James Cain, Head of Workforce Transformation, Health Education England, presented the report on Workforce. He said that when the 44 STPs were formed Health Education England was tasked with creating 44 multi-agency action boards.

Population growth has resulted in pressure on health services.

There are pockets in east London which are under doctored. In addition to this the nursing workforce is migrating away due to affordable housing issues.

Workforce retention is included in a work stream. Providing people with careers as opposed to jobs is a key theme in the work. The apprentice levy has increased to enable more local people to enter the workforce as local people are more likely to stay on longer term.

The national target for increasing the number of GPs is 500. North East London has a target of employing 19 additional GPs. Given the population demand, new roles are to be introduced into primary care including physician associate and care navigator. In secondary care a nursing associate role will be introduced.

Dr Sam Everington said that investment is a key factor in retention. Commissioners have invested in training science graduates to learn some GP skills over a 2 year training course. He argued that the diversification of roles is an essential benefit to a changing workforce and used the example of utilising pharmacists, who are over represented in the borough, to support GPs with paperwork and prescriptions. He also advocated for e-contact consultations.

The Chair asked primary care colleagues what they thought about virtual consultations, also referred to as the Babylon Project.  On the whole the GP’s agreed that it was a major risk and encouraged ‘cherry picking’. They thought the funding formula was rather crude, for example a young person with significant needs would generate the same charge as a low risk patient.

Steve Gilvin, Chief Officer, Newham Clinical Commissioning Group, acknowledged that cherry picking is an issue but said there will be a menu of options on what can be provided which is a good thing.

Wendy Matthews, Deputy Chief Nurse /Director of Midwifery, Barking, Havering and Redbridge University Hospital NHS Trust, asked what impact Brexit would have on European nurses.

Mr Cain replied that on average European junior nurses leave after two years but experienced nurses tend to stay on. Health Education England is focussing efforts on training newly qualified nurses. There is a Capital Nurse Programme to ensure London nurses are given the best training. With regard to Brexit, there has not been a significant shift towards nurses leaving the country but the reduction of the pound has resulted in difficulty in attracting European nurses on salary.

Councillor Hayhurst asked a question about housing options available to nurses and whether the health service and local authority worked in a joined up way to ensure key workers are provided with suitable housing.

It was noted that there has been little joined up working with the health service and local authorities on key worker housing. Members suggested offering workers a suite of benefits such as nursery places, housing, and training to encourage people into entering the profession.

Councillor Susan Masters asked about the job roles of these physician associates. Dr Everington said some of them will be trained on hospital work and some on GP work. It is envisaged that the roles will specialise in areas such as chronic conditions but this will depend on the individual’s strengths.  

A member asked what the contingency plan would be if these roles could not be filled. Mr Gilvin responded saying that the GP Resilience Programme has allocated some funding to practices that are struggling. It is not a huge amount but the workstream is there in case intervention and advice is required.

There was a discussion on NHS estates and the sale of land.

Mr Tompkins explained that any sale of NHS assets goes into a general pot with no guarantee the funds will be allocated to an east London Trust.

Councillor Richard Sweden asked how GPs felt about the dilution of their profession with the introduction of the new roles. Dr Everington responded that initially there was some opposition to the idea but it is now widely welcomed due to the demands on the service.

Mr Gilvin informed the committee about a piece of work on quality improvement with Newham CCG that is being piloted.

RESOLVED

(a)  To note the report

The Chair thanked delegates for their contributions and brought the meeting to a close.