The Scrutiny Health & Social Care Sub-Committee met on Tuesday 12 March 2024 to discuss the readiness of local pharmacies for the Pharmacy First scheme and the management of elective care waiting lists at Croydon University Hospital. The committee also received an update from Healthwatch Croydon and reviewed its work programme.

Update on Pharmacy First Scheme

The Sub-Committee received an update on the Pharmacy First scheme, a national initiative launched on 1 February 2024, which allows community pharmacists to supply prescription-only medicines for seven common conditions without a GP visit. Croydon has a high uptake of the scheme, with 66 pharmacies signed up, representing 96% of those in the South West London region. Councillors were assured that the scheme had not yet shown any unintended consequences and that pharmacists are trained professionals capable of providing the necessary advice and treatment. While confirmation could not be given on whether every participating pharmacy has a designated private space for consultations, it was stated that this would be expected. The Council and Croydon Health Service NHS Trust (CHS) are working to publicise the scheme, with further promotional activity planned. Early estimates suggest around 1500 visits to pharmacies under the scheme in the first six to eight weeks, with no current capacity issues. The Sub-Committee requested further information regarding the suitability checks of participating pharmacies' facilities, concluding that the cleanliness and tidiness of examination spaces would be key to building patient trust.

Croydon University Hospital - Elective Care Waiting Lists

An update was provided on the management of elective care waiting lists at Croydon University Hospital. Between July 2023 and January 2024, 18,780 patients received elective care, an increase of 5.2% on the previous year and 10.8% on pre-pandemic levels. While patients waiting over 52 weeks has increased, those waiting over 65 and 78 weeks have seen significant reductions. The hospital aims to have no patients waiting over 65 or 78 weeks by 31 March 2024. The Croydon Elective Centre, a dedicated hub for planned care, received national accreditation from NHS England's 'Get it right first time' (GIRFT) programme in December 2023. The Trust has also met or exceeded the Faster Diagnostic Standard (FDS) target since October 2023, meaning three out of four patients referred for suspected cancer receive a diagnosis or have cancer ruled out within 28 days.

Challenges remain in specialties such as gynaecology, ENT, dermatology, pain management, maxillo-facial surgery, and trauma and orthopaedics. The hospital is working with partners and increasing staffing to run extra clinics and has halved the waiting times for gynaecology services. The opening of a new 'Head and Neck' hub and a state-of-the-art Intensive Care Unit have also improved capacity. Industrial action has impacted elective activity, leading to the rescheduling of approximately 1,400 operations and appointments between December 2023 and January 2024. The Trust has made progress in reducing theatre staff vacancies from 30% in April 2020 to 7.2% currently.

The Sub-Committee also discussed sexual health provision, with the Director of Public Health highlighting the Council's focus on preventative work and destigmatising sexual health. The Chief Executive of Croydon Health Service noted the changing population demographics and the increased life expectancy for HIV patients, with all blood samples in Croydon being tested for HIV unless a patient opts out. The Sub-Committee noted that the Council's website was signposting to the incorrect website for sexual health services and requested this be rectified.

The Sub-Committee recognised and commended the work of the Croydon Elective Centre for its accreditation and acknowledged the progress made in reducing elective care waiting times.

Update from Healthwatch Croydon

Gordon Kay, representing Healthwatch Croydon, provided a presentation on two key areas: Preventable Mental Health and Wellbeing Support Services within Black African and Caribbean Communities, and Virtual Wards. The Sub-Committee recognised and commended the work of Healthwatch Croydon.

Scrutiny Work Programme 2023-24

The Sub-Committee reviewed its work programme for the remainder of the year and agreed to hold a separate meeting to discuss the programme for the upcoming municipal year. Members stressed the importance of including mental health topics, such as the work of SLAM (South London and Maudsley NHS Foundation Trust) and Croydon Health Services Quality Accounts. The Sub-Committee resolved to note its work programme.