ICB ‘a hindrance’ to improving services after Grenfell

Grenfell United chair Natasha Elcock told delegates at a King’s Fund event this morning that North West London Integrated Care Board had “prevented the access” of local people, and “how we could shape the [NHS response]”.

NWL ICB commissions health services for the London Borough of Kensington and Chelsea, where the disaster happened, and seven others across the capital.

In October 2018, NHS England announced a £50m fund to be spent over five years in the wake of the fire. This came to an end in March 2024, with extra money confirmed for this year, although NHSE and NWL ICB would not confirm how much.

Ms Elcock told the meeting, which coincided with the release of a King’s Fund report on the subject, the community “was given a large amount of money” but said “when that money is mismanaged and not spent in the way it ought to be spent… We have to look at the purse holders and how they deliver that money.

“They think that they have the right to decide how services are delivered to us”.

King’s Fund chief executive Sarah Woolnough said: “It does jump out at you from that report and how well [the £50m] was spent is something we should reflect on.”

North West London ICB has been approached for comment about the criticism voiced this morning.

Ms Elcock told the meeting that the health system can act as if it “doesn’t like the people it serves” and “thinks that they’re the heroes”.

The King’s Fund report found that in 2019, the then clinical commissioning group funded extended GP appointments for survivors and the bereaved to review mental and physical health, plus specialist care for respiratory health, toxicology monitoring and paediatric long-term monitoring, as well as social prescribing.

The report said in the first year after the fire “a high number of therapists and other staff were ‘borrowed’ from other London trusts and [Central and North West London FT] found that a number of therapists volunteered their help too.”

Some of the money also went to the Grenfell Health and Wellbeing Service, run by CNWL.

One of the report’s authors, Dan Wellings, told the meeting that the investigation had revealed lots of problems with NHS practices.

He cited the sense of local people that the communications and engagement functions of the NHS were actually acting as “a buffer between the system and the community” and could feel “performative”.

He also said it took a level of humility to accept that sometimes the services the NHS offers as a default do not work and “it can be difficult for the system to recognise that”.

Professor Kevin Fenton told the meeting statutory bodies like ICBs were focussed on performance measures like waiting times but did not always acknowledge that “we’re not all starting from the same place.”

The London regional public health director asked: “How does the NHS pivot to provide universal services and tailored services that meet communities where they are at?”

He also said ICBs felt they lacked the “capabilities, staff and training” to do the “deep work to co-produce with communities”, and that teams that did this kind of job were often scrapped in reorganisations or cuts.

Ms Elcock was asked what advice she would give to other community groups like Grenfell United. She warned they would have to be persistent and that “the system will absolutely try and break you”.

She added that the key was “tapping into the good people within the system”. “We were fortunate to meet a person in the system who was willing to do something different,” she added.