The Tower Hamlets Health and Adults Scrutiny Sub-Committee met to discuss health and adult social care priorities for 2025-26, preparations for the Care Quality Commission (CQC) inspection, and the sub-committee's draft work programme. The committee agreed to review postnatal support for black, Asian, and multi-ethnic mothers, and also discussed A&E waiting times, winter pressures, and performance data.

Here's a breakdown of the key topics discussed:

Health and Adult Social Care Priorities for 2025-26

Councillor Sabina Akhtar, Cabinet Member for Health and Well-Being, and officers outlined their key priorities, including preparing for the upcoming CQC inspection¹, managing demand for care, and addressing financial pressures. Key discussion points:

• CQC Inspection: A primary focus is preparing for the CQC inspection, with the aim of improving understanding of financial pressures and changes within the Integrated Care Board (ICB).
• Demand and Financial Pressures: Like many local authorities, Tower Hamlets is experiencing continued pressure on demand for care and support, leading to financial challenges. Focus is being placed on improving the quality of work and achieving the best value for residents.
• Adult Social Care: Key areas of focus include person-centred, strength-based practice, supporting self-advocacy through Tower Hamlets Connect, increasing the use of technology, and ensuring timely hospital discharges.
• Integrated Commissioning: Efforts have been made to stabilise market payments and explore the best commissioning models. A new home care framework is under development, with a focus on learning from previous procurement issues.
• Public Health: Priorities include embedding co-production, recommissioning school nursing, and developing a model that integrates school nursing, substance misuse, and lifestyles in adults. Recommissioning of health visiting services is also a key area, with a focus on co-production with families.
• Demographic Demand: A sharp rise in demand for adult social care among the under 65s, particularly driven by an ageing Bangladeshi population with higher rates of diabetes and heart disease, is creating complexity.

Councillor Amy Lee raised concerns about the impact of the failed home care procurement process and the lessons learned. She also sought clarification on when free home care started, which officers confirmed had commenced on 1 April.

Councillor Mark Francis raised concerns about anxiety among residents whose care providers are changing due to the procurement issues. Councillor Akhtar confirmed that letters had been sent to service users to reassure them that their care would continue, and a statement had been issued to carers to reassure them about job security.

Strategic Health Partners

The committee heard from strategic health partners regarding their priorities and how they align with local needs.

Primary Care

Roberto Tam Sanguan, GP Partner at Bromley by Bow Health and Clinical Director of Tower Hamlets Together, and Joe Sheldon, Head of Primary Care for Tower Hamlets, discussed challenges in accessing primary care and initiatives to address them.

Key points:

• Same-Day Access Hubs: Three pilot same-day access hubs have been set up, providing an additional 44,902 GP appointments.
• Challenges: Rapid population growth, increasing complexity, on-the-day demand, and financial sustainability of GP practices remain challenges.
• Priorities: Further developing the pilot hubs, increasing online access to GP practices, and supporting practices in developing neighbourhood health services.
• Face-to-Face Appointments: There has been a 5% increase in face-to-face appointments.

Acute Care

Tom Conwell, Divisional Director at Royal London & Mile End Hospitals, presented on acute care priorities.

Key points:

• Achievements: Continued development of initiatives to support patients waiting for treatment and reviewing surgical hubs.
• Priorities: Reducing long waits, improving hospital flow, delivering excellent quality care, and working with partners on prevention.
• Challenges: Staffing, increased demand for urgent and emergency care, and managing long waits.
• A&E Performance: Statistical improvement in four-hour performance has been maintained.
• Emergency Care Plan: Focus on reducing ambulance attendances through the REACH (Remote Emergency Access Care Coordination Hub) initiative, improving virtual wards, and using IT to improve patient flow.

Integrated Care Board and East London Foundation Trust

Charlotte Pomeroy, from the North East London ICB, and Dave Giovannoni, Borough Director at East London Foundation Trust (ELFT), spoke on their respective areas.

Key points:

• ELFT Achievements: ELFT have avoided out-of-area admissions.
• ELFT Priorities: Improving inpatient care and addressing breaches within ED (Emergency Department) mental health services.
• ICB Priorities: Implementing the NHS 10-year plan[^3], delivering integrated neighbourhoods, and preparing for winter. [^3]: The NHS 10-year plan is a long-term plan for the National Health Service in England, published in January 2019. It sets out ambitions for improving healthcare services and outcomes over the next decade.
• ICB Challenges: High levels of demand, financial challenges, and changes in health architecture.
• Integrated Neighbourhood Working: A major priority is integrated neighbourhood working, with a focus on relieving pressure on primary care and providing a rounded offer for people.
• Health Inequalities: Focus on using data to target services on communities most in need and proactive work around long-term conditions.

Councillor Alia Begum raised concerns about a Healthwatch survey that found a significant proportion of residents did not know who to contact for mental health support.

CQC Inspection Preparation and Readiness Update

Councillor Akhtar and Julie Davidson, Interim Director of Adult Social Care, provided an update on preparations for the CQC inspection.

Key points:

• Preparation: The council submitted its self-assessment and supporting documents in May and is awaiting notification of the on-site inspection.
• Areas of Focus: Key areas of focus include managing demand, reducing waiting times, direct payments, service models, reablement outcomes, and co-production.
• Strengths: Strengths include the information and advice service, digital inclusion initiatives, the Independent Living Hub, integrated working, and discharge processes.
• Areas for Improvement: Areas for improvement include reducing waiting times for assessment and review, developing the direct payment service, improving reablement outcomes, and embedding co-production.
• Safeguarding: A safeguarding culture is in place, with a focus on learning and development.

HASSC Draft Work Programme

The committee discussed the draft work programme for 2025-26 and considered areas of focus for upcoming meetings.

Key points:

• Maternity Review: The committee agreed to review postnatal support for black, Asian, and multi-ethnic mothers.
• A&E Waiting Times and Winter Pressures: The committee discussed focusing on winter pressures at the September meeting and potentially revisiting A&E waiting times at a later date.
• Performance Data: The committee agreed to allocate time at future meetings to review performance data.
• Cabinet Agenda: The committee emphasised the importance of staying informed about items on the cabinet agenda.
• Cabinet Member Attendance: The committee expressed the expectation that cabinet members should come prepared to answer questions at meetings.