Report attached.

The Accountable Officer for the North East London CCG stated that the pandemic period had meant a number of necessary changes to services. Some changes had now been reversed but others would remain in the long term as they had been found to give benefits to patients. Work had been undertaken recently to reduce waiting in areas such gastric conditions and orthopaedics.

A Member felt that there were issues about the way in which both Trusts communicated changes. He felt that the Committee should see the proposals for the redesign of surgical services and that it was important to get the mechanics of communication with Members right. The Chief Executive of BHRUT confirmed that the list of wards and their usage requested by the Committee would be available shortly.

It was accepted there was a lot of pressure on primary care at present. Officers agreed that the availability of face to face GP appointments remained important. There was high demand for primary care with for example Havering GPs doing 24% more appointments than previously. Phone triage was often used but patients were then given face to face appointments if appropriate. It was noted that many younger people did prefer remote consultations.

Additional practice staff such as paramedics or pharmacists could often give effective treatment without patients needing to see a GP. Primary care systems were working flat out and fatigue of the GP workforce was a major factor. The number of Covid vaccinations given by primary care was also a factor in excessive workloads etc.

It was accepted that some complaints were received about GP reception staff but this was a very pressured environment. Many GPs were working 7 am – 9.30 pm to clear backlogs. Officers were however happy to look at specific complaints.

There was also a shortage of GPs in the area and many GPs were not willing to work in the local area. There were also significant vacancies across the whole health system. Many members of the public were also given GP appointments via NHS 111. It was felt that people may need to be reducated about the role of the NHS 111 service.

A member of Healthwatch Redbridge asked for details of the patient engagement process around service changes. Officers responded that this depended on which provider ran the service. It was accepted that the NHS should be better at communicating such changes. The BHRUT Chief Executive added that the NHS should accept that it needed to get better at explaining the clinical rationale for changes to service. It was accepted that people wanted BHRUT to explain changes and involve patients. The Chief Executive was happy to have discussions with Members and Healthwatch re  service changes.

Service changes were shown in the agenda papers and on Trust websites. Newsletters were produced for stakeholders and the public but it was accepted that communication could be more effective. Regular meetings were held with Healthwatch in order to discuss service improvements.

A representative of Healthwatch Barking & Dagenham stated that he appreciated the Covid pressures but a lack of communication re service changes had been taking place prior to the pandemic. It was felt that many NHS communications with the public were not clear enough. NHS officers agreed, feeling that the public were often confused about where to go for medical treatment. Any advice patients received from a pharmacy would not replace their relationship with a GP. Officers were happy to work with Healthwatch on guidance on this.

Other issues raised included the difficult patient access at Mile End Hospital and the lack of a plan for hospice services in North East London. Plans for renal services would be shared with stakeholders shortly.