The North West London Joint Health Overview and Scrutiny Committee met on Thursday 13 March 2025 to discuss the North West London Planned Care Strategy and receive an update on the Integrated Care System. The committee also reviewed a tracker of previous recommendations.

North West London Planned Care Strategy

A significant portion of the meeting was scheduled to be dedicated to the North West London Planned Care Strategy. This strategy aims to ensure that all NHS planned care in North West London is delivered in a timely manner, meeting constitutional access standards by 2029, through high-quality, equitable, and financially sustainable services. The strategy is being developed in three phases, focusing initially on hospital-delivered planned care, then extending to community settings, and finally including planned care commissioned from the independent sector.

The report pack highlighted that the strategy development is supported by extensive communication and engagement with local communities and professionals. This has included the publication of issue papers for both professionals and residents, borough-based drop-in sessions, webinars, and workshops. The strategy development is also informed by the principle of health equity, with representatives from NHS North West London’s Health Equity Team involved in its approach.

Key challenges identified in the development of the strategy include:

• Demand: A projected 44% increase in activity is needed to meet constitutional standards by 2029. Referral rates are rising above the national average, compounded by population growth and increasing case complexity. Diagnostic activity has also increased but is insufficient to meet demand, with waitlists growing by 21% annually.
• Capacity: While demand has increased, planned care activity has remained relatively constant, leading to growing waiting lists. Although this trend has started to reverse, there is variability across specialties, with all currently below the national target of 65% to be achieved by April 2026.
• Productivity: Opportunities for improvement exist, particularly as overall activity has remained steady despite workforce growth. North West London falls below the median for several outpatient productivity markers, including Patient Initiated Follow Up (PIFU) rates and pre-specialist advice.
• Health Equity: Disparities in access to care exist, with individuals from deprived and ethnic minority backgrounds more likely to be on waiting lists.
• Patient Experience: While overall patient feedback is positive, concerns have been raised regarding appointment booking, communication about waiting times, transport, and access to translators.
• Cost: The cost of delivering planned care has increased, driven by growing patient volumes and supported by higher-cost routes such as insourcing and agency staff.

The report pack also detailed best practice examples from national and local initiatives aimed at addressing these challenges, including the use of AI for risk stratification, specialist hubs, and integrated approaches to care delivery.

Integrated Care System (ICS) Update

The committee was scheduled to receive an update on key developments across the North West London Integrated Care System (ICS) from Rob Hurd, Chief Executive of NHS North West London, and Rory Hegarty, Director of Communications and Engagement. This update was expected to cover various aspects of the ICS's work, including:

• New Appointments: Information regarding new appointments within the ICS, including the potential appointment of Penny Dash as the new Chair of NHS England.
• Winter Performance: An overview of the ICS's response to winter pressures, noting that North West London is considered among the best-performing ICSs nationally in this regard.
• Finance and Planning: An update on the financial position of the ICS, with projections for achieving breakeven for the 2024/25 financial year, and initial considerations for the 2025/26 planning round.
• Joint Forward Plan: A refresh of the Joint Forward Plan for 2025/26, outlining the ICS's strategic priorities for the next five years.
• NHS Ten Year Plan: Information on the government's consultation for the NHS Ten Year Plan and the ICS's role in promoting this and gathering local input.
• Grenfell Tower Fire Response: An update on services and support for those affected by the Grenfell Tower fire, including engagement with survivors and bereaved individuals.
• Compassionate Care for All Consultation: The progress and outcomes of the public consultation on the future of adult community specialist palliative care services.
• Neighbourhood Health: Developments in neighbourhood health teams (formerly integrated neighbourhood teams), focusing on proactive care for older people and children's health.
• New Health Centre: The upcoming opening of the new Chiswick Health Centre.
• Estates: Updates on the Estates Team's work, including plans for a collaborative 5 to 10-year delivery plan, the impact of the deferred New Hospital Programme, and the development of a North West London Sustainability Strategy.
• Health Equity: Progress on the ICS Health Equity programme, including a Shared Needs Assessment and initiatives to address health disparities.
• Community Engagement: A summary of the ICS's communications and involvement activities, particularly concerning the compassionate care for all consultation.
• Access to General Practice: Key findings from an engagement exercise on access to general practice, highlighting both positive feedback on staff and challenges in securing timely appointments.
• Work with Practitioners: Information on events and programmes for practitioners, such as the Additional Roles Reimbursement Scheme Personalisation Networking Event.
• Cardiovascular Health: Updates on the Cardiovascular Disease (CVD) Champions Programme and its impact on improving cardiovascular care.
• Dentistry: Progress on improving dental services, including initiatives for children and vulnerable populations.
• Neurodiversity and Mental Health: Information on the extension of the Partnerships for Inclusion of Neurodiversity in Schools (PINS) programme and the work on the new Children and Young People Mental Health Strategy.
• Children and Young People: The launch of Harrow Family Hub Networks.
• Falls Prevention: Details of the Stay Steady and Active falls prevention offer in Hounslow.

North West London JHOSC Recommendations Tracker

The committee was also scheduled to review the North West London Joint Health Overview and Scrutiny Committee Recommendations Tracker. This document provides a summary of scrutiny recommendations made during the 2023/24 and 2024/25 municipal years, tracking the decisions made by NHS bodies and the progress of implementation. The tracker includes updates on various previous recommendations and information requests related to acute beds, ophthalmology services, musculoskeletal services, palliative care, mental health provision, accident and emergency alternatives, and the ICS workforce strategy.