The Joint Health Overview & Scrutiny Committee met on Tuesday 15 April 2025 to discuss a range of health-related issues impacting residents across Outer North East London. Key topics included an update on the proposed Superloop bus route SL12, a deep dive into cancer services within the North East London Integrated Care Board (ICB), and a general health update covering financial challenges, structural changes within the NHS, and various service improvements.

Superloop Bus Route SL12

Healthwatch Havering, represented by Ian Buckmaster, presented concerns and an alternative proposal for the proposed Transport for London (TfL) Superloop bus route SL12, which is planned to run from Gants Hill to Rainham via Romford. Healthwatch Havering suggested an amended route that would serve Hornchurch Town Centre, Hornchurch Station, and crucially, the St George's Health and Wellbeing Hub.

The proposed alternative route was argued to be more beneficial for residents due to several factors:

• Serving a more populous area: The route would serve Hornchurch Town Centre, which is considered more populous than Elm Park.
• Improved access to Hornchurch Station: While Elm Park Station is also served by the District Line, Hornchurch Station would receive better bus connectivity.
• Access to St George's Health and Wellbeing Hub: This is a significant health facility serving a wide area, including patients undergoing kidney dialysis. The proposed route would provide a direct link from Rainham and the Beam Park development area to this hub, which is currently lacking. The existing proposed route already serves King George Hospital, Goodmayes, and Queen's Hospital, Romford, from which patients are often referred to St George's.
• Better access to local amenities: The alternative route would also improve access to Harrow Lodge Park and Leisure Centre, and Hornchurch Country Park.

The committee received this information and will consider the recommendations.

NEL ICB Deep Dive - Cancer Services

Femi Odewale, Managing Director of the North East London Cancer Alliance, and Angela Wong, Chief Medical Officer for the same alliance, presented an in-depth overview of cancer services within the North East London Integrated Care Board (ICB). The presentation highlighted the significant impact of cancer on families across London, with approximately 7,735 new cancer diagnoses in North East London in the 2023-2024 period. Despite this high volume, a small proportion of cases were classified as advanced.

The committee was informed about the ongoing efforts to improve cancer services, focusing on three key pillars: prevention, early diagnosis, and timely treatment.

• Early Diagnosis: This strategy includes:

  • Screening Programmes: Efforts are being made to increase uptake for breast screening (targeting women aged 35-64, with additional age groups considered), lung cancer screening (a new initiative for asymptomatic individuals who have ever smoked), and bowel cancer screening (a free service for eligible populations). Performance data showed mixed results for breast screening uptake across different boroughs.
  • Awareness Campaigns: Non-traditional methods are being employed to raise awareness, including targeted social media outreach and campaigns aimed at specific demographics, such as encouraging women to seek early diagnostic tests and engaging 50% of men. Sustainable awareness materials are also being developed.
  • Technological Innovations: Artificial intelligence (AI) is being integrated into diagnostic processes, particularly for chest X-rays, to reduce backlogs and prioritise urgent cases. The AI system can process and report findings within three minutes overnight, addressing a significant portion of the X-ray backlog. A system is in place to prioritise urgent cases (P1A) for reporting within 24 hours, with other cases having a maximum of 72 hours. Nineteen animated videos have also been developed to support education and awareness.

• Diagnosis and Treatment: Progress has been made in improving Multidisciplinary Team Meetings (MDTs), which are crucial for discussing patient treatment plans. A new Breast Pain Pathway has been developed, and a Breast Pain Clinic has been established at Barts Health. Efforts are also underway to enhance oncology services, with BHRUT supported to establish a nurse consultant role for chemotherapy. A new pathway has been introduced for gynaecology patients experiencing unscheduled bleeding whilst on HRT.

• Personalised Cancer Care: All North East London Trusts now have operational Personal Stratified Follow Up for Breast, Colorectal, and Prostate cancers. Remote monitoring systems are live at BHRUT and Barts, with Homerton expected to implement it soon. Prehabilitation services have been sustained, benefiting over 1,600 patients by preparing them for treatment, reducing hospital stays, and improving outcomes. The 2023 National Cancer Patient Experience Survey showed improvements in how patients are informed about their diagnosis, involvement in treatment decisions, and receiving adequate information.

• Workforce Development: A review of the oncology workforce has been conducted to identify strategies for involving Allied Health Professionals and pharmacists. Training and support for MDT chairs and coordinators are being developed, and a pilot for Cancer Clinical Nurse Specialist Development Leads is underway across London.

The committee noted the presentation and acknowledged that further updates may be required.

Health Update

The committee received a comprehensive health update covering various aspects of healthcare provision and management across North East London.

• Provider Updates:

  • Barking, Havering and Redbridge University Hospital NHS Trust (BHRUT): Fiona Wheeler, presenting for BHRUT, highlighted improvements in elderly care and patient services. A campaign for £35 million in capital funding has been launched to redesign the emergency department at Queen's Hospital, which is currently seeing over 750 patients daily, double its original capacity. Efforts are being made to improve safety and efficiency. The trust is managing a high number of mental health cases and collaborating with police and healthcare partners to provide better assessment alternatives. Waiting lists have been significantly reduced, with fewer than 500 patients waiting over a year. However, there are 4,500 cancer patients awaiting diagnosis or treatment, and while urgent referrals meet targets, treatment delays persist. BHRUT is implementing a £61 million savings programme focused on efficiency, workforce costs, procurement, and service partnerships.
  • Mental Health and Emergency Services: Marie Johnson, Chief Operating Officer, acknowledged that while emergency department wait times have improved, they remain excessively long. The initiative to develop crisis cafés in Barking, Dagenham, Redbridge, and Waltham Forest is progressing, with Barking and Dagenham in the tender process for a June go-live. A new community facility in Redbridge offers structured support and inpatient beds. Community teams are reviewing their capacity to reduce ambulance responses and A&E visits. Patient numbers in out-of-area mental health placements have reduced, with a goal to lower this further. A bid for capital funding for new inpatient wards, potentially two if funding allows, has been submitted, with a focus on bolstering female bed capacity.
  • Broader Community Health Initiatives: Efforts are underway to standardise musculoskeletal (MSK) services, with a business case for a new service offer. Children's nursing services are expanding in Redbridge, and collaboration with partners like BHRUT is being intensified. Community education boards are being explored to support physical health, particularly for the elderly. Integration of primary care, nursing services, and virtual wards is a priority to provide swift, comprehensive assessments near patients' homes.

• Financial and Structural Changes:

  • Government and NHS Structural Changes: Henry Black, Chief Finance Officer, reported on the government's announcement to abolish NHS England and transition its functions to the Department of Health and Social Care, reverting to a pre-2012 model. The government's agenda focuses on digitising services, shifting resources from acute hospitals to community care, and moving from treatment towards prevention. A tenure plan and Comprehensive Spending Review are expected later in the year.
  • Management Cost Reduction Targets: Integrated Care Boards (ICBs) and divisions face requirements to reduce management costs by 50% of the growth since 2019. For the BHIT team, this reduction is already part of a broader savings plan. Overall ICB-related management costs have been reduced by 30% since 2022, with a further 50% reduction from that baseline now expected. In North East London, management costs represent about 1.5% of total allocations, and further reductions are mandated. The ICB is being steered towards a more strategic commissioning role.
  • New Models and Timelines: A new model for the ICB is being developed for publication by the end of April, with ICBs required to submit returns by the end of May. Implementation is targeted for Quarter Three (October-December).
  • Financial Update and Savings Culture: March accounts have been closed, and preliminary feedback indicates targets are on track. The financial plan for 2025/26 is in place with challenging savings targets. A cultural shift is recognised as necessary, requiring significant innovation and efficiency improvements.

The committee commended the officers for their presentations and resolved to note the updates.