Members are reminded to consider the categories of interest in the Code of Conduct for Members to determine whether they have an interest in any agenda item and any action they should take. For further details, please see the attached note from the Monitoring Officer.

Members are reminded to declare the nature of the interest and the agenda item it relates to. Please note that ultimately it’s the Members’ responsibility to declare any interests and to update their register of interest form as required by the Code.

If in doubt as to the nature of your interest, you are advised to seek advice prior to the meeting by contacting the Monitoring Officer or Democratic Services

There were no declarations of disposable pecuniary interest.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 18^th October 2022 – To Follow

The minutes of the Sub-committee meeting held on 18^th October 2022 were deferred by the Chair until the next meeting on 14^th February 2023.

The Chair:

-       Informed the Sub-committee members that Councillor Amy Lee will replace Councillor Asma Islam going forward.

-       Thanked David Burbidge for his contribution as Healthwatch representative, then welcomed Matthew Adrien as his replacement.

-       Commented on the INEL and JHOSC meeting held on 13 September which focused on: provider performance, collaboration and staff updates, resilience system pressures and further ways to enhance primary care. The Chair explained that he had visited several GP services to discuss issues with resident access to physical appointments. This will be looked at in more depth in item 4.1 of this meeting.

To Follow

Jo-Ann Sheldon, Head of Primary Care, Tower Hamlets, introduced a presentation detailing the 32 practices under the national GP contract within the borough, and the challenges faced with the vast numbers of residents awaiting care. These include the lack of growth, high turnover and the effects of the recent pandemic. The high level of patient numbers across the borough in quarter 3 relate to the number of practices registering with Covid vaccinations.

Further to questions from the Sub Committee, Dr Khyati Bakhai and Dr Roberto Tamsanguan, Tower Hamlets Primary Care and Clinical Lead’s respectively:

·       Concluded that the Healthwatch recommendations are contradictory regarding the telephone booking system, and solutions lie in updating telephone lines and more promotion of the online consultation service. The appointment waiting times can be reduced with the streamlined triage system for urgent care, and more empowerment by service users to access their care on a general level. Currently 7 million people nationally are on the elective care service list, causing extra pressure on services. Further methods are required to educate the community on alternative means of access.

·       Noted that all GP practices in the borough are encouraging patients to use to NHS app, enabling accessibility to personal records. Many calls received are admin related, which can be resolved quickly if more promotion is given to the service.

·       Indicated that Tower Hamlets was one of the first boroughs to use social prescribing, a holistic approach to improve access to services. GP surgeries also work in tandem with the voluntary sector to assist with social issues, including the cost-of-living-crisis.

·       Clarified that non-clinical staff have undergone the most radical changes in their roles to ease the pressures of GP appointments. Further awareness is required to change the communities misconception of a GP surgery. Patient assistants are the first point of contact for service users and facilitate all care requirements. Other capable clinicians can assist with patient’s needs, such as trained pharmacists, physiotherapists and nurse practitioners, who are available besides doctors to empower patients to seek care in more beneficial ways.

·       Explained that many staff are leaving the profession due to burn out and wellbeing is a top priority. Ongoing training, coaching and development support has been provided, in conjunction with counselling, PCN’s and employee assistance programmes are available to ensure staff are receiving the support required. These are difficult times and negative media scrutiny compounds social perception. All patients are consulted over the phone; however, GPs would request a face-to-face visit to the surgery depending on the severity of symptoms.

The Sub-Committee:

·       Noted that Councillor Gulam Choudhury will discuss proposed methods of upscaling and promotion of the available health service options for the community to Cabinet. Further discussions on the Council working in partnership with the Primary Care team and the NHS will take place outside of this meeting.

RESOLVED that:

1.    Councillor Gulam Kibria Choudhury will discuss proposed methods to upscale and promote available health options to Cabinet.

2.    Further discussions on the council working in partnership with the  ...  view the full minutes text for item 4.1

To Follow

The Sub-Committee were requested to review the presentation detailing the workforce disparity and staffing requirements from Alison Arnaud, Principle, New City College and Victoria Corcoran, Deputy Group Curriculum, Director, Social Sciences / Sciences and Early Years and Professor Martin, Queen Mary University London (QMUL). 

Further to questions from the sub committee, Alison Arnaud, Victoria Corcoran and Professor Martin; 

·       Clarified the significant decline in the volume of applicants, compounded by the pandemic and negative press around health and social work. Details were given on numbers which have halved with younger placements, and older workers leaving the sector despite the high demand. The barriers appear to be pay, long hours and lack of childcare.  A newly established T Level qualification which requires a minimum of 360 placement hours, is proving difficult with NHS placements. 

·       Explained that more collaboration between NCC and other providers is required. Although QMUL does provide higher degrees for registered nurses, they do not provide nursing degrees. Several other programmes are available across the sector, such as a Biomedical Science approved course, Neuroscience, Dentistry and Pharmacology degrees. A graduate entry programme is also available. 

QMUL also has a two-year Physicians Associate course to assist the workforce shortage.  Support is given by Primary Care & Mental Health Trusts; however, more medical school placements from Health Education England and the government is required. It is hoped that Tower Hamlets can assist in advocating in this respect. 

·       Indicated that workforce challenges include the increase in mental health issues, particularly during and after the pandemic. Extra support has been given, with assistance from ELFT and other organisations. Finance issues are also a factor, as student bursary’s stop in the last 2 years of medical training. The University support championed by the Mayor will be extremely beneficial.  

QMUL are currently developing a degree apprenticeship programme, which will allow students to learn whilst working. This does not however alleviate the funding gap for Primary and Secondary Care Trusts, as they too are experiencing difficulties. The parameters of the schemes also make it difficult to support one speciality over another.  

·       Clarified the details of the ongoing Integrated Care Board Workforce Strategy. This will consider ways of easing the current staffing shortfall and create meaningful work across the sector and borough. Collaborative working and the need to engage is vital to combat this issue. 

·       Expanded on the curriculum planning and historical analysis NCC use to map the progress of students into employment. This year has seen a drop from 200 to 90 students, partly due to; the lack of engagement between 16 to18-year-olds, the pandemic and negative press. 

·       Clarified that NCC’s key priorities are for NHS to engage, build strong relationships and provide contracts within NHS Boards, to support the workforce shortages. They work with education partners and use liaison officers, hold online and in person open days within all 8 campuses to raise the profile of the medical field to students. QMUL existing students also work as tutors and mentors in schools as advocates. 

·       Indicated that the  ...  view the full minutes text for item 4.2

None.  

The Chair called the meeting to a close and thanked the Sub-Committee members and stakeholders, for their attendance and participation.

The Sub-Committee are asked to note the current Action Note