The Joint Health Overview & Scrutiny Committee (JHOSC) met on 9 December 2025 to discuss several key healthcare issues affecting the North West London region. The agenda included updates on urgent and emergency care, primary care access, continuing healthcare, and services for children with special educational needs (SEN). The committee also planned to review the North West London JHOSC's recommendations tracker and work programme.

Urgent and Emergency Care Delivery

The committee was scheduled to discuss a report on urgent and emergency care (UEC) across North West London. The report noted that North West London had made significant progress in strengthening urgent and emergency care, and was operating more as a single integrated system.

Key achievements listed in the report included:

• The launch of the Integrated Care Coordination Hub (ICC).
• Record levels of Same Day Emergency Care (SDEC).
• Strengthened community and mental health alternatives.
• Improved handover, response and ED performance.
• Evidence based impact for high need and underserved groups.
• Digital front door and Optica roll out.
• Discharge performance and flow improvements.

The report stated that challenges remained, particularly around rising demand, mental health waits, community workforce fragility and virtual ward utilisation. The report also included an overview of winter readiness, and next steps for the UEC system.

Implementation of the Same Day Access Model in Primary Care

The committee was scheduled to discuss a report on the implementation of the same day access model in primary care ¹. The report noted that improving access to primary care remained a top priority, and that the access programme had evolved through several phases since 2023. The report stated that from 1 October 2025, online consultations must be available throughout core hours, and that NHS England had completed a national audit of online consultation compliance, with no North West London practices being flagged.

The report also noted that 82% of calls were answered within 10 minutes, and 88% of e-submissions were responded to by the next working day. It stated that approximately 55% of GP appointments were same day or next day, and that 70% of appointments across North West London were face to face.

The report identified key opportunities for improvement, including:

• Strengthening integrated models of care.
• Building on neighbourhood health and population health approaches.
• Optimising GP capacity and existing pathways.
• Ensuring continuity of care.
• Maximising the role of the digital front door.

Application of the Continuing Healthcare Criteria

The committee was scheduled to discuss a report on All Age Continuing Healthcare (AACC) in North West London². The report focused on adult Continuing Healthcare (CHC) and Funded Nursing Care (FNC) provision. Key messages from the report included:

• North West London ICB funds more CHC eligible individuals than any other ICB in London.
• The number of referrals and patients funded have exceeded pre-pandemic levels.
• Conversion rates for adult CHC funded care remain above London average across North West London.
• Fast Track referrals are above London and national average.
• The number of individuals with learning disabilities and/or autism eligible for CHC funded care has increased significantly over the past couple of years.

The report stated that the ICB had been working closely with acute providers to streamline and digitise the fast-track process. It also noted that the overall North West London conversion rate for standard CHC assessments had shown a gradual increase since the pre-pandemic period, reaching 25% in Q2 2025/26, compared to a national rate of 17% and a London rate of 14%.

SEN Continence Service

The committee was scheduled to discuss a report on continence services for children with special educational needs and disabilities (SEND). The report noted that children and young people with SEND often face complex health and care challenges, including continence issues that can significantly affect their dignity, independence, and educational experience.

The report described the model for children's continence services as having three levels:

• Level 1: Universal services provided by health visiting and school nursing teams, and sometimes GPs.
• Level 2: Children's Community Bladder and Bowel Service Nurse-led multi-disciplinary team.
• Level 3: Medical assessment Paediatrician-led services.

The report noted that experiences of families were variable across North West London, and that there was a need to reduce unwarranted variation in services. It stated that to reduce the current unwarranted variability of level 2 services, North West London ICB was working to codesign and implement a common offer for bladder and bowel services for children and adults in every borough in north west London.

North West London JHOSC Recommendations Tracker and Work Programme

The committee was scheduled to review the North West London JHOSC's recommendations tracker and work programme. The recommendations tracker provides a summary of scrutiny recommendations made during the previous two and current municipal years, and tracks decisions made by NHS colleagues and gives the committee oversight over implementation progress. The work programme outlines the decisions and health policy areas the committee plans to review during the municipal year.