The Hertfordshire Health Scrutiny Committee convened to discuss patient experiences across Hertfordshire, with a focus on GP practices. The committee heard evidence from the Hertfordshire and West Essex Integrated Care Board (HWE ICB) and agreed to a series of recommendations including improvements to digital inclusion, clarification of structural changes to the ICB, improvements to patient record interoperability, and improvements to the complaints process. The committee also requested an overview of NHS services in Hertfordshire and sought clarification on the role of carer champions.

Annual Patient Experience Scrutiny

The committee undertook its annual scrutiny of NHS organisations, responding to the Francis Inquiry¹ by focusing on the quality and experience of services delivered to patients. The committee gathered evidence from the HWE ICB on variations in GP practices across Hertfordshire, with a focus on access, quality and equality.

The committee noted several challenges:

1. Digital Access and Inclusion: There were concerns about ensuring that patients without digital access are not excluded, especially in accessing medical records, appointments, and communications with GPs. The ICB is to provide an update on how patients without digital access are being supported, particularly in accessing medical records, booking appointments, and receiving communications. A follow-up report should be scheduled in 6–12 months to assess progress in supporting non-digital patients across the GP practices. The committee recommended that digital exclusion be monitored as a standing issue, with clear metrics and updates.
2. NHS Reconfiguration and Resources: The committee acknowledged that ongoing NHS structural changes have implications for ICB operations, service delivery, and resourcing in Hertfordshire. The ICB is to submit a scoping paper outlining expected changes to its structure and footprint, anticipated timescales, impacts on services in Hertfordshire, and resourcing implications. The paper should also explore how the Health Scrutiny Committee can support the ICB's work, including national escalation where appropriate.
3. ICT Systems and AI: Issues around system interoperability and the emerging role of AI in healthcare were discussed, with a need to understand responsibilities across local and national bodies. The ICB Digital Strategy Team is to clarify the timeline for full end-to-end transfer of patient records between providers, especially in light of recent incidents involving missing records. A specific written response should include system interoperability status, anticipated resolution timeframe, and mitigations in place for patient safety.
4. Patient participation groups: Updates are expected post-September, and the committee expressed interest in receiving this update formally. The ICB is to clarify progress on patient participation groups, with an update expected post-September.
5. Complaints Process: A request was made for written information on contact details for submitting complaints and the complaints handling process. A written update is to be provided with contact details for submitting complaints and an overview of the complaints process and governance.
6. Carer Champions: There was interest in training, recruitment, and standards for Carer Champions, with a request for written clarification. A written response should be provided covering recruitment and training of Carer Champions and standards and expectations associated with the role.
7. Urgent Care Centres and NHS Service Overview: The committee requested a simple, clear summary of service roles and functions across NHS in Hertfordshire to support new members' understanding. The ICB and NHS partners are to produce an easy-to-understand overview of healthcare services in Hertfordshire, explaining who delivers what, where services are based, and contracting arrangements (e.g. GP practices). This overview should support new Health Scrutiny Committee members and aid future engagement.
8. Missing Patient Notes (Case Example): A real case involving missing notes for a baby patient highlighted system failure. A timeline for full integration and record return was requested.
9. Monitoring of Offline Patient Access: Emphasis was placed on the need to track and report progress for patients who cannot access services online due to age, health, or capability.

The responses will be circulated to Committee Members when received.