The Health Scrutiny Sub-Committee of Bromley Council met on Tuesday 08 April 2025 to receive updates on King's College Hospital NHS Foundation Trust, dental services, the South East London Integrated Care System (ICS)/Integrated Care Board (ICB), and the Healthwatch Bromley Patient Experience Report. Key discussions included elective recovery, emergency care performance, cancer services, workforce, estates, digital patient records, and the financial position of King's College Hospital. Updates on dental services covered primary care, urgent care, and secondary care provision, alongside challenges in contract delivery and financial landscapes. The committee also reviewed patient feedback on GP and hospital services, noting areas of success and ongoing concerns.

Update from King's College Hospital NHS Foundation Trust

Angela Helleur, Site Chief Executive for the Princess Royal University Hospital (PRUH) and South Sites, provided an update on King's College Hospital NHS Foundation Trust's performance. Key points included:

• Elective Recovery: Efforts are ongoing to reduce long waiting lists, with a national focus on ensuring all waits are under 52 weeks from referral to treatment.
• Emergency Care: The PRUH is currently achieving around 70% performance against the 4-hour emergency care standard, despite challenging winter periods and the adaptation of same-day emergency care services. Efforts are being made to reduce corridor care.
• Cancer Performance: The Trust has maintained the 28-day faster diagnostic standard and shown consistent performance against the 31-day standard for cancer treatment.
• Workforce: The Trust has limited vacancies. The PRUH and South Sites have successfully integrated three Care Groups (Dental, Radiology, and Women's Health) from Denmark Hill. The National Staff Survey indicated a response rate of 52.59% for the PRUH and South Sites, with results suggesting further work is needed on staff morale, engagement, and wellbeing.
• Estates: Construction of the Endoscopy Unit is progressing and is anticipated to be completed by September 2025, which will support new cancer standards. The ward refresh programme is also continuing.
• EPIC and MyChart: The digitisation of hospital processes through EPIC has improved patient safety. Over 230,000 King's patients have signed up for MyChart, which provides direct access to patient records and has significantly reduced the 'did not attend' (DNA) rate. MyChart users have a DNA rate of 5%, compared to 11% for those not using the system. The system also provides immediate access to blood test results, though interpretation may lead to increased calls to GP practices. The committee requested a breakdown of MyChart user ages in future reports.
• Finance: The Trust achieved its control total for the financial year and has a financial strategy in place to reach a breakeven position within five years.

Regarding specific questions, it was noted that initial issues with outsourced pathology systems to Synnovis have been resolved. Work is ongoing to integrate MyChart and the NHS App. The 28-day cancer standard refers to referral to diagnosis, and the 31-day standard refers to diagnosis to the start of treatment. The potential for increased demand on primary care due to patients accessing results via MyChart is being addressed by the Primary and Secondary Care Interface Group.

Update on Dental Services

Kelly Nizzer, Regional Lead for Primary Care Commissioning: Dentistry & Optometry Services, provided an update on dental services in Bromley. Key points included:

• Access and Targets: Dental practices have targets to meet by the end of March, with new targets commencing from April, which is expected to increase availability. Bromley has 39 General Dental Services (GDS) providers with a contract value of approximately £12.8m, delivering 397,000 Units of Dental Activity (UDAs). Practices are required to meet a minimum of 96% UDA delivery, with potential financial clawbacks for unmet activity and additional payments for exceeding targets. Bromley is expected to deliver around 77% of UDAs for 2024-25.
• Urgent Dental Care: Urgent dental care hubs and services have been procured until 2029. Bromley's urgent care hub is located at Beckenham Beacon, offering 24-hour telephone triage and face-to-face emergency dental services from 8:00 am to 10:00 pm.
• Secondary Care Dentistry: This is delivered in hospitals and is consultant-led, with patients able to access services across boroughs based on provision.
• Community Dental Services (CDS): Bromley Healthcare manages the CDS contract, providing services for paediatrics, special care patients, older people, and homeless individuals. Oral Health Promotion, including supervised tooth brushing and fluoride varnish, is also delivered. Paediatric referrals to CDS have increased by 40% since pre-pandemic levels.
• Current Position: Urgent Dental Care Hubs and Triage are procured until 2029, with 24/7 triage and extended hours for face-to-face services. General dental activity has returned to pre-pandemic levels. A 3-5 year roadmap for dental services is in place. Dental, Optometry, and Pharmacy commissioning were delegated to ICBs in April 2023, and the National Dental Recovery Plan was implemented in March 2024, though a challenging financial landscape exists post-delegation.
• Additional Capacity: £2.5m has been commissioned to increase provision within dental practices, and further funding has been approved. Information on Bromley dental practices' uptake for additional capacity will be provided.

In response to questions, it was noted that discussions are ongoing regarding long-term oral health initiatives for older people in care homes. Further information on contract values and a needs assessment for London's dental access issues will be shared. The committee requested an annual update on dental services.

SEL ICS/ICB Update

Dr Angela Bhan, Place Executive Lead for South East London (SEL) ICB, provided an overview of the One Bromley collaborative's work. Key points included:

• Integrated Care Networks (ICNs): Health and care teams are working together within defined geographical areas. Bromley is divided into four neighbourhood teams to facilitate integrated working.
• Long-Term Conditions and Frailty: The ICB is focusing on managing residents with multiple long-term conditions and addressing the needs of frail individuals. This involves identifying vulnerable patients, assessing their needs through multidisciplinary teams, and providing tailored care packages. This approach has shown improvements in wellbeing and reduced GP visits and hospital admissions.
• Diabetes: Bromley has nearly 19,000 residents living with diabetes, with a significant number at risk of developing Type 2 diabetes. The Diabetes Partnership Group is developing initiatives to address prevention, weight management, and education.
• Blood Pressure@Home Service: This service has been successful in improving blood pressure control through remote monitoring and patient self-management.
• Medicines Optimisation: The team is reviewing guidelines for weight loss drugs, with a focus on tiered weight management and exercise programmes. An overview of weight loss drug prescriptions across SEL will be requested.
• Digital Inclusion: Efforts are underway to improve digital literacy among older people, those with disabilities, and those in deprived areas, with a focus on increasing NHS App uptake.

The committee noted the success of the Blood Pressure@Home service and the ongoing work on digital inclusion. The possibility of providing a breakdown of NHS App user ages will be investigated.

Healthwatch Bromley - Patient Experience Report

Charlotte Bradford, representing Healthwatch Bromley, presented the Quarter 3 Patient Experience Report (October-December 2024). Key findings included:

• Data Collection: 598 reviews of health and care services were collected, with 58 visits conducted across various locations.
• Service Feedback: The top service types reviewed were GPs (59% positive reviews), hospitals (79% positive), dentists (77% positive), pharmacies (69% positive), and opticians (85% positive).
• Trends: Positive feedback for GP practices and hospital services has increased since Quarter 1. However, positive experiences for dental services have decreased from 90% to 77%, and pharmacy services have seen a significant decrease of 20% in positive feedback. Opticians' services also showed a decrease.
• Challenges: Healthwatch Bromley faces challenges in engaging with pharmacy services due to low footfall. They are working to gather feedback on multiple services during engagements and are considering a deep dive into pharmacy services.
• Data Limitations: The report provides a snapshot, and the small numbers of responses can lead to fluctuations. The data highlights trends but is not always specific enough to disentangle all influencing factors.
• GP Appointment Booking: 61% of patients reported problems booking appointments, with a focus on improving the use of online systems and addressing potential bias in feedback from those unhappy with the system.

The committee noted the importance of both quantitative and qualitative data and the challenges of capacity for Healthwatch Bromley. The report was seen as a valuable indicator for further research.

South East London Joint Health Overview & Scrutiny Committee (Verbal Update)

Councillor Mark Brock, Chairman of the Health Scrutiny Sub-Committee, provided a verbal update on the South East London Joint Health Overview and Scrutiny Committee meeting held on 25 March 2025. Presentations included updates on Sickle Cell Services in SEL ICB, the reconfiguration of cancer treatment services for children in south London, and oral health across South East London. A Sickle Cell clinic is held weekly at the One Bromley Wellbeing Hub. The papers for this meeting are available on the Bromley Council website.

The committee resolved to note the update.

Future Meeting Dates

The next meeting dates were confirmed as:

• Thursday 3 July 2025 at 5.00 pm
• Tuesday 16 September 2025 (Briefing) at 5.00 pm
• Tuesday 20 January 2026 at 5.00 pm
• Thursday 5 March 2026 (Briefing) at 5.00 pm