The Joint Health Overview & Scrutiny Committee (JHOSC) was scheduled to discuss a range of significant health service matters affecting North West London. Key topics included a planned temporary move of specialist children's heart, lung, and critical care inpatient services, and updates on cancer prevention and early diagnosis initiatives. The committee was also set to review the transformation of a specialist learning disability CAMHS ward.

Planned Temporary Move of Specialist Children's Heart, Lung, and Critical Care Inpatient Services

The committee was scheduled to consider a planned temporary move of specialist children's heart, lung, and critical care (CRIC) inpatient services currently provided by Guy's and St Thomas' NHS Foundation Trust (GSTT). This move is driven by clinical risk escalation regarding the safety and sustainability of the paediatric cardiac surgical service, with a particular concern over the 1:2.5 on-call rota for surgeons, which cannot be sustained beyond April 2026 without compromising patient safety. The proposal is to consolidate all heart and lung paediatric inpatient services and day cases requiring sedation at the Evelina London Children's Hospital (ELCH) and St Thomas' Hospital site. This consolidation is also necessary to meet mandated national Congenital Heart Disease (CHD) standards for co-location of services.

The report indicated that outpatient clinics, day-case procedures not requiring anaesthetic or sedation, outpatient imaging, and research would remain at existing sites. The relocation of cardiac surgery necessitates the temporary move of paediatric respiratory inpatients, as these services rely on the Paediatric Intensive Care Unit (PICU) and other co-located specialist paediatric services, which would become unsustainable at the Royal Brompton Hospital (RBH) site once cardiac surgery moves. The approach prioritises patient safety, learning from historical reviews into paediatric cardiac surgery failings. This planned temporary move has been approved for implementation by NHS England and serves as a safeguard until a formal, commissioner-led long-term options appraisal and service reconfiguration is completed.

The report highlighted that the current two-site model does not meet national CHD service standards, specifically regarding the on-call rota and the provision of an un-scrubbed surgeon on both sites for emergencies. It also noted a lack of other specialist services on the same site at Royal Brompton Hospital, such as general surgery, nephrology, and gastroenterology. The dependency of the RBH PICU on the cardiac surgical programme was also a key factor; without it, PICU activity would fall to an unsustainable level. The transfer will involve world-leading respiratory sub-services, including Cystic Fibrosis (CF), Primary Ciliary Dyskinesia (PCD), Severe Asthma, Long-Term Ventilation (LTV) and Sleep Medicine, and Rare Lung Disease and Thoracic Surgery. The Trust has planned for reprovision of existing respiratory capacity, including ward beds, High Dependency Unit (HDU) beds, and intensive care beds, at the Evelina London and St Thomas' campus.

The report detailed that approximately 2,500 children and young people with heart and lung conditions have used these inpatient services in the last year or have upcoming appointments. These patients are located across North West London, South West London, and a wider geography across the UK. The report also outlined the governance and regulatory oversight for this temporary move, including internal Trust leadership and NHS England London Region. A formal approval to proceed was given by NHS England London Region on 9 January 2026, viewing the move as an essential and urgent requirement to safeguard clinical standards. The report stressed that this temporary change is not a decision on the long-term configuration of the service and does not replace the formal process for permanent service change. Patient involvement has been a key consideration, with a comprehensive engagement plan in operation, including direct notification to families, briefing sessions, outreach, and digital access. Key learnings from patient feedback include the importance of continuity of care, clear communication, and support with travel and accommodation. The move is scheduled to start in mid-May 2026, phased over 2-3 weeks.

Cancer Prevention and Early Diagnosis Across North West London

The committee was scheduled to receive an update on the landscape of cancer provision across North West London (NWL), focusing on work undertaken by RM Partners NHS Cancer Alliance to improve cancer prevention, lung screening participation, and early diagnosis. The report summarised key programme areas, progress to date, and priorities for continued improvement. It also included an update on changes at the Mount Vernon Cancer Centre.

RM Partners NHS Cancer Alliance covers both NWL and South West London, bringing together the NWL Acute Provider Group, primary care, and public health teams. The Alliance's work is structured around four strategic programmes: Prevention and Screening, Early Diagnosis, Time to Treatment, and Treatment, Care, and Survival. In terms of prevention, RM Partners has focused on primary HPV vaccination, noting poor uptake across NWL boroughs due to a lack of awareness regarding the link between HPV and head and neck cancers. Strategies are in place to improve awareness and reduce barriers to access, including working with schools and targeted communications. Smoking cessation is also a focus, with an augmented offer for participants in the Lung Screening Programme.

The report detailed progress in cancer screening, with RM Partners directly commissioning the Lung Screening Programme, which has found 233 lung cancers across NW and SW London. Support is also being provided for the rollout of cervical self-screening in London. For early diagnosis, RM Partners has focused on community awareness campaigns for bladder, bowel, and lung cancers, reaching thousands of people through in-person events and digital channels. A Quality Improvement (QI) programme in primary care aims to reduce variation and improve the diagnostic process prior to referral for suspected cancer. This scheme has involved GP practices in Brent and Ealing, with plans to roll out to the remaining six NWL boroughs. Overall early diagnosis rates across NWL have increased by 4.3% since 2019, with stage inequity by deprivation narrowing.

Transforming the Crystal House Specialist LD CAMHS Ward

The committee was scheduled to discuss proposals for transforming the Crystal House Specialist Learning Disability (LD) Child and Adolescent Mental Health Service (CAMHS) ward. The current inpatient model is described as no longer meeting patient needs or aligning with national priorities and upcoming legislation for the care of children and young people with learning disabilities. Crystal House is a 5-bed specialist LD inpatient unit with high annual running costs, but has admitted a very low number of patients (23 in six years, with only 11 from NWL). The unit is staffed for five patients but often has only two, and has experienced periods of being completely empty. The service is deemed unsustainable, inequitable, and clinically unjustified, and has stopped taking new admissions.

The proposed changes are driven by shifts in national policy, including changes to the Mental Health Act, which will limit detention criteria for those with learning disabilities. The low use, high cost, and long length of stay, coupled with evidence that only 50% of children in learning disability hospitals have a mental illness, support the need for change. The NHS 10-year plan mandates a reduction in admissions and length of stay for people with learning disabilities. The current crisis-driven admissions are considered traumatic for children and families. A new model of care has been developed, focusing on earlier, community-based support to prevent escalation and reduce hospital admissions. This model aims to reach up to 40 times more children and young people, providing care in familiar community settings. The report highlighted that the current service costs £2.9 million per year, with a significant portion of this funding to be reinvested into the new CAMHS pathway in NWL. The new model proposes a pathway of community care, assessment, and only short hospital admissions if needed, followed by a return to community support. Engagement activities have shown a strong preference for community-based support, continuity of care, and reduced disruption. The plan is to discharge the current patient by the end of March 2026, implement a transitional model in April 2026, and fully embed the new model by October 2026.

North West London JHOSC Recommendations Tracker

The committee was scheduled to note the latest scrutiny recommendations trackers for the 2023/24, 2024/25, and 2025/26 municipal years. These trackers provide a summary of scrutiny recommendations made and information requests submitted during previous and the current municipal years, allowing the committee to track decisions made by NHS bodies and monitor implementation progress.

North West London JHOSC 2025/26 Work Programme

The committee was scheduled to note the North West London Joint Health Overview and Scrutiny Committee's work programme for the 2025/26 municipal year. This programme outlines the health policy areas the committee plans to review, with a focus on scrutinising the plans for meeting the health needs of the population and the provision of health services in North West London. The programme is designed to be flexible and adaptable, with potential for items to change during the year to address emerging issues. Two additional agenda items were added to the 2025/26 work programme for discussion on 19 March 2026: the Planned Temporary Move of Specialist Children's Heart, Lung, and Critical Care Inpatient Services, and Transforming the Crystal House Specialist LD CAMHS Ward. Two items, Digital Health, Data Use, AI and Digital Inclusion and Weight Loss Drug Supply and Roll Out, have been deferred to the 2026/27 municipal year. The meeting on 19 March 2026 was scheduled to be hosted by the London Borough of Brent.