The Inner North East London Joint Health Overview & Scrutiny Committee was scheduled to discuss updates from the London Ambulance Service, the NEL Health update, and the Joint Forward Plan for 2024/25. The committee was also set to consider closer collaboration between Barts Health and BHRUT, and review its 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 the LAS aims to deliver outstanding emergency and urgent care across London, 24/7. The service has been working to treat more patients over the phone or on scene, and convey fewer patients to hospital. The LAS has also focused on staff recruitment and retention, with a rise in staff satisfaction. Winter plans included increasing ambulance capacity, utilising specialist resources, and working with partners to ensure timely patient handover at emergency departments. The LAS's five-year strategy, published in September 2023, outlines three missions: Our Care, Our Organisation, and Our London, with 50 commitments organised under 10 priority areas. The strategy development involved extensive engagement with staff, partners, and the public across London's boroughs, including those within North East London. The report also detailed the LAS's performance in North East London, including average response times for different categories of calls and the service's estate and patient demographics within the sector.

NEL Health Update

An update on health matters within North East London (NEL) was scheduled for discussion. 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 residents to appropriate services. Winter Wellness guides, co-produced with local authorities and residents, were distributed to provide holistic information on staying well. The update also covered vaccination figures, with Covid-19 and flu vaccine uptake detailed. Successes were highlighted, including two NEL projects winning HSJ Awards and the Richmond Road medical centre reception team winning a National General Practice Award. The system's commitment to addressing sexual violence against women and girls was also noted, with the signing of the Mayor of London's pledges and the adoption of NHS England's sexual safety charter. A consultation on North Central London's (NCL) Start Well programme, focusing on children, young people, maternity, and neonatal services, was mentioned, with potential impacts on NEL residents to be considered. An update on AT Medics/Operose Health was also included, detailing a potential change of control and the ICB's responsibilities in scrutinising the proposed new owner to ensure continued service provision for patients. Financial updates for the NEL ICB and the system as a whole were presented, outlining deficits and financial recovery plans. Provider updates from Barking, Havering and Redbridge University Hospitals (BHRUT) and Barts Health detailed improvements in urgent and emergency care, cancer services, and financial recovery. Homerton Healthcare NHS FT provided an update on operational performance and corporate activity, while NELFT and ELFT shared information on mental health, learning disability, and autism services, including the implementation of the Right Care Right Person initiative and efforts to address capacity challenges. The report also included information on testicular cancer, highlighting data availability and outreach programmes in schools.

Joint Forward Plan 2024/25

The committee was scheduled to review the Joint Forward Plan (JFP) for 2024/25. This plan builds upon the interim Integrated Care Strategy published in January 2023 and the first Joint Forward Plan for 2023/24. The JFP outlines how the ICB and its partners intend to arrange and provide NHS services to meet the population's physical and mental health needs. The refresh of the JFP for 2024/25 involved earlier engagement with NEL stakeholders to ensure improved awareness and input. The plan details the challenges faced by the system, such as poverty, deprivation, population growth, and inadequate investment, alongside the assets within the partnership. It also sets out the system planning approach, divided into integrated care strategy, delivery plan, and operational planning. The main changes from the previous JFP include new slides covering strategic system improvement portfolios, Place plans, cross-cutting themes, and enablers. The plan also highlights what is important to residents, successes to date, and the development of a strategic outcomes framework. The document details the unique population of North East London, its diversity, growth, and the impact of poverty, deprivation, and ethnicity on health. It outlines key factors affecting health and driving inequalities, and the need for a greater focus on prevention and addressing unmet need. The plan also addresses population growth and its uneven distribution, particularly in deprived areas, and identifies significant assets within the system, including its people, research and innovation, leadership, financial resources, and primary care. The report details the challenges and opportunities facing health and care services, including urgent and emergency care, planned care backlogs, and the need to expand and improve primary and community care. It also discusses the financial unsustainability of the current blend of care provision and the need for workforce growth. The plan outlines how the system is transforming its ways of working, enhancing productivity, and shifting towards prevention and earlier intervention. This includes detailed programmes for urgent and emergency care, community health services, primary care, planned care, cancer services, maternity services, babies, children and young people, long-term conditions, mental health, employment and workforce, specialist commissioning, digital infrastructure, finance, and physical infrastructure. The plan also details the priorities for each Place-based Partnership within North East London: Barking & Dagenham, Havering, Redbridge, Tower Hamlets, Newham, Waltham Forest, and City & Hackney. Cross-cutting themes such as health inequalities, prevention, personalised care, co-production, learning systems, and high trust environments are also addressed. The document concludes with implications and next steps, including lessons learned from the previous JFP, the development of an outcomes framework, and the prioritisation of transformation programmes.

Barts Health/BHRUT Closer Collaboration

The committee was scheduled to receive an update 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 of effective local delivery, including leadership, workforce, informatics, and corporate services. The report highlighted that collaboration is expected to reduce unwarranted variation and inequality in health outcomes, improve resilience through mutual aid, and ensure specialisation and consolidation where it leads to better outcomes and value. The paper outlined the significant asset base shared by Barts Health and BHRUT and detailed focused areas for collaboration, including clinical collaboration to enable clinicians to work together more effectively, digital infrastructure improvements such as the procurement of an electronic patient record (EPR) for BHRUT, workforce redesign to create flexible staffing models, and corporate services for greater effectiveness and efficiency. The APC's role in shaping clinical strategy was also mentioned, with benefits achieved to date including planned care backlog reduction through mutual aid and strong cancer performance.

Committee Action Tracker and Forward Plan

The committee was scheduled to review its Action Tracker and Forward Plan. The Action Tracker details actions and recommendations from previous meetings, including those related to the monitoring of the Assurance Framework for GP Practices, updates on IAPT concerns, virtual clinics, efficiency savings, financial impacts of savings plans, Continuing Healthcare policies, occupational therapist and physiotherapist vacancies, and the disputes resolution procedure. The Forward Plan outlines potential agenda items for future meetings, including community voice on North East London Talking Therapies, updates on various collaboratives (Mental Health, Disabilities and Autism; Community Health), a standing health update covering NEL Big Conversation, staffing structure, financial environment, strike action, and Trust updates. Other potential items include the ICS Five Year Forward Plan, system recovery and resilience, and the Joint Forward Plan 2024/25. Specific items to be scheduled include follow-ups on the NEL Estates Strategy and the Acute Provider Collaborative.