The Chair introduced the sub-committee to members of the THT Partnership and the Integrated Care Board, who provided reflections and achievements from last year and outlined the priorities for 2024/25.

Integrated Care Board (ICB)

Charlotte Pomery, Chief Participation and Place Officer, presented a brief overview of the service and noted the development for a financial strategy across the integrated care system. Residents will be encouraged to use primary and community services, such as GP's and pharmacies, rather than hospitals.

The main objective is to improve urgent and emergency care and implement the commissioning method to respond to health issues and improve resident’s health. Details of the Integrated Neighbourhood Teams who assist in early intervention were noted.

Ms Pommery then touched on the Vital Five promotion within Primary Care, and the consideration being given to the model of care required, particularly with young people with Special Educational Needs and Disabilities (SEND) who may require a holistic approach. Finally Ms Pommery discussed the challenges with a growing population, high demand in services and limited funding.

Primary Care

Dr Roberto Tamsanguan, GP and Tower Hamlets Place Clinical Director, began with the achievements made last year, primarily the Pride and Practices scheme to support LGBT+ patients, cloud based telephony, which includes real time data monitoring of call waiting, the Respiratory Illness Hubs and extended Primary Care Access provision. Discussions are now underway to ensure a smoother transition for patients moving from different care settings.

Dr Tamsanguan acknowledged residents' concerns regarding accessing Primary Care and noted the transformation initiatives with the Primary Care Networks (PCN) to combat this. Priorities include the finalisation of the Same Day Urgent Care service, ensuring information events for all GP's are available for patients, continually informing children and young people of their healthcare rights and strengthening the primary and secondary Care services.

Acute Care

Fiona Peskett, Director of Strategy and Integration, BARTS NHS Health Trust, highlighted the Women's Hub and the Children's Hospital at Home services located in Mile End. Priorities for this year include a continuing commitment to reducing waiting lists, the implementation of the Diagnostics Centre, strengthening the workforce and enhancing pathways for mental health service users.

Ms Peskett lastly touched on Maternity Services, following the visit from patients who gave lived experiences at the meeting in February and the response given in April. BARTS NHS Health Trust and Partners will continue the ongoing efforts to improve patient outcomes and welcome feedback from the community to enhance the service.

Mental Health

Dr Richard Fradgley, Director of Integrated Care and Deputy CEO, East London NHS Foundation Trust, (ELFT), outlined three areas of achievement within the service; the ‘111 Crisis Phone line’, which supports residents to access care when required, the ‘Children's Home Treatment’ team, which is open 24hrs daily and the Talking Therapist services, who assist residents with anxiety and depression. The teams were praised for their quality of service.

Dr Fradgley then discussed the challenges, namely the severe pressure on staff and inpatient services, particularly for adults in the borough, due in part to the increase in homeless residents who are clinically ready for discharge. It was noted that the number of people waiting to be assessed within the neurodiversity service has increased. At present, there is no significant national policy or funding to address the issue. NEL partners are working  to reduce this.

Tower Hamlets Together Partnership

Warwick Tomsett, Joint Director of Integrated Commissioning, presented a brief overview of the partnership and how frontline staff work collaboratively across organisations to support residents. Mr Tomsett discussed the outcomes framework developed with residents and the seven partnership priorities.

Further to questions from the sub-committee; ICB Health Partners and Officers;

·       Confirmed that the 111 Crisis Line has a variety of services depending on the users' needs. This can range from assisting them to the community mental health team, the home treatment team or the emergency department. Face to face assessments are also available.

·       Explained that the extended Access provision's budget is based on the number of registered patients on the list. The number of hours is calculated by the patient population  for Saturdays and weekday evenings.

·       Clarified that the Association of Directors for Adult Social Services (ADASS) Peer Review outlined areas for development which included, working across the service to ensure residents can access healthcare funding. Enhance the effectiveness of referrals to healthcare assessments and have a better understanding of user and carers service satisfaction.

·       Confirmed that work is ongoing to address the above named issues including a new quality assurance framework, an increased level of case work auditing,  requesting feedback from service users and reflective work with practitioners to fully understand and improve the user experience. Further details on this and other improvement and transformation programmes  can be brought back to the sub-committee if required.

·       Acknowledged that the high proportion of residents in adult social care with long term conditions not accessing primary care is an issue, as well as linking data across systems, so residents do not have to continually repeat information. Data governance and a streamlined infrastructure can resolve these concerns.

·       Confirmed that details on staff retention percentages compared to the national average, will be brought back to the sub-committee for review.

·       Observed that recruitment campaigns are ongoing to promote career opportunities for both clinical and non-clinical roles in both Royal London and Mile End Hospital. Staff incentives include a Wellbeing Hub to provide respite, encouraging clinical staff to take time out when possible, as well as ‘time to talk and listen’ events for staff to raise any concerns.

·       Clarified that the main objectives are to focus on early intervention prevention with the integrated neighbourhood teams, ensuring robust models of care for future demand are effective, enhancing infrastructure and service delivery. As well as lobbying for more capital funding, promoting immunisation and vaccinations for residents and reducing the level of variation between local authorities to ensure best practice.

Members requested a summary of the CQC findings on borough care placements, as well as ASC key performance indicators be brought back to the sub-committee for review.

[Clerk’s Note – the CQC findings referenced are available here: Search Results - Care Quality Commission (cqc.org.uk)

The Chair thanked all ICB and Health Care partner representatives for their presentations and for ensuring residents continue to receive the best health care available. The sub-committee will be monitoring progress throughout the municipal year.

The Health and Adults Sub-Committee RESOLVED;

1.    That ASC key performance indicators be brought back to the sub-committee for review.

2.    That details on staff retention percentages compared to national averages be brought back to the sub-committee for review.

3.    That the presentation be noted.