Agenda and minutes

Apologies for absence were received from Councillor Ian Dunn and Councillor Angela Wilkins attended as substitute.

Apologies for absence were also received from Councillor Judi Ellis and Francis Poltera.

There were no declarations of interest.

In accordance with the Council’s Constitution, questions that are not specific to reports on the agenda must have been received in writing 10 working days before the date of the meeting. 

Questions specifically relating to reports on the agenda should be received within two working days of the normal publication date of the agenda. Please ensure that questions specifically on reports on the agenda are received by the Democratic Services Team by 5pm on Friday 1^st October 2021.

No questions had been received.

RESOLVED that:

i)  the minutes of the meeting held on 23rd March 2021 be agreed; and

ii)  the minutes of the informal meeting held on 13th July 2021 be noted.

The Chairman welcomed Michael Douglas, Founder and Hon Trustee of the Chartwell Cancer Trust to the meeting to provide an update on the work of the charity.

Mr Douglas informed Members that he had been diagnosed with leukaemia in 2003 and had received treatment in the Chartwell Unit at the Princess Royal University Hospital (PRUH). During this time he had been struck by how understaffed the Unit was, particularly the shortage of Health Care Assistants (HCA). In 2005 he had established the Chartwell Cancer Trust and the first fundraising was for the cost of funding an extra HCA in the treatment suite. Ever since, the Chartwell Cancer Trust had funded additional medical staff specifically for the unit, including junior doctors and haematologists; specialist haematology and breast screening clinics; and transportation for those patients that required it. The money received by the Chartwell Cancer Trust had also been used to fund the refurbishment of the treatment suite within the Chartwell Unit to improve the layout to make it more accessible, moving the reception to the front and installing air conditioning and a coffee machine for the nurses.

Since then, the Chartwell Cancer Trust had grown and provided support to other out of borough hospitals – Queen Elizabeth Hospital – Woolwich (QEH), Croydon University Hospital, King’s College Hospital, Guy’s Hospital and St Thomas’ Hospital. Through fundraising, the Chartwell Children’s Cancer Trust also provided support to the Tiger Ward – QEH and Frog Ward – Croydon University Hospital. The nurses on the Tiger Ward had created a “wish list”, and over time they had installed a kitchen, new flooring and beds. Fundraising towards the target required to develop a new playroom on the Frog Ward was nearly complete. Money raised was also used to run four oncology groups, purchase tickets for the children to attend the Christmas pantomime, and fund a holiday home on the Isle of Wight that the children could visit. The funding of local Childhood Cancer Support Groups for children undergoing treatment for cancer or leukaemia provided monthly meetups. These events provided families with the opportunity to make special memories together and allowed them to have some “normal” time with other families in similar situations. It also provided parents with the opportunity to “swap news”. One parent had suggested the development of an app, which could be used following a diagnosis, that showed a film of each stage the child would go through on their treatment journey ahead.

Mr Douglas highlighted that courses of treatment for childhood cancer were much longer than those for adult cancers, which often left the children missing out on time at school. To help combat this, the AV1 ‘No Isolation’ Robot had been created. The robot could sit on the child’s desk at school, and acted as their eyes, ears and voice in the classroom, allowing them to feel as if they were in the room. It could be accessed from wherever the child was, be it in hospital or at home, and allowed them  ...  view the full minutes text for item 14.

·  Vaccinations

·  GP Access

·  Long COVID (verbal update)

·  NHS patients referred to private health providers (verbal update)

Vaccinations

Cheryl Rehal, Acting Head of Primary Care, Bromley – SEL CCG (“Acting Head of Primary Care”) provided an update on vaccination uptake in Bromley. The Acting Head of Primary Care informed Members that the uptake of the COVID-19 vaccination (first dose) had commenced in December 2020 – uptake in Bromley had peaked in spring 2021, and the second doses had been delivered during a busy period in summer 2021. The uptake in the borough was high – the total percentage uptake for the first dose of the vaccine was over 80%, and just under 80% for the second dose. The vaccination of 12–15-year-olds had now commenced, and it was anticipated that vaccinations would have been provided to this cohort at all schools in the borough by the end of November 2021.

In relation to the COVID-19 booster programme, it was noted that this would help to improve the protection that people had from their first two doses of the vaccine, giving longer term protection against getting seriously ill from COVID-19. Those that were eligible would be offered a booster dose from six months after they had received their second dose. The booster dose offered to most people would be the Pfizer/BioNTech vaccine or Moderna vaccine. In response to a question from a Co-opted Member, the Acting Head of Primary Care said that the advice issued by the Joint Committee on Vaccination and Immunisation (JCVI) was for the Pfizer/BioNTech vaccine or Moderna vaccine to be given regardless of the vaccine used for a patients’ first or second doses. Dr Angela Bhan, Borough Based Director – SEL CCG (“Borough Based Director”) highlighted that this was general advice as the use of different vaccines showed a strong protective response. However it was recommended that anyone with a complicated medical history speak with their GP as some people may instead be offered a booster dose of the Oxford/AstraZeneca vaccine.

The Acting Head of Primary Care highlighted that the circulation of flu had been very limited in the 2020/21 season and as a result, a lower level of population immunity against flu was expected this winter. This was also expected to be the first winter when seasonal influenza virus (and other respiratory viruses) would cocirculate alongside COVID-19. To help mitigate the potential impact from flu, the NHS would vaccinate additional cohorts, and aim for a high uptake of the flu vaccine to maximise protection. As there was a high degree of overlap of those eligible for flu and COVID-19 boosters, the CCG was encouraging co-promotion to eligible individuals, and co-administration wherever possible. With regards to plans for the autumn, it was noted that the coinciding seasonal flu campaign and COVID-19 booster programme would bring additional workforce pressures – the preparation and administration of the COVID-19 booster vaccine was more time consuming than the flu vaccine, and the 15-minute post vaccination observation period for Pfizer currently remained a requirement. The volunteer workforce had been an essential part of the success of the vaccination programme,  ...  view the full minutes text for item 15.

Jonathan Lofthouse, Site Chief Executive – PRUH and South Sites (“Site Chief Executive”) provided an update on the King’s College Hospital NHS Foundation Trust.

The Site Chief Executive informed Members that as of that afternoon, there were 23 patients across the PRUH and South Sites with a confirmed inpatient diagnosis of COVID-19. Of these patients, 22 were in general beds and 1 was  in an intensive therapy bed. It was highlighted that the number of inpatients had  remained stable over the last four and a half months, and there did not appear to be any trends in terms of the age range and ethnicity of patients. Members were advised that Bromley’s Mass Vaccination Centre would come to natural close around mid-December 2021. In the coming weeks the PRUH site would be used to deliver third doses of the COVID-19 vaccination to healthcare staff.

The Site Chief Executive advised that in terms of the recovery of elective surgeries that had been delayed due to the pandemic, the Trust was currently

performing just below the national standard – for cancers this currently stood at 91%, compared to the national figure of 93%. It was noted this had improved greatly since the second wave of the pandemic.

With regards to the latest Friends and Family Test data, the PRUH had received high scores for the following areas of care: professional and competent; emotional and psychological support; compassion; and politeness. ?There had been some shortfalls in terms of the emergency care, which had been impacted by three main factors. This included a reduction in the number of Physicians – a number had been stranded overseas due to the pandemic however it was anticipated that this issue would shortly be resolved. The Care Quality Commission (CQC) had visited the PRUH in June 2021 and reassessed the ‘inadequate’ rating issued in November 2019. The Emergency Department was now rated as ‘requires improvement’, with nursing rated as ‘good’, which showed positive signs of improvement.

With regards to investment, the Site Chief Executive advised that two inpatient wards had been completely refurbished, and work would continue to ensure that all 18 wards were up to the same standard over a rolling two-year programme. It was noted that several of the wards were now classed as ‘dementia friendly’. An Older Person’s Assessment Unit would be opened at the PRUH in November, providing dedicated assessment and treatment spaces. It was also planned that a Rapid Diagnostic Centre would be in operation in the New Year. The Endoscopy Unit at the PRUH was receiving investment of £20m for two new buildings, housing 6 procedure rooms. Construction was expected to take 14 months to complete, and it was anticipated that ground would be broken for the initial works during December 2021.

The Site Chief Executive advised that the Trust had received a bonus payment for responding to the elective restart favourably and part of this had been used to invest in the modular theatre at Orpington Hospital. This would allow thousands more  ...  view the full minutes text for item 16.

The Assistant Director for Integrated Commissioning provided and update in relation to the Winter Plan 2021/22.

It was noted that an earlier version of the Winter Plan 2021/22 had been presented to the Adult Care and Health Policy Development and Scrutiny Committee at its meeting on 9^th September 2021. The Plan was now complete and being mobilised on the five pillars as follows:

1. Increasing System Capacity

2. Data Sharing and Escalation

3. Single Point of Access and Discharge Arrangements

4. Admissions Avoidance

5. Communication and Engagement

The Assistant Director for Integrated Commissioning highlighted that pillar number 4 – Admissions Avoidance would be a key part of the Plan, and further communication and engagement would be needed. Members were advised that progress would be reported on throughout the winter period.

RESOLVED that the update be noted.

Marzena Zoladz, Service Coordinator – Healthwatch Bromley (“Service Coordinator”) provided an update to the Sub-Committee regarding the Healthwatch Bromley Quarter 1 2021-2022 Patient Engagement Report.

The Service Coordinator informed Members that over 600 reviews had been collated during the Quarter 1 period (April to June 2021). Overall, based on the star ratings received, 65% of responses received from patients had been positive, and 28% had been negative. It was noted that during Quarter 1 feedback from patients had been collected through online review platforms,  telephone engagement, and direct feedback could also be left via the Healthwatch Bromley website. It was anticipated that during Quarter 2 face to face engagement would take place.

The report included various reviews of GP and hospital services which highlighted patients’ high levels of satisfaction with the attitude of staff, the quality of care and treatment. However there were some concerns regarding with the need to improve external and internal communication, and systems for booking appointments. Another area where patients had indicated high satisfaction in all areas (including quality of treatment, communication and cleanliness) was dental services, with 95% of all reviews having been positive. This was in contrast to complaints received regarding patients being unable to access NHS dentists, which was something that Healthwatch England would be looking at in further detail.

With regards to Children and Young People’s – SEND services, 52% of negative reviews related to access to information, advice and guidance and meeting needs. In response to a question, the Service Coordinator said that Healthwatch Bromley would welcome closer working with Children and Young People’s – SEND services to provide more clarity. A Co-opted Member asked  that an update on this be provided at a future meeting of the Health Scrutiny Sub-Committee.

The Chairman thanked Marzena Zoladz, Service Coordinator – Healthwatch Bromley for her update to the Sub-Committee and the Vice-Chairman congratulated her on an excellent piece of work.

RESOLVED that the update be noted.

Report CSD21110

Members considered the forward rolling work programme for the Health Scrutiny Sub-Committee.

As suggested during the meeting, an update on the measures to improve access to information, advice and guidance and meeting needs within Children and Young People’s – SEND services would be included on the Work Programme and brought to a future meeting of the Health Scrutiny Sub-Committee.

Members were asked to notify the Clerk if there were any further items that they would like added to the work programme.

RESOLVED that the update be noted.

There was no other business.

4.00pm, Thursday 13^th January 2022

4.00pm, Wednesday 20^th April 2022

4.00pm, Thursday 13^th January 2022

4.00pm, Wednesday 20^th April 2022

Following the publication of the agenda, the Leader of the Council received the attached letter from the Londonwide Local Medical Committees, drawing attention to matters which fall within the remit of the Health Scrutiny Sub-Committee. In order to deal with matters efficiently and effectively, the Chairman agreed to add the following urgent item to the agenda:

Discussion on this item took place earlier in the meeting, following the item on ‘Update from the SEL CCG – GP Access’.

The Chairman noted that the letter received from the Londonwide Local Medical Committees did not recognise the problems associated with GP access. GP’s and practice staff had worked hard throughout the pandemic, although it was considered that the most efficient processes had not necessarily been used. The Health Scrutiny Sub-Committee would offer all the help that it could – it was highlighted that the issue of GP access had been raised several months ago, and this was a real problem that needed to be addressed.

The GP Clinical Lead advised that data indicated the average call time to a GP practice had increased from 2 to 3 minutes over the pandemic. This increase had been impacted by the need for staff to explain the new ways of accessing appointments, and it was noted that there was a high turnover of reception staff, which was not specific to Bromley. Pressure and morale were “at a tipping point” in most practices. The support of the Sub-Committee was appreciated and some of the solutions were being worked through in relation to telephony and access. Customer service training was already being undertaken, but following the comments received today this would be looked at further.