The North West London Joint Health Overview and Scrutiny Committee is scheduled to meet on 9 December 2025, at Hounslow House, to discuss urgent and emergency care, primary care access, continuing healthcare criteria, and special educational needs (SEN) continence services. The meeting will also cover the North West London Joint Health Overview and Scrutiny Committee's recommendations tracker and work programme.

Urgent and Emergency Care Delivery

The committee is scheduled to discuss a report on urgent and emergency care (UEC) across North West London (NWL). The report responds to a request from Councillor Ketan Sheth, Committee Chair, made in October 2025, for an update on urgent and emergency care across North West London, with a focus on performance, system resilience and preparations for Winter 2025/26.

The report highlights key achievements including:

• The launch of the Integrated Care Coordination Hub (ICC), which brings senior clinical decision making into a single NWL wide function. The report claims that the ICC is already reducing avoidable ambulance conveyance and improving patient routing, and is expected to manage up to 900 cases per month as it fully matures.
• Record levels of Same Day Emergency Care (SDEC) activity, which is supporting faster assessment and reducing pressure on EDs.
• Strengthened community and mental health alternatives, enabled by new investment in expanded Urgent Community Response, Frailty Hospital at Home, community beds, and expanded mental health crisis alternatives.
• Improved ambulance handover, response and ED performance, with ambulance handover times among the best in London.
• Evidence-based impact for high need and underserved groups, based on evaluations of the High Intensity User service, Homeless Health, immunisation campaigns and mental health crisis pathways.
• Digital front door and Optica roll out, with 111 digital redirection, Pharmacy First pathways, automated dental and pharmacy triage and borough wide Optica implementation transforming access and improving visibility of capacity across the system.
• Discharge performance and flow improvements, with Pathway 1 delays reduced to 2.3 days.

The report notes that challenges remain, including significant and rising demand, particularly for children, people with long term conditions and those with mental health needs. Variation across boroughs, community workforce fragility, virtual ward utilisation and mental health waits are also noted as pressure points.

The report also provides details of winter planning, and touches on equity and access to UEC services.

Implementation of the Same Day Access Model in Primary Care

The committee will also discuss the implementation of the same day access model in primary care. The report pack includes a report on 2025/26 Primary Care Access, which states that improving access to Primary Care remains a top priority, aligned with the 10 Year Plan¹ and national planning guidance.

The report notes that from 1 October 2025, online consultations must be available throughout core hours (8:00am - 6:30pm, weekdays excl. holidays) with no caps or restrictions.

The report also notes that NWL continues to improve access to Primary Care, with a £6.6m investment in addition to national funding, and that in 2025/26, all 45 PCNs submitted PCN-led Improvement Plans to meet the agreed Access Specification targets.

The report states that NWL strategies show that Primary Care appointment numbers have risen over the past 5 years, and that NWL provides 11% more appointments than other London areas. It also notes that approximately 55% of GP appointments are same day or next day, and that 70% of appointments across NWL are face to face as of Oct-25.

The report identifies key opportunities to:

• Strengthen integrated models of care, expanding access beyond general practice through Dentistry, Optometry and Pharmacy partners, for example, Pharmacy First² and the Community Eye Service.
• Build on Neighbourhood Health³ & population health approaches to shift activity from reactive care to proactive, preventive care.
• Optimise GP capacity and existing pathways, including Out-of-Hours services, Enhanced Access, and improving utilisation of 111 slots
• Ensure continuity of care for patients who may not require same/next-day appointments but need ongoing care.
• Maximising the role of the digital front door (NHS App) and innovative tools to signpost patients to the right care, first time.

The report also identifies a number of redirection opportunities, including Pharmacy First service (1,600 attendances/month), Community Eye service (attendances/month TBC), Wound Care (2,025 attendances/month), and 111 Appointments to GP Practices (2,580 attendances/month).

https://www.longtermplan.nhs.uk/

Application of the Continuing Health Care Criteria

The committee is also scheduled to discuss the application of continuing healthcare (CHC) criteria. The report focuses on adult CHC and Funded Nursing Care (FNC) provision, and notes that the North West London Integrated Care Board (ICB) manages several services under All Age Continuing Care (AACC) with an active caseload at any time of around 4,400 individuals.

Key messages in the report include:

• North West London ICB is the largest ICB in London and funds more CHC eligible individuals than any other ICB in London.
• The number of referrals and patients funded have exceeded pre-pandemic levels.
• Post pandemic, the ICB has worked to ensure consistency of approach in all of its London boroughs, which has been reflected in changes on both conversion rates and numbers of individuals funded.
• Conversion rates for adult CHC funded care remain above London average across North West London, with some borough variations.
• 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 notes that at the end of Q2 2025/26, there were 1,981 CHC funded patients, and that patient numbers have remained relatively constant over the past 12 months and are currently above pre-covid levels. However, the number of CHC LD/autism patients has increased by 12% (43 clients), and this rise in client numbers is being investigated and will be benchmarked with other ICBs.

The report also notes that NWL London ICB has consistently recorded the highest number of CHC funded patients per 50,000 population across London, and that in Q2 2025/26, it reported 41.03 funded CHC patients per 50,000 - 23% higher than the London average of 33.24.

The report states that the overall NWL conversion rate for standard CHC assessments has shown a gradual increase since the pre-pandemic period, reaching 25% in Q2 2025/26, and that by comparison, the national and London rates are 17% and 14% respectively.

SEN Continence Service

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

The report notes that across North West London, there is notable variation in how these services are commissioned, delivered, and accessed, and that families commonly report long waiting times and unclear referral pathways.

The report states that all children in north west London have access to a range of continence services, ranging from advice to parents as a usual part of child development, through to specialist medical assessments.

The report describes the model for children's continence services as:

• 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 includes feedback from Parent-Carer Forums, and notes that families value health visitors, school nurses, and education staff as an initial point of contact for advice on toilet training.

The report notes that to reduce the current unwarranted variability of level 2 services, NWL ICB is working to codesign and implement a common offer for bladder and bowel services for children and adult in every borough in north west London.

Recommendations Tracker and Work Programme

The committee will review the North West London Joint Health Overview and Scrutiny Committee Recommendations Tracker, which 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 committee will also review its work programme for the 2025/26 municipal year, which outlines the decisions and health policy areas the committee plans to review during the year.