The North West London Joint Health Overview and Scrutiny Committee (NWL JHOSC) met to discuss maternity provisions, adult mental health services, and the reconfiguration of the Integrated Care Board (ICB). The committee reviewed progress against prior recommendations and set its work programme for the coming year.

Maternity Provisions in North West London

The committee examined maternity provisions in North West London, focusing on outcomes and equity across the region.

Key points covered:

• Birth Rates: There were 26,486 births across six maternity sites in 2024/25, a 1% increase compared to the previous year, contrasting with a national decline.
• Stillbirth Rates: The stillbirth rate in North West London is 2.9 per 1,000 births, below the national average of 3.3.
• Ethnic Disparities: Significant disparities persist, with Asian women experiencing a stillbirth rate of 3.7 per 1,000 births and Black women 2.5, compared to 1.4 for white women.
• Equity and Equality Action Plan: The Local Maternity and Neonatal System (LMNS) has a five-priority action plan to address disparities through inclusive service restoration, digital access, data quality, targeted prevention, and strengthened leadership.
• Centralised Booking System: A centralised maternity booking hub is planned to improve timeliness, reduce duplicate bookings, and ensure equitable access.
• Start Well Programme: The committee discussed the impact of the Start Well programme, noting it is expected to support the LMNS ambitions to improve equity and safety.
• Northwick Park Hospital: Northwick Park Hospital has exited the Maternity Safety Support Programme, with improved safety outcomes and patient satisfaction.
• Service User Feedback: The committee heard that inconsistent communication, involvement in decision-making, and staff availability remain concerns, while personalised, compassionate care was also recognised.

Recommendations included developing a five-year maternity strategy, aligning local actions with national priorities, implementing the Maternity Outcomes Surveillance System (MOSS) toolkit, strengthening co-production with service users, and publishing disaggregated outcomes data.

Councillor Concia Albert raised concerns about consultants relying on race and age rather than health when making decisions about birth pathways. She shared her own experience of feeling pressured to have an induction and highlighted the need for equitable access to personalised care.

Catherine Shaw, Chief Executive of Healthwatch, raised concerns about building trust with the community around Northwick Park Hospital, despite improvements, and ensuring harder-to-reach communities have their voices heard.

Councillor Chetna Halai requested more information on the cultural competency plan, the North West London targeted work strategy, and wider sharing of the 97% friends and family score for Northwick Park.

Councillor Ketan Sheth, Chair of the committee, summarised the recommendations and thanked Pippa Nightingale, Chief Executive at London Northwest, and her team for their presentation.

Reconfiguration of the ICB and Implications on Services

Rob Hurd, Chief Executive of the North West London Integrated Care Board (ICB), provided an update on the reconfiguration of the ICB and its potential implications for services.

Key points covered:

• Funding Reductions: The ICB faces a 41% reduction in running costs, about £90 million, signalling a need for significant resource reduction.
• Strategic Commissioning: The ICB will focus on strategic commissioning, working with health and wellbeing boards and using joint strategic needs assessments to inform service planning.
• Operational Coordination: Operational coordination will be handed over to place-based partnerships and borough-level partnerships.
• Merger Considerations: The ICB is considering a formal merger with North Central London, with a decision expected soon.
• Borough-Based Partnerships: The importance of upholding borough-based partnerships and ensuring local voices are heard was emphasised.

Councillor Nick Denys raised concerns about decision-making in a larger, less-resourced organisation and sought assurance that decision-making would remain efficient and quick.

Catherine Shaw expressed concerns about user involvement and guaranteeing independence, especially with the planned closure of Healthwatch.

Councillor Chetna Halai asked about the structures and responsibilities of the various organisations involved in the change and how residents would be reassured that their health outcomes would not be impacted.

Councillor Claire Vollum expressed concern that acute care may not happen borough-based and asked how that would be managed.

Adult Mental Health

Toby Lambert, Executive Director of Strategy and Population Health, NHS North West London, and Dr Christopher Hilton provided an update on the adult mental health strategy.

Key points covered:

• Strategy Themes: The strategy focuses on raising awareness, promoting well-being, increasing equity and equality of access, and ensuring care in the right place.
• Pilot Programmes: Pilot programmes are underway to reach seldom-heard communities and address inequalities.
• Community Mental Health Services: Efforts are being made to standardise community mental health services and improve access to specialist support.
• Mental Health Crisis Assessment Service: The Mental Health Crisis Assessment Service at St Charles covers Westminster, Kensington & Chelsea, Hammersmith & Fulham, and parts of Brent, with plans to set up a similar service in Ealing and Hounslow.

Councillor Chetna Halai noted that mental health is on the increase and asked how the council would meet demand with the closure of wards and units.

Councillor Concia Albert asked how Primary Care Networks (PCNs) are held accountable for using population health needs when deciding on their budgets.

Councillor Marina Sharma asked how maternity services at West Middlesex Hospital are addressing the higher risk of stillbirths and emergency caesareans among Asian women.

Other Business

The committee noted the recommendation tracker and confirmed that the next meeting would be held in Harrow.