The Inner North East London Joint Health Overview and Scrutiny Committee met on Tuesday 23 January 2024 to discuss updates from the London Ambulance Service, NHS North East London, and the Joint Forward Plan for 2024/25. The committee also reviewed the progress of closer collaboration between Barts Health and Barking, Havering and Redbridge University Hospitals (BHRUT), and considered the committee's action tracker and forward plan.

London Ambulance Service Update

The committee was scheduled to receive an update on the London Ambulance Service (LAS). The report pack indicated that LAS aims to deliver outstanding emergency and urgent care across London 24/7. The service's five-year strategy, published in September 2023, focuses on three missions: Our Care (delivering outstanding emergency and urgent care), Our Organisation (being an inclusive, well-led, and skilled organisation), and Our London (contributing to the health of the capital). The LAS has seen significant recruitment, with over 1,600 new starters in 2022/23, and has increased staff hours on the road by 10% compared to the previous year. The service has also exceeded its target to reduce hospital conveyances, achieving this through upskilling its workforce, introducing specialist services, and utilising new technology. Winter plans included additional resources such as ambulances, response vehicles, control room staff, and clinicians, alongside a 10% increase in fleet capacity. The LAS also highlighted its London Lifesavers campaign, aiming to train 100,000 Londoners in basic life-saving skills.

NEL Health Update

An update on health matters within North East London (NEL) was scheduled. This included information on system resilience over winter, with key stakeholders collaborating through a new clinically led System Coordination Centre. The Finding the Right NHS Help campaign was ongoing to guide people to the appropriate services. Winter Wellness guides, co-produced with local authorities and residents, were distributed to vulnerable households. The report noted that as of 19 December 2023, 169,235 seasonal Covid-19 vaccines and 375,000 seasonal flu vaccines had been administered. Two NEL projects received HSJ Awards: the Tree Of Life In Schools project for African and Caribbean heritage young people, and a specialist pharmacy-led cardiovascular risk factor management initiative. The report also detailed a potential change of control for AT Medics Ltd, part of the Operose Health Group, which holds seven Alternative Provider Medical Services (APMS) contracts in North East London. The ICB's role in scrutinising the proposed new owner and ensuring no change to service provision for patients was outlined. Financial updates indicated a month 8 year-to-date deficit of £58.2m for the ICS, with a forecast outturn of breaking even due to strict NHS England rules. The NEL ICB itself had a year-to-date deficit variance of £15.1m against its plan. Provider updates included BHRUT reporting improved Type 1 A&E performance and progress in reducing waiting lists, while Barts Health noted a 67% A&E performance in October and progress in reducing 78-week waiters. Homerton Healthcare NHS FT reported strong Elective Recovery Fund (ERF) performance and improvements in emergency care targets. NELFT and ELFT provided updates on mental health services, including the Right Care Right Person initiative and the opening of new male acute mental health beds at Goodmayes.

Joint Forward Plan 2024/25

The committee was set to discuss the Joint Forward Plan (JFP) for 2024/25. This plan builds upon the interim Integrated Care Strategy published in January 2023 and the first five-year plan, the Joint Forward Plan 2023/24. The JFP outlines how the Integrated Care Board (ICB) and its partner trusts intend to arrange and provide NHS services to meet the population's physical and mental health needs. The refresh process for the 2024/25 JFP involved earlier engagement with NEL stakeholders. Key challenges highlighted included poverty and deprivation, significant population growth, and inadequate investment for clinical and capital development. The plan also detailed the system's assets, including its diverse population, research and innovation capabilities, leadership, financial resources, and primary care infrastructure. The JFP refresh proposed minor adjustments to the 2023/24 structure, with new slides covering strategic system improvement portfolios, Place plans, cross-cutting themes, and enablers.

Barts Health/BHRUT Closer Collaboration

An update was scheduled on the closer collaboration between Barts Health NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT). This collaboration is part of the North East London Acute Provider Collaborative (APC), which aims to provide strategic leadership for the transformation of acute clinical services. The closer collaboration, established in October 2021, focuses on enablers such as leadership, workforce, informatics, and corporate services. The report highlighted that by collaborating, the trusts aim to deliver better services to patients, reduce unwarranted variation and inequality, improve resilience through mutual aid, and ensure specialisation and consolidation where it leads to better outcomes and value. Specific areas of focus included clinical collaboration, digital infrastructure improvements (including a new Electronic Patient Record system for BHRUT), workforce redesign, and streamlining corporate services.

Committee Action Tracker and Forward Plan

The committee was due to review its Action Tracker and Forward Plan. The Action Tracker detailed outstanding actions from previous meetings, including follow-ups on the assurance framework for GP practices, updates on IAPT concerns, financial impacts of savings plans, and the role of community pharmacist services. The Forward Plan outlined potential future agenda items, including updates on various NHS collaboratives, health updates, the ICS Five Year Forward Plan, system recovery and resilience, and recovering access to primary care. Items proposed for future discussion included disputes resolution procedures, organogram of GP surgeries, the 111 service, virtual wards, IAPTs, and parasite transmission and treatment.