Minutes:
The Place Executive Lead advised that pressure was being experienced within the Trust following the roll out of the Epic system – there had been a lot of pressure for general practice in relation to the way results were received and reviewed. In response to questions, the GP Clinical Lead advised that the hospital provided pathology services for primary care. These were reported, and results were coded in a particular way which fed into referral/recall systems. Following the roll out some codes had now changed or were reported differently, and they were working closely with primary care across the South East London to resolve these issues as quickly as possible. The delays and issues with coding had impacted on workload and caused some frustration within primary care. However there would be a number of benefits going forward, including the use of My Chart which was an excellent care navigation offer. Patients could interact with the app, and it would also help hospitals interact directly with its patient cohort.
With regards to acute services the Place Executive Lead noted that they had been impacted be periods of industrial action, with more to follow. The hospital had done a good job in ensuring that minimum standards were met, however this had resulted in increased waiting lists. Across South East London they were managing to “keep their heads above water” in relation to this years’ target of patients not waiting more than 78 weeks, but this was a considerable challenge.
Members were advised that, as mentioned at the previous meeting, a national management cost reduction exercise was being undertaken – all ICBs had been asked to reduce management costs by 30% by April 2025, with 20% of these reductions in place by April 2024. The ICB had reviewed its activities and delivery to ensure they were fit for purpose, meeting core requirements and statutory functions. The proposed structure, which included the Bromley team, was out for consultation until 29th November 2023. A management response would be provided by mid-December 2023 and the structure would be implemented in the new year. They were working with partners to ensure the right structures were in place to deliver the One Bromley priorities and it was noted that not all processes would be completed for 2024. In response to questions, the Place Executive Lead noted that the management cost reduction just related to the ICB team, and did not include partner organisations, and a broad approach had been taken. There was already a lot of sharing of resources, information and intelligence – they had looked at what they could do differently as a partnership, for example using the Better Care Fund (BCF) to support some posts. They were looking to reduce the baseline cost of running an ICB team – inevitably there would be some redundancies, but savings would be made in terms of the ongoing costs.
The Place Executive Lead informed Members that the autumn/winter campaign for flu and COVID-19 immunisations had commenced in September. Bromley residents were able to access the vaccinations in a number of ways – through their GP practice; the Health Hub in The Glades Shopping Centre; Primary Care Network (PCN) sites; and 20 pharmacies. Bromley had one of the best uptake percentages across London however it was not at the level seen in previous years. It was noted that the programme would continue until Christmas and would be scaled down in the new year. All of the care homes in Bromley had been visited with the offer of flu and COVID-19 vaccinations for residents – Bromley Healthcare had also been assisting with the delivery of vaccinations for those that were housebound. It was noted that a further COVID-19 vaccination programme was expected to take place in spring 2024.
In response to a question from the Chairman, the Place Executive Lead advised that following learning taken from previous campaigns GP practices had been asked to use a variety of different methods to contact patients, rather than using text reminders all of the time. The Chairman considered that there did not appear to be as much advertising pressure in relation to the vaccinations and noted that private companies seemed to be stepping away from offering vouchers to staff for the flu jab. The Place Executive Lead said that there may be less need due to more staff working from home, but they could look at undertaking more media work with organisations and campaigns to improve uptake. Other Members echoed the comments made by the Chairman – it was noted there were lots of reminders on social media, however the target audience would not necessarily use these platforms. It was agreed that the Place Executive Lead would provide information to Councillors which could then be shared with residents. In response to a question, the Place Executive Lead advised that a number of pharmacies delivering the vaccinations had free on-street parking nearby.
With regards to mental health services, the Place Executive Lead said there was an increasing need for capacity – they were seeing an increased number of people in A+E with mental health issues, and some of these individuals were staying there for long periods of time. As previously mentioned they had been working across South East London to increase capacity in terms of bed number and enhance the psychiatric liaison service.
Members were advised that a consultation regarding paediatric oncology services would be running until 18th December 2023. For patients living in SEL, Kent, Sussex and Surrey, specialist children’s cancer services were currently provided by The Royal Marsden NHS Foundation Trust, however if a patient required paediatric intensive care they would be transferred to St George’s Hospital, Tooting. Two options for the new paediatric oncology centre were proposed:
- Evelina London Children’s Hospital, Lambeth, south London with conventional radiotherapy services at University College Hospital; or,
- St George’s Hospital, Tooting, south London, with conventional radiotherapy services at University College Hospital.
The Place Executive Lead informed Members that there were national initiatives to improve access to primary care services. These were divided into four categories:
- empowering patients to access primary care;
- implementing new technologies;
- building capacity within general practice; and,
- cutting bureaucracy.
Members requested that a written report be provided to future meetings of the Sub-Committee.
The Chairman thanked the Place Executive Lead for the update to the Sub-Committee.
RESOLVED that the update be noted.