The Health Scrutiny Committee of Barking and Dagenham Council met on Wednesday 7 February 2024 to discuss the potential of the Voluntary and Community, Faith and Social Enterprise (VCFSE) sector, receive updates on the NELFT CQC inspection and a CQC report on Together First. The committee agreed the final report and recommendations from the VCFSE sector review, requesting an action plan for implementation and a progress update in six months.

Scrutiny Review into the Potential of the VCFSE Sector

The committee received an update on the scrutiny review into the potential of the Voluntary and Community, Faith and Social Enterprise (VCFSE) sector. The review highlighted the importance of collaboration between the Health and VCFSE sectors to reduce health inequalities, with recommendations focusing on developing community capacity, improving information sharing, fostering a common culture and language, and increasing the longevity of funding opportunities. Members expressed support for the recommendations, emphasising the need for transparency through qualitative and quantitative data and the potential of a locality model to facilitate these changes. The Director of Community Participation and Prevention (DCPP) noted that the Council system supports collaboration, sustainability, and flexibility. Organisations such as Together First and LifeLine agreed that coproduction and collaboration are key to reducing health inequalities. The Cabinet Member for Adult Social Care, Health and Housing, Councillor Maureen Worby, supported the recommendations, acknowledging the challenge of delivering services differently and stressing the importance of the emerging localities model.

The committee agreed the final report and recommendations, requested the DCPP to develop a formal action plan for implementation, and asked for an update report in six months.

NELFT CQC Inspection - Progress Update

The Associate Director of Nursing & Quality and the Integrated Care Director for Barking and Dagenham, from North East London NHS Foundation Trust (NELFT), provided an update on the NELFT Care Quality Commission (CQC) inspection and progress against their improvement plan. They reported that all staff had completed training on the Patient Safety Incident Response Framework (PSIRF) and that NELFT had adopted a new PSIRF ahead of the implementation deadline. The Trust has also changed its incident report system to enable more dynamic progress with PSIRF compliance.

Quality Improvement (QI) projects in Children's Services have focused on addressing complaints and waiting times, with significant improvements reported in autism spectrum disorder (ASD) waiting lists in Kent, reducing them from 36 months to 17-22 weeks. Complaints have reduced from an average of three to zero, with 85% positive feedback. Interventions for staff retention include overseas recruitment, targeted strategies for hard-to-fill posts, and the promotion of substantive Band 5/6 development posts, showing positive growth in district nursing staff.

Regarding waiting times for ADHD diagnostics, it was noted that approximately 300 patients are currently on the waiting list, with the influx of neurodiverse patients post-pandemic straining service capacity. The committee was also informed about the care and facilities available for young people in mental health wards, including various activities, employment opportunities, and access to technology, with a focus on patients' physical health and wellbeing through GP checks and ECGs.

The committee noted the report.

CQC Report on Together First

The Chief Operating Officer of Together First CIC, Barking & Dagenham GP Federation, and a General Practitioner from The White House Surgery presented a Care Quality Commission (CQC) Report on Together First. The report detailed the CQC's judgement of the quality of care provided at Barking Hospital, which received an overall rating of good, with the responsive to people's needs domain rated as outstanding. This marks an improvement from the previous inspection in 2018. Of the five areas identified for improvement, four have been achieved, with the remaining area, a review of policies and procedures, expected to be completed by May 2024.

The committee congratulated the staff and management on their achievement. Discussions focused on how Together First shares its positive experiences and good practices, with the COO highlighting regular data sharing across the healthcare sector, particularly with GP surgeries in the borough. Regarding staff retention, the COO emphasised the importance of creating the right culture and working environment, valuing staff contributions, and providing support and freedom to innovate. Recruiting local people with a vested interest in the community was also highlighted as a key factor.

The value of partnership working was recognised, and the COO acknowledged the need to address structural inequalities and confusion regarding the roles of Federations and Primary Care Networks (PCNs). The distinction between inner and outer London pay was discussed as a factor impacting recruitment and retention, although the COO stressed that a safe and respected working environment with effective management structures is equally important for clinicians. The Integrated Care Board (ICB) has acknowledged these pay differentials in its new workforce strategy and is committed to abolishing them, though this depends on securing additional funding.

The Chair concluded by noting the importance of sharing best practice with other GP practices in the borough whose CQC reports have been less positive. The COO confirmed that Together First CIC maintains positive relationships with CQC NHS Commissioners and has previously been involved as a subcontractor to help a local practice improve its standards.

The committee noted the report.

Joint Health Overview and Scrutiny Committee

It was noted that the agenda reports pack and minutes of the last meeting of the Joint Health Overview and Scrutiny Committee could be accessed via the link provided on the front sheet of the agenda.

Work Programme

The Work Programme was noted.