The Healthier Communities and Older People Overview and Scrutiny Panel of Merton Council scheduled a meeting to discuss the Care Quality Commission (CQC) update, the impact of Integrated Care Board (ICB) changes, and the panel's work programme. The meeting was scheduled to take place at the Merton Civic Centre, and members of the public were welcome to attend.

Care Quality Commission (CQC) Update

The panel was scheduled to note the contents of a report on the CQC's assessment of adult services, and the rating of 'Good' that the CQC gave to Merton Council. The report noted numerous areas of strength and areas where the council could achieve more.

The CQC's assurance framework for adult social care came into operation on 1 April 2023 as a result of the Health and Care Act 2022¹. The CQC is in the process of completing baseline assessments of all 154 local authorities over an initial two-year period and will give a narrative report alongside a rating (outstanding, good, requires improvement or inadequate). The baselining phase is due to be completed by March 2026.

The report stated that Merton Council's adult services had been assessed over a nine month period, and that the final report was published on 13 August 2025. The report highlighted numerous areas of good practice across all the four CQC themes. There was also positive feedback from residents, staff, leaders and partners about the work of adult services in Merton. The report stated that there were no significant risks or major areas for concern.

The report also outlined some areas where the council could achieve more. An action plan had been created and would be reviewed and monitored via the Live Well in Merton Programme Board.

Some of the strengths outlined in the CQC report were:

• The approach to assessing needs was holistic, person centred and joined up with other agencies.
• Unpaid carers spoke positively in relation to the assessment of their needs as being distinct from the person they cared for.
• A clear understanding of local population needs was demonstrated, including the experiences of seldom-heard groups.
• A good range of community-based resources improving the wellbeing and independence of residents.
• Strong safeguarding arrangements.
• Stable leadership and staff focused, with staff and partners stating that leaders were highly visible, compassionate, and that they listened to them.
• A strong learning and development offer for the workforce and wider care sector.

Some examples of positive feedback from residents included:

• The local authority's approach incorporated their right to choice and reflected how they wanted to live their lives.
• All unpaid carers the CQC spoke to shared positive feedback about their carers assessments, saying they felt listened to and were given the option to be assessed in person or on the phone.
• Safe transition of people from hospital to home.
• People's feedback in relation to the provision of equipment was positive.
• Residents told the CQC that the local authority supported then to feel safe by providing telecare and falls-monitoring service.

Some examples of where the council could achieve more included:

• Ensuring that all staff are aware of all Safeguarding Adult Reviews (SARs) and the recommendations contained within each report.
• Involving key partners, stakeholders and residents in key strategies and projects to strengthen the council's approach.
• Improving the access to information and advice to residents so that it is more accessible and people are aware of it.
• Strengthening the council's commissioning approach to include improving the awareness of and simplification of direct payments to enable greater access.

The report included a summary action plan, which detailed the actions that would be taken to address the areas where the council could achieve more.

Impact of the ICB changes on health and care systems and outcomes for Merton residents

The panel was scheduled to receive an update on the impact of changes to the ICB on health and care systems and outcomes for Merton residents. The update was scheduled to include information on the model for Integrated Neighbourhood Teams and the Merton Alliance, the new operating model for the ICB following staff reduction, and transitional plans and retained functions as the ICB moves to a new way of working.

In March 2025, all ICBs in England were asked to reduce their management costs by 50%, depending on their current spend. For Southwest London ICB (SWL ICB), the reduction required was 58%. A national model for Integrated Care Boards was published at the beginning of May 2025. The functions of the new ICB, as a strategic commissioner, would be:

• Understanding local context
• Developing Population Health Strategy
• Delivery of the strategy through payor and commissioning functions and resource allocation
• Evaluating impact
• Governance and core statutory functions

The savings described were on management costs, not commissioned services. However, SWL ICB had a very challenging savings plan across all sectors to bring it into a balanced budget.

Neighbourhood level integration is a key national priority. A London Target Operating Model for London for Integrated Neighbourhood Health has now been published. It sets out how care will be delivered at neighbourhood level across London and supports the direction of travel set out in the blueprint where, over time, some ICB functions may move to integrators and place partnerships as they become more established, helping to create a more joined-up, community-based approach to care.

Neighbourhood service delivery will be delivered by partners across health, social care and the voluntary sector. In Merton, all partners are represented in the partnership Alliance which over time will take on functions currently held by the ICB.

The presentation that was scheduled to be given to the panel included information on:

• The NHS 10 Year Health Plan²
• The Model ICB Blueprint
• ICB functional changes
• The London Target Operating Model
• The SWL Neighbourhood Health Steering Group
• The Integrated Neighbourhood Teams model
• The Merton Provider Alliance

The presentation stated that the vision for the Merton Alliance had been collaboratively developed and defined as:

Joined up support centred around community that enable people to live their fullest life.

The presentation also stated that the shared ambition of the provider alliance was to be an equal and inclusive borough partnership, passionate about health inequalities and residents.

Work Programme 2025/26

The panel was scheduled to review and agree its work programme for 2025-2026. The work programme sets out the items that the panel will review over the course of the year, the nature of the scrutiny, and the intended outcomes.

The draft work programme included the following items:

• Budget and Business Plan
• St Georges CQC Report
• Report of the Health and Wellbeing Board
• Healthwatch Annual Report
• Adult Safeguarding - Annual Report
• Adult Social Care and Public Health Performance
• Annual Public Health Report
• St Helier Hospital – Update on Disrepair
• Mental Health
• Impact of the ICB changes on health and care systems and outcomes for Merton residents
• Healthy Weight – Action plan
• Dementia Care
• Topic Suggestions 2026-2027