Health & Adults Scrutiny Sub-Committee - Tuesday 20 January 2026, 6:30pm

Health & Adults Scrutiny Sub-Committee
Tuesday, 20th January 2026 at 6:30pm

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Good evening and welcome to this first health and

meeting for 2026 and happy new year

each and every one of you.

I am Councillor Gulam and I will be

chairing in this meeting today.

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Before I move to apologies

can I welcome

our new DSO,

who has taken

over from

Justina

I have been awarded the NACIMA will be covering health housing and oil

over women's good on the committee. Yes. I

Also want to use opportunity to recognise and thank Justyna for the contribution and support to this committee over the

Last years. So with this NACIMA have any apologies have you been received or recorded here, please?

We haven't received any apologies, Councillor.

Before we move on the DPI, and I am sure many of you would have heard the news, but I want

to make a moment to acknowledge the recent death of Simon Baxter, our corporate director.

Both the mayor and chief executive have put out statement, but I too want to acknowledge

Simon's commitment to public service and the lasting impact he has made across the organisation

and for our residents.

On behalf of colleagues here today, I want to express our condolences to their family

and friends and all who worked alongside them.

Simon will be missed and his contribution will not be forgotten.

With this, I am going to ask everyone to stand for a one -minute silence, please.

Thank you.

the state which expect the interest

relates, state whether the interest

of a personnel or pre -judicial

nature provide an explanation for

each declaration.

Thank you.

Good evening, everyone.

My name is

Councillor Ahmad Al Kebi

here.

I don't have any DPI.

Good evening, everyone.

Councillor Abdulla from the north.

Thank you.

My name is Leo De Souza.

I'm from Health Watch Tower Hamlet Co -opty.

I have no interest whatsoever.

Thank you.

Councillor Mark Francis from Bow East Ward.

No declarations of pecuniary interest.

Hi, my name is Alia Begum.

I'm a representative of the Hamlet.

I'm a co -opter here. Thank you.

minutes from the last meeting on 11th of November 2025 already circulated and

can committee members confirm this and true for accurate record.

We are awaiting responses from services on information required which will be updated

on the action log in due course.

Just a note here, we've received some of the responses.

Some of the responses will be later in the last meeting.

So just to confirm that.

Quick question, please, just on this.

So does that include the actions that were outstanding around the home care contract?

Is some information that's come in?

Is that what we're saying?

There has been information but it isn't yet included in this action log?

Councillor, I'll double cheque that.

I think some of the home care information was sent offline.

but I'll double cheque off outside of this meeting.

Thank you.

Like, this is a massive contract.

It's a huge issue and the re -procurement has been through some challenges

and is facing further challenges.

So I know that that is in part discussed at the main overview and scrutiny committee.

but I don't think that that means that this subcommittee shouldn't be made aware of what's happening with that.

And I guess like when we've asked for some of the information previously,

that's what we were hoping that we would at least get that for noting here.

Like I'm not a member of the other committee. I don't know what's given to the other committee either privately or publicly.

I think it's really quite important that given the number of people in receipt of home care

from these organisations that we ourselves get a full update on what's happening with the repreguilment.

I'm not sure if you can see the slide.

Can I just clarify which action specifically Councillor Francis is referring to?

Sorry, Councillor Francis, I'm just looking at the action log.

Which one?

This is the one that dated the 4th of September.

Sorry, there aren't any numbers on the action log, so it's quite difficult to, when it's

a long one, to determine which one.

It might be helpful to have numbers.

If it's the one on the 4th of September in terms of action, it does actually say see

appended letters.

we did send the letters but I'm just wanting to make sure that that is the one you're talking

about. I haven't missed anything.

So we talked in the committee about the impact of one of the providers not being, going ahead

with at this stage for some reasons. And we were asking about the, I guess, the, about

what assurance, sorry I'm not explaining this clearly,

about what is being done to assure those in receipt

of home care about any transition arrangements.

And we also asked about what's subsequently I think

about the carers themselves who are involved in this.

And you know there was some information that was given

to us after that meeting in September,

but that's quite a long time ago now.

But look, I'm happy to take this discussion offline.

My point is that this is a massive part of what the Adult Social Care team do and that

this committee has a role in overseeing that.

So I wanted to ask a separate thing about one of the other actions which is about community

equipment and we did get an update around that and I know that the team has faced a

real challenge since the company that were contracted folded and that's been going on

as well. We were also told by officers in this committee that a decision was due to

go to CMT, MAB and then it would come forward about what's going to happen with that. I

is actually happening with community equipment and I continue to have queries from constituents

who are facing some delays in getting the equipment that they've been told that they

need either. Not usually to facilitate a discharge but just around some other aspects of that.

So I think, I guess what I'm saying is that both of those two things should be considered

as life, not just closed after the provision of one piece of information.

Thank you Mark. Is it your new inquiry for community equipment?

So I'm going by the action log, Councillor Francis, and I certainly recall at the last

meeting, which was, was that November, the last of these meetings, I think it might have

been you and other members raised questions in relation to that particular supplier which

we answered. I wasn't aware that there was any other information that was requested and

if there is nothing reflected that I can tell on the action log. So my apologies. If you

want information I'm very happy to provide it. In relation to the community equipment

service, there's an action here, if I'm looking on the action log that's dated the 11th of

November and it says to be provided for the March meeting, which is what we're working

However, those timescales have changed. I'm happy to be guided by you.

I don't want to pull on this. I think the committee should be kept updated in what's happening with these key elements.

I don't know why this is down, that we're not going to get an update until March. That wasn't my decision.

Like, from my perspective, I kind of feel that we need an update as soon as possible.

but if it's not available now, like if we can just get it in in the next few weeks so that we know what's going on with it.

Thank you.

I'm very happy to provide an update in terms of community equipment.

We're still in a position where we are still in what we would still describe as business continuity,

where we have interim arrangements in place.

We have a paper that's due to go to the mayor's advisory board and possibly then cabinet for a decision

But no decision has been made whatsoever

They are just a set of proposals in terms of a more medium to long term solution

But at the moment nothing has changed in terms of the landscape or certainly in terms of how we're operating

From from the last we had this conversation, which is noted on the action log in terms of November

but certainly there are things that we can update in terms of

direction of travel in terms of some of the things we are exploring but as I

said nothing concrete as yet. So again happy to be guided by the committee in

terms of whether you'd want something imminently or whether you wanted to wait

a little bit later. That's all I was really after.

Thank you. Now tonight our first substantive item is considering

and the

I know there has been a fair

account of national media

coverage on this issue in

2025.

It is right that as a

committee we consider this.

So with this

I would like to invite

Kelly Neiser,

regional lead, primary

care commissioning,

dentistry and optometry

services.

I believe our officers

have provided

a steer on what this

committee is looking for.

and you will have up to 10 minutes to provide us with an overview and then we will move

questions from the committee. You may start whenever you are ready and I will let you

know when you are nearing your last minute, please.

Thank you so much. There's actually two of us here, so myself, Kelly Nisser, Regional

Lead for Dentistry and Ophthalmic Services for London and Huda Yousif from Public Health

So I'm going to do a joint presentation if that's okay.

My understanding is that I'm taking it that the slides have been looked at, because obviously

I wouldn't be able to go through all of the information on there.

What I am going to do is since the last time we've presented, I think it was myself and

Jeremy, I'd like to just update on specifics that were sent through and specific questions.

So I think the slide that I'm going to be working on, which are additional and new slides,

is the slide on dental access, which is slide five.

One of the questions was asked about dental access,

what dental access is like in North East London

and what we're doing about the gaps.

So what we have been doing is where we've commissioned services,

there are practises that will either rebase their contract.

What that means is that they are not able to meet the contract for whatever reason.

It may be capacity with NHS dentists,

or it may be a number of other determinations possibly,

it might be a difficult year.

And just bearing in mind that since COVID,

we have gone back up to sort of pre -pandemic level.

So as far as activity is concerned,

our practises are all now back up to 96 to 98%.

So each year we seem to be going closer and closer

and we are pretty much the only area in the whole country

that was actually there.

So London has gone back to pre -pandemic levels for dentistry.

What that means is any more money we can put into dentistry obviously would help get us

more capacity.

So what we have been doing is all the funding that has been either rebased or terminated

has been presented to the ICBs and we have had business cases that I've produced where

I've asked for additional funding to be given to the practises that are hitting capacity

or over capacity and we know that they've got sufficient capacity to do more.

We have been able to spend all of the funding in Northeast London ICB and I'm

going to go further down to how much we've spent but pretty much everything

that was available has gone back into practises. The waiting lists are held by

the practises so there was one of the questions was you know what are the

waiting lists like that could change every day every week or even months

because we don't carry it's it's it's quite it's not simple as you know how

many patients or how many patients are on a waiting list in one particular week.

On the 1st of April, the units of dental activity target comes through, and that could basically mean you've got sufficient capacity in April, May, June, might be really busy.

Or it may be that through summer they're quiet, so that activity could change. So there is no list as such that is held by us.

Urgent cares, so the information about urgent care, I know we went through this last time, but just to go through it again, urgent cares are dealt with through 111.

We have been doing a lot of campaign work on this, so there is a poster that we produced over the last year,

and we have sent those out to GP practises, pharmacists, the opticians and healthcare centres, etc.

And we have been speaking to specialist services about where else we could use those.

We've produced that, got it accepted and agreed by comms, because that took quite a while,

because as you know there's certain specifics that they want.

But that poster actually says if you have toothache, we don't want people turning up to the hospital or trying to have any self.

I mean up till now we have been quite fortunate in the last 25 years. I think we've been doing this job

We have not seen anyone have any sort of emergency where they've taken out their own tooth

But you do hear that on the news and we're trying to prevent that so we do have a compulsory

Service where patients can access a dental nurse triage service

But actually access to dentists that starts from 5 p .m. In the evening and the dentist worked at 2 a .m. In the morning

So we do have a full service triage works 24 hours

So you've always got somebody you can talk to.

So if you're speaking to somebody at five o 'clock

in the morning, they'll try and book you

in for the next morning.

So there is quite a comprehensive service

as far as urgent dental care is concerned.

There are numerous practises that

have the resources to see additional patients,

as I've talked about, and funding has been given to those.

We have also done that on a needs basis,

because we've asked public health to give us

information on the wards that are of highest needs.

And the funding has been given in that order.

The next slide talks about the recommissioned services and the amount of money.

So that's £447 ,000 that's gone into our helmet specifically.

And that is for 16 practises in total, giving you an additional 13 ,360 UDAs.

If you were to ask me what that means in patient numbers, you couldn't confirm that because it depends on what the patient needs.

So it's either a cheque -up and cleaning, it could be x -rays and fillings,

or it could be a whole, you know, a patient of high needs that needs a number of treatments

and possibly crown and bridge or anything else or even a denture.

So it's just to give you an outline of that.

Everything else on there, sorry, the other key one is to tell you who your urgent care services

in Tallahasn, so it's a practise called Align and Smile.

And the address we've provided there, that's a practise

and provider has been working with us since COVID.

So provides an excellent service and I know that because I was at work at Canary Wharf

and needed to see them and actually went to see them myself.

So I can highly recommend that we definitely

have a good service there where it's fully NHS.

And I didn't say who I was either.

So the staff didn't know who I was.

So just to sort of assure you, you

do have a really, really good practitioner who works and

provides an urgent dental care to late night

in the actual borough.

I will leave the rest because it's

all self -explanatory, but hand over to Huda with regards

to the oral health elements.

In terms of oral health, Tower Hamlets has been doing some fantastic work among children

and young people.

We have a universal fluoride varnish programme that targets three to six year olds and that's

been ongoing for a number of years and we are expected to continue with these programmes.

The Department of Health and Social Care, as you all know, has given £11 million in

funding to England to target the most deprived areas for supervised tooth brushing programme,

and Tower Hamlets has received around £100 ,000 to implement supervised tooth brushing programmes

in those deprived areas, and we hope to actually expand that programme to make it a universal

programme. We are also been involved in training frontline staff working in family hubs and

children's centres. I have provided that training myself to staff as well as providing an online

oral health training module for frontline staff because it's really important that we

think about children and young people and ensuring that we're giving every child the

best start in life. The other thing that we're doing is implementing the London

Mayor's strategy around healthy early years and healthy schools and Tower Hamlets.

The healthy schools team have been actively involved in implementing that

and the last thing that I wanted to mention was that the dental school next

door, we have been delivering sugar smart Tower Hamlets where our dental students

go out into primary schools to promote oral health as well as child healthy weight.

I'm just going to finish up with the roadmap for recovery for dental services. So the roadmap that

you've been probably been seeing as far as we've been creating, I think this is something I created

in during Covid times and we've been updating it ever since. So we are sort of on track of what we

had said would happen but actually it's gone a little bit ahead of what we thought where

practises have gone back to pre -pandemic much quicker than we thought.

So one of the things and presentations we have constantly been doing with

the national team is talking about dental access and the fact that if there is

dental funds anywhere in the country, we would be happy in London to take them

because we clearly we don't have underperformance in comparison to other

areas and if they need to use the money on dentistry and dental access,

then we are able to do that.

So we have been making that noise quite a lot at all levels.

And lastly just to raise that you may hear and you actually will hear about dental contract reform.

So there are some reforms happening to the dental contract on the 1st of April.

We had a meeting yesterday with the national team to talk about what those look like.

Largely things like pathways that are going to be for patients of high needs.

So rather than a patient going in and having one course of treatment, it could be a course of treatment that could last 6 months to 12 months.

And the dentist get an additional funding for that on a monthly basis, which is quite a difference to the UDA system.

There is also a lot of discussion about urgent care and you may have heard on the news,

you know, we're talking about 700 ,000 urgent dental care appointments.

We have been feeding back into that in London and saying we actually don't need additional urgent dental care.

We have sufficient urgent care and if anything, not all of it has been fully utilised,

but what we do need is dental access because you see patients with emergencies, not an issue in London.

The issue for us is really about having people going in to go and see a dentist for all the rest of their treatment.

and that's the bit we want to do rather than just the short term, a temporary filling or a prescription.

So again that's information that we have been feeding back as well.

I think we've made it within the 10 minutes.

Thank you, Kelly, for your nice overview and information.

I will take two questions at a time

from our members.

If we have time,

then we will have a second round here,

please.

Thank you for your presentation.

Basically, I'm not quite clear, as you

mentioned,

our bar has 16

dentists,

I think.

My question is,

you know the dental service,

who decides to house the

How many dental services should be in each barra and who control or monitor this?

And how many dentists do we have?

Thank you.

Okay, so we were not actually commissioning NHS dental services directly until 2006.

So my role when I came in, I was working in a practise and came into the job as a dental

commissioner to understand exactly what this meant because prior to this, dentists used

to get paid a fee per item.

So you do 10 fillings, you get paid for 10 fillings, you get, you know, whatever you did.

In 2004 when I joined NHS Hounslow at that point, my job was to actually look at what a dentist does,

what a practise, we call that the reference period.

So if you were a practitioner that did say, I don't know, 250 fillings, 5000 crowns, etc, etc,

that was then converted into units of dental activity.

So a unit of dental activity, depending on what band of treatment you're in, could be in band one, two or three.

It could be one unit of dental activity which is worth, say, £35, three or twelve.

And twelve is usually if you're a high needs patient.

So when your contract was pulled together, the reference period was based on if I had

a practise that was already open and an NHS contract which I was submitting FP17 forms

from, I would get a new contract in 2006.

My contract would then say how many units of dental activity I have to do, and it was

all based on that.

We've come in in 2006 as commissioners to look at the spread, so exactly as you've said,

how many have we got and what does that look like?

And that piece of work has only started since 2006, so it's only in the last 20 years that

we're able to say actually that practise is closing down or they're going or whatever

else is happening, it may be a house with a one man practise and he hasn't sold, he

doesn't want to sell the practise, it's his home and he's closed shop.

If we have say £150 ,000 there, we'll pick that up and say right, it's in this borough,

But where is the need?

And that's where public health and commissioners have been working closely.

And you could actually look at in the last 20 years, which ones have opened.

But prior to that, it's all historical.

And I will be honest, there isn't a lot of practises shut down on a daily basis.

The most shutdowns we ever saw were during COVID.

And that's in my history of working as a commissioner.

And that happened during COVID, and

that was largely sort of practises that were 50 % private and 50 % NHS.

Or it was practises that had dentists from abroad, etc.

So overall, this is not something that we put together.

We were given a map of the practises

that we've got in each area.

We had to work with them, and we had to pay them according

to that historical info.

But going forward, what we've been doing constantly,

like now, when I told you about the additional funding,

what we did said that practise is busy.

It's in a high street.

It's seeing a lot of patients.

We can see the history and actually the activity

levels of what they're doing.

Lots of fillings, lots of crowns.

Not repeat patients are actually doing a lot of treatment.

and that's where the info comes from,

and the deprived areas, obviously,

as Huda's just talked about,

not just for children but adults,

will then go in and say,

that practise is the one we want to put a big chunk in

so that they can see more patients.

But if there's any closures,

one of the things we haven't been feeding back to the ICBs

is we've given this non -recurrent funding for three years,

but we have said at the end of three years,

would you like to procure for some new practises?

And if you've got something in Tallahamlets, for instance,

if you're half a million pounds wanted to go,

So just bearing in mind that would only go into one practise because to open a new practise

you're looking at a contract of about four to five hundred thousand as a bare minimum.

So that's what you get is one.

In some areas they may have much more than that so they're able to look at a couple.

The advantage of doing what we've done right now is we've spread out the money.

So there's lots of practises in Tower Hamlets right now which is near the end of the financial

year.

Normally by now a lot of practises say my money's run out, won't be able to see you

till April.

We're pleased to say that we have 16 practises in Tower Hamlets that right now are seeing

patients because we've given them some additional funding.

Thank you.

I'm going to apologise if I'm going to ask you a question that you're going to think is really stupid.

But if waiting lists are held by practises and not monitored, how are we monitoring anything?

How are we monitoring? You might think I'm being really stupid but I'm just not, I don't get that.

How are we, if we don't know any of the figures, how are we monitoring progress?

How are we, maybe there's other figures, I don't know.

And then is this tied to, so I'm looking at the NEL dental flows and it's going over my head a bit.

Are these appointments, are these appointments in specific services?

Just a little bit more information, because I think obviously in an ideal world the question we'd ask is how many people living in this borough are waiting for a dentist.

I think the answer is we can't quite answer that, but something that might help us have a bit more of an idea about that I think would be helpful.

What slide were you talking about, about the flow?

I am not really understanding either of them, to be honest.

Are you talking about the slides at the bottom, the last few slides?

Is that what you are talking about?

So there is NEL dental flows by patient, NEL dental patient flows by provider.

So there is, yeah, I am just going over my head a little bit.

There is a map and some bar charts.

As far as the waiting lists are concerned, NER has, North East London has been one of

the areas that we've always had where I use as an example whenever I'm talking to the

public about dentistry or whenever we're on any kind of courses or anything, I will usually

say if you take North East London and you take South West London, they're very, very

different. The boroughs that you've got in South West London, if you ring up to find

in NHS centres, you'll probably get one in one or two weeks,

Westminster, if you call up.

If you bring up one of our practises in Northeast London,

you're probably looking up to four to six weeks.

So the waiting list is a lot longer.

How do we know that?

Because we speak to our practise regularly.

Our urgent cares, so we've talked about the urgent care

one practise, but you have out of hours practises.

We have regular meetings about their contracts, et cetera.

And when we meet with our practises,

we obviously will know which areas are highest need.

We have had two practises opened in the last, just pre -COVID,

in North East London.

And every time there is any chunks of money,

North East is the one we talked about,

putting in additional funding and procuring funds.

But even pre -pandemic, North East London was the one

ICB we used to always talk about

that has probably the highest need.

That is because of the areas of deprivation.

It's also about access to dentistry.

We'd done an oral health programme here

where we actually stood in the shopping centres

and talked to people about finding an NHS dentist.

And it was just interesting.

It wasn't even about, I can't find an NHS dentist.

It was more about, I didn't know you have NHS dentists here.

I thought I have to pay for this.

So people not realising that if you're on benefit,

you can access dentistry.

We did quite a lot of that for about a year and a half.

And we bought in lots of additional new patients.

Northeast London in total has put around 3 and 1

half million pounds into this additional funding.

They've done that for three years now.

So it's basically been allocated to access for dentistry.

So what we do know is we've got more access in Northeast London now that we've had in the last probably 15 years

So we have got more access. We've got the urgent care etc

The other way you usually know is obviously from patients so patient complaints people trying to find an NHS dentist their websites, etc

and

And health watch, you know, there's a large part health watch that feeds back to us as well

So it comes from a combination of things where we know what's going on

But our practise is a large one where they'll say actually we've got patients and we're you know

We're able to see them but it's a three -week wait in comparison to other areas that will say what they are

The waiting this thing is not just for Northeast anybody in London

In fact anybody in the Commission in the country any commissioner would not have a waiting list for a practise because if I ask somebody

Today they may say you can see someone in two weeks if I asked them in April

They'll probably say we've got five dentists working full -time right now. So actually there isn't a waiting list. It changes on a weekly basis

Thank you.

Before we go to the Councillor Abdul -Mannan, because we have received in our pre -meeting

two questions from Leo, who will ask this question now.

Thank you, please.

Thank you, Chair.

One of the tasks that Health Watch do besides taking on projects is enter and view.

I was physically involved on the ground level, enter and view, when Royal London Hospital

and it was a full day affair for me.

And what did I hear about the residents?

The residents' voice, touch point, was that

we, they were told, we are not taking

any NHS patients even when the

contracts exist between NHS

and individual providers. Now my question

on this is access and capacity.

How do you access it?

What proportion of Tower Hamlets adults

are currently unable to access NHS dentist

and how this has changed over the last three to five years?

What is the change you have envisaged in this period?

And depending on that, I have one more follow -up question.

Jai?

That's a really good question.

Just to make it very clear, you can access NHS dentistry anywhere in the country and

anywhere in London.

So even though you're a Tower Hamlets resident, you're able to access dentistry in another

area of London.

We do have the patient flows that clearly show that there are patients coming into the

and accessing services, but there are also patients going out of the borough to access

services, and that's the way things are for dentistry.

It's not like a static GP clinic where you can access it by the patient postcode, but

you can access services anywhere.

Now in terms of knowing the proportion of patients who cannot access, we can't find

that information.

There's no way for us to collect that information, but what we do collect from the NHS Business

Service Authority on a regular basis is the proportion of patients who access the services

by age groups, and we have that data that we have included in the pack.

Thank you for clearing that.

But supposing, just hypothetically, they are refused.

they want to voice their concern about refusal, where do they go to?

There's patient complaints, same as always.

There's a complaints process within the ICB.

So there is a complaints process, there is a process, and there is a contact number.

Those are always available on all of the websites.

That hasn't changed.

The team's got smaller, but the actual advice is still always there.

And I think just one other thing I just want to pick up.

One of the things you were saying was people saying,

this dentist, even when they have their NHS contract

and it starts on the 1st of April,

are saying they don't see NHS patients.

That's pretty much impossible.

I say that from the experience I've got,

which is over 20 years.

I don't know of any practise that

has an NHS contract that doesn't see an NHS patient.

I mean, if they didn't, we'd take their money back.

It's that simple.

We get a list of how many patients they see.

We even get a list if a patient is reoccurring.

So as an example, if I've been to my dentist and they go keep coming back every six months,

Kelly, and just keep having a checkup and actually, you know, we'll keep getting you

back in and actually we'll get you in every three weeks because that's what we feel like

doing.

That comes up with, you know, an identity issue saying this patient is reoccurring and

the business services authority that Huda just talked about will highlight that to us

to say as commissioners, you probably want to look at this and they will then look at

their record cards and see what's going on.

and this is how we pick up when there's anything going on in a practise that shouldn't be.

So a practise is not able to hold an NHS contract for NHS patients and not be able to see them.

The only time somebody might say, even though my units of dental activity have started on the 1st of April,

but I can't see anyone, is if they have an absolutely tiny contract.

So it might be that they can only see 15 or 20 patients.

We prefer not to have small contracts, of course, because we would like large NHS contracts.

But any we have got, we do try and say to them, either you extend that and make it larger,

or you give us that funding back and we put it into another practise that's going to see it.

The other thing is about where those are sitting.

And since 2006, commissioners have always tried to do that,

because the smaller ones are the ones where you sometimes have the issues,

and they're doing lots of private, but they're doing a tiny amount of NHS.

but access to practises in North East London is available.

We have a list of all the dentists in Teller Hamlets

and we look at what they do as far as mid -year,

which is what we're doing at the moment,

and year -end is concerned and their activity levels.

Thank you. Thank you, Abdulmannan.

Thank you, Chair.

On page 4, about the performance,

set out the dental practise performance against targets

What was the target 24 -year -old low?

74 % compared to last year's 91%.

Is there a specific reason for that?

So we talked about the pre -pandemic when practises were paid,

when they were just assessing over the phone, etc.

And then 21 -22 was their first part when they came back,

but again it was sort of, they didn't have to do 100 % activity.

22 -23 was the first year when they actually started returning.

The 77 minimum threshold, which is what they were told to do,

is based on just Tower Hamlets.

If you look at Northeast as a whole,

it was closer to the 85%, 90%.

But now, when I've talked about the last year,

I've talked about how that's coming back.

So 24, 25 is our first year where we've seen pre -pandemic.

25, 26, which is the year we're in right now, it's even higher.

So you're looking at the activity levels

are close to 96%, 97%.

And as I said, those figures are much higher than the rest of the country.

Nobody has any figures close to that.

What that means is your practises are getting back to normal quicker than much, many of the rest around the country.

Thanks for the presentation and for all of this information as well.

It's really helpful and interesting.

So I don't understand how the funding works and that's on me and I'll take away and think about that harder.

But what I can see from page 43 of our pack, I don't know what one is of yours in your presentation,

is that Newham and Redbridge get around a third extra contract value than Tower Hamlets.

and as a result they seem to be delivering about a third extra contracted units of dental activity

and they have slightly bigger populations but not massively bigger populations, certainly not a third bigger

and the amount of money that goes to the practises in Tahel Hamlets is comparable with Hackney, Barking and Dagenham and Haverin

all of which have lower populations, like 20 % lower.

So I just wanted to, I guess my question is,

is this because there is insufficient demand

from people with entire hamlets for NHS dental services,

or is there another thing that impacts,

that means our contract value is lower,

and does that then restrict the amount

of NHS dental activity?

I think the first question I'm going to ask you is,

I don't have a slide 47, so I'm just trying to work out

which slide you're actually looking at.

I'll just do activity levels, which is...

This one.

Yeah, got it. I've got it.

Sorry, yeah, slide three for us, I think.

Yeah, sorry. Okay.

Yeah, so what this slide gives you is what the...

So, you know, when we talked about earlier,

How did you end up having XML contracts or practises

and term limits?

This goes back to that.

Your budget was set from what the historical level was

in 2004.

And when that was put together, that's

what established what the dental value is.

Anything extra that came in there

would be anybody that closed down, et cetera,

I talked about.

And so everybody ended up with whatever they did based

on that historical time.

Your point about some areas needing more,

and they might have a smaller population, for instance.

Those are exactly the points that we do go back and feedback

You know, there are areas that we say are actually much when new is a great example new and you could open three new practises

We've opened to five years ago their fault to the rim and we still could open another couple and still fill them up

So it's one of the areas we know Tower Hamlet says another one

Yeah, we've both talked about public health respect back and we've gone right we need to put a big chunk

So when that I think it's two and a half million pounds or something that came through

We went right these are that these are the areas they need to go in

We had to put the bigger chunk in those areas.

You also had to base it on the practises that were interested

in even offering us any services,

because you've got some that you'd like them to,

but they've said, no, we're fine as we are.

We don't want any additional funding.

But the funding that's already there,

it's based on rather than the population size,

rather than if you've got more NHS dentists,

it's slowly based on the hysterical info.

And unless you get a big chunk of money

and the government was to say, right, we've got,

which has happened in the past, in the last 20 years,

they've said we're chucking some money to dentistry. Found it at the back of the sofa, do you want to

spend it this year? You know here's five million pounds and we've gone yeah absolutely and we've

gone and quickly used it into those areas that we know are of the high need. But unfortunately

recently that hasn't happened and since Covid it hasn't. So the only way I could think of using

any additional funds is anybody who's closed down or anybody who's rebasing and saying I'm having a

tough year, you know it could be personal issues you know my mum's not been well I'm looking after

her I'll only be doing three days but I don't want to lose my contract. So that's absolutely

fine we're going to rebase you for a year or two years and that money's then gone back

to another practise. So we are trying to ensure every penny in dentistry stays in dentistry

but there is no additional money and again going back to the point that I fully hear

what you're saying and agree with you and we are making the noise that some more additional

funding for dental access is what we definitely need, definitely in North East London.

Thank you, I understand that much better now. So if more money was to be made available

on a more consistent basis rather than just a kind of a like three months before the end

of the financial year, here's some use it. How would we make sure or ought we to be doing

more to make sure that Tower Hamlets brings the level of the contract value that it gets

up nearer to those sorts of levels with comparable sized populations?

So the funding that we've got at the moment is what is existing historical.

The only way to do that is if there was any additional funding to come into NHS Dentistry.

The dental reform may change it.

It could go either way.

And I have fed that back to the national team yesterday.

If they're looking at more urgent care and saying to practises, we're going to give you

X percentage of your contract to do urgent care for patients when somebody comes in with

a bit of toothache, see them and we're going to get you to do that.

We've got a bit of an issue with that because we're saying actually we need access.

We don't need that.

We've got an urgent care centre already because what that's going to do is reduce

the UDA's even further and you're spending more money on urgent care rather than access.

So from our perspective, the thing that we're asking for is additional money.

To get it back up there, there is only one honest answer which is if there was additional

funding, we would be able to do that.

And that goes back to my point that with the national team, the one thing that Jeremy and

myself have repeatedly said, if you have underperformance, which we know they do because they're talking

about why everybody is not hitting their targets.

We're saying in London they are.

So if you need to spend the money,

can you please use it in London?

Because we can give you the dentistry you need.

So we will keep pushing for that.

But outside of that, there isn't an easy answer.

I can just say that the ICB has committed all the money back

in, in Northeast London.

There are ICBs that haven't done that.

So we're glad we've managed to get that.

Thank you.

Chair, if that's the end of the questions, this has been a really helpful presentation

for me. I'm kind of keen, as you know, from other meetings that we don't just receive

the information and ask some questions and feel a degree of assurance or not about them,

but that we kind of think about what the actions we can do as a committee. And I think we've

done that on things like scrutiny challenge sessions where we've done about maternity

services and things like that and made recommendations. So I think around this I'm always conscious

that we don't get, we don't really have that much evidence as councillors to be able to

give us a very informed judgement. But we've had a very clear kind of steer and advice

from those who lead on this and I think that maybe this authority ought to be making that

argument. I wouldn't want to see us make an argument that says we should take money from

the contract value in Newham or Redbridge but I do think that in some way to endorse

the argument that's being made by the NHS professionals would be useful. I don't know,

would that be useful in any way for Talhamlet's council itself or its MPs or its mayor to

saying something on this? I think the answer would probably be yes because at

the moment the government is very keen on more you know stuck on a dental reform

and urgent care and we are making the noise but yeah I would have thought so

so anything would be helpful because what we're looking for here is not just

find the money because as you know there are no pots of money anywhere which is

sometimes the answer we get it's actually I'll be able to get some of

that money for dentistry we've been promised it for a lot of years as we

know in every government change and I'm still waiting so yeah if we can have

and money to dentistry it would be great.

I suggest that as an action point that we explore how this committee and this authority

might support that call for additional funding. There's no need to be specific and if it's

not possible it's not possible but maybe people can take away the kind of what we've talked

about here and see if that could come together in some kind of public statement.

And our MPs being encouraged to argue for it as well.

So yeah, just in kind of support of that, I was wondering whether from the Healthwatch

perspective who have done work around understanding the experience of residents around trying

to access dental care, whether it be helpful to bring that into the thinking around how

the committee might make the case for change. So I think that useful piece of work from

Health Watch might be helpful in this instance.

Thank you very much.

Thank you for the presentation.

Now quite impressive now to transform the impression into real accountability and next

steps, that is, what milestones and performance indicators will scrutiny see in the next six

to 12 months, and this particular performance indicators, how will the progress be reported

back to this subcommittee?

Am I clear?

So with regards to feedback, I think the first thing to say is the additional funding we

talked about, I have managed to secure it for three years, so it's not just normally

it's for the six months, but I have managed to put this case that we were able to get

approved, especially with restructures going on in the NHS as you probably know.

I wasn't expecting it to, but we have had approval for three years on this.

So the good news is for three years you've got that access funding, so that half a million

pounds in town hamlets has been used for three years and committed to practises.

Outside of that as far as performance is concerned we have performance indicators

on pretty much everything in dentistry by the Business Services Authority. We

are happy to share. I mean you can be overwhelmed with it, that is what I'd

say, so it's probably the key bits that you'd want which is you know our

practises providing all ranges of treatment rather than picking and

choosing the easy ones. You know cleaning is easier than actually having to do a

filling and extraction instead of saving the tooth etc. So that information is

what I think is probably the key information,

and I'd be happy to pull that together

and share that with you.

If you tell us what sort of intervals you'd like that,

whether you'd like that presented,

or whether you'd like it, like us to present it to you,

we'd be happy to do either of those.

And outside of that, I think generally,

anything else that we do within our community

dental services, our hospitals,

feedback from a public health perspective,

we can update whatever you want us to,

bearing in mind that we are working now

across five ICBs and all 32 boroughs rather than individual NHS England.

So for myself, there's just one of me at my level doing that job

and a team which was 22, became 15 and is soon going to be around eight people.

And Huda's situation is...

I'm on my own.

As well. So it's just thinking about...

Covering 33 local authorities, yeah.

Yeah. So it's just thinking about how much of us we have.

Thank you.

I have a small question to you.

How much of your work is genuinely preventative rather than focused on treating the existing need?

In relation to the preventative before treating the...

So we have supported Tower Hamlets with a joint strategic needs assessment for children

and young people and there is an oral health strategy in place. So there is a lot of prevention

happening in terms of the Healthy Start vouchers, in terms of promotion of breastfeeding, in

programme and the supervised tooth brushing programme is all about prevention.

In terms of dental services they are recommended to provide preventative

advice to patients and we monitor that through the NHS Business Service

Authority in terms of fluoride varnish applications and delivery of oral health

advice and Fisher Sealant.

And part of the dental contract reform,

there's going to be more of an emphasis on prevention

again, with increased focus on fluoride

varnish applications for children and young people

in dental practises and Fisher Sealants.

Yeah, go ahead.

Since you have a very tight budget, children, young people who have mental health as well

and learning disabilities as well, how do you support them in terms of like, you know,

like we have people with special needs, they need more budget, more specific way of like

putting extra money for this kind of group of children.

How do you support this group of children?

Thank you.

Do you have any specific like budget for them?

Yeah, sorry, I was just.

That's it, sorry.

Yeah, so we have community dental services,

which is one of the slides on there.

So it shows you a big chunk,

a big budget goes towards community dental services.

This is separate from the general dental budget.

And that goes specifically

for exactly those group of patients.

That service is one that, so Andrew my counterpart is of the lead for specialist services, both

acute and community dental services. So I think the one thing Andrew will probably say

is we have a fantastic community dental service in fact. It's one that's coming to the end

of its procurement years and there's a process we're doing to extend those. But yeah, there

is a service that provides all of those special services for those and again the waiting times

et cetera, are monitored on a regular basis.

The hospital services work within.

They all work hand in hand.

Huda talked about the supervised tooth brushing, et cetera.

All of that comes as part of that

to ensure that those patients are seen as quickly as possible.

And those patients don't take up the general budget,

if that makes sense, because there's actually

a separate pathway for them.

Thank you.

Thank you for attending today and providing us with information on this issue.

Whilst we don't have any local GSN states on adult dental care, we know from the London

Assembly Health Committee report, decay and delay, January 2025, suggests that adult dental

care continues to lag behind national averages.

various to access persists including UDA model discouraging, preventative care,

inequalities prevail amongst vulnerable groups including homeless people,

prisoners, those with disabilities and refugees faces disproportionately poor

oral health. As a committee we would like to see more work done expediently on

contract reform to including prevention and local practises invest in early

intervention.

Increase school -based initiatives and outreach programmes in areas of greater need.

Bring together our public health teams, NHS providers, community organisations and local

schools to deliver culturally tailored health education.

Involve families and community leaders in shaping outreach and preventing ensure that

message connect the diverse population of Tower Hamlets.

Once again, thank you. Okay, feel free to leave with this. Thank you.

Thank you.

So tonight our final item of this evening is approved to the next health and wellbeing

strategy.

Now I welcome Councillor Sabina Akhtar, Cabinet Lead for Health, Wellbeing and Social Care,

Giorgia Simbani, Corporate Director Health and Adult Social Care and Suman Benardji,

Director of Public Health, Tower Hamlets.

We will have as usual up to 10 minutes to give a strategic overview and we will take

the papers as read and perhaps just most issues that this committee needs to be aware of.

Then I will swiftly move to committee questions and you may start now.

I will let you know when you are nearing your last minutes. Thank you.

Thank you, Chair. Just due to timings, I'll allow Shoman to do the presentation on this part.

Great. Thanks very much. I think the committee wanted just early sight on the approach to the health and wellbeing strategy.

So it's planned to launch the health and wellbeing strategy in May 2026.

I should just say that this, producing a health and wellbeing strategy is a statutory, oh,

sorry.

Oh, sorry.

So the health and wellbeing strategies, the statutory role of health and wellbeing boards to develop.

The last strategy was developed in 2021 and actually that was in the midst of COVID.

The sort of current context which I put in the presentation is like really acute financial

challenges being faced by organisations across the system. There's some fundamental policy

drivers which I'll talk about, persistent and in some cases increasing health inequalities

and increasing demand on both the health and care system. So it's a very challenging context

that we're operating in.

The other thing that I wanted to highlight

is that we are developing this strategy

at the same time as the launch of the partnership vision,

which is the Our Tower Hamlets vision for 2025 to 2035.

So there's an opportunity to align

the Our Tower Hamlets vision with the development

of new health and wellbeing strategies.

So that's just a bit of a context.

Just a few words about the previous strategy.

So as I said, this was done during COVID.

The consultation was actually before COVID.

But some of the key bits about it was recognising the right of people to have equal opportunity to be as healthy as possible,

reflecting the WHO right to health.

There were some principles that residents said would be really important for the strategy,

which is actually resources going to those who need it most, the importance of connexion

in relation to wellbeing, the importance of people being treated equally and without discrimination.

There was a really strong one about health and wellbeing information being really simple

and clear and working for all our communities.

There was something about co -production and people having equal power and say in shaping

designing services and there's also a recognition that there are a lot of assets within the

communities and it's important that we make the best use of that.

So that was kind of the framework and then also thinking about what does a healthy borough

look like and it was a very much life course approach, children, families, young adults,

middle -aged and older people and then a kind of integrated system in which people get the

help, easily get the help that they need and are supported to find the right help. So that

was the kind of, those are the principles of that strategy. In addition, the Tower Hamlets

Together which is the partnership of organisations across the health and care system, I've set

out the priority every year they review the priorities at 24, 25 they had really

key priorities around primary care access, prevention, also developing a

neighbourhood approach to our health and care system, a lot around the interface

between hospital and community and getting that right, a lot about equity

and then also best start in live maternal health

and the health in early years,

and then mental health was also a real priority.

So these kind of remain really important priorities

that the strategy would need to address.

So I've just put in a little slide around strategic context.

I think some of the key things to recognise

is nationally life expectancy has stopped increasing and that might be an impact of

Covid and it may continue to increase later but that's something that's quite interesting

about what is going on nationally. The other bit is particularly in relation to 2021 is

the role of technology and how rapidly that is advancing and how that might improve health

for some people but some people might get left behind. Obviously the cost of living

crisis is a real thing. Also in relation to climate change that creates risks for the

health of our residents particularly in terms of extreme cold and adverse weather and prolonged

heat waves and those sorts of things. Key kind of national policy is the NHS 10 year

plan which talks about shifts from treatment to prevention, from hospital to community,

and then this issue about digital, so analogue to digital. So those are the three key shifts

that are outlined in the 10 -year plan, but also this emphasis on neighbourhood working.

And so we are due to get the guidance on neighbourhood working very imminently, and that is going

be a key guidance for us in how we shape our local policy.

I've also just put in the packets and work that we've done with residents about what

matters to them around their health and wellbeing. They've talked a lot more broadly about housing,

about crime and safety, about economic security and opportunities for residents and specifically

particularly in relation to health.

They've talked about prevention,

particularly a lot about mental health,

a lot about access, and a lot about how

communities support each other.

So that's some of the insights from residents.

In relation to the data, I think,

it's some of the, I mean, it's the issues

that we'd all be familiar with in Tower Hamlets,

which relate to maternal health, child health.

we talked about oral health now and Tower Hamlets has a particular issue around dental decay, particularly in children.

Healthy life expectancy in women is a real issue, but also lower life expectancy in men.

And all of those issues around long -term conditions which are kind of more prevalent in Tower Hamlets around diabetes,

particular forms of cancer, long -term conditions.

So, and all of that within the context of a population

which is particularly mobile and is growing very fast.

So those are particular characteristics of Tower Hamlets.

I put in the slide just highlighting all the strategies

that kind of impact on people's health and well -being.

And so there are a whole set of slides,

some were particularly in relation to health,

but others are more around the kind of drivers of health

that are gonna impact on people's wellbeing.

So it's just to highlight that,

and then that obviously raises a question of,

actually what do we need

a health and wellbeing strategy for?

And that was a question that we discussed

with the Health and Wellbeing Board at previous meetings.

And I think there's a lot, this is particularly about the role of the health and wellbeing

board in having oversight of those issues that really matter to residents around their

health and wellbeing board and connecting to residents and what matters to residents.

And so it's how the health and wellbeing strategy can kind of set out the way of working that

brings leaders across the system to address those things that matter to residents.

So some of the things that we merge out with discussions are having a small set of measurable

priorities so we can really track impact.

There was a lot about something that is a perennial issue with the health and care system,

which is the join -up of the system.

Also how do we build prevention into the system, I mean from the perspective of residents but also for the sustainability of the health and care system.

How do you really embed the role of residents and communities into shaping and supporting each other's health.

But also there was something about how do we make the system work?

What is the accountability and the governance of the Health and Wellbeing Board?

How does it relate to the Tower Hamlets vision?

And how does it relate to Tower Hamlets together? So those are some of the key issues.

I've put in also the vision statement for our Tower Hamlets, which I think is very, which is quite inspiring.

and I was involved in some of the sessions and the vision was very co -produced.

And I think one of the things it talks about, it's about Tower Hamlets, how it stands together,

how people support each other, but also specifically in relation to Tower Hamlets, how we break

the cycle of poverty and inequality.

And so from the health and wellbeing perspective, it's about what we do, how we break the cycle

around health inequalities.

So I think the Tower Hamlet's vision is very aligned

to what we need to do around health and wellbeing

in the borough.

So just to say a little bit about the approach.

So we did say we were looking to launch it in 2026.

Some of the things that we need to think about,

as I said before, alignment with the Tower Hamlet's vision,

governance and accountability,

what we need to do about integrating the system

both within the NHS and across health and social care,

really key issues, how we integrate prevention.

That neighbourhood model is gonna be really important

going forward, and how we think about sustainability

of the system, how we embed co -production.

And then there was another recurrent thing

which related to what is the relationship between the health and care system and housing

and what can we do about that and how do people in the health and care system work with people

in housing on common issues. So I'll just stop there and I think what would be helpful

would just be to kind of go does this feel about right and also how would the committee

want to be involved going forward. Thank you.

Thank you, Shuman. Georgie, do you want to add anything?

Two questions at a time and if we have time after the first round, we'll allow for more. Thank you.

Thank you for this.

I can really see where not just residents' views but also where the views of the board,

particularly from the session that we did on this, have been taken in, particularly

about housing because I remember talking a lot about housing in that session and had

some really good conversations about it. So I'm really pleased to see that you've made

this sort of a core thing. But my question is obviously going to be about how does that

happen and how do we, I think it's tied to this theme of seamless experience of services

and system integrations and this kind of thing because I think that is everybody's dream.

I think if you asked everybody what they want from all of these different partners that

work together it would work together and it would work well.

I think that's always the dream.

So it's what specifically are we going to do to make that work and make that better.

I'm not expecting a very specific this person will speak to this person but a better idea

of how that will work and then if I can, just in terms of you're talking about the role

of the board and accountability and governance, just a reflection from me having sat on the

board for almost four years, it needs to be more accessible and I mean accessible in terms

of, again I've been on it for four years and sometimes I sit there and go I can't remember

what this means and how this relates to X and I've been in all those meetings.

It's quite, I think it's really positive to talk about co -production to bring people in.

I know that's an effort that's being made but I think it needs to sort of even philtre down into the board

and how the board operates. You kind of understand what I'm getting at.

Sometimes I sit there and forget who is who and why they're here and what that means and how it relates to this

and I just think a bit of that might help some of this also come together.

Thanks, Chancellor. I was going to sort of raise two things.

So, one of your, I think the first question was if you take, say,

housing and health, how will that work in practise?

And I think that really comes down to how we work across the whole system.

So over the past year or so we've actually worked quite a lot with the housing team in

the council and that's a really mutually beneficial process so as a result of that we have developed

our housing and health group which has both people from the council, the housing department

and the other partners.

And I think the really important thing

with the housing and health is recognising

where you can make impact by working together.

So we all recognise that better housing

is going to improve health.

But actually for health and care partners,

they don't really have a role around that.

Where they do have a role is kind of integrated,

a wider sense of integration.

So if you have a district nurse going into a home

and the issue that's causing the problem

is the dampened mould,

what is the role of that district nurse

in connecting that household to interventions

that could help connect them to the housing department?

So I think those practical things

are things that we are able to do.

And so that's what I'm hoping will come out of this housing

and health priority in which we have some real kind

of specific things in which the NHS and housing officers

can work together.

And some of that might be training as well.

So that's kind of how I can see that sort

of collaborative working happening.

In terms of the role of the board, I think the core function of the board is democratic accountability to the population and the residents.

So I think I've said this before, what's noticeable in town Hamlets is like the Health and Wellbeing Board is a public meeting but not really well attended.

Whereas, you know, I am sure yourself have been to a number of events, community events,

where you have to turn people away because they're so passionate about the issues.

So there is something here about how the health and wellbeing can have that energy

and how we can look at it in a different way.

And so what I would be hoping from this strategy is that kind of enables us to really rethink

how the Health and Wellbeing Board works.

Thanks Amy. So the key word I think collaborative work and working together. So I've had the opportunity to chair the Health and Wellbeing Board once. I think last time you were there.

but I get what you're trying to say, like, you know, five or two people that are on the board who's coming from what angle,

and who's from where, why they're here, so it did take a bit of time, you know, to kind of get that information across.

And then once, you know, when we were having those discussions, I could see why certain people were on the board,

and what the aim of the board is, so fundamentally, it's to kind of work together to achieve, you know,

outcomes that cannot be achieved individually and a strategy I think from the board that

we can really work on is that to kind of work and inspire the community and putting residents

at the heart of any kind of decision making. So whoever is in the board, myself as the

chair, whatever discussions we're having in terms of each department like you said,

we have other councillors, members, yourselves, kind of giving that view and having that accountability.

And if we have a strategy where we can go back and evaluate, only then we can improve for the future.

And it's really important that we continue that monitoring and that's where we can have the board,

so we can come back, have those discussions, what's working, what's not.

So we can have all the strategies, but if it's not for the residents and if it's not where we can still have accountability

of the services that have been provided, there's no point. So a strategy or a board that we have, that we have a well -being,

it's where we can actually work together and have that place where we can have business continuity as well as improvement space.

Otherwise there's no point. And where people coming from different organisations, we have someone like you out there as well,

and it was kind of interesting to see the different kind of views and how they go about,

because obviously in the entire hundreds we have a diverse community, we have all the

other determines, wider determines housing, employment, mental health issues. So gathering

all the different things that we have and knowing that every area could be different,

but at the same time regardless of the resident, regardless of, we want to have a service and

where people can have access to the service that they require when they want to.

And it's about working together in terms of, like you said, housing issues, like Shoman said,

it's working together and that's how, you know, the vision that we have in Ta Hamlets,

how we can early, so this is kind of a draught, how we're coming in early and kind of seeing how we can work together

through the ambition and not just having a, we've got this ten year strategy, we need to come on board,

We need to come back and keep monitoring and evaluating.

Please.

Thank you, Sabina.

Thank you, Sumit.

Thank you for your presentation.

My question is, when your data looks at wider determines of health and how you're going

to tackle those wider determine, you know.

The second question is, you mentioned, Sumit, you mentioned health and wellbeing strategy

should we reduce duplication and what kinds of steps you are taking to stop duplication things.

Thank you, that's a quick question.

In terms of wider determinants of health, I think there's a sort of recognition that one's state of health is

it's maybe five, ten percent to do with your access to health and care and it's actually more driven by factors like housing, employment, poverty, income and those sorts of issues.

So those are the real drivers of health and when you see, you know, you look at the relationship between poverty and health outcomes, it's like really apparent.

So there's it's recognising that you know

the things that impact on health and well -being in the borough are the things that the

Partnership plan are really focused on you know the our town its vision or partnership

which do look at housing employment and those sorts of things and so

Those are the kind of obviously those things those are things that the council has real significant levers around

So that's what's meant by wider determinants of health.

I think it's really important to ensure that the health and well -being strategy has kind of boundaries to it.

So it is interested in housing, but it's interested in how it can work with housing, you know, the housing system in town,

Hamlets to improve health or how for instance in relation to employmental benefits the health

and care system can connect people into those services that impact on their wider determinants.

So one of the kind of key initiatives within Tower Hamlets but also more broadly is social

prescribing and that is recognising that someone might go and see their GP but their key issues

housing or they might be welfare or it might be employment, it's an opportunity to connect

them into those things which are really impacting on their health. So that's the relationship

between the health and wellbeing strategy and wider determinants of health sitting in

a kind of system where you have housing departments, employment, all of those things that the council

So does that help?

And crime is obviously the other key determinant of health.

My second question was how are we going to do duplication?

Yeah, so one of the issues that we've been looking at in terms of duplication is that we have a place partnership,

which is Tower Hamlets Together board which is also a subcommittee of the Integrated Care

board and then you've got the Health and Wellbeing board and often what we find is that the agendas

are quite similar. In the same week, people who are on the board might experience this

which is that you'll have a set of agenda on what matters, what's important around health

of the Health and Wellbeing Board and then you'll have pretty much the same agenda at

the Town Hallenets Together Board. So it's thinking through how we make sure that the

place partnership, which is a Town Hallenets Together Board, has a distinct role from the

Health and Wellbeing Board. And there is a space in which, obviously as I was saying

before, the health and care system is experiencing real challenges at the moment and there needs

to be a space in which the system leaders can come together to really deal with the

challenging operational issues, which may not be issues for the health and wellbeing

board. So it's trying to make sure that the different bodies and boards are not duplicating

with each other and have distinct roles and are clear about the impacts that they're having.

So that's what's meant by duplication in this context.

Yeah, and I'd just like to add, as a resident of the borough, when I'm seeking any kind of support or care,

I certainly don't want to go to the same people twice or, you know, having the same kind of information, like duplicated.

Sorry, Sean.

Awesome.

Yeah, so it's really important, and it's a good question, how we kind of not have that duplication,

because as a patient, I wouldn't want to go to the same people, same time, or being moved,

or going back and forth for a care that could be really simple like a process.

So like Shoman said, it's about early intervention,

kind of speaking to the relevant departments

and every kind of healthcare professional.

I believe Shoman, there's something that when they ask,

like when they see a patient, they can report back to a system

where other professionals can also see.

So it kind of reduces duplication, if you know what I mean.

First and foremost, thank you very much for a wonderful presentation.

The take -off message for me that resonates with me was your page 80 and 82, which explained to me in your nutshell.

I have a couple of, but the first very important critical friendly question to you is on accountability

and monitoring.

How will resident experience be used to measure and monitor whether the strategy is working

once implemented in May 2026?

I assume everything is going on track for it to be implemented.

What are the KPIs metrics you will use or involve in it?

And what happens if residents, many a times they come up, you know, I experience it, they

continue to report the same problems two or three years into the strategy.

Am I clear, sir?

So I think there's one question on outcomes and how we track that and how we hold ourselves

to account.

So I think there's a lot of metrics that are used across the system.

I think from the health and wellbeing perspective, one of the things we'd want to do, and actually

people from the health and wellbeing board have mentioned that, is that we'd want a small

number of really impactful measures that we would track at the time.

There's two types of measures.

So one measure is like, you know, when you look at a population and you will go, there

is health improvement or there are improvements in access and those sorts of kind of measures.

There's also another set of measures which are about people's experience.

So you'll actually have seen within the presentation I presented what are called the I statements.

So these were statements that are developed by THT,

a co -producer of the community around what matters to them.

So those are metrics like, you know,

I'm treated with dignity and respect.

I understand the health information I'm receiving.

I have access to things to support my health.

So I think there's, I think one of the things

that we'll need to do in the Health and Wellbeing Board

is go, actually here is some high level measures.

if you look at things from a population perspective,

you can see that things are changing in terms of people's,

say, diabetes outcomes or mortality and those sorts of things.

But you'd also want to see improvements in those I statements.

And actually how you measure those I statements is something that we'll need to think about.

But it's really important that the outcomes that are developed are developed together and are owned

and are not seen as just a kind of dashboard at the site, but something that everyone is invested in.

Thank you.

Thanks for the presentation and thanks especially for this opportunity to try to feed in some

thoughts at an early stage. So I didn't realise that we were going to have quite so much reference

to the board but I should just as a declaration of interest in the interest of transparency

say that my wife was formerly the chair of the board and so oversaw the

introduction of the last strategy. So I'm not a strategy person at all and so I'm

not the best person to feedback on on this and these early thoughts but I'll

give you some kind of my random collection of thoughts about where I

think whatever strategies have been in place before aren't yet hitting the mark

in terms of delivering improved user experience,

resident experience for our constituents.

So the first of those I think is around home care

and I think that is about,

there's some really excellent services being delivered

and there's some that are not so good.

So I don't know exactly whether this falls into that bracket

but I think that I'm trying to have a focus

on bringing all of them up to at least a good standard

and for that to be reflected in service users feedback to the council

would be a really positive thing.

Secondly, I think people's access to services when they're suffering from,

when they have relatives that are suffering from dementia and Alzheimer's

is something that's really problematic

and my kind of generation maybe is talking more about how we understand that,

how we know what's there and how we help older relatives navigate that system and get into good settings.

and I think people's feedback that I, people that I talk to that have been through this process

in Tower Hamlets and outside is quite mixed and I think that's something that we as a society

should learn from or we need to kind of do more about and I think that we probably need to do

more about that here in Tower Hamlets as well. So the next one is around mental health services and

that's in my mind because I spoke to a constituent a couple of weeks ago whose

housing situation is seriously exacerbating his mental health

state and I said to him you need to get a supportive letter to go for a medical

assessment for housing and he was like yeah I've put him for that and I checked

in with him last week and he said yeah they're giving me an appointment in the

And that to me just seems to be falling quite a long way short of the kind of service that

we would all hope that the NHS and local government is able to provide collectively.

So I think those areas are really, really important.

I guess the key thing, the question that like beyond that, what I would throw back at the

The question I would ask back to the team is,

what do you think worked well?

Where do you think that the last five year strategy

accelerated progress towards the objectives that were set?

Where do you think that still didn't keep pace?

And then what did you think that we maybe

could have included last time but didn't include

just because of the knowledge that you can't prioritise

everything at the same time you have to try to make a sufficient focus in you

know a few areas and really try to really try to deliver the improvement so

those would be my thoughts

sorry yeah thanks very much I think those examples that you highlighted I

I think one of the things that's really worked over the past five years is really bringing residents into discussions.

I don't think we're there yet, but I kind of, reflecting back on some of the THG board meetings or some of the Health and Wellbeing board meetings,

those have really had impact when you've had residents come in and talk about, well actually

in this forum as well, when you have residents talking about their experience and sometimes

the system leaders are actually quite surprised when they hear what residents are saying about

their experience of services. So I think the really important thing here for services to

work well for residents is to make sure, whether it's dementia or whether it's mental health

services or whether it's other services, that the development of those services is really

connected into the experience of residents and I think that's, there's examples of patches

where that co -production has really worked but it's by no means kind of something that's

experiences of the past five years that we need to do more of this.

And we also, I think, one of the things is how you can give residents more power, like empower residents,

so give them roles around developing services as well and thinking about how you, ways of doing that.

I think.

Yeah.

There was one other that I meant to mention, access to GP surgeries as well.

Like that's just a perennial issue I think and that hasn't been cracked.

I was going to say that, yeah, that hasn't been cracked.

I think, and obviously this is something that obviously the council has a role in but doesn't

have the levers to make the change, but I do feel that the neighbourhood's model in

which you're really engaging with residents around the services that they need and also

how they can appropriately use services may be a way to go in terms of, you know, if you

look at what comes for instance through general practise, maybe a proportion of that could

have been self -care or could have been done over the phone, it could be triaged better.

So I think there's an opportunity there, particularly in Tower Hamlets, you know, where we have

such a diverse population, we know that health literacy is an issue, it's a barrier for people,

so that connexion between a general practise and its population and how you tailor your

approach, I think those might be things that might help, but clearly underpinning all that

is a financial issue and so you know there's only so much we can do but the other big area

I think relates to the relationship between primary care and secondary care and how those

services within secondary care can come out to communities, intervene early and prevent

further deterioration, you know, examples like, say, renal care, how you prevent renal

dialysis. There's a clinician in BART who is really focused on that. So some of those

things I think are going to be really important. Thank you.

I just add, I think in moving on for the new strategy, there's more discussions from the

I mean, Health and Wellbeing Board in terms of like how the borough is influenced by various

factors, the residents, in terms of, you know, unemployment, housing, migration and mental

health. I think we're looking much more or we're discussing much more about mental health

in the borough and I think in the last question, the Health and Wellbeing Board, we would want

to look at these different variants and how it affects people's health. But I also agree

with the Councillor about the primary care access to a lot of people still complaining

or there's still a lot of discussions of how to get in the care they need from primary

and how we can get access

, especially after

COVID -19

, especially in terms of getting appointments

in the first place

I think the new strategy

should have this kind of discussion

We are happy.

Thank you.

We have heard today about the importance

of partnership

working,

community engagement

and ensuring that

the status are ambitious and

achievable.

Members have raised

valuable points around monitoring

progress, accountability

and

making sure that the

voices of diverse

communities are

reflected throughout

the implementation.

As a committee, we will

continue to

scrutinise delivery

against these

priorities and

hold partners to

account for

progress.

I would like to

thank officers and

partners for

their support

contribution and commitment to this work.

And we look forward to seeing how this strategy

translates into tangible improvement for residents

over the coming years.

And my final question to you,

when will we get this strategy?

So as I said, we plan to launch it in May,

so we could bring a sort of draught,

I'm not sure when the committee ends,

but maybe in March or April.

So, Chair, on that point, I mean, I think there is something else happening in May,

which would be in the elected members' minds,

but whether that changes the direction of this or not, I don't know,

but we only have one more committee session, I think, before we finish.

I think it might be useful.

I can have a discussion with Philok around how board members, sorry, committee members might contribute, given that there is only one meeting left.

Thank you. Before we leave, Councillor Acton, Giorgia and Shuman, I want to ask you when we will get the CQC report feedback?

We don't know, Councillor, in terms of when we'll get that.

CQC time scales are difficult to determine, but as soon as we have an outcome, we'll let

you know.

Thank you.

I just want to say thank you.

I think Mr. Barney wasn't at the, I can't remember if you were at the last meeting,

but really appreciate this information being provided to us

and being provided to us in such a clear way.

Inevitably, and I did say this when I first asked for it,

like it might prompt questions.

So I think like just to put on record,

there is really good performance

across a number of these KPIs,

and that's really encouraging.

There are two that I wanted to,

or two areas that I wanted to ask a question

and it might not be possible to answer that today but just to kind of for an

action to kind of feedback to us. So the first of them is around safeguarding so

queries and then inquiries I think I don't know what the exact kind of

separation or definition of each of those two things is but they are lower

than the target and they've been lower than the target like fairly consistently

So I'm okay about things not hitting the target because I think that means you've got a stretching target and that's really positive

But it would just be useful to have a little bit of extra information about what's being done

to try to bring those closer and

You know be straight with us as a committee and like if this target is just not an achievable target

Then that perhaps needs to be thought about and a trajectory towards back to where you say it ought to be

but that's the target, the direction it's set.

And then the other one is just to go back to the issue

around community equipment.

So I really massively understand the disruption

that's been caused to the service

as a result of the company going into administration.

So the two KPIs that are in here,

there's no performance data been provided,

and that includes for the period prior to the company

going into administration.

So I appreciate that that might not be possible

to be provided in the way that it might have before,

but I don't think we can just say this is a KPI,

but at the moment we're not able to produce

any actual data on it.

So just if we can have a note about whether there is

anything and if there's not, at what stage,

that will be provided again.

While I'm on, oh, sorry, go.

Thank you, Councillor Ponsas. I have got the data in front of me, but I apologise. It is

so small and I've left my glasses. I can't read it. I will look at that and give a proper

response. I'm not sure which one in terms of safeguarding, because we don't have a target

in relation to concerns and inquiries, because that's needs led. So it would be really difficult

to come up with, unless it's the target in relation to,

apologise, somebody can be my eyes,

unless it's the target in relation to time scales

in terms of managing them, but in terms of reporting them,

we would generally not have a target on that,

because that's just based on people's needs

and safeguards, referrals that are made,

which we have no control over,

so we wouldn't have a target on that.

So apologies if you're able to clarify,

I could give you a response now,

but if not, happy to do that afterwards.

and then should I just touch on the community equipment, we did have real

difficulty trying to get information from NRS. As you can imagine it was a

national provider going into liquidation. The last thing on their minds was

providing us with performance data. It was incredibly challenging. I think we

managed, just about managed to get a few bits before they closed shop but of

course we do have performance data off certainly since that's been about July

August since we've been in business continued so we're very happy to share

in terms of what that looks like.

Great, thank you. So you're right, it's not about the reporting of the

safeguarding concerns, so it's described as percentage of safeguarding concerns

completed within five working days and it is currently at about 50 % and the

target for that and is higher and then there's a similar one percentage of adult safeguard

inquiries completed within 20 working days and again it's just over 50 % I think.

So it was those two so just a note on the actions that are being taken or how you might

in what you might envisage that kind of target setting for KPI in the year ahead given how

late in the year we are.

Yes, thank you, Councillor Francis. I'm happy to provide a more detailed note, but just for the purposes of this meeting now,

what this doesn't show, which we will be able to demonstrate in the note, is the trajectory in terms of the improvement.

So one of the challenges, I think it is a realistic goal and a target, and I think it's important that we meet that target as a service,

because actually when we're talking about safeguarding, we're talking about people who are very vulnerable,

who are possibly at the risk of coming to harm,

and it's important that any referral we have,

we turn that around very quickly to ensure people's safety.

One of our improvement journeys has been,

we recognised, certainly sometime last year,

that we were not meeting that target,

because actually there was a mixed understanding

from practitioners in terms of what needed to happen

and when, and being able to move that on.

So when we provide the note I'll be able to demonstrate to you actually how well that trajectory has moved.

We're not where we need to be but it's definitely made considerable improvement and I think that would be important for you to be able to see that so that you can get assurance as a scrutiny committee in terms of the fact that we are definitely moving in the right direction in terms of safeguarding people.

Fantastic. While I'm on a roll, I just wanted to ask one other thing which is of the lead

member. So does Meals on Wheels service fall within your portfolio?

Yes.

Yes?

Yes.

Can we also get a note on, so we're getting some mixed feedback about access to Meals

on Wheels service. So I just wondered if we can get a note which explains about the number

people that are currently in receipt of that service and also what the plan is for the

kind of further roll out of that.

Okay, I think so.

Okay, further roll out in terms of small demand, are we, like if there is a resident that needs

meals or meals, how are they able to get one meal?

Are you talking about funding?

Yeah, yeah, for the Meals on Wheels for adults.

So it will continue?

Yeah, well I think there was a million pound put into the budget for Meals on Wheels service last year.

Yeah, so it would be helpful to get that note on the numbers of people that are actually in receipt of it

and what the plan is to extend that. I don't know if it falls within adults.

So just a point of clarification, Councillor Francis. Meals on Wheels in the strictest sense of it absolutely would sit in adult social care because that is intended to support people to get a hot meal and so forth.

We have not had Meals on Wheels, as my understanding, as a local authority for a significant period of time.

A lot of local authorities have stopped Meals on Wheels for various reasons.

I think what you're referring to in terms of the investment is something that actually is not sitting in health and adult social care, but actually rather sitting in customer service.

One of my asks has been for us not to call it Meals on Wheels because it's probably the wrong description of what's actually being provided.

If we're talking about the same thing, my understanding is it's something that's been provided to support elderly residents,

but more in the form of a lunch club and so forth, rather than a meal at home provided by somebody who delivers a meal at the door.

but it's something that we're happy to clarify.

But I just wanted to clarify it in terms of meals and wheels

in the strictest sense is certainly different from,

I think, possibly what you're referring to.

But it may be something, it may be we're talking about

two completely different things.

I can tell from Councillor Lee's face

that she may have something else in mind,

but maybe it's worth us clarifying.

How many residents have been sent?

So just for clarification, I'm looking at a page in our East End,

where a meal seems to be being delivered from a van,

and the storey says Meals on Wheels.

So maybe that's a journalistic kind of some euphemism.

I'm absolutely happy to cheque it. My understanding is somebody who's been in the organisation for a little over a year,

I've always been told that we don't have Meals on Wheels anymore, so that it was stopped.

So if we are still providing Meals on Wheels, certainly the corporate director needs to know that we are providing Meals on Wheels,

but that's something I will need to clarify. That is my understanding that I've been told that we don't provide,

but clearly something's been provided based on what article you're looking at, so I'm happy to clarify.

and how we can make sure that we have the

Thank you.

The question, as I said, possibly of

terminology.

As I said, meals and wheels

in adult social care

terms

may mean something very different

to an offer

that might be under another

directorate possibly.

But we can clarify.

Have we got that for the action?

Thank you.

If there is no other business, I call

this meeting

Thank you.

Thank you,

Scootoony members, for your attendance and participation tonight.

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Health & Adults Scrutiny Sub-Committee - Tuesday 20 January 2026, 6:30pm - Tower Hamlets Council webcasts

Health & Adults Scrutiny Sub-CommitteeTuesday, 20th January 2026 at 6:30pm

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Health & Adults Scrutiny Sub-Committee
Tuesday, 20th January 2026 at 6:30pm