The Health Scrutiny Committee met to discuss patient flow, overcrowding, and elective care backlogs at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), and to review the work of community GP hubs in supporting the Trust. The committee also received an update on the services provided by Together First CIC, a GP federation, and its role in managing demand on urgent and emergency care.

Patient Flow, Overcrowding, and Elective Care Backlogs at BHRUT

Andrew Deaner, Chief Medical Officer of BHRUT, presented a report on patient flow, overcrowding, and elective care backlogs. He highlighted the significant increase in daily attendances at Queen's Hospital, which was designed for 300 patients a day but was seeing over double that number. Deaner expressed gratitude for the £42 million funding secured to rebuild the A&E department at Queen's Hospital, with construction expected to begin in the coming months.

The committee heard that BHRUT had seen a 25% reduction in patients receiving care in corridors over the past three months, with 4,681 patients receiving care in corridors compared to 6,274 in the same period last year. Initiatives to improve patient flow included daily flow meetings involving senior clinical staff and site teams, and partnership working with organisations like Partnership of East London Cooperative (PELC) to divert less seriously ill patients from A&E.

Councillor Marion Hull shared a personal testimony detailing her experience of a broken hip and wrist, which she sustained after a fall. Her account highlighted significant issues with pain management, privacy, and dignity while she was treated in a corridor at Queen's Hospital. She described prolonged waits for pain relief and a catheter, lack of privacy, and the distressing experience of being in a busy corridor. Deaner apologised for the care Councillor Hull received and acknowledged that while efforts were being made to reduce corridor care, it was not yet eradicated. He assured the committee that efforts were underway to improve patient dignity, confidentiality, and safety when corridor care could not be avoided, including the use of screens and designated areas for toileting and showering.

Regarding elective care backlogs, the report indicated that the total number of patients on the waiting list in August was the lowest since the launch of the electronic patient record, at 66,800. However, there had been an increase in patients waiting more than 52 weeks, and the Trust was contracting additional capacity with the independent sector to address this. Improvements were noted in diagnostic waiting times, with a 10% improvement in the Cancer 28-day Faster Diagnosis Standard and an 8% improvement in the 62-day standard since April. The Trust was also benefiting from additional funding from North East London Integrated Care Board (ICB) to reduce waiting times, with a commitment to be back on track for planned care by the end of January. Initiatives to drive improvement included targeted waiting list initiatives, the use of robotic surgery, and the opening of two new MRI scanners at Queen's Hospital.

Community GP Hubs in Support of BHRUT

Craig Nikolic, Chief Executive Officer of Together First CIC, presented a report on the impact of GP hubs and the Acute Respiratory Infection (ARI) hub in supporting BHRUT. Together First CIC is a GP federation owned by local GP practices, operating on a not-for-profit basis.

Nikolic explained that the GP hubs provide out-of-hours appointments, operating evenings, weekends, and bank holidays, with 25,000 commissioned appointments per year. He highlighted that 98% of residents in Barking and Dagenham are within one mile of a hub. The service has a low Did Not Attend (DNA) rate of 2.9%, significantly lower than the national average for GP appointments. Patient-reported experience measures indicated that 22% of patients would have gone to A&E if they had not accessed the GP hub service.

The ARI hub, commissioned for 12 weeks during peak respiratory illness season, saw 5,535 patients in winter 2025/26, exceeding its commissioned volume by 168%. Nikolic presented data suggesting that the ARI hub had contributed to a one-third lower attendance rate for respiratory conditions at A&E in Barking and Dagenham compared to Newham, which did not have a similar service. He also noted that the cost of appointments at the GP hubs was significantly lower than at Urgent Treatment Centres or A&E.

Concerns were raised about the capacity of the GP hubs, with Nikolic stating that they could easily double their appointments and still meet demand. He also discussed the challenges of equitable access for all population groups, particularly those who are digitally excluded or new to the borough. Safeguards for elderly and digitally excluded residents include phone calls and the availability of face-to-face appointments.

Regarding the long-term funding model, Nikolic stated that the GP hub had been consistently funded since 2014, although it had experienced a 20% cut in the rate per appointment in 2022. He expressed hope that the ICB would continue to commission the service. The ARI hub funding was confirmed for the current year, but Nikolic indicated that he had to fight for this funding each year.

The committee also discussed the use of Artificial Intelligence (AI) in healthcare. Nikolic explained that Together First CIC was implementing AI for tasks such as creating transcripts of consultations and acting as a search engine for clinicians. He assured the committee that these AI systems were designed to support, not replace, human clinicians and would not provide clinical advice. Concerns were raised about the potential for AI to misdiagnose, particularly with patients who underplay their symptoms, but Nikolic emphasised that the chosen AI systems were not diagnostic and would refer to human clinicians when necessary.

Councillor Kim Barti raised a question about facilities for young people with alcohol and drug abuse issues. Nikolic stated that while Together First CIC did not directly provide these services due to capacity limitations, they worked closely with Voluntary, Community, Faith and Social Enterprise (VCFSE) colleagues and the new neighbourhoods model to ensure residents could access appropriate support. Councillor Ajanta Deb Roy confirmed that the council had commissioned alcohol and drug services through St Luke's, separate from GP services.

The committee noted both reports and thanked the presenters for their contributions. The work programme for 2026-2027 was also noted, with amendments including the addition of the LGA public health progress review and updates on NHS health checks, the public health grant, and Healthwatch.