The Health and Adult Social Services Scrutiny Panel of Ealing Council was scheduled to discuss Ealing's adult mental health services, immunisation and screening programmes, and the role of the voluntary and community sector in health services. The meeting also included an update on primary care access and the operating model for Integrated Care Boards.

Ealing Adult Mental Health Services

The panel was scheduled to receive an overview of adult mental health services in Ealing, with a particular focus on the crisis pathway, the need for intensive support for a specific group of patients, and the impact of the Right Care, Right Person (RCRP) initiative. The report pack indicated that the board was invited to review the report and comment on any aspect to make recommendations to the provider regarding service challenges, mitigations, and improvement plans. The presentation materials highlighted the local context, an overview of Ealing's adult mental health provision, and the trust's response to a Care Quality Commission (CQC) review. Discussions were also scheduled to cover the adult mental health crisis pathway's performance, challenges, and interventions, as well as the impact of RCRP on mental health teams. The report pack noted current challenges in bed availability, differing perspectives on community treatment thresholds, and low footfall to crisis alternatives. It also detailed inpatient flow challenges, including a high proportion of beds occupied by patients from outside Ealing, which affected availability for local residents. Data on adult mental health-related Emergency Department (ED) attendances and the average time spent in ED for such cases was also scheduled for review, with Ealing noted as an outlier for high figures. The impact of RCRP on mental health services was to be discussed, including its implications for police involvement and partner expectations.

Immunisations and Screening in Ealing

An annual update on immunisation and screening programmes in Ealing was scheduled for discussion. The report focused on school-age immunisations, with a brief overview of under-5s and adult immunisations, as well as population screening programmes. The panel was invited to review and discuss key themes for school-age immunisation and consider specific aspects for further scrutiny. The report highlighted that vaccination is a highly effective public health intervention. It detailed immunisation uptake in Ealing for children aged 0-5 years, noting that while some vaccinations were above the London average, rates showed a downward trend. For school-age vaccinations, there were wide variations in uptake between Ealing schools, and efforts were underway to understand and address these. Adult immunisation programmes, including flu and shingles vaccines, were also to be discussed, with a noted decrease in uptake for flu vaccinations in at-risk populations and those aged 65 and over. Regarding screening, the report indicated an increasing trend in breast cancer screening coverage in Ealing, though bowel cancer screening coverage remained below London and England averages. Cervical cancer screening coverage for women aged 25-49 showed a decreasing trend, while coverage for those aged 50-64 remained stable. The report also outlined the roles and responsibilities of various bodies, including NHS England, the North West London Integrated Care Board (ICB), and Ealing Local Authority, in delivering immunisation and screening programmes.

Role of Voluntary and Community Sector within Health Services

The panel was scheduled to receive an overview of how the voluntary and community sector (VCS) contributes to improving health and delivering health services in Ealing. The report aimed to provide the panel with an overview of the sector's role, the partnership vision to support it, and upcoming priorities. The report defined the VCS as independent, self-governing bodies established for community benefit, and also considered the broader concept of civil society. It explained that the work of most VCS organisations impacts on determinants of health, ranging from individual lifestyle factors to broader societal influences. The concept of asset-based commissioning, which focuses on leveraging existing community strengths and resources, was also to be discussed. An analysis of the formal VCS in Ealing was presented, detailing the number of charities and social enterprises, their employees, volunteers, and trustees. The report also acknowledged the existence of under-the-radar groups, estimated to be three times more numerous than registered organisations. The report outlined how the VCS improves health and delivers health services through strategic partnerships, a grants programme, and commissioned services. Upcoming priorities included ongoing delivery of the Health & Wellbeing Strategy and the role of the VCS in developing Neighbourhood Health teams.

Primary Care Access

An update on the work being done to improve primary care access in Ealing was scheduled. Members were to be informed about the objectives for general practice and Primary Care Networks (PCNs), which include delivering high-quality patient care, managing demand, and maintaining continuity of care. The report noted that North West London had delivered more appointments than other areas in London and was on track to exceed 17 million appointments by the end of the financial year. Work was underway to reduce unwarranted variation between practices, PCNs, and boroughs. The panel was to hear about variations in online consultation submissions, the introduction of cloud-based telephony systems to improve call handling and demand management, and the use of artificial intelligence to identify urgent issues. The utilisation of NHS 111 GP slots and potential for wider booking by Urgent Treatment Centres and A&E were also on the agenda. The Jubilee Gardens Health Centre Hub, part of the NHS Neighbourhood Rebuild Programme, was mentioned as being scheduled for completion in 2030.

NHS NCL and NWL ICB Place and Neighbourhoods

The meeting was scheduled to include a presentation on the high-level operating model for Place and Neighbourhoods for NHS North Central London (NCL) and North West London (NWL) Integrated Care Boards (ICBs). Members were to be informed about the requirement for ICBs to reduce running costs by 50%, shifting towards a more strategic commissioning role. The report indicated that staff consultations had concluded and executive teams were reviewing feedback to finalise new structures. It was noted that funding was insufficient to retain historic place-based teams, with staff facing voluntary or compulsory redundancy. The new ICB would cover 13 boroughs across North Central and North West London, serving a population of 4.5 million. Discussions were expected to cover the strategic commissioning oversight unit, the organisation of teams into neighbourhoods serving populations of 50,000–100,000, and ongoing conversations about engagement with local authorities and Healthwatch.