Agenda item

RESOLVED: That the Overview and Scrutiny Committee would like to

(A) Make the following comments to the Healthier Communities Select Committee in relation to the proposed closure of the Walk In Centre at New Cross:

1.     We have heard a number of concerns about the proposed closure.

2.     We appreciate that the NHS Lewisham Clinical Commissioning Group (CCG) is likely to need more time to consider the responses received during the conclusion and we welcome that.

3.     We would welcome the final response from the CCG on this matter being provided to all councillors as the walk-in centre is a borough-wide service.

4.     We would welcome further details on GP recruitment and nurse retention bearing in mind Lewisham's population increase and Our Healthier South East London (OHSEL) / the Sustainability and Transformation Plan (STP) primary care requirements.

5.     Current A&E performance figures for local trusts (Lewisham, King's and Guys and St Thomas') were discussed at our meeting and we question how this proposal will help improve performance.

(B) Refer this issue to Full Council.

3.1       Martin Wilkinson, Chief Officer; Ashley O’Shaughnessy, Deputy Director of Primary Care; and Dr Jacky McLeod, Clinical Director, Primary Care Lead, (NHS Lewisham Clinical Commissioning Group) introduced the item.

3.2       It was noted that:

·         The CCG had been responsible for primary care commissioning from 1 April 2017. Certain core services had to be provided but other ‘at scale’ services could be locally determined.

·         There was a focus on prevention, co-ordinated care plans and an integrated care model.

·         To reduce the strain on accident and emergency services at the University Hospital Lewisham, streaming and re-direction was being piloted to deliver rapid clinical assessment and appropriate redirection of patients to urgent care, outpatient care, Neighbourhood Care Networks and GP services in addition to A&E. 

·         There would be a GP Extended access service in a purpose built site at the hospital from 1 November 2017 offering a service from 8am to 8pm, seven days a week.

·         35 out of the 39 GP practices located in Lewisham offered extended hours.

·         Lewisham was the third best borough in London in terms of the number of patients signed up for online services.

3.3       In response to questions from members of the Committee, it was noted that:

·         There were 143 full time equivalent GPs in Lewisham (not including locums and retainers) and the borough fared well in terms of list sizes.

·         Practice nurse numbers were more of a concern and it was likely that there would be an increase in retirements over the next 3 to 4 years. A targeted international recruitment campaign would be launched.

·         The CCG was working with GPs in terms of incentivising GP trainees to stay in the borough and there had been some successes in terms of nursing recently. The CCG had, for example, appointed the first Nurse Consultant in Primary Care in the country alongside three General Practice Nurse Advisors to support with professional development and recruitment.

·         GPs were considering whether reception and healthcare assistant staff could take on a broader range of responsibilities.

·         The incorporation of public health into the local authority had resulted in a number of positive outcomes including influencing the thinking of a wider range of officers. The provision of the flu jab to all staff (if they wanted it) was one such example.

·         The Better Care Fund had brought additional funding into the Council although it had not totally resolved the funding crisis in adult social care. Officers were working on plans to sustain the improvements.

·         Free flu jabs would be offered to all residents in care homes and all domiciliary care workers. School pupils in years reception, 1, 2, 3 and 4 were receiving the flu jab and schools were also being encouraged to offer the vaccination to staff.

·         High house prices were a factor in the recruitment and retention of A&E, GP and nursing staff.

·         Technology was improving primary care with video consultations, online booking of appointments, better transfer of calls via the 111 number etc.

3.4       In relation to the proposed closure of the Walk In Centre at New Cross, the Committee heard from Jane Mandlik of the Save Lewisham Hospital Campaign. She felt that the proposals to fill the gap that the closure of the centre would create were insufficient. In the discussion that followed the points below were noted:

·         The equalities impact needed to be fully considered. The centre served, amongst others, a large homeless population, people who found it difficult to get appointments with their GP, patients who had not registered with a GP for a variety of reasons, and those with ill children who needed an urgent appointment.

·         The CCG was open to the idea of delaying a decision to allow extra time to fully consider the results of the consultation and how any gap in provision caused by the closure might be addressed.

3.5       The Committee agreed to make a referral to the Healthier Communities Select Committee in relation to the proposed closure of the New Cross Walk In Centre. The Committee also agreed that the matter should be referred to Full Council.

3.6       RESOLVED: That the Overview and Scrutiny Committee would like to

(A) Make the following comments to the Healthier Communities Select Committee in relation to the proposed closure of the Walk In Centre at New Cross:

1.  We have heard a number of concerns about the proposed closure.

2.  We appreciate that the NHS Lewisham Clinical Commissioning Group (CCG) is likely to need more time to consider the responses received during the conclusion and we welcome that.

3.  We would welcome the final response from the CCG on this matter being provided to all councillors as the walk-in centre is a borough-wide service.

4.  We would welcome further details on GP recruitment and nurse retention bearing in mind Lewisham's population increase and Our Healthier South East London (OHSEL) / the Sustainability and Transformation Plan (STP) primary care requirements.

5.  Current A&E performance figures for local trusts (Lewisham, King's and Guys and St Thomas') were discussed at our meeting and we question how this proposal will help improve performance.

(B) Refer this issue to Full Council.