The Health Scrutiny Committee met to discuss the work of Positive East in supporting residents affected by HIV, receive an update on the interim health facility at Barking Riverside, and review the Healthwatch Barking and Dagenham Work Programme for 2026-2027. The committee also appointed members to the Outer North East London Joint Health Overview and Scrutiny Committee.

Positive East Update

Mark Santos, Executive Director of Positive East, presented an overview of the organisation's work over the past three decades supporting Barking and Dagenham residents affected by HIV. Positive East's vision is to create a future where people living with HIV live full and healthy lives, free from stigma, with no new transmissions, and where good sexual health is realised for all.

Despite significant progress, challenges remain. Barking and Dagenham has a HIV prevalence rate of 4.82 per thousand, exceeding British HIV Association guidelines for high prevalence areas. A significant issue is the high rate of late diagnosis, with 44.4% of individuals diagnosed at a late stage, which drastically increases the risk of mortality. There is also a low uptake of PrEP (pre-exposure prophylaxis), a medication that prevents HIV acquisition. Disengagement from HIV care, poverty, and poor housing are also significant issues, with 82% of presenting issues at Positive East relating to these factors. Furthermore, people living with HIV are living longer, leading to an increase in complex health needs, with 66.8% experiencing comorbidities, rising to 88.7% for those aged 65 and over. Mental health conditions are also prevalent, with 39.4% of people living with HIV having been diagnosed with at least one mental health condition. HIV stigma and discrimination persist.

Positive East addresses these challenges through various initiatives. They offer community-based HIV testing and prevention services at locations such as Barking College, Coventry University, Dagenham Library, and through a testing bus at Barking Market. They also focus on PrEP equity, particularly for heterosexual individuals from Black heritage communities and women, through projects like Women for Women and community-based PrEP clinics. Positive East leads the Pan-London Outreach and Engagement Programme, focusing on gay and bisexual men, and amplifies the national HIV Prevention England campaign.

For those living with HIV, Positive East provides comprehensive support services, including an advice service that secured £184,000 in benefits and hardship funds in the last financial year. Peer support, recommended by the British HIV Association, is a key offering, with peer support workers based in the community and clinics. They also run support groups for specific demographics, such as a positive over 50 group, and offer a specialist psychology service for women experiencing trauma.

The organisation also engages in research and insight, contributing to campaigns like the Five Basics for people in temporary accommodation. Positive East hosts the UK AIDS Memorial Quilt and organises the World AIDS Day Red Run, a major fundraising event for HIV charities.

Councillor Donna Lumsden, Deputy Chair of the Health Scrutiny Committee, asked about training for GP surgeries to offer routine HIV tests and initiatives to tackle stigma. Mr. Santos explained that while training is provided to GPs, access can be difficult. He highlighted the importance of opt-out testing in emergency departments and suggested this could be a model for GP registration. Regarding stigma, he mentioned workshops on self-stigma, outreach work, and promoting the message of U equals U (Undetectable equals Untransmittable).

Councillor Marion Hull inquired about effective community-based strategies for reducing HIV transmission and how local policies and education tackle HIV awareness. Mr. Santos emphasised community-led strategies, citing the Women for Women project as an example. He also highlighted the North East London Sexual and Reproductive Health Strategy as a key policy driver.

Councillor Glen Spoor asked for evidence demonstrating that Positive East's work is improving outcomes and moving towards ending new HIV transmissions, and where the most significant gaps remain. Mr. Santos identified inequities and inequalities, late diagnosis, stigma, access to PrEP, and disengagement from care as key challenges. He noted that while overall numbers are on a downward trajectory, specific communities, particularly Black and global majority communities, are not faring as well. He provided quantitative data, stating that Positive East engaged with 1,285 people in Barking and Dagenham in the last financial year, working specifically with 113 people living with HIV and testing 122 for HIV and STIs.

Councillor Spoor also asked about lessons learned from engaging with communities that experience higher levels of stigma and barriers to access. Mr. Santos explained that they are focusing on women from Black heritage and South Asian communities, adapting their approach to meet the specific needs and concerns of these groups, such as discussing HPV vaccines and consent before addressing HIV.

The committee also discussed how the success of this initiative will be measured. Mr. Santos indicated that they track new diagnoses and epidemiological data, and use surveys and impact reports. He also mentioned that a third of people tested by Positive East have never tested before, and significant numbers have not engaged with any services, including primary care.

Regarding education in schools, Mr. Santos clarified that Positive East does not have a specific focus on children and young people, but acknowledged the importance of this area. He also outlined lessons learned from delivering services, emphasizing the importance of community-based testing and integrated support provision within clinic settings.

When asked about safety and effectiveness, Mr. Santos explained that clinical governance is supported by Barts Health NHS Trust, with training and audits for testers. He also noted that feedback from service users, such as the development of the positive over 50 group and the clinical psychology service for women, drives service development.

Finally, regarding PrEP equity, Mr. Santos highlighted the need for increased awareness, particularly in Black and global majority communities, and the importance of making PrEP as accessible as possible through community clinics and online provision.

Barking Riverside Health Services Update

Moira Coughlan, Deputy Director for Neighbourhood Development, provided an update on the interim health facility at Barking Riverside. This facility is being developed in partnership between NHS North East London and Barking Riverside Limited to provide essential primary care services to the growing community, which is expected to reach 20,000 homes. The interim facility will offer continuity of care while plans for a larger, permanent health and well-being facility are developed.

Barking Riverside Limited has provided a unit for the interim facility and is supporting fit-out costs and early operational expenses. Detailed design is complete, a fit-out contractor has been appointed, and work is expected to begin on-site in September 2026. NHS North East London is procuring a provider for primary care services, and a communications campaign is underway. The interim facility will include five clinical and treatment rooms, reception, waiting, and office space.

Councillor Glen Spoor expressed concern about the five-year delay in reaching this interim stage and the lack of a confirmed permanent solution. He stressed that any further reduction in the permanent scheme would not be accepted. Councillor Marion Hull echoed these concerns, highlighting the long wait for the facility and the need for a permanent solution to support the growing population.

Ms. Coughlan stated she had no information on the permanent facility's timeline, as its development is a negotiation between the council and Barking Riverside Limited, with the NHS acting as a provider. Councillor Ajanta Deb Roy inquired about the capital funding for the permanent hub and how it would avoid similar delays. It was explained that an allocation exists within Section 106 agreements, but the leisure centre component of the original plan had to be dropped due to rising building costs. David Harley, the council's Director of Place or Inclusive Growth, will report back on the timescale for the permanent facility.

Councillor Hull asked about the demand and capacity modelling for the interim facility, given the growing population. It was explained that existing health modelling suggests current provision, with additional GPs at Thames View Health Centre, could cope with the current population. However, the space at Thames View is not suitable for additional capacity, and residents of Barking Riverside should not have to travel. The interim facility is designed to accommodate current demand and future growth.

A question was raised about resident involvement in shaping the services and internal design of the facility. It was noted that a resident committee was involved in the initial design of the permanent facility, but the interim nature of the current project meant less direct involvement. However, the structure to involve local residents remains, and future designs will prioritize community input.

Councillor Hull also asked what services residents would expect from the interim facility, beyond general practice, such as mental health support and child clinics. Ms. Coughlan stated she did not have this information but would take the question away to provide a response.

Healthwatch Barking and Dagenham Work Programme 2026-2027

Manisha Modhvadia, Healthwatch Barking and Dagenham Manager, presented the work programme for 2026-2027. The programme focuses on gathering and representing local people's experiences of health and care services. Key projects include research into NHS referrals, Pharmacy First, and the NHS App. The programme also involves Enter and View visits to local services, a self-evaluation of Healthwatch's awareness, and ongoing community engagement.

The referral project aims to gather detailed insights from residents about their referral journeys, identifying areas for improvement. The Pharmacy First Part 2 project will gather feedback from local professionals on their awareness and use of the service. The NHS Digital App project will explore residents' experiences with the app, identifying barriers and areas for improvement.

Councillor Hull asked about the connection between hospital discharge and primary care services, specifically regarding follow-up appointments for things like dressings. Ms. Modhvadia explained that due to resource limitations, the current project focuses on the referral pathway to the first appointment, but feedback on discharge experiences is gathered through other avenues.

Councillor Donna Lumsden questioned how the Healthwatch programme complements or duplicates the scrutiny of local authorities and the Integrated Care Board (ICB). Ms. Modhvadia stated that Healthwatch has regular meetings with the ICB and BHRUT to avoid duplication and ensure their work complements existing efforts. She provided an example of collaborating with Public Health on a deep dive into carers' needs.

Councillor Glen Spoor asked about measuring the tangible improvement of Healthwatch's work and what success would look like. Ms. Modhvadia explained that recommendations are sent to service providers and commissioners, who must respond within 21 working days with an action plan. Healthwatch then monitors the implementation of these changes. Councillor Spoor pressed for quantitative, measurable objectives, but Councillor Lumsden clarified that Healthwatch's role is to be an independent community voice, not to produce SMART outcomes, which are the responsibility of the NHS and local council. Ms. Modhvadia added that even impacting one person is considered a success.

Regarding ensuring feedback is representative of Barking and Dagenham's diverse communities, Ms. Modhvadia outlined strategies including working closely with the Faith Leaders Network, attending community events, and collaborating with adult social care to reach isolated individuals. They also monitor demographic data quarterly and adapt their engagement schedule accordingly.

When asked about the role of Healthwatch in relation to the Care Quality Commission (CQC), Ms. Modhvadia confirmed that CQC receives all Healthwatch reports and they work closely together. Healthwatch's feedback has previously triggered CQC visits.

On how insights will be used by commissioners, Ms. Modhvadia stated that recommendations will be sent to commissioners and service providers, who will be expected to respond and outline their plans. Healthwatch will follow up to ensure recommendations are implemented and changes occur. Councillor Lumsden added that Healthwatch is an advisory body and its power lies in persuasion.

Appointments to the Outer North East London Joint Health Overview and Scrutiny Committee

Lois Taylor, Senior Governance Officer, presented the report on appointments to the Outer North East London Joint Health Overview and Scrutiny Committee (JHOSC) for 2026-2027. The JHOSC reviews and scrutinises large-scale NHS service changes affecting two or more boroughs. It was recommended that Councillor Michel Pongo, Chair of the Health Scrutiny Committee, and Councillor Donna Lumsden, Deputy Chair, be appointed to the JHOSC, along with one additional member.

Councillor Glen Spoor noted that the ICB has requested a single JHOSC covering seven boroughs, rather than the current inner and outer structure, and that the ICB does not wish to service a joint committee. This debate is ongoing.

Other Business

The committee noted the minutes from the last Joint Health Overview and Scrutiny Committee meeting and the Health and Wellbeing Board and ICB Sub-Committee meeting. The current work programme for 2026-2027 was also noted. There were no other public or private items to be considered.