The Health and Adult Social Care Scrutiny Panel were scheduled to meet on 23 April 2025 to discuss workforce strategies, the quality of services at Lewisham & Greenwich NHS Trust, and to receive an update from Healthwatch Greenwich. The meeting was also scheduled to include a period for public questions related to the agenda items.

Here's a breakdown of the topics that were scheduled to be discussed:

Lewisham & Greenwich NHS Trust (LGT) - Improving Patient Experience and Service Quality

The panel was scheduled to review a report on how the Lewisham & Greenwich NHS Trust (LGT) is improving patient experience and service quality. This was commissioned in response to concerns raised following the 2021 NHS Adult Inpatient Survey and a Care Quality Commission (CQC) inspection that gave the trust an overall rating of 'requires improvement'.

The report included a summary of the strategies and actions in place to address concerns raised by both patients and the CQC, and to understand the mechanisms by which the Trust ensures improvements are made.

The areas that the report focused on were:

• Urgent and emergency care
• Services for children and young people
• End of life care

The panel was scheduled to note the progress and challenges that remain for the Trust in its improvement programme.

The report noted that since 2017, the Trust has shown progressive improvement in CQC domains, particularly in caring, effective, and well-led services. It also noted achievements recognised in unannounced inspections, including strong ward leadership, staff engagement, medicine management, patient safety, and the use of patient feedback in shaping services. The most recent 2023 inspection of maternity services at Queen Elizabeth Hospital (QEH) confirmed a “Good” rating in both the “well-led” and “safe” domains.

The Trust has reportedly implemented a range of completed improvement actions, including:

• The introduction of the Same Day Emergency Care (SDEC) Unit
• Deployment of Omnicell medicine cabinets[^1] [^1]: Automated dispensing system used in hospitals.
• A dedicated end-of-life care space
• Enhanced training in learning disability care
• The rollout of a new patient portal

It was noted that strategic development continues across the QEH site, with the expansion of diagnostic services and the planned opening of Ward 26 by May 2025 to support patient flow. Oversight of improvement actions is maintained through governance structures including QSIG, QSPEC, and QPC, and further reinforced through regular mock inspections involving senior leaders and patient representatives.

The Trust's approach is based on the Patient Experience Strategy 2022–2025, which aims to embed a culture of co-production and patient-centred care.

The 2023 NHS Adult Inpatient Survey reportedly shows measurable improvement in 23 out of 38 comparable areas, notably around nursing levels, post-discharge support, and nutritional care. However, areas such as communication, pain management, discharge arrangements, and food and hygiene continue to be priorities for improvement.

To further embed best practice, the Trust has launched the “Compassion in Care” programme, focused on key care fundamentals and staff accountability. A phased rollout is underway, with early evaluation results expected in May 2025.

The panel was scheduled to consider the following draft recommendations:

• Repair or replace malfunctioning security equipment as a matter of urgency and develop a protocol for contingency measures when safety equipment is non-operational.
• Explore opportunities to expand hours of volunteer support in the Emergency Department.
• Explore clearer signage or prompts to encourage check-in compliance.

Long and Medium Term Workforce Strategies Across Health and Care

The panel was scheduled to discuss a report providing an update on long and medium-term workforce strategies across health and care, including an update on the Health Ambassadors Programme.

The report noted that the Health and Social Care workforce is a valuable resource within the Royal Borough of Greenwich. It also noted that there are some national policy developments that will hopefully support ways to address some of the workforce challenges across the system, including the Casey review¹ and the NHS 10-year plan. The report also provided an overview of the national social care workforce context and priorities, noting that there is no single entity with all the levers for change in adult social care, and that it is a complex system with influence spread across several groups. It stated that social care is important for people, for communities and for the economy, and enables people to live well and contributes £60 billion to England’s economy each year.

The report stated that demographic changes mean that it is likely that the adult social care workforce will need to grow, and that we may need 540,000 new social care posts by 2040. It also noted that we are in a globally competitive labour market, and that we cannot currently attract or keep enough people.

The report provided the following recommendations:

• Government to lead joined up, consistent action on pay and terms and conditions over a number of years with local government, employers and unions.
• To keep investing, consistently, in training and clear career pathways to equip social care workers for exceptional care in a changing world.
• A legislative basis for a workforce strategy, similar to the Health and Care Act requirement on the Secretary of State to publish a report describing the system in place for assessing and meeting the workforce needs of the health service in England at least once every five years.

Skills for Care provided the following update on the Greenwich social care workforce:

• The total number of posts in Greenwich was around 7,300 in 2023/24.
• This was comprised of 6,900 filled posts and 475 vacant posts across all sectors.
• Since the previous year, the total number of posts has increased by 425 (6%), the number of filled posts has increased by 475 (7%) and the number of vacancies has decreased by 50 (10%).
• The estimated 6,900 filled posts were split between local authorities (7%), independent sector providers (74%), posts working for direct payment recipients (11%) and other sectors (7%).
• In 2023/24, the CQC register showed there were 144 regulated services in Greenwich; 43 were residential and 101 were non-residential services.
• If the workforce grows proportionally to the projected number of people aged 65 and over then the total number of adult social care posts in the London region will increase by 33% (from 255,000 to 340,000 posts) between 2023/24 and 2040.

The report also included information on Greenwich's social care commissioned workforce, including homecare, and the Cooperative Commission – Adult Social Care next steps.

The report stated that Greenwich Adult Social Care service has focused on addressing the challenge of recruiting and retaining Social Workers by providing some opportunities for existing Social Care Assessment staff to qualify as Social Workers, and that the AOPS continue to support the BA Social Work apprenticeship.

The report also included information on the Lewisham and Greenwich Trust - Workforce Update, and the Oxleas approach to workforce challenges.

Health Ambassadors Programme

The Health Ambassadors Programme is an initiative in Greenwich where primary care and community clinicians volunteer their time to offer health advice and inspire young people to consider careers in the NHS.

The report stated that dozens of primary care and community clinicians are stepping beyond their clinics and into Greenwich secondary schools, volunteering their time to offer health advice and inspire young people to consider careers in the NHS.

The programme was launched three years ago with junior doctors visiting seven local schools. Today, the programme has expanded, with trainee GPs and other healthcare professionals engaging students on essential health and wellbeing topics—ranging from how to access healthcare to understanding their own bodies.

Dr. Eugenia Lee, a GP at Gallions Reach Health Centre and lead for the programme, is quoted as saying:

“We focus on the issues young people want to learn about. By addressing real concerns and providing practical advice, we empower them to take charge of their own health.”

The report stated that inspired by their outreach work, many participating GPs and health professionals have also volunteered at food banks, children’s centres, and shelters for rough sleepers, bringing healthcare knowledge and support directly to those in need.

This year, the programme introduced interview coaching for Year 13 students applying to university, alongside career fairs that showcase the full spectrum of NHS roles.

Healthwatch Greenwich Update

The panel was scheduled to receive a verbal update from Healthwatch Greenwich. Healthwatch is the independent consumer champion for health and social care. It exists to gather the views of patients and the public about health and social care services, and to use these views to influence those who provide and commission services.

Declarations of Interest

The panel was scheduled to note the list of councillors’ memberships on outside bodies, joint committees and school governing bodies. They were also scheduled to declare any personal or financial interests in items on the agenda. Councillor Christine May is a member of Middle Park Community Centre and Deputy on the Overview and Scrutiny Joint Health Committee. Councillor Dr Dominic Mbang is a member of Edmund Godson Charity and the Overview and Scrutiny Joint Health Committee. Councillor Sarah-Jane Merrill is a member of the LGA General Assembly and Deputy on the Overview and Scrutiny Joint Health Committee. Councillor Matthew Morrow is Deputy at Greenwich Leisure Ltd and on the Overview and Scrutiny Joint Health Committee. Councillor Christine St. Matthew-Daniel is a member of Blackheath Joint Working Party, Greenwich Bluecoat Foundation, Greenwich Charities of William Hatcliffe and the MisthemberM, and Deputy on the Overview and Scrutiny Joint Health Committee. Councillor Nick Williams is a member of DG Cities Limited and Deputy on the London [Pensions] Collective Investment Vehicle, London Youth Games, and the Overview and Scrutiny Joint Health Committee. He is also a governor at Charlton Manor Primary. Councillor Roger Tester is also Deputy on the Overview and Scrutiny Joint Health Committee.