health is primarily scrutinised by the children's sub-scrutiny subcommittee, while the Public Health team focuses on promoting positive mental health.

Councillor Hutton asked about improving community and public awareness of neighbourhood health work, noting a lack of awareness during recent canvassing. Councillor Moore acknowledged the challenges with GP access and the evolving nature of neighbourhood health plans, mentioning Healthwatch-brokered sessions with residents and the voluntary sector.

Councillor Cornelius recalled the low public attendance at an early Health and Wellbeing Board meeting and questioned the reasons for this. Councillor Moore acknowledged the practical challenges of webcasting from community venues and partner attendance, but agreed there is merit in meeting at outside venues and that this might be reconsidered.

Public Health Annual Report 2025/26

Dr. Janet Djomba, Director of Public Health, presented the Barnet Public Health Department's End of Year Report for 2025/26. She highlighted that despite decreasing capacity and funding, the department had delivered against its work plan, with noticeable impacts on population health, including improved uptake of the HPV vaccine and NHS Health Checks returning to pre-pandemic levels. Commissioned services, such as stop smoking and sexual health, exceeded targets and saw good uptake. Community engagement and focus on inequalities remain important, with strengthening work with Barnet's Health Champions. Barnet is leading in North Central London on suicide prevention and gambling harm reduction.

Despite significant financial constraints, Barnet has the third lowest per capita public health grant in London. Dr. Djomba expressed hope that an upcoming peer review of public health functions by DHSC, for which Barnet has been chosen, will provide an opportunity to raise the issue of insufficient funding. The department is managing increased demand through strategic commissioning, such as joint commissioning of sexual health services. Looking ahead, the focus is on preventing long-term conditions and using the neighbourhood health framework to support areas of highest need.

Councillor Stock requested a personal discussion about the funding calculations, as previous written requests had not provided clear answers. Councillor Barnes questioned the allocation of funding, noting only 10% going to staffing. Dr. Djomba and Dawn Wakeling explained that staffing costs are covered by the core public health grant and commissioned services. Councillor Haskew raised concerns about the culture of pathologising mental health among young people and welcomed further discussion. Councillor Moore clarified that children's mental health is primarily scrutinised by a different subcommittee, while Public Health focuses on promoting positive mental health.

Councillor Hatton asked about the Health Champions programme, which Dr. Djomba confirmed has been running for several years and continues to expand. The Chair noted comments about Palantir products and asked for any updates, though it was deemed not the appropriate forum for discussion. Councillor Cornelius confirmed her attendance at the first Health and Wellbeing Board meeting and questioned the low public attendance. Councillor Moore acknowledged the practical challenges of meeting in community venues.

Councillor Stock requested a personal discussion about the funding calculations, as previous written requests had not provided clear answers. Councillor Barnes questioned the allocation of funding, noting only 10% going to staffing. Dr. Djomba and Dawn Wakeling explained that staffing costs are covered by the core public health grant and commissioned services. Councillor Haskew raised concerns about the culture of pathologising mental health among young people and welcomed further discussion. Councillor Moore clarified that children's mental health is primarily scrutinised by a different subcommittee, while Public Health focuses on promoting positive mental health.

Councillor Hatton asked about the Health Champions programme, which Dr. Djomba confirmed has been running for several years and continues to expand. The Chair noted comments about Palantir products and asked for any updates, though it was deemed not the appropriate forum for discussion. Councillor Cornelius confirmed her attendance at the first Health and Wellbeing Board meeting and questioned the low public attendance. Councillor Moore acknowledged the practical challenges of meeting in community venues.

Urgent Business: Homelessness and Aggression

Councillor Caroline Stock raised an urgent item regarding an incident at the Dollis Valley Nature Reserve involving a person living in a tent who had become aggressive. This highlighted a broader issue of people living in tents across the borough, with councillors receiving numerous reports and complaints. Councillor Stock emphasised the need for a multi-agency approach involving different council departments and external agencies to address homelessness, mental health issues, and the impact on the public. Councillor Richard Barnes echoed these concerns, noting that a man in his ward living in a tent cited mental health as his primary problem, with no accessible support.

Dawn Wakeling, Executive Director, Communities, Adults and Health, acknowledged the complexity of the issue, involving homelessness, mental health, and multi-agency working. She stated she would take the list of locations away to speak with colleagues about potential steps and consider where the issue best sits for member governance, potentially Cabinet or the main Overview and Scrutiny Committee. Councillor Cornelius shared an experience at St Andrew's Church where a homeless individual, despite offers of mental health support and accommodation, preferred to live outdoors and became violent, leading to police involvement and eventual move-on. She questioned the legal position regarding evicting individuals from council land. Councillor Hatton added that for the North Finchley bus station, which is TfL property, police can search for drugs and weapons but do not have the power to move people on, reinforcing the need for a multi-agency approach. Dawn Wakeling agreed to take the matter away for further investigation and report back.

Other Matters

Health and Wellbeing Board Work Programme

Councillor Moore provided an update on the Health and Wellbeing Board's work programme, including the formal sign-off of the Neighbourhood Health Plan and the work of neighbourhood health integrators. He also discussed the move towards a more informal, workshop-style discussion format to allow for more expansive discussions.

Task and Finish Groups Update

An update was provided on the published reports from the Primary Care (GP) Access and Discharge to Assess Task and Finish Groups. The committee noted that the Integrated Care Board (ICB) was unable to attend to provide their response to the committee's questions and recommendations due to ongoing organisational restructure, and a written response has been requested.

Cabinet Forward Plan

The Cabinet Forward Plan was noted by the committee.

Adults & Health Overview and Scrutiny Sub-Committee Work Programme

The forward plans for the Health and Wellbeing Board and the Adults & Health Overview and Scrutiny Sub-Committee were noted.

Urgent Item: Cancer Screening Services Consultation

Members were informed about the ongoing consultation on cancer screening services and the proposed closure of services at Mount Vernon Hospital. While this would affect a small number of Barnet residents, the committee was kept informed and invited to read the consultation documents. Ms Omijie confirmed that the information had been shared with the Involvement Board and People's Voice channels for resident participation.

The meeting concluded with thanks to the presenters and committee members.