This meeting of the Health and Adult Social Care Scrutiny included for discussion a report on making GP services more accessible, and the Scrutiny team's report on the committee's work. A late item about the proposed closure of the Markhouse Centre was added to the agenda after the meeting was called-in by Councillors.

The Markhouse Centre

Councillors were asked to consider a call-in of the Cabinet Member for Adult Services and Health’s decision to close the Markhouse Centre. The call-in request, submitted by Councillors Emma Best, Alistair Strathern and Grace Williams, focussed on the consultation process and what were described as inadequate alternative provision. The Councillors stated that they were extremely concerned about the proposals, in particular the impact on users with complex needs, many of whom are from Asian and Minority Ethnic communities. The call-in requests that Cabinet reconsider the decision and instead commit to working with users, families and staff to co-design a sustainable future for the Markhouse Centre that meets the needs of some of the borough’s most vulnerable residents. The Scrutiny Committee was asked to consider the call-in request and the service response and make a recommendation to the relevant Cabinet Member.

Accessibility of GP Services

The committee was asked to review a report on the accessibility of GP practices in Waltham Forest. The report discussed the national policy context for access to primary care, as well as the challenges faced in North East London. The report also provided an update on the number of appointments being delivered and the latest data from the national GP Patient Survey. The Committee was also asked to consider the ongoing work being undertaken by Healthwatch Waltham Forest. Specifically, the committee was asked to review feedback from residents about their experiences of accessing GP services in the borough. The report noted that there had been a 4.4% increase in the number of GP appointments booked in Waltham Forest between 2022/23 and 2023/24. The average number of appointments offered per 1,000 patients in the borough each week rose from 82 to 85 over the same period. The report noted that across North East London as a whole, face-to-face appointments increased slightly from 57 to 58 per 1,000 patients per week and accounted for 64% of appointments. In Waltham Forest, face-to-face appointments increased by 3 appointments per 1,000 per week. In terms of patient experience, the report highlighted data from the 2024 GP Patient Survey which showed that Patients have a more positive experience with the care they receive from their practice than the experience of getting access to their GP Practice. It also noted that Waltham Forest’s response rate to the survey (20%) was on par with London (20%), 2% higher than in NEL (18%) and 7% lower than the England rate (27%).

The question, how people felt about how long they had to wait for an appointment, has a positive response rate that is lowest compared to the national result - 57% (NEL) compared to 66% (Eng).

The report also provided an update on the Additional Roles Reimbursement Scheme (ARRS) for Primary Care Networks (PCNs). This scheme has seen 154.7 full-time equivalent staff recruited into GP practices in Waltham Forest. This includes pharmacists, mental health practitioners and social prescribing link workers. The report noted that 95% of the funding available for this scheme had been used in Waltham Forest, compared to an average of 89% across North East London.

The report concluded by stating that the model of access to primary care is changing and highlighted the ICB’s ambition to develop locality health & wellbeing hubs within Waltham Forest to provide a range of services in one place.

The Scrutiny Report

The Scrutiny team provided their regular report to the committee, which included a draft of their work programme, the Action Tracker and the Recommendation Tracker from the previous meetings. The Committee was also reminded about the council's legal duty to publish details of key decisions. The Scrutiny report listed the following key decisions:

• A review of in-house learning disabilities day opportunities services.
• Integrated sexual health provision for residents of Waltham Forest.

The committee was invited to review and comment on the Forward Plan for the rest of the year, with the report reminding them of the criteria that should be used to prioritise scrutiny topics.

P – Public Interest – The concerns of local people should be addressed through scrutiny of the issue

A – Ability to Change – Priority should be given to issues that the committee can realistically influence

P – Performance – Priority should be given to areas in which the Council or other agencies are not performing well

E – Extent – Priority should be given to issues that are relevant to all or large parts of the borough

R – Resource – Work programmes must take account of what else is happening to avoid duplication or wasted effort if there is not enough resource to support scrutiny of a matter

S – Statutory responsibility – Priority should be given to issues where there is a statutory duty to scrutinise or hold to account

The Scrutiny team noted that the following topics had been suggested for inclusion on the work programme during previous meetings:

• Services to provide a future update to the Committee outlining how the Babies, Children and Young People (BCYP) strategy is progressing.
• The Commissioning Framework Paper.