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.

To confirm as a correct record the minutes of the meeting of the Health and Adults Scrutiny Sub-Committee held on 12 December 2023.

The minutes of the Sub-committee meeting held on 12 December 2023 were approved and signed by the Chair as a correct record of proceedings.

TO FOLLOW

The sub-committee were informed that a discussion on capacity issues will be heard at the next meeting on 18 April 2024. For this meeting, residents Momina Begum and Farhana Anjuman, discussed their experiences of poor maternity services provided in the borough. The residents described how some hospital staff dismissed requests for assistance, were persistently requested to either regulate diabetes with insulin or accept epidurals against their wishes, told not to push whilst having contractions and left alone by night staff to relieve themselves after a premature birth. These events resulted in severe anxiety for the women and a lack of empathy by staff.

Farhana Anjuman observed the vastly different treatment received in Italian hospitals where her first two children were born, compared to the Royal London hospital’s service. She was kept in the hospital longer in Italy and received compassionate care from staff there. Momina Begum suggested that some night staff at the Royal London, appear to refrain from taking responsibility without adequate clinical handovers and expect mothers to wait for day staff assistance.

Karen Wint, Chief Executive of Sister Circle, presented an overview of the charity that supports women with challenging experiences and complex issues and advocates for more investment in women’s services. Many of the women have experienced gender violence and are more likely to experience poor health care.

Ms Wint informed the sub-committee that around 10 years ago, the borough assisted in funding the ‘Maternity Mates’ programme, to support women who experienced similar issues. Local women residents are recruited and trained by the program to support pregnant women, referred by BARTS Health, ensuring they receive adequate care and support. Although this has improved health care in many cases, poor care concerns are still being addressed.

BARTS were highly commended for the ongoing learning and education programs for health professionals and welcome this in practice on the wards. Although some women receive positive care, the service requires improvement, as all women should experience the same quality service. Members were also informed  of a UK midwife shortage which exacerbates the issue.

Irantzu Perez Arribas, Head of Programmes at Sister Circle then presented an overview of issues faced by 13 women who gave lived experiences of maternity services. The main concerns were around resources, culture and care. They also recommended improvements, which included having one midwife, better clinical handovers, and a holistic approach to pregnant patients, to significantly improve the experience.

Other recommendations included, reducing request to induce  labour rather than allowing a natural birth, more effective post-natal care, to reduce the need for urgent care, breast feeding support, more kindness and empathy given to mothers by staff, and  a reduced use of technical terminology which can be frightening or confusing, particularly for women who do not speak English as a first language or have disabilities such as hearing impairments. Although BARTS is increasing the language support, pregnant women should be informed that this is available.

Further to  questions from the sub-committee, Momina Begum, Farhana Anjuman, Karen Wint and Irantzu  ...  view the full minutes text for item 3.1

Update on Primary Care

Dr Roberto Tamsanguan, Tower Hamlets Primary Care & Clinical Lead, and Jo-Ann Sheldon, Head of Primary Care, Tower Hamlets, returned to the sub-committee presented an update on improving access to Primary Care. Dr Khyati Bakhai, GP and Tower Hamlets Primary Care Development Lead, also discussed the current initiatives implemented within the service.

Dr Tamsanguan reminded sub-committee members of the current challenges within the service which include a rapid population growth, high patient turnover, a workforce shortage, long hospital waiting lists, telephony queues and face to face services affected since the pandemic. Performance feedback from the GP Appointments Data Dashboard (GPAD)  on booked appointments from January to November 2023 was provided on both in borough  and North East London statistics. This included a breakdown on the mode of contact to services from home visits, telephone or video consultations and face to face visits, which showed a significant increase in numbers.

Sub-committee members were also given an overview of various delivery plans to improve access, such as encouraging patients to use the NHS app to view test results and their position on the waiting list, increasing patient self-referrals to bypass GP’s and promoting the ‘Pharmacy First’ initiative, which enables community pharmacists to supply prescriptions and antibiotics to patients for common conditions.

Other plans include a move to modern telephony with call-back services, more staff training, less time liaising with hospitals to improve primary and secondary care links and improved support for GP practices through a National General Practice Improvement Programme. Increasing the Additional Roles Reimbursement Scheme (ARRS) in the service, with physician associates providing additional assistance for patients.

Dr Khyati Bakhai, then updated members on the ‘Improvement Week’ which took place last October on patient survey feedback, to better understand residents' experiences. Interviews were conducted with 151 patients that week, across one of the five practices within the N6 borough. Staff interaction was reported by patients as the best part of the practice, Along with using e-consult to obtain appointments, the locality of the practice and familiarity with the clinicians. In contrast, lengthy waiting times for telephone bookings, difficulties with online access to appointments and admin staff appearing overwhelmed were considered the most difficult.

The general consensus seemed to be that making appointments and e-consult were both the most positive and the most unpleasant. Further work is required to reduce telephone waiting times, as data received showed the longest times marked at over 30 minutes, with many patients hanging up before they got through to reception staff. Although satisfaction figures received were generally satisfactory, more support in listening to patients' concerns, a holistic approach to patient needs and more flexibility is required to improve the service for the community. Further efforts to improve patient concerns are ongoing.

Further to questions from the sub-committee, Dr Tamsanguan, Dr Khyati Bakhai and Jo-Ann Sheldon;

·       Explained that further awareness is necessary to alter the perceptions of physician associates, as they can ease the pressure and shortage of GP’s within the service.

·       Clarified that  ...  view the full minutes text for item 3.2

None.