Agenda item

Report attached.

The Joint Committee received an update on the work of the East London Health and Care Partnership including plans for a single Clinical Commissioning Group (CCG) for North East London.

Officers explained that the movement towards a single CCG from a commission perspective was about partnership organisation and co-ordinated working. In October 2020, GP members had agreed to the new formation across the seven CCGs. The new single CCG had been designated as a North East London integrated care system and would be one of eleven nationally organised CCGs in place from 1 December 2020.

A recent National Health Service (NHS) England publication on the future direction of travel for integrated care systems had reported the options available for statutory changes from April 2022, which was in line with developments across North East London.

It was noted that Barking, Havering and Redbridge (BHR) as part of the national CCG ratings had moved from a ‘requiring improvement’ rating to ‘good’ . This was a positive position to be going forward to the next phase of integration.

It was explained that the partnership was under pressure within the system as a result of COVID prevalence with North East London being significantly impacted by the second wave, with significant numbers of patients requiring ventilation within critical care.

It was noted that test numbers had risen amongst the younger population and the over 60s but, dependent on the implementation of tier three and the Christmas period, this may change and therefore it would be necessary to ensure a collaborative approach in the safe delivery of services to patients and the protection of staff. 

The primary care flu vaccination program had been rolled out, with 80% of all care home residents having received the vaccination and 28% of care home staff.  Officers were working with local authority colleagues and care home forums to encourage staff to come forward. The Partnership had carried out mapping of pharmacies and identified the pharmacists which were most local to the care homes where staff could go and be vaccinated.

It was explained that there needed to be clarity of COVID vaccination versus flu vaccination messages to the public.  Members noted that there was a high refusal rate amongst care home staff to come forward for the flu vaccine and the Partnership was working with local authorities to encourage vaccinations.

Webinars were being held to provide care home staff the opportunity to discuss the COVID-19 vaccine and any concerns that they might have. It was noted that there was more to be done to counteract some of the discouraging media messages.

The Covid-19 vaccination had been rolled out to GP hubs and Queens Hospital and the partnership had extended invites to care home workers and high-risk shielding staff and officers were working with CCG leaders to ensure that the partnership maximized the use of the vaccine in all the primary care hubs.

In response to questioning, it was noted that the vaccination programme at Queens Hospital was on target for vaccinating the over 70s and plans were in place to utilise vaccines where appointments were missed.  Individuals were encouraged to have the vaccination to assist in the reduction of pressures in hospitals.

Responses to staff mental health continued with innovative work provided to support the health and wellbeing of those working in emergency care departments, directly impacted by COVID-19. 

Acute hospitals and community services continued to operate to assist with the pressures elsewhere and reduce the risk of COVID jumping localities.  The importance of supporting long COVID-19 was highlighted.  The use of multidisciplinary teams was a key part of supporting those with complex needs and the elderly at home, with the use of pulse oximeters and remote monitoring of COVID symptomatic patients in their home.

In terms of Local Authority involvement, officers agreed that this involvement was integral to the work of the partnership (BHR) and also in the Integrated Care System in North East London.

There was a focus on bringing together the primary care clinical directors, the Acute Trusts and Local Authority services to consider how the delivery of needs could be met on a daily basis. The borough Partnership Boards provided a collective voice and were an important part of the integrated care system, with its decision-making at the level of patients and residents, and would be a focus for the transformation programs providing commonality across BHR. The introduction of the BHR Academy was intended to support workforce recruitment across the system.

In response to questioning, it was noted that the Trust’s position was unchanged on the Paediatric A & E Unit at King George Hospital.  The unit continued to remain closed overnight on health and safety grounds.  The Trust was working on paediatric recruitment, a key driver impacted by the COVID-19 pandemic, and were committed to reviewing the closure by April 2021.

Members took the opportunity to express their appreciation of the work carried out by the NHS during the pandemic and the stress that staff have endured.

Data on the number of Essex COVID-19 patients being treated in a North East London hospital was sought and this would be provided at the next meeting.

Clarification was sought on the continuation of elective services such as cancer care, and on flu vaccinations. It was explained that there was a strategic command approach at Level 4, which was focused on the balance of demand and capacity and the delivery of cancer and cardiac care through the hubs, whilst ensuring infection control. The Committee would be kept updated on the delivery of the COVID-19 and flu vaccination programmes and the delivery and level of critical care support. 

It was stated that the partnership would be attempting to balance and maintain elective services, delivery of critical care and meeting the challenging delivery of the flu and COVID-19 vaccination programme. The Committee would be kept updated on progress.

It was explained the uptake for the flu vaccine by the over 65s was impressive across the North East London at about 69%. The uptake for the under 65s and 50 to 60 age groups were low. The Partnership was trying to establish a way of using text messages to contact people to have their vaccinations.

The Committee commended officers on their work and noted the position.