The North West London Joint Health Overview and Scrutiny Committee was scheduled to discuss several key areas impacting healthcare services across the region. These included updates on urgent and emergency care delivery, the implementation of a same-day access model in primary care, and the application of continuing healthcare criteria. The committee was also set to review the SEN continence service, track recommendations from previous meetings, and consider the council's work programme for 2025/26.

Urgent and Emergency Care Delivery

The committee was scheduled to receive an update on urgent and emergency care across North West London, focusing on performance, system resilience, and preparations for winter 2025/26. The report highlighted significant progress in strengthening urgent and emergency care, with a move towards a more integrated system across acute, community, mental health, primary care, the London Ambulance Service (LAS), and local authority partners. Key achievements noted included the launch of the Integrated Care Coordination Hub (ICC), record levels of Same Day Emergency Care (SDEC) activity, strengthened community and mental health alternatives, and improved ambulance handover and A&E performance. Challenges remain, however, particularly concerning rising demand, mental health waiting times, community workforce fragility, and virtual ward utilisation. Winter plans for 2025/26 have been developed with system-wide mitigations in place, but the system is described as finely balanced. Future work will focus on embedding the ICC, strengthening neighbourhood-based urgent care pathways, standardising virtual ward models, and maturing digital tools.

Implementation of the Same Day Access Model in Primary Care

This agenda item was set to provide an overview of the Access Programme and its associated Access Specification. The report indicated that North West London is making progress in improving access to primary care, with a commitment to equity and patient voice, moving towards more integrated, digitally enabled, and patient-centred care. The strategy aims to optimise GP capacity to manage primary care presentations and relieve wider system pressures. Key priorities include enhancing the role of Dentistry, Optometry, and Community Pharmacy (DOPs), building on Neighbourhood Health, expanding digital access via the NHS App, and utilising existing pathways. The Access Programme has evolved through several phases since 2023, with extensive engagement shaping the revised 2025/26 Access specification. From October 2025, all practices are required to offer Online Consultations throughout core hours. Performance metrics show that 82% of calls are answered within 10 minutes, and 88% of e-submissions are responded to by the next working day. The report also highlighted the importance of continuity of care for high-risk patients and patient engagement, with a focus on health equity.

Application of the Continuing Healthcare Criteria

The committee was scheduled to receive a report on All Age Continuing Care (AACC) services managed by the North West London Integrated Care Board (ICB), which includes Standard Adult Continuing Health Care (CHC), Fast Track CHC, Funded Nursing Care (FNC), and Children's Continuing Care (CCC). The report focused on adult CHC and FNC provision. It noted that North West London ICB funds more CHC-eligible individuals than any other ICB in London. Referral and patient numbers have exceeded pre-pandemic levels, and efforts have been made to ensure consistency across boroughs. Conversion rates for adult CHC remain above the London average, with some borough variations. Fast Track referrals are also above the London and national average. A significant increase in individuals with learning disabilities and/or autism eligible for CHC has been observed. The report detailed the assessment process for CHC, including Fast Track and Standard CHC, and provided caseload numbers, referral activity, and conversion rates, comparing NWL figures to London and national averages. Future plans include work across London on a Once For London approach to the specialist market place for out-of-hospital care, and the purchase of new digital software with AI tools to streamline back-office functions.

SEN Continence Service

This report was intended to provide a review of the North West London integrated care system concerning continence services for children and young people with special educational needs and disabilities (SEND). The report aimed to highlight current service models, identify gaps, and support the development of more equitable and person-centred care. It acknowledged that continence issues are often under-recognised and inconsistently supported, leading to challenges for families in navigating the system. The report outlined the ERIC Children's Continence Pathway model (Level 1: Universal services, Level 2: Children's Community Bladder and Bowel Service, Level 3: Medical assessment) and detailed the provision across different boroughs. Experiences from Parent-Carer Forums indicated variability in service access and support, highlighting the need to reduce unwarranted variation. The report also discussed system-wide improvement opportunities, including the co-design and implementation of a common offer for bladder and bowel services for children and adults, and potential collaboration with acute provider collaboratives.

North West London JHOSC Recommendations Tracker

The committee was scheduled to review the latest recommendations and information requests trackers for 2023/24, 2024/25, and 2025/26. These trackers provide a summary of scrutiny recommendations made and information requested, allowing the committee to monitor implementation progress by NHS colleagues. Updates from previous meetings were to be highlighted.

North West London JHOSC 2025/26 Work Programme

This item was to present the committee's work programme for the 2025/26 municipal year. The programme outlines the decisions and health policy areas the committee plans to review, focusing on the implementation plans and actions of the North West Integrated Care System and their Integrated Care Board. The work programme is designed to be flexible and adaptable, with confirmed meeting dates and scheduled agenda items for each meeting. The committee's principal role is to scrutinise plans for meeting health needs and arranging health services across North West London.