Agenda item

RESOLVED: that the health system recovery update is noted and that the committee thanks NHS partners for going above and beyond in unprecedented times and while under extreme pressures.

Sarah Wainer, Director of System Transformation, Lewisham Health and Care Partners, introduced the report noting that while progress with recovery activity has been impacted by the Omicron variant, partners have risen to the challenge and worked collaboratively.

Ben Travis, Chief Executive, Lewisham and Greenwich NHS Trust, and Paul Larrisey, Divisional Director of Operations, Medicine and Community Division, Lewisham and Greenwich NHS Trust gave a presentation on the key issues for the Trust. The following was noted:

1.1  The key challenges for the Trust are: high demand at the front door; the Omicron variant and any future waves; and lengthy waiting lists.

1.2  After having to stand down a number of services during the first and second waves of Covid, there are now 1,900 patients across Lewisham, Greenwich, and Bexley who have waited more than 52 weeks for surgery.

1.3  Another key challenge is around staffing numbers. Although many are vaccinated, many are still getting Covid and this is making it a challenge to staff all services. For example, elective care had to be stood down to deal with challenges at the front door.

1.4  The Trust’s 4-hour A&E target performance currently stands at 77%, against a target of 95%.  The Trust is exploring alternative to meet this challenge, including: streaming people at the front door; increasing use of the same day emergency care unit; creating separate entrance for A&E; working with partners on the Urgent Community Response Service. 

1.5  The Trust has also received funding from the CCG to increase other community services.

1.6  Going forwards, focus will be on: elective care recovery; meeting new national targets on discharge; making the most of Lewisham’s Population Health System; working with partners to deliver ambitions of adult social care changes.

1.7  In response to questions about the number of people having to wait in ambulances because they can’t be admitted to A&E, it was noted that on most days there reasonable numbers of people waiting more than 15 minutes and small numbers waiting for more than an hour.

1.8  In response to questions about vaccination requirements for staff it was noted that the Trust has been collecting data and working with staff to better understand the risk. There also needs to be a conversation across southeast London to discuss and manage risks.

1.9  Catherine Mbema, Director of Public Health, also delivered a presentation on local prevention measures.

1.10      IN response to questions about ‘long Covid’, it was noted that the prevalence of this will be looked at as part of the council’s Covid Impact JSNA (joint strategic needs assessment) which will feed into a refresh of the Lewisham Health and Wellbeing Strategy.

1.11      Simon Parton, Chair of Lewisham Local Medical Committee, noted that primary care is seeing fewer patients presenting with acute Covid, but that there has been a significant increase in staff sickness and absence which has been a challenge. It was also been difficult to recruit to primary care, nurses in particular.

1.12      In terms of unplanned care and acute sickness, work is going on across primary care network in Lewisham, and with the southeast London CCG, to look at how to support patients through a digital suite of tools.

1.13      There is also a challenge in terms of unvaccinated staff. 13% in primary care remain unvaccinated and this needs to be mapped to understand where acute need sits.

1.14      It was noted by the committee’s Healthwatch representative that Healthwatch Lewisham has recently published a report and recommendations on digital exclusion in primary care. It was agreed that this would be shared with members of the committee.

1.15      Kenny Gregory, Lewisham Mental Health Provider Alliance, noted that mental health services have mostly returned to face-to-face with some support still being provided through video conference.

1.16      It was noted that the overall challenges coming out of the pandemic are: increased demand for services through A&E; increased demand for acute care (beds); increase in patients requiring a Mental Health Act assessment; staffing capacity and recruiting, in particular nurses. There has also been further work to reduce health inequalities and support BAME communities.

RESOLVED: that the health system recovery update is noted and that the committee thanks NHS partners for going above and beyond in unprecedented times and while under extreme pressures.