The Hertfordshire Health Scrutiny Committee met on Friday 13 June 2025, and agreed that Councillor Dee Hart would continue as chair of the Joint Health Overview and Scrutiny Committee (JHOSC). The committee also discussed a Local Maternity and Neonatal System (LMNS) update, and agreed the Scrutiny Work Programme for 2025-26.

Local Maternity and Neonatal System (LMNS) Update

The committee received an update on the Hertfordshire and West Essex Local Maternity and Neonatal System (LMNS). Natalie Hammond, Director of Nursing and Quality at Hertfordshire and West Essex Integrated Care Board, gave an overview of the LMNS's role in assuring the quality and safety of maternity and neonatal services.

The LMNS aims to improve outcomes for mothers and babies by:

• Overseeing quality and safety within trusts
• Working with trusts to support improvement
• Ensuring the patient voice is heard

Caroline Swishovska Dodd, the LMNS Programme Manager, shared information about changes being made to maternity and neonatal services. She noted that the Care Quality Commission (CQC) is due to visit the three hospital trusts¹ in the area. She said that the LMNS is hopeful that the system position will change in a positive manner after the visits.

Ms Swishovska Dodd highlighted the Saving Babies Lives Care Bundle, a national initiative with six elements designed to improve perinatal quality, safety and outcomes. She reported that all three providers have made significant progress with implementation, with rates rising from below 50% to over 70% in all three trusts.

She also discussed the rollout of pulse oximetry screening for hypoxia (low oxygen in the body) in newborn babies. She said that Hertfordshire and West Essex were early adopters of this screening programme, and that it has helped to identify babies with major congenital cardiac abnormalities and other health issues.

Leslie Overy, Head of Midwifery at Eastern North Hearts, reported on a recent visit from the regional chief midwife. The findings were positive, with improvements found in all areas of the staff survey and a no-blame culture observed within the unit. Areas for continued development included improving medical staffing within the neonatal unit and reducing the number of induction of labour delays.

Katie Kaye, deputy director of midwifery at Princess Alexandra Hospital in Harlow, reported that 30% of the women that choose to birth there are Hertfordshire residents. She noted that improvements have been made in the staff survey, and that the hospital has made great strides in embedding Maternity and Neonatal Voices partnership members within its governance processes. She also highlighted the hospital's gold accreditation for the Baby Friendly Initiative².

Ms Kaye noted that the hospital is facing challenges due to delays to the new hospital build programme. She said that the existing estate is not ideal, particularly the antenatal ward and midwifery-led unit.

Unfortunately, senior colleagues from West Hertfordshire Teaching Hospitals could not be at the meeting, but Ms Swishovska Dodd reported that they had received an enhanced visit report which highlighted how they have enhanced their governance processes.

Ms Swishovska Dodd also noted some systemwide areas for development, including cross-border working, development of personal care and support plans for women, implementation of maternity and neonatal early warning systems, and improved access to interpreting services.

She also highlighted three system risks:

• Cross-border care: When service users access care at a hospital different from their community care hospital, there can be a lack of available service user information across different trusts.
• Electronic Patient Records: Each trust uses a different Electronic Patient Record (EPR) system, which can lead to issues with interoperability.
• Community venues for midwifery care: GP surgeries are becoming unavailable for community midwifery appointments and clinics, or are charging for the space.

Bex, the development commissioning officer for the LMNS, provided an update on the Maternity and Neonatal Voices Partnership (MMVP). She said that the MMVP focuses on putting the service user voice at the heart of all service user improvement.

Ms Kaye then provided an update on pregnancy and parenting circles, which are group-based support systems designed to provide information, social support, and a shared experience for pregnant women and new parents.

Following the presentation, councillors asked questions and made comments.

Councillor Nigel Bell, Leader, Labour Group, raised concerns about the different electronic patient record systems being used by the three trusts. He asked how much work is being done to address this issue and reassure residents that their information will be shared safely.

Councillor Chris Lloyd, Vice-Chairman of the Health Scrutiny Committee, asked about staff turnover and wellbeing.

Councillor Peter Taylor asked about patient voice, feeding choices, estates, and the pandemic.

Councillor Seamus Quilty said that scrutiny should request outcomes with time scales attached.

Councillor Miriam Swainston asked if anything could be done about the GP access issue.

Councillor Wendy Rouse said that she felt that health services were coming home with the focus on continuity of care and integrated care.

Councillor Dee Hart asked about GP surgeries becoming unable to accommodate midwifery clinics.

Councillor Jon Claydon asked how representative the patient voice groups are of the population more broadly.

Councillor Colette Wyatt-Lowe asked about home births.

Following the discussion, the committee agreed to note the update.

Scrutiny Work Programme 2025-26

Tim Parlow, Head of Scrutiny, presented the Scrutiny Work Programme for 2025-26. He noted that the Overview and Scrutiny Committee (OSC) and Health Scrutiny Committee (HSC) have a combined work programme.

He reminded the committee that the annual patient experience scrutiny, which was originally due in December 2024, has been rescheduled to 1 July 2025. He also noted that the committee had previously requested an update on mental health services and gambling harms, which are both due to come back in September.

Mr Parlow invited members to suggest additional items for the work programme.

Councillor Nigel Bell asked if the annual patient experience scrutiny was still taking place on 1 July.

Councillor Seamus Quilty said that the committee should prioritise the estates and hospital sites issue.

Neil Tester asked about planning for health infrastructure in light of the extra 100,000 homes being built in Hertfordshire.

Councillor Chris Lloyd suggested that two items might be sufficient for each meeting.

Councillor Lucy Musk asked about scrutiny of pharmacies.

Councillor Nigel Bell asked how the abolition of NHS England will affect the committee's work.

Councillor Dee Hart raised concerns about phlebotomy services.

Councillor Miriam Swainston asked about scrutiny of the digital patient records issue.

Councillor Aaditya Kaza asked about scrutiny of dental surgeries and dental practices.

Councillor Peter Taylor agreed with Councillor Quilty on the estates issue and Councillor Musk on the pharmacy point.

Following the discussion, the committee approved the Scrutiny Work Programme 2025-26 with the agreed amendments and additions.

Other Part 1 Business

The committee agreed that Councillor Dee Hart would continue as chair of the Joint Health Overview and Scrutiny Committee (JHOSC). The committee also agreed that Councillor Rachel Carter, Councillor Chris Lloyd, and Councillor Wendy Rouse would be appointed as new members of the JHOSC, and that Councillor Nigel Bell would be the named sub-member. The JHOSC is responsible for scrutinising the consultation process on the future of Mount Vernon Cancer Centre³.