The Committee received the Health Update report from various providers within the NHS.

Fiona Wheeler presented for BHRUT covering the following key points:

• Care & Environment: Improvements have been made in elderly care and patient services.
• Accommodation: A campaign for £35 million in capital funding has been launched to redesign and improve the emergency department at Queens.
• Emergency Care: The department sees over 750 patients daily—double its original capacity. Efforts are underway to enhance safety and efficiency.
• Mental Health Services: High numbers of mental health cases are being managed. Collaborations with police and healthcare partners aim to provide better alternatives for assessment.
• Elective Care & Waiting Lists: The hospital has reduced waiting lists significantly, lowering the number of patients waiting over a year from nearly 2,000 to under 500.
• Cancer Services: There are 4,500 cancer patients awaiting diagnosis/treatment. Urgent referrals are processed within 28 days, exceeding targets, though treatment delays remain.
• Financial Challenges: A £61 million savings programme is in place, focused on efficiency, workforce costs, procurement, and service partnerships to maximize taxpayer funds.

Update from Marie Johnson, BU Chief Operating Officer.

1. Mental Health & Emergency Services

• Long Waits in A&E:
  • Acknowledge agreement with previous updates: emergency department wait times have improved yet remain excessively long.

2. Enhancing Community Mental Health Care

• Crisis Cafés Initiative:
  • Ongoing work on developing crisis cafés by engaging local communities (Barking, Dagenham, Redbridge, Waltham Forest) to assess needs.
  • Specifications have been established for each area.
  • Barking and Dagenham are already in the tender process, with an anticipated go-live around June; similar processes are underway for other areas.
• Community Inpatient Support:
  • A new community facility (“bank”) has been opened in Redbridge to offer structured support and inpatient beds for those needing an organized stay.
  • Community teams are reviewing their capacity to manage cases, aiming to reduce calls that result in ambulance responses or A&E visits.

3. Mental Health Bed Capacity & Inpatient Ward Development

• Current Capacity & Targets:
  • Patient numbers in out-of-area placements have reduced from 50–60 to mid-30s, with a goal of lowering this to under 30 within the next year.
• Plans for New Wards:
  • A bid for capital funding has been submitted for a new inpatient ward, with proposals for two wards if funding permits.
  • Final funding details are expected in the next one to two weeks.
  • Special emphasis is placed on bolstering female bed capacity through consultations with East London partners.

4. Broader Community Health Initiatives

• Musculoskeletal Services:
  • Efforts are underway to standardize service offerings across different locations, with a business case in place for a new service offer.
• Children’s Nursing & Collaborative Teams:
  • In Redbridge, children’s nursing services are expanding in community settings.
  • Collaboration with partners such as BHRUT is being intensified to ensure teams work effectively together, addressing capacity challenges.
• Community Education & Integrated Care:
  • Community education boards are being explored to support physical health, particularly for the elderly.
  • Integration of primary care, nursing services, and virtual wards is being prioritized to provide swift, comprehensive, “one-stop” assessments and care near patients’ homes.
  • A designated focal point (at Saint George’s) is being identified to coordinate these efforts.

5. Operational Efficiency & Financial Considerations

• Productivity and Staffing Adjustments:
  • Discussions are ongoing regarding temporary staffing, productivity, and efficiency improvements.
  • Collaboration with social care clinics aims to ensure that community services collectively deliver comprehensive care.
  • These operational improvements align with broader savings plans which will.

Update from Henry Black, Chief Finance Officer spoke to the following:

The presentation covered highlights from the previous committee, including a response to the government’s 10?year NHS plan, updates on artificial intelligence support, and progress on priorities in health and well-being, primary care quality, and NHS 111 pre-procurement.

1. Government and NHS Structural Changes

• Abolition of NHS England:
  • On March 30, the government announced that NHS England is being abolished, with its functions transitioning to the Department of Health and Social Care.
  • This structural change reverts to the pre?2012 model and aims to streamline decision-making.
• Three Channel Shifts:
  • The government’s agenda emphasizes:
    • Digitising services (moving from analogue to digital)
    • Shifting resources from acute hospitals to community care
    • Transitioning from treatment toward prevention.
• Tenure Plan & Comprehensive Spending Review:
  • The tenure plan, alongside the Comprehensive Spending Review, is expected later this year to detail how the NHS will achieve these shifts.

2. Management Cost Reduction Targets

• Mandated Reductions:
  • Integrated Care Boards (ICB) and divisions face requirements to reduce management costs by 50% of the growth in these costs since 2019.
  • For example, if spending increased from £10 million (2019) to £12 million now, a reduction of half that increase is expected.
• Team-Specific Impact:
  • For the BHIT team, the necessary reduction of approximately £7 million is already part of a broader £61 million savings plan—there is no additional saving required.
• Overall Challenges:
  • The ICB-related management costs have been reduced by 30% since 2022, and an additional 50% reduction from that baseline (roughly a total 65% reduction) is now expected.
  • In North East London, while management costs currently represent about 1.5% of total allocations (with overall spending near £90 million against a £5.5+ billion total), further reductions are mandated.
  • The organization is being steered toward a more strategic commissioning role, moving away from the absorption of statutory functions inherited from former CCGs.

3. New Models & Timelines

• A new model for the ICB is being developed and is expected to be published by the end of April.
• All ICBs will be required to submit their returns by the end of May.
• The implementation of these changes is targeted for Quarter Three (October 1–December 31).

4. Financial Update and Savings Culture

• The March accounts have been closed, and work is ongoing to finalise month?12 figures.
• Preliminary financial feedback indicates that targets are on track with no significant concerns identified.
• The financial plan for 25/26 is in place, alongside challenging savings targets—typically around 6% in most programs.
• A cultural shift is recognized as necessary: the approach will need to go beyond maintaining current service levels at marginally lower costs, as significant innovation and efficiency improvements are required over the next 9–12 months.

The Committee received responses to its question and commended Officers for their presentations.

The Committee RESOLVED to note the updates and there were no further recommendations.