The North West London Joint Health Overview and Scrutiny Committee met on Thursday 19 March 2026 to discuss significant planned changes to specialist children's heart, lung, and critical care inpatient services, and the transformation of a specialist learning disability CAMHS ward. The committee also reviewed updates on cancer prevention and early diagnosis across North West London.

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

The committee was scheduled to discuss a planned temporary move of specialist children's heart, lung, and critical care inpatient services currently delivered by Guy's and St Thomas' NHS Foundation Trust (GSTT). This move is proposed to consolidate services at the Evelina London Children's Hospital (ELCH) and St Thomas' Hospital site. The report pack indicated that this decision was driven by clinical risk escalation regarding the safety and sustainability of the paediatric cardiac surgical service, specifically the 1:2.5 on-call rota, which cannot be sustained beyond April 2026 without compromising patient safety. The move is also intended to meet mandated national Congenital Heart Disease (CHD) standards for co-location of services.

The report pack detailed that outpatient clinics, day-case procedures not requiring sedation, and outpatient imaging services would not be affected by this move. The relocation of cardiac surgery necessitates the temporary move of paediatric respiratory inpatients due to their reliance on the Paediatric Intensive Care Unit (PICU) and other co-located specialist paediatric services. The report highlighted the critical dependency of the Royal Brompton Hospital (RBH) PICU on the cardiac surgical programme, stating that without it, the unit would become clinically unsustainable and unsafe. World-leading respiratory sub-services, including those for Cystic Fibrosis (CF), Primary Ciliary Dyskinesia (PCD), severe asthma, and long-term ventilation, would also be transferred.

The report pack indicated that the move, approved by NHS England, is a temporary measure until a formal, commissioner-led long-term options appraisal and service reconfiguration process is completed. It was noted that approximately 2,500 children and young people with heart and lung conditions across North West London, the South East, and wider UK would be affected by these changes. The report also outlined the proposed facilities to accommodate the consolidated services, including the refurbishment of Edward Ward and the conversion of Sky Ward at ELCH, alongside the integration of the RBH PICU team.

Transforming the Crystal House Specialist LD CAMHS Ward

The committee was scheduled to consider proposals for transforming the Crystal House specialist learning disability (LD) Child and Adolescent Mental Health Service (CAMHS) ward. The report pack indicated that the current 5-bed specialist LD inpatient unit, with an annual running cost of over £2.9 million, is no longer meeting the needs of patients or aligning with national priorities and upcoming legislation for the care of children and young people with learning disabilities.

The report highlighted that the unit has admitted a low number of patients over the past six years, with only 23 admissions in total, of which 11 were from North West London. It was noted that the unit is often staffed for five patients but frequently has only two, and has experienced periods of being completely empty. The report stated that the service is not sustainable, equitable, or clinically justified 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 to mental illness, meaning many young people with learning disabilities may not meet new criteria. The NHS 10-year plan also mandates a reduction in admissions and length of stay for people with learning disabilities. The report suggested that admissions are frequently crisis-driven rather than clinically indicated, causing distress to children, young people, and their families. A new model of care is being developed, focusing on earlier, community-based support, aiming to reach up to 40 times more children and young people than the current model. This new model prioritises prevention and early intervention, with funds being reinvested into the CAMHS pathway. The report detailed that if admission is required, it would be a short, focused, and goal-oriented hospital admission, with a return to community support thereafter. Engagement activities with patients, families, and stakeholders have taken place between summer 2024 and the present, with key themes including a preference for community-based support and continuity of care.

Cancer Prevention and Early Diagnosis Across North West London

The committee was scheduled to receive an update on cancer prevention and early diagnosis initiatives across North West London. The report pack indicated that this item would follow, suggesting that detailed information was not yet available at the time of publication.

North West London JHOSC Recommendations Tracker and Work Programme

The committee was also scheduled to review the North West London JHOSC Recommendations Tracker, which provides an overview of scrutiny recommendations made and the progress of NHS bodies in responding to them. Additionally, the committee was to note the North West London JHOSC 2025/26 Work Programme, outlining the health policy areas the committee plans to review during the municipal year. The report pack indicated that the work programme is designed to be flexible and adaptable, with potential for items to change or be deferred. Two additional agenda items, the Planned Temporary Move of Specialist Children's Heart, Lung, and Critical Care Inpatient Services and Transforming the Crystal House Specialist LD CAMHS Ward, had been added to the work programme for this meeting. The items Digital Health, Data Use, AI and Digital Inclusion and Weight Loss Drug Supply and Roll Out were noted as having been deferred to the 2026/27 municipal year.