Islington Council is gearing up to tackle winter health pressures, focusing on vaccinations, community care, and ambulance services. The Joint Overview and Scrutiny Committee on Health met on Friday 21 November 2025, to discuss preparations for the upcoming winter season, with a focus on key performance indicators to monitor system risks. These include targets such as 78% for A&E 4-hour performance, and aiming for zero ambulance handovers exceeding 45 minutes. The committee's discussions are detailed in the Public Reports Pack.
Key areas of focus include improving vaccination rates, increasing care in community and mental health settings, and ensuring timely ambulance handovers. The council is also working to ensure equitable access to vaccinations and community support services across all demographics, particularly for vulnerable or hard-to-reach populations, through measures such as expanding the number of vaccination sites, targeted communication campaigns, and outreach clinics within communities.
Vaccination Programme
The seasonal vaccination programme will prioritise eligible populations, including those aged 75 and over, care home residents, and immunosuppressed individuals. Efforts will also be made to increase vaccination uptake among staff. The NCL COVID-19 Vaccination Coverage program has approximately 154 sites across NCL, including 125 community pharmacies, 25 PCNs, and 4 NHS trusts, with a capacity of approximately 90,000 vaccinations per week.
To ensure equitable access to vaccinations, the plan includes expansion of sites, a national call/recall programme, locally funded call/recall programme, targeted communications, outreach clinics, in-reach capacity in hospitals, inequalities projects, a flexible approach to vaccine supply, working with VCSEs, and partnering with education to improve access in schools.
The NCL Winter campaign, launched on Wednesday 24 September, is extending the vaccination phase in line with the national Big Vaccination Week. The campaign is live across a range of paid and organic channels including pharmacy bags, bus shelters, social media and advertising with Mumsnet in North London. Community outreach workshops and vaccine pop-ups in local mosques, foodbanks and churches are also planned.
Integrated Care and Community Support
The council is working to increase the number of patients receiving care in primary, community, and mental health settings. This includes enhancing the Integrated Care Coordination Hub (ICC Hub) and expanding the Mental Health Clinical Assessment Service (MHCAS) to the north of NCL. To address the potential increase in mental health needs during the winter months, particularly in light of the cost of living crisis, a new 24/7 crisis response has been set up which aims to divert young people from ED, seeing them in the community instead. Other measures include progressing work with the Metropolitan Police to use community crisis centres for mental health patients not requiring physical health intervention, and bolstering Liaison & Crisis Pathways with additional staff.
London Ambulance Service (LAS) Update
The committee received an update on the performance and achievements of the London Ambulance Service (LAS) for 2024/25. Key achievements include:
- Answering 999 calls in an average of 5 seconds.
- Treating over 273,000 patients over the phone.
- Seeing 1,084,922 patients.
LAS is also working with system partners to implement the 45-minute patient handover process, which aims to ensure ambulance clinicians can attend to patients in the community more quickly. Challenges in achieving this target include ambulance handovers within 30 minutes and inconsistent discharge processes. To address these challenges, the NCL Winter Plan 2025/26 includes improving flow through hospitals, embedding criteria to admit methodology, and continuing to work with hospitals on handovers to aim for the national target of 15 minutes with no handovers beyond 45 minutes. The Patient Flow Framework will continue to oversee hospital conveyances, routine and blue calls and the patient flow app.
The LAS winter plan for 2025/26 focuses on improving ambulance response times, reducing avoidable ED conveyance, and improving staff vaccination rates. LAS will also maximise resource to meet demand by increasing staffing levels across 999 and ambulance operations and deploying clinical managers to the frontline. To support Londoners impacted by health inequalities, LAS will provide targeted communication, including translated leaflets, on when & how to access 999 or 111, promote UCPs to support individualised response to vulnerable patients, work with Neighbourhood teams to support our most vulnerable patients and work with ICBs to ensure communication with care homes, mental health teams and other vulnerable patients.
The LAS update also highlighted the London Heart Starters campaign, which fundraises to ensure there are an additional 150 public-access defibrillators in unlocked cabinets where they are needed most. The London Ambulance Service is aiming to make London a city of lifesavers, by organising life-saving CPR and defibrillator training for communities, organisations and schools. The London Lifesavers schools programme launched in September 2023 sees paramedics teach life-saving skills to Year 8 children in every borough over the course of the campaign. Support the campaign by encouraging community groups, businesses and not-for-profit organisations to sign up for training with our experts and promoting London Lifesavers to secondary schools and encouraging them to express an interest on our website.
To keep staff fit for winter, an extensive staff health and wellbeing plan is underway across NLFT, including pop-up wellbeing sessions and wellbeing webinars for staff, including sessions on smoking cessation, mindfulness, green nutrition, winter health, and shift working and healthy living. NLFT will deploy peer vaccinators within all Clinical Care Groups as well as utilising the skills of the Physical Health Team (PHT) and Infection Prevention and Control (IPC) Team, to proactively vaccinate staff across the Trust, in particular among groups where there has been an historic hesitancy among staff to be vaccinated. This is anticipated to increase the take-up by at least 5%.
The Joint Overview and Scrutiny Committee on Health will continue to monitor the implementation of these plans and work with partners to ensure residents receive the care they need this winter.