Agenda item

Report and presentation attached.

Health officers explained that the local health economy faced a number of challenges including population growth, challenging health outcomes and an overreliance on emergency health services. The attraction and retention of workforce was also a significant challenge and officers were keen to hear from the Committee what it felt priorities should be. There was also a highly ambitious 10 year NHS plan at national level and the impact of the Social Care Green Paper would also need to be considered.

Some services in North East London had improved with for example the establishment of an Early Diagnosis Cancer Centre at Mile End. Workforce initiatives had included the introduction of physician associate roles and investment had also been increased in digital innovation.

It was wished that care would be community-based with borough-based integrated community care partnerships being established. Multi-borough systems had also been established across the BHR area and initiatives at North East London level had included the Commissioning Alliance, Clinical Senate and work on air pollution.

It was planned to bring a refreshed version of the local NHS Plan to the joint meeting with the Inner North East London Joint Health Overview and Scrutiny Committee in September 2019. Work was in progress with Local Healthwatch organisations and localised public engagement events were also planned. Engagement work would also be undertaken with Health and Wellbeing Boards and a digital citizens panel and a stakeholder event was planned on 6 June.

With the agreement of the Chairman, the Committee was then addressed by three members of the public who felt that financial resources for local healthcare were very stretched and that it was crucial to consider equality issues. It was felt that resources locally had been moved from areas of high deprivation to areas of low deprivation and that Council should be mindful of the Public Sector Equality Duty.

Another member of the public who was visually impaired and had hearing difficulties explained that they could easily access A & E services at King George but would find this much more difficult if services were moved to Queen’s. Confirmation was therefore sought over whether the long term plan would secure A & E services at King George.

Members of the public also raised issues such as the mention of a £49m reconfiguration of AS & E across BHR in the papers for the Inner North East London Committee and that detailed plans for the future of local A & E services should now be published. In response, the Chairman read out a statement from the Leader of Redbridge Council giving assurances that A & E services would continue to be provided at King George.

NHS officers agreed that it was important to have clear measures of how effective the long term plan was being and were happy to have discussions on what these measures should consist of. It was also noted that the three BHR CCGs already worked as a single team with for example the clinical lead covering all three boroughs. Local control would be retained via the integrated care system.

Long Term Plan work on mental health services would focus on what types of service would be needed, rather than necessarily altering the number of in-patient beds. Investment in mental health services was already being increased by the CCGs. The mental Health Transformation Board for the areas focussing on community, non-inpatient mental health services. Officers felt though that it was unlikely that the number of existing mental health beds would need to be reduced any further. It was also confirmed that an Equalities Impact Assessment would be carried out on the proposals in the Long Term Plan.

It was accepted that primary care performance had been poor in Outer North East London though officers felt this was now improving. Efforts to improve GP retention included offering more portfolio careers which allowed new GPs the opportunity to also work with partners such as NELFT and BHRUT. It was suggested that the Primary Care Strategy could be brought to a future meeting for scrutiny.

The changes to the GP contract would also see extras investment coming in and the physician associate roles would continue to be established in North East London. A GP careers had also recently taken place.

It was AGREED:

1.    That the Primary Care Strategy should be brought to a future meeting of the Committee and that an update on implementation of the NHS Long Term Plan in Outer North East London should be given to the Committee in approximately 12 months time.

2.    That it to be noted that more detailed scrutiny of the NHS Long Term Plan would place in a joint meeting with the equivalent committee for Inner North East London,  scheduled for 18 September 2019.