The Health & Adults Scrutiny Sub-Committee of Tower Hamlets Council was scheduled to discuss improving adult oral and dental health, and the proposed approach for the Tower Hamlets Health and Wellbeing Strategy 2026-2030. The meeting also included a review of the ASC Performance Dashboard.

Improving Adult Oral and Dental Health

A report was scheduled to be presented on the state of NHS dental care in Tower Hamlets, focusing on issues of access and barriers to treatment, patient experiences, and key oral health outcomes. The discussion was expected to cover the equity of dental services for vulnerable and disadvantaged groups, as well as workforce and commissioning pressures. The report was also set to address urgent and out-of-hours dental provision, oral health promotion activities, and local findings from the Tower Hamlets Health and Wellbeing Strategy 2021-25.

The report detailed the mix of General Dental Services (GDS) and Personal Dental Services (PDS) agreements in place, noting that GDS providers are contracted to deliver a set level of activity known as Units of Dental Activity (UDAs) for a fixed sum. It was highlighted that NHS dental practices do not receive reimbursement for premises or staff costs, and formal registration with NHS dental practices ceased in 2006.

In North East London, Tower Hamlets has 34 GDS providers with a contract value of £12.9 million and 313,800 contracted UDAs. The report indicated that in the 2023-24 contracting year, 74% of practices achieved over 96% of their contracted activity, rising to 91% in 2024-2025.

Regarding dental access, the report noted that the number of practices accepting patients changes daily and waiting lists are not monitored due to this fluctuation. Urgent cases are managed via NHS 111 and a Dental triage service, with urgent treatment typically provided within 12 hours. The report also mentioned that additional funds have been commissioned in Tower Hamlets over the past two years to provide more access to dental services, with £447,000 spent and 13,360 additional UDAs commissioned.

The report also touched upon the complexity of dental treatment, categorised into three levels, and the seven dental specialities. Community Dental Services (CDS) are provided by Kent Community Health NHS Foundation Trust at their Barkantine site, offering services for adults including special care dentistry, domiciliary care, and services for homeless individuals. For children, CDS provides paediatric dental services for those with specific needs, anxiety, or complex dental issues. The report noted a 40% increase in paediatric referrals to CDS since pre-pandemic levels.

The report also outlined the Roadmap to the Recovery of Dental Services, detailing phases from the pandemic through recovery to normalisation, and identified risks such as funding allocations and increased need due to oral health deterioration during the pandemic.

Tower Hamlets Health and Wellbeing Strategy 2026-2030 Proposed Approach

The Sub-Committee was scheduled to consider the proposed approach for developing the new Tower Hamlets Health and Wellbeing Strategy 2026-2030. This strategy is a statutory role for Health and Wellbeing Boards and is being developed during a period of significant financial challenges, national policy shifts, persistent health inequalities, and increasing demands on health and care systems. The development of the strategy is intended to align with the local Partnership vision, Our Tower Hamlets 2025-2035.

The report outlined that the current Health and Wellbeing Strategy 2021-25 is founded on the World Health Organization's constitution, which upholds the right to the highest attainable standard of health. Residents' feedback highlighted the importance of resources going to those most in need, building connections between people and services, equal and respectful treatment, clear and co-produced information, shared power in service design, and making the best use of community assets. Residents also envisioned a healthy borough with accessible social spaces, healthy and confident children and families, opportunities for young adults, support for older people, and clear pathways to help.

The previous strategy had seven core priorities for 2024-25, including improving access to primary and urgent care, enabling healthy living and managing long-term conditions, implementing a localities and neighbourhoods model, facilitating smooth hospital discharges, being an anti-racist and equity-driven system, ensuring the best start for children and young people, and providing integrated mental health services.

The development of the new strategy is being informed by a wide range of contextual factors, including political and economic changes, social trends such as life expectancy, technological advancements, and environmental concerns like climate change. It also needs to align with the Tower Hamlets Council Strategic Plan, the A Tower Hamlets for All: Partnership Plan 2023-2028, and the NHS 10-year plan and Integrated Care Board (ICB) blueprint.

Key themes emerging from discussions with residents and stakeholders for the new strategy include a focus on Housing and Integrated Neighbourhood Teams, Measurable Priorities (5-10), ensuring a Seamless Experience of Services, promoting Prevention and Early Intervention, fostering Community Engagement and Inspiration, and establishing clear Accountability and Governance. The proposed strategy aims to align with the Our Tower Hamlets Vision 2025-2035, which has five ambitions: people working together, children and young people getting the best start, adults building good lives, older people living well, and Tower Hamlets being a place people are proud to call home.

The approach to developing the strategy includes addressing governance and accountability, system integration, prevention, a neighbourhood health model, defining priorities and outcomes, ensuring sustainability, resident engagement, and the link between housing and health. The committee was asked to consider the proposed approach, identify any gaps, suggest important areas for the strategy to address, and indicate how they wished to be involved.

ASC Performance Dashboard

The Sub-Committee was scheduled to review the ASC Performance Dashboard, which provides an overview of Adult Social Care performance. The dashboard includes various indicators, such as the percentage of care package-related delays to discharge, the total number of residents awaiting discharge, and the percentage of social worker-related delays to discharge. It also tracks the percentage of discharges to the usual place of residence through the Transfer of Care Hub.

The dashboard also presents data on the percentage of new short-term placements that are in borough, and service user satisfaction ratings for agency/provider services and carer services. A significant focus of the dashboard is on Adult Safeguarding, with indicators for the number of concerns contacted within one day, concerns completed within five working days, open safeguarding concerns, and the percentage of conversion from concern to enquiry. It also tracks the number of safeguarding enquiries opened and completed within twenty working days, and the proportion of enquiries where desired outcomes were achieved.

The dashboard includes data on hospital discharge delays, showing the percentage of patients discharged on their discharge-ready date (DRD) for Tower Hamlets and its ranking within London and nationally. It also provides insights into A&E attendances due to GP access issues and return rates from Urgent Treatment Centres (UTCs) to A&E.

The report indicated that for October 2025, Tower Hamlets ranked 13th out of 33 London boroughs for the proportion of patients discharged on their discharge-ready date, with 88.48% discharged on time. Nationally, this ranked Tower Hamlets 42nd out of 153 local authorities. The dashboard also highlighted performance in safeguarding, with consistent exceeding of targets for contacting residents within one day of a safeguarding concern. However, concerns were noted regarding the percentage of safeguarding concerns completed within five working days and enquiries completed within twenty working days, with plans to disaggregate data by service area to identify and address bottlenecks.