The Health, Wellbeing and Adult Social Care Scrutiny Committee of Islington Council met on Thursday 12 March 2026 to discuss the performance of Whittington Hospital and University College London Hospitals (UCLH), review draft recommendations for a scrutiny review, and examine the Quarter 2 performance report for Public Health. Key discussions included concerns over the proposed involvement of Palantir in NHS data systems, the performance of local hospitals, and various public health initiatives.

Concerns over Palantir's Involvement in NHS Data Systems

A significant portion of the meeting was dedicated to discussing the proposed involvement of Palantir in running the NHS federated data platform. Councillor Joseph Croft, Chair of the Health, Wellbeing & Adult Social Care Scrutiny Committee and Mental Health Champion, outlined his concerns, which were also published in the Islington Tribune. These concerns centred on the potential for privatisation of NHS data systems, legitimate questions about the chosen contractor's trust and accountability, and the need for robust safeguards, transparency, and independent oversight to protect patient data. Councillor Hyde had raised these concerns directly with senior management at Whittington NHS Trust and with Baroness Merrin, the Lord's Health Minister. Councillor Hyde and Councillor Croft were also writing a joint letter to the Secretary of State for Health, West Streeting, detailing their worries.

Shirley Franklin, a convener of the Defend the Whittington Hospital Coalition, addressed the committee, questioning why Whittington Hospital was proceeding with training staff on Palantir systems if the council and the coalition were opposed to its use. She stated, Whittington will tell us, and they've told you, they've told everybody, that they're not using it. But the truth is that they're training people up in it. And they have used our health monies to pay Palantir to train their staff. Franklin urged the council to investigate whether they had the power under the 2012 Act to instruct the Trust to cease this activity.

Councillor Mick Gilgunn also voiced his opposition, noting that the Good Law Project was making a legal challenge to the contract, with a significant portion of the contract documents redacted. He expressed worry about US companies handling sensitive data, particularly in light of an authoritarian government like the U.S.

Whittington Hospital Performance Update

Sarah Wilds, Chief Nurse at Whittington Health, and Nicky Sands, Deputy, presented an update on the hospital's performance. They acknowledged the challenges highlighted in a recent CQC inspection report, particularly concerning mental health services and the hospital's aging infrastructure, noting that Whittington was built in, I think, 1970s. It's not fit for purpose for the population we serve.

Key points discussed included:

• Paediatric Department: The hospital had agreed to recruit permanent staff for the paediatric department, moving away from temporary staff.
• Staff Survey Results: Whittington Health reported pride in improved staff survey results, stating they were the most improved this year across the integrated care system.
• Urgent and Emergency Department (ED): The ED environment was acknowledged as tough, but strong leadership and regular executive team presence were highlighted. Initiatives like tier three well-being events were mentioned.
• Cleanliness and Infection Control: The CQC acknowledged good infection control practices, despite the challenges of a cramped environment.
• Staffing Levels: A six-monthly safer staffing review process was in place, with the board responsible for overall staffing levels. However, it was noted that patients are much sicker than they've ever been, contributing to challenges in maintaining consistent training and support across wards. Sickness rates were also reported as higher than usual.
• Estates and Infrastructure: The estates team was actively campaigning for additional funding to make the urgent and emergency care facilities fit for purpose, acknowledging the difficulty of undertaking works in a busy environment and the overall space constraints at the Whittington.
• Virtual Healthcare: The hospital is expanding its hospital at home service, which will be renamed to virtual wards, to support patients, particularly the elderly, in remaining at home.
• Supply Chain Resilience: While not formally on the risk register, the hospital has business continuity plans in place to manage potential fuel crises and supply chain disruptions, adapting to problems over the years.
• Patient Experience: Efforts are being made to improve patient experience, including the development of a new online sexual health system and addressing long waiting times in some clinics. The high rate of patients not attending appointments (DNA rates) was identified as exacerbating long waits.
• Healthwatch: Preparations were underway for the end of Healthwatch's presence, with discussions focusing on how to ensure patient voices continue to be heard.

Councillor Janet Burgess MBE, Carers Champion, shared a positive experience of visiting Merrick Ward, noting the cleanliness and the relationship between staff and patients. She inquired about addressing the need for intensive care on wards, to which it was explained that a six-monthly safer staffing review is conducted.

University College London Hospitals (UCLH) Annual Performance Update

The committee received an update on UCLH's annual performance. Key performance indicators and areas of discussion included:

• Infections: There had been two cases of MRSA infection, which was above the tolerance of zero but an improvement on the previous year. Cases of Clostridium difficile (C. diff) had increased, partly due to a rise in community-onset cases, and the annual threshold had been significantly reduced.
• Summary Hospital-Level Mortality Indicator (SHMI): UCLH's SHMI score had continued to improve, indicating a positive trend in mortality rates relative to expected figures.
• Pressure Ulcers: There had been 87 cases of category 2, 3, and 4 pressure ulcers reported year-to-date.
• Inpatient Survey: UCLH ranked highly in the 2024 inpatient survey, with patients reporting a good overall experience and performing better than peers on specific questions.
• Referral to Treatment (RTT) Times: The number of patients waiting 65 weeks or over had significantly decreased. UCLH was making progress towards the national ambition of reducing the proportion of patients waiting longer than 52 weeks. However, the overall 18-week RTT performance remained below plan, although the percentage of patients with a first outpatient attendance before 18 weeks had improved. The total waiting list had grown to 76,073.
• Diagnostics: Performance against the national ambition of 95% of the diagnostics waiting list waiting less than 6 weeks had worsened due to an increased waiting list, primarily driven by equipment shortfalls for MRI scanners. The opening of additional imaging capacity was anticipated to improve performance.
• Cancer Performance: The faster diagnosis standard (FDS) performance ranged between 74-88%, with most months compliant with the 80% standard. 62-day performance for cancer treatment commencement was mostly compliant with the increased ambition of 75%, though the 62-day GP backlog was above target.
• A&E Performance: Performance against the four-hour standard had reduced, falling below the national target, with increased demand in the Emergency Department (ED). The proportion of patients spending longer than 12 hours in the department had also risen.
• Patient Flow: UCLH had steadily improved the percentage of patients discharged by 5 pm. However, the proportion of beds occupied by patients who no longer met the criteria to reside had worsened, with an investigation underway to identify the drivers.
• Staff Survey: For the third consecutive year, UCLH remained the top trust in England for staff likelihood to recommend their organisation as a place to work.
• Workforce: Vacancy rates had decreased before increasing again, and the 12-month rolling sickness absence rate had remained relatively static, though monthly sickness absence had increased.
• National Oversight Framework: UCLH was in the top segment (high performing) of the national oversight framework, ranking 13th out of 134 trusts.

Councillor Benali Hamdache, Leader of the Independent and Green Group, asked for clarification on whether UCLH was using Palantir, to which it was confirmed that the Palantir contract was with UCLH.

Scrutiny Review – Draft Recommendations

The committee reviewed draft recommendations for a scrutiny review. Key recommendations included:

• Tackling inequalities in life expectancy and reducing premature mortality from preventable causes.
• Improving data insight and targeting interventions to communities with the highest unmet health needs.
• Addressing avoidable hospital admissions for long-term conditions (LTCs).
• Implementing a health in all policies approach.
• Reducing tobacco smoking and vaping, with a focus on local response capability and monitoring systems.
• Enhancing insights and engagement, and evaluating education on drugs, tobacco, and vaping.
• Providing an annual update on the life course approach and progress on joint health initiatives.

Councillor Tricia Clarke highlighted the mention of working closely with Healthwatch in recommendation nine, noting its importance. Councillor Janet Burgess MBE also commented on the crossover with children's scrutiny and the importance of the life course approach.

Quarter 2 Performance Report – Public Health

Jonathan O'Sullivan, Director of Public Health, presented the Quarter 2 performance report for Public Health.

Key highlights and discussions included:

• Overall Performance: Public Health met or exceeded targets across all 11 indicators, with several areas performing better than regional and national averages.
• Healthy Start Vouchers: Uptake of the NHS Healthy Start scheme was strong, with 1,809 families in Islington participating. The council's Fill the Gap scheme was also highlighted as providing additional support to families between the end of Healthy Start eligibility and the start of school.
• NHS Health Checks: The number of NHS Health Checks delivered was on course to meet the annual target, with Islington exceeding London and England averages for uptake. Additional payments were being offered to incentivise health checks for individuals with Serious Mental Illness (SMI) and Learning Disabilities (LD).
• Smoking Cessation: Access to stop smoking support was high, with 445 people accessing services in Q2, putting the borough on track to meet its annual target. The successful quit rate of 60% exceeded regional and national averages. The Breathe service was noted for its effectiveness, particularly for those with complex needs. The upcoming Smokefree Generation policy and legislative changes around tobacco and vaping were discussed, with a focus on regulation and control.
• Health Visiting: Coverage for New Birth Visits was 93%, comfortably within the local target, and exceeding London and England rates. The 6-8 week Health Visitor review coverage was 85%, meeting the target. Challenges remain in increasing uptake of childhood immunisations, particularly MMR, due to vaccine hesitancy and misinformation.
• Substance Use: 2,095 people accessed treatment and support for drug or alcohol use, exceeding the target. A new metric for successful recovery upon leaving the service showed improvement, with a reduction in unplanned exits. The Better Lives service was highlighted for its flexible and responsive approach, including expanded specialised pathways and outreach. Concerns were raised about the risks associated with synthetic opioids, and the council was working to strengthen reporting systems and partnership work to address drug-related deaths.
• Sexual Health: 272 Long-Acting Reversible Contraception (LARC) fittings were completed in Q2, on track to meet the annual target. The Integrated Sexual Health service also offers HPV vaccination and STI testing.
• Vaccinations: While MMR uptake remained a challenge, efforts were being made through training and community outreach to address vaccine hesitancy. Changes to the vaccination schedule, including the earlier MMR dose and the introduction of chickenpox vaccination, were seen as opportunities to increase uptake. The council was monitoring measles cases and responding to any local outbreaks.

Councillor Mick Gilgunn raised concerns about the hidden epidemic of nitrazine deaths and the risks associated with synthetic opioids. It was confirmed that the council was aware of these risks and had strengthened reporting systems and partnership work.

The committee also discussed the disposal of vapes, with a concern raised about fires in waste centres due to lithium batteries. The council was looking at options for a service to address this.

The meeting concluded with the noting of the Work Programme for 2025/26.