The Healthier Communities and Older People Overview and Scrutiny Panel met to discuss the performance and estate of Epsom and St Helier hospitals, and to review the work of the Health and Wellbeing Board. The panel noted the ongoing challenges and planned improvements at Epsom and St Helier hospitals, and reviewed the Health and Wellbeing Board's activities and future strategy.

Epsom & St Helier Planned Cuts + Update on Disrepair

The panel received an update on the performance and financial situation at Epsom and St Helier hospitals. James Blythe, Managing Director for Epsom and St Helier, reported improvements in the emergency department's performance, with patients being seen or admitted within four hours. However, challenges remain, particularly with patient discharge, which is being addressed through collaboration with housing agencies and families. The hospital is also working with Surrey health providers to manage patients presenting with mental health conditions.

Significant progress is being made in reducing long waiting times for elective care, with a target to eliminate waits of over 65 weeks by the end of September 2024. Gynaecology services have seen a 30% increase in referrals post-Covid, contributing to some of the remaining long waits. Positively, all cancer performance standards were met in May 2024, with 86.4% of patients receiving a diagnosis within 28 days.

Financially, the trust is facing challenges, with an expected year-end deficit of £51.7 million. These savings are being sought through efficiencies rather than service withdrawals, with improvements in recruitment and the use of internal bank staff instead of agency staff. The hospital is also exploring income generation through private patient sites.

Investment in the hospital estate is ongoing, with refurbishments to the intensive therapy unit, new ventilation systems, upgraded x-ray equipment, and lift repairs. The panel was informed that the government is reviewing the hospital building programme, and St Helier aims to retain 85% of its services even if a new hospital is built.

Regarding maternity services, Steph Sweeney reported on the Care Quality Commission's (CQC) inspection in August 2023, which resulted in St Helier's overall rating being downgraded from 'good' to 'requires improvement', and its safety rating for maternity services from 'good' to 'inadequate'. A robust action plan is in place, including a dedicated triage phone line and improved privacy measures. Despite these challenges, Epsom and St Helier maternity care was rated number one in London and in the top ten nationally in the CQC patient experience survey. The panel was assured that provisions are being updated to meet evolving CQC expectations.

Councillor Peter McCabe, Cabinet Member for Health and Social Care, stated that Merton Council opposes the removal of services from St Helier and commended the staff for their dedication.

Report of the Health and Wellbeing Board

Russell Styles, Interim Director of Public Health, presented the report on the Health and Wellbeing Board's (HWBB) activities in 2023-2024. The report highlighted the board's work on the annual public health review, integrated care partnerships, a young inspector review, and updates on smoking cessation and sexual health services. It also covered initiatives like Beat the Street, Right Care Right Person, the Borough of Sport campaign, Actively Merton, and substance misuse.

The report also outlined future plans, including the production of a new annual health report focused on tackling drugs and the development of the Health and Wellbeing Board strategy for 2025-2030. Mr. Styles emphasised the importance of tackling health inequalities, viewing it as a social good and a matter of social justice, noting that avoidable health inequalities incur significant economic costs.

The approach to the new strategy will be discussed at the October board meeting, with a consultation period involving wider partners running until March 2025. This process will incorporate new approaches for the Merton Together plan and engage with community and voluntary sector partners. The final strategy is scheduled to be presented to the Health and Wellbeing Board in March 2025.

In response to questions, it was confirmed that Merton has air quality initiatives, and diet and obesity remain a priority that can be added to future agendas.

Work Programme

The panel reviewed its work programme for the upcoming year. The next panel meeting is scheduled for 31 October 2024, though this date may be subject to change. An update on defibrillators in Merton is to be added to the work programme, and the London Ambulance Service will be invited to attend. Members also requested broader updates on cardiovascular and mental health, rather than focusing on specific sub-topics within these areas.