Agenda item

Information sand covering report attached.

The accountable officer for North East London Clinical Commissioning Group (CCGs) explained that work was in progress to prepare for the second wave of Covid-19 and the winter peak of demand on health services. Health systems were still in an emergency phase but plans were also being worked on to return to business as usual.

Work had been undertaken with Healthwatch to identify the lessons learnt from the pandemic as well as with partners such as primary care, social care and Council Public Health teams. Next steps would include working with colleagues to address the impact on areas such as outpatients and elective surgery. It was also wished to keep open channels of communication between Health bodies and Councils.

Regular primary care services were resuming with face to face GP appointments available where clinically appropriate. This would be emphasised in NHS communications and  there would be a focus on people with long term conditions. A & E attendances were now rising again and were now at two thirds of pre-pandemic levels. It was important that people used the NHS appropriately.

The flu vaccine would initially be available to over 65s and those at risk but would be extended to the over 50s from November. Officers apologised for the increase in waiting times for blood tests. Work had been undertaken with NELFT in order to increase blood testing capacity for the area.

Covid testing in care homes had commenced at an early stage in North East London and named clinical leads had been established for care homes. PPE deliveries to care homes were also in place regularly.

Surgical hubs were working to restore patient services and it was accepted that waiting times had increased due to the backlog. Work was under way to try to reduce this.

Work at BHRUT included establishing ‘green’ patient pathways to allow Covid-free operations, principally at King George Hospital. Both A & E departments at the Trust were open as usual with emergency surgery being performed at Queen’s. Paediatric in-patients were still treated at Queen’s although overall numbers were low. This would only be for the pandemic period and was not intended to be a long term configuration.

Waiting lists at BHRUT were prioritised according to clinical need. Capital investment had been secured at Queen’s Hospital to establish point of care testing in A & E and to expand the Rapid Assessment and Fast Treatment area. Investments had also been made at King George on the frailty unit and expanding the Urgent Treatment Centre as well as on improving wellbeing facilities for staff. It was hoped the new facilities at King George would be complete by the end of 2021.High volume elective services would take place at King George which would also retain it’s A & E.

Around 20% of BHRUT patients were from South West Essex with a small amount also from the Chigwell area.

 It was accepted that there was some reluctance among GPs to see patients face to face but 39% of GP appointments across the three local boroughs were now being undertaken face to face. Officers were happy to take reports of areas where this was not available. Video and phone consultations were also available. There had sadly been some deaths of GPs due to Covid-19 and it was important that GPs remained safe whilst undertaking their work. There had been a rise in demand for GP care since children had returned to school. A representative from Healthwatch Havering remained concerned that people were not getting the required service from their GP, even allowing for Covid-19 issues.

Concern was raised over the considerably higher death rate from Covid-19 among people with learning disabilities and problems with the availability of Covid-19 testing. People requiring tests were being sent as far away as Leicester, even if local centres appeared empty. Officers agreed that the learning disabilities death rate was unacceptable and factors such as underlying conditions in this group had to be addressed more effectively. There had been a rise in demand for testing amongst the general population, even from people with no symptoms. The vast majority of tests were carried out within 10 miles of a person’s home and more laboratory capacity would be made available over the next two months

Infection control support was being extended to patients with learning disabilities and officers could provide further details on these issues. A written briefing on the position with Covid-19 testing centres could also be supplied. A Member from Redbridge stated that he was happy with the way blood testing issues had been handled in Redbridge but there that there remained issues with those carried out at Whipps Cross Hospital.

Members requested more information on surgical hubs and an assurance that they met with the overall strategic objectives for the NHS locally.

It was noted that recent weeks had seen a rapid increase in the numbers of Covid-19 cases. Work had been undertaken to prepare high risk  groups for any second wave. This included the BAME population, care home residents and people with diabetes or long term kidney disease. GPs had been asked to focus on patients who were higher risk and were able to use hot clinics to get Covid-19 advice from hospitals. Regular contact was also in place between NHS staff and borough public health consultants.

Officers apologised for a previous communications error regarding the availability of blood testing at Whipps Cross. A phlebotomy service would also reopen at Wanstead Hospital from 21 September. Processes at Whipps Cross were similar to those being followed at BHRUT. Face to face outpatient appointments would recommence in the next week and a full emergency service was contributing. Phone and video consultations were also available for outpatients.

The surgical hub had been split between elective and emergency pathways with low complexity surgery taking place at Whipps Cross. Higher complexity surgery would take place at the Royal London and Barts Hospitals. Emergency surgery would also take place at Whipps Cross.

It was AGREED that a detailed written briefing should be supplied by NHS officers to the Joint Committee covering Covid-19 testingCovid-19 death rates and treatment for people with learning disabilities and surgical hubs.

Members thanked officers for their input to the meeting.