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 disclosable pecuniary interest. For transparency Nicola Lawrence, Co-optee declared she works for NHS England.

To confirm as a correct record the minutes of the meeting of the Health and Adults Scrutiny Sub Committee held on 27 July 2023

The minutes of the Sub-committee meeting held on 27 July 2023 were approved and signed by the Chair as a correct record of proceedings.

Chairs Update

The Chair;

-      Noted that a written response is still pending from ICB officers on the 30% reduction to the ICB budget, where this will be and if this will have any implications for Tower Hamlets.

Kat Davidson, Chief Operating Officer, Royal London & Mile End Hospitals and Tom Cornwell, Divisional Director of Operations, Emergency Care & Trauma Division (RL & ME Hospitals), gave an overview of the Urgent and Emergency Care service for the sub-committee. This included the changing demands of the service, A&E department and Urgent Treatment Centres (UTC) performance summaries, system wide challenges, the referral to treatment process and cancer and diagnostics KPI’s.

Healthwatch Tower Hamlets also submitted a report on patient feedback for waiting times for elective surgery and accident and emergency procedures.

Mr. Cornwell explained that the four hour performance level  for A&E in April 2019 was around a 75% which has dropped to about 58% since August 2023.This equates to around 1000 per month. The UTC are managed by the GP Care Group,  this departments four hour performance level was around 98% in April 2019. This dropped to 76.9% for August 2023. Overall attendance has risen by around 80% at around 3 to 4000 per month.

There are numerous reasons, such as the decline of the pandemic, the increase in transport links with the Elizabeth line opening, enabling access to neighbouring borough UTC's and system wide changes to Primary Care. Discussions are taking place with Primary Care around access and supporting colleagues with the high turnover in patients.

Sub-committee members were informed of NHS challenges regarding the number of mental health referrals and the lack of beds for patients, as waiting times in the department have risen from 6 hrs to 12  since July 19 at an 11% increase. The levels of patients from outside the borough are causing considerable pressure on staff and patients and there can be delays in discharging patients from other areas who are medically fit but require care packages and community assistance to remain at home.

Kat Davison noted that waiting times for elective surgeries were also impacted by the pandemic, although steady progress to reduce this has been made. High Volume Low Complexity (HVLC) recovery of elective care services at Whipps Cross and Newham hospitals has enabled Royal London and Mile End Hospitals to focus on more complex procedures. The 78 week wait has decreased significantly and progress towards a 65 week clearance is underway.

A major challenge is addressing the inequalities data and access to elective and dermatology services, which paused in the borough and contributed to significant waiting times. Discussions are ongoing to develop a recovery plan now the service has been reactivated. Ms Davison then explained that achievements in cancer diagnostics recovery plan.

Further to  questions from the sub-committee, Tom Cornwell and Kat Davison;

·       Explained that details of mental health referrals requiring ongoing assistance noted in the presentation relate to adults. Figures for children are lower, as East London Foundation Trust (ELF) would usually provide assistance to children and adolescents and hold data. Ongoing work with ‘Care Navigators’ takes place to offer community assistance.

·       Noted that around 65 to 75 patients who are classed as medical fit, require a community bed, nursing  ...  view the full minutes text for item 3.1

TO FOLLOW

Angela Wong, Director for Applied Health Diagnostics, Pharmacy & Cancer Services and Nabeel Hussain, Programme Director, Community Diagnostics Centre, NHS North East London, sent apologies. They will attend the next meeting scheduled for 12 December 2023.

Femi  Odewale,  Managing Director NEL Alliance, and Caroline Cook, NEL Early Diagnostics Programme Lead, gave a brief overview of the cancer screening programmes available responsibilities, targeted checks inequalities and improvements in uptakes. Mr. Odewale informed the sub-committee that the Cancer Alliance is one of 21 in the country who provide transformational programmes affiliated with the national programme. They focus on four main areas: early diagnosis, diagnostics and treatment, personalised care and operational recovery, working alongside provider organisations.

Caroline Cook then discussed the cancer screening programme, commissioned by NHS England, and holds  contracts for screening providers overseeing both local and regional teams. The four main services discussed were breast, bowel, lung and cervical screenings. GP registration is required to access breast, bowel and cervical screenings. Cancer Alliance provides funding for transformational services and seeks to understand the signs and symptoms for early diagnosis by enhancing screening uptake.

Ms Cook then updated the members on the service coverage within the borough and went through the performance figures. It was noted that bowel cancer screening targets in Tower Hamlets are lower than the rest of North East London (NEL). Breast cancer screenings have not recovered since the pandemic and are also below target.

Sub-committee members were informed that Council Alliance will be implementing lung health checks as a screening programme over the next three years. Over the last year, this has been phased into the borough and is currently available for over 55 year old males who have smoked at some point. Since July 2023 approximately 1000 patients have received the recommended Low Dose Computed Tomography scan (LDCT)

Details of the inequalities data for residents unable to access screening by ethnicity or depravation were outlined. These are triangulated as GPS system may not record all information and not all details are currently accessible. Work to improve this is ongoing. The information gathered shows barriers to participating in screening are due to location, a lack of trust in the health service, accessibility issues, misconceptions around screenings, or language barriers which prevent attending appointments or effective communication.

Ms Cook  went on to discuss improvement measures to support the uptake. This included Primary Care Networks (PCN) cancer co-ordinators to support delivery of a direct enhanced service (DES), GP screening guides to assist in uptake levels of breast and cervical screening, promotional campaigns to spread awareness of symptoms and bowel screening reminders calls to patients, who have not returned screening kits after six months.

Ms Cook lastly touched on the projects currently in development. These include the Eclipse text reminder pilot now in five practices. Contacted patients fill out a questionnaire to receive a kit. The pilot will be expanded to more practices if successful. Further engagement to support residents from Polish, Lithuanian, Turkish, Romani and Gypsie communities is ongoing, as language barriers may prevent screenings.

Further to questions from the sub-committee, Femi Odewale and Caroline Cook;

·       Explained that any resident over the cut over age of 75 can request a bowel screening kit or receive one  ...  view the full minutes text for item 3.3

The Cold and Flu update was noted.

The Chair also informed sub-committee members of the Safeguarding Briefing Session scheduled for 7th  November in the Council Chamber.

The Chair also noted a site visit scheduled for 15th  January 2024 to Independent East, at the PDC in Bethnal Green. Members were urged to attend both events.