The Inner North East London Joint Health Overview and Scrutiny Committee ¹ convened to address several key healthcare issues affecting the region. The agenda included discussions on improving GP access, LGBTQ+ health services, and a general health update, alongside financial reviews and scrutiny reports. The committee also planned to elect a chair and vice-chair for the upcoming term.

Improving GP Access in North East London

The committee was scheduled to receive a report on improving access to primary care in North East London, including a case study from Addison Road Medical Practice (ARMP). The report was to detail a programme implemented across North East London aimed at improving patient experience, moving away from the traditional 8am phone queue to a system where patient needs are assessed and triaged.

Dr Janakan Crofton, GP Clinical Lead Waltham Forest and GP/ Medical Director ARMP, and Sindhu Balakrishnan, Chief Operating Officer ARMP, were expected to present ARMP's approach as an example of a practice that has transformed access to primary care. ARMP, described as a at scale GP provider based in North East London, aimed to provide accessible, equitable, and patient-centred care, serving 75,000 residents across seven GP practices within four Primary Care Networks (PCNs) in Waltham Forest and Havering.

ARMP's key success ingredients included:

• Digital Hubs and Call Centres: Multiprofessional co-located spaces.
• Cloud Based Telephony (CBT) and GP led AI powered triage.
• 100% digitised access through single point of access virtual front door.
• Data-led continuous improvement culture embracing modern general practice access.
• Outreach access models, continuity of care, and equitable access.

The presentation was to cover the challenges faced in 2017, including rising demand, unmet needs, the 8am rush, increased use of 111 ² and A&E, long call wait times, rising patient dissatisfaction, and widening health inequalities. Supply-side challenges included a shortage of GPs, suboptimal workforce skills mix, lack of physical space, and a burnt-out workforce.

ARMP's journey to better access involved continuous improvement capabilities, offering patients a choice of contact channels (phone, online, or walk-in), modern cloud-based telephony with real-time data dashboards, and online consultations with self-referral options. Structured forms and AI-powered triage were used to understand patient needs, supported by digital hubs and call centres, and personalised support.

Administrative efficiency was achieved by separating admin from clinical demand, streamlining processes, and freeing up clinician time. The assessment, prioritisation, and allocation of resources were facilitated by GP-led total triage, utilising in-hours and out-of-hours appointments, and balancing same-day demand with continuity of care.

The expected outcomes of ARMP's model included 100% response to online consultations within three hours, call wait times reduced to less than 1 minute 30 seconds, missed calls down from 33% to 9%, high staff and patient satisfaction scores, and recognition as an NHS England exemplar of best practice.

The presentation was also set to share lessons learned and next steps, focusing on continuous improvement, enabling continuity of care, supporting inclusive access for seldom-heard groups, and keeping the patient voice at the centre.

LGBTQ+ Health Services

Dr Paul Gilluley, Chief Medical Officer, was scheduled to present a report on LGBTQ+ Health Services. The report provided background information on gender dysphoria and gender identity, noting that gender services in the NHS offer ongoing assessments, treatments, support, and advice tailored to individual needs.

The report also included an update on the Cass Review ³, highlighting its final publication on 10 April 2024, the closure of gender services for children at the Tavistock and Portman NHS Foundation Trust, and the opening of two new services in London and Manchester. The review made 32 recommendations relating to care provision, changes in NHS care pathways, and future research.

As of March 2025, there were 194 patients on the Great Ormond Street Hospital (GOSH) South Hub caseload, with three being North East London ICB patients. Once transferred into the service, wait times were 6.8 weeks for an initial assessment.

The report noted that in June 2024, the Secretary of State issued an emergency restriction on the prescribing of puberty blockers in the treatment of gender incongruence in those under 18 years, with legislation passed in December 2024 to make the restriction permanent. Additionally, a review of adult gender services was commissioned in August 2024 to assess quality and care pathways, with the outcome awaited.

The report also highlighted that the LGBTQ+ population in the UK experiences significant physical and mental health inequalities compared to the general population, and mentioned the Pride in Practice programme in North East London, which delivers tailor-made interventions to meet the needs of local LGBTQ+ residents.

Health Update

The committee was scheduled to receive a general health update covering several key areas. This included organisational changes within the NHS, strategic commissioning plans, and progress on implementing the NHS 10-year plan.

Organisational Change

The update was to address the national decision in March 2025 to reduce Integrated Care Boards' (ICBs) running costs by 50%, requiring ICBs to develop a new operating model focused on strategic commissioning. The proposed new operating model for ICBs, providers, and the region was to be outlined, clarifying responsibilities and placing patients at the centre.

The restructure of the senior team was to be confirmed, with four roles reporting to a Chief Executive:

• Chief Clinical and Quality Commissioning Officer (CQCO) - Dr Paul Gilluley
• Chief Finance Officer (CFO) - Henry Black
• Chief Strategic Commissioning Officer (CSCO) - Charlotte Pomery
• Chief Strategy Officer (CSO) - Ralph Coulbeck

It was also expected that Dame Marie Gabriel would continue to lead the ICB as Chair. The recruitment for an interim CEO was underway, following the announcement that Zina Etheridge would be stepping down.

Strategic Commissioning Plans

The update was to discuss the recently published NHS 10-year health plan, which created a new context for commissioning plans and a clearer policy agenda centered on achieving three shifts:

1. Hospital to community
2. Treatment to prevention
3. Analogue to digital

A draft NHS Planning Framework confirmed a two-phase approach to the creation of medium-term plans, with ICBs leading system-level strategic planning and providers and ICBs creating five-year integrated delivery and strategic commissioning plans.

The scope of the system strategy was to be detailed, focusing on:

• Starting Well
• Living Well (prevention and early detection)
• Ageing Well
• Quality Care and Access
• Health Inequalities and Communities
• Sustainable Services

The update was also to cover the commitment to building and strengthening local partnerships with local authorities, the voluntary sector, and public health organisations.

Implementing the Three Shifts

The update was to provide examples of work underway to deliver the three shifts outlined in the NHS 10-year plan.

• Hospital to Community: This included integrated neighbourhood working, an integrated pathway for women's health, and a care closer to home approach. A case study on the community health and wellbeing drop-in model in Barking and Dagenham was to be presented.
• Analogue to Digital: This included implementing an electronic patient record, working towards implementing the Secure Data Environment, promoting the NHS App, and rolling out Health Navigator AI. A case study on using Artificial Intelligence for faster Chest X-ray results was to be presented.
• Sickness to Prevention: This included standardising secondary prevention, reducing the number of people with undiagnosed long-term conditions, and reducing health inequalities. A case study on ShowerBox Barking, a permanent shower facility for people experiencing homelessness, was to be presented.

Other Updates

The update was also to cover the NHS England model region, managing winter pressures, and a review of the ICB's work over the past three years, including achievements such as implementing Women's Health Hubs and improvements in Child and Adolescent Mental Health Services (CAMHS).

Provider updates from North East London NHS Foundation Trust (NELFT), Homerton Healthcare NHS Foundation Trust, Barts Health NHS Trust, and Barking, Havering and Redbridge University Hospital NHS Trust (BHRUT) were also scheduled.

Lorraine Sunduza, Chief Executive Officer (ELFT), was expected to provide North East London Collaborative updates, including mental health, learning disability, and autism collaborative updates, as well as community healthcare collaborative updates.

Finance Review

Henry Black, Chief Finance Officer, was scheduled to present a finance overview. The report was to cover the ICS month 4 (July) 2025/26 reported position, NEL ICS efficiencies, and NEL ICS risks and mitigations.

The ICS operating plan expected a system breakeven position by year-end, with efficiencies of £367.7m to be delivered. At month 4, the expected year-to-date position was a deficit of £24.4m, with actual delivery resulting in a deficit of £43.9m. Due to the financial position, the system had been asked by NHS England to outline a financial recovery plan (FRP).

The total system efficiency and cost improvement plan at month 4 was £94.9m, with £81m delivered, leaving a year-to-date balance against plan of £13.9m. The risk to the delivery of the ICS breakeven position was reported as £93.9m in month 4, with the largest proportion relating to the delivery of efficiencies.

The Scrutiny Report

The committee was scheduled to discuss the Scrutiny Report, which included a review of the Forward Plan, Action Tracker, and Recommendations Tracker. Members were invited to make suggestions for items to be considered in the 2025-26 cycle.

The Action Tracker captured all actions required of officers by the committee at the previous scrutiny meeting, providing an update on progress. The Recommendation Tracker captured all recommendations made by the committee, requiring a written response from officers.