The Bromley Council Health Scrutiny Sub-Committee met to discuss updates from King's College Hospital NHS Foundation Trust, Bromley Healthcare, and the South East London Integrated Care Board (SEL ICB). Members also reviewed Healthwatch Bromley's patient experience report and the committee's work programme.

King's College Hospital NHS Foundation Trust Update

Angela Helleur, Site Chief Executive of the Princess Royal University Hospital (PRUH), provided an update on the King's College Hospital NHS Foundation Trust, including information on postpartum haemorrhage and stillbirth rates.

Elective Recovery and Waiting Times

The Trust is working to reduce waiting times, aiming to have all waits under 52 weeks from referral to treatment. While the EPIC system launch presented challenges, efforts are ongoing to improve performance in specific specialities. The Trust aims to have zero patients waiting more than 65 weeks by March 2026.

Diagnostic waiting times have also been a challenge, but improvements have been seen in some areas.

Cancer Performance

The Trust has exited the cancer tiered system due to consistently meeting standards.

Workforce and EDI

The Trust is moving to a new divisional structure between July and August 2025. They are also focusing on staff wellbeing and Equality, Diversity, and Inclusion (EDI).

Estates and Capital Updates

The Endoscopy Unit construction is on track for completion by the end of September 2025. Ward refurbishment programmes are ongoing, with plans to refurbish maternity and paediatric wards in the coming years.

EPIC and MyChart

248,159 King's patients have signed up to MyChart, providing access to patient records. Integration with the NHS app is planned between October 2025 and March 2026.

Financial Position

The Trust recorded a deficit of £33.7 million for the 2024/25 financial year, which is better than the planned deficit. Cost-saving initiatives are in place to achieve a deficit of no more than £120 million by March 2026, with the aim of receiving £120 million in one-off funding.

Postpartum Haemorrhage (PPH) and Stillbirth Rates

Dr A. Hameed and Dr A. Appiah presented data on postpartum haemorrhage (PPH) and stillbirth rates at the Princess Royal University Hospital (PRUH).

Postpartum Haemorrhage (PPH)

PPH is a leading cause of maternal morbidity and mortality worldwide¹. King's College Hospital shows a significantly lower PPH rate per 1,000 deliveries compared to its peers.

An audit of PPH cases showed:

• 85% adherence to protocol
• 90% recognised within 15 minutes of delivery
• 47% of patients received blood transfusions
• 24% returned to theatre

The audit identified issues such as recognition delays, communication, and documentation. Recommendations include introducing a standardised PPH chart and improving documentation.

Stillbirth Data

The report also included stillbirth data at King's College Hospital. MBRRACE-UK² data indicates that the trust's stillbirth and neonatal mortality rates are around the average for similar trusts.

A thematic analysis of stillbirths since January 2024 led to several safety recommendations, including:

• Implementing growth charts for symphysis fundal height (SFH) measurements³
• Considering additional ultrasounds for women with a BMI over 35
• Improving documentation on scan reports
• Updating guidelines for obstetric care of women aged 40 and over
• Improving compliance with carbon monoxide (CO) testing

The data showed that stillbirth rates are disproportionately high in Black, Asian and Minority Ethnic (BAME) populations at the PRUH site compared to King's College Hospital.

Initiatives to tackle health inequalities include visits to local mosques, personalised care plans, and the use of interpreting services and the MyChart app.

Bromley Healthcare Update

Bromley Healthcare presented an update on their services and strategic goals. Their strategy, Community First, focuses on building a culture of growth for their people, expanding integrated neighbourhood teams, and investing in digital transformation.

Key Metrics and Strategy

Bromley Healthcare highlighted key metrics for 2024/25 and outlined their Community First strategy, which focuses on:

• Building a culture of growth and opportunity for staff
• Expanding integrated neighbourhood teams
• Investing in digital transformation

Digitising Wound Care

Bromley Healthcare introduced Minuteful for Wound (MfW), an AI-powered wound management app, with the aim to reduce variation, improve patient outcomes, and enhance resource utilisation. Outcomes include:

• 85% of wounds healed within 12 weeks, up from 71% in November
• Time to assessment reduced from 78 days to 26 days
• 9% reduction in the use of antimicrobial dressings
• £91,965 in non-cash releasing benefits and £46,012 cash releasing gains per annum

Neighbourhood Working

A case management pilot is underway, providing care for proactively identified patients with complex needs. Initial feedback has been positive, with patients appreciating the continuity of care.

National Benchmarking - Urgent Community Response

Bromley Healthcare's Urgent Community Response (UCR) service is performing well compared to national benchmarks.

Integrated Therapies

A virtual model has been launched for integrated therapies, providing flexibility for patients and staff. Adult Speech and Language Therapy is offering a new treatment programme for people with Parkinson's disease, supported by a grant from Parkinson's UK.

Children's Services

The Bromley Child Health Integrated Partnership (BCHIP) is a collaboration between the PRUH, primary care GPs, and community children's nurses. The service saved 582 bed days for IV-only patients in 2024/25, with a cost saving of £267,720.

Adult Services

The Adult Hospital at Home (H@H) service provides hospital-level care in patients' homes. In 2024/25, the service saved 10,984 acute bed days, with an approximate £2 million cost saving.

Digital Transformation in the Care Coordination Centre

SMS appointment reminders and online appointment booking have been implemented, contributing to a reduction in the DNA (Did Not Attend) rate.

Clinical and Quality Strategy

Bromley Healthcare is developing a Clinical and Quality Strategy with priorities including:

• Delivery of high-quality and safe clinical care
• Reducing health inequalities
• Integrated working to improve health outcomes
• Improving access to care

External Awards

Bromley Healthcare has received several external awards in 2024/25, recognising their innovation, impact, and collaboration.

SEL ICS/ICB Update

Dr Angela Bhan, Bromley Place Executive Lead, provided an overview of key work, improvements, and developments undertaken by the SEL ICB and partners within the One Bromley collaborative.

Learning Disabilities Health Checks

Bromley achieved 87% uptake of annual health checks by patients on the Learning Disabilities register in 2024/25, exceeding last year's highest uptake and reflecting Bromley as the highest-achieving borough in SEL.

Integrated Neighbourhood Teams (INTs)

The vision for INTs is to create better connections between services and work closely with communities, integrating health, social, voluntary, and community organisations to improve health and wellbeing. A phased rollout is planned across Bromley, starting in South West Bromley.

Bromley Digital Workshop

The First One Bromley Digital Workshop was held on 1 May 2025, bringing together colleagues to explore opportunities for enhanced collaboration and joint working, with a particular focus on patient remote monitoring and self-management.

Bromley Covid Spring Booster

The national Covid Spring Booster campaign commenced on 1 April 2025 and concluded on 17 June. Bromley continues to have good uptake, at the highest level across south east London.

Healthwatch Bromley - Patient Experience Report

The Sub-Committee received the Quarter 4 Patient Experience Report for Healthwatch Bromley, covering January to March 2025.

Key Findings

• 610 reviews of health and care services were shared with Healthwatch Bromley.
• 75 visits were carried out at various locations, including hospitals, GP practices, and community events.
• The top five service types listed in the report were GPs, hospitals, dentists, pharmacies, and community health.

GP Services

• 52% of reviews were positive.
• Key positive aspects included staff attitudes, telephone appointments, and quality of treatment.
• Areas for improvement included getting through on the telephone and appointment availability.

Hospital Services

• 80% of reviews were positive.
• Key positive aspects included appointment availability, staff attitudes, and quality of treatment.
• Areas for improvement included waiting times and getting through on the telephone.

Work Programme and Matters Outstanding

The Sub-Committee considered progress on matters outstanding from previous meetings and reviewed its work programme for 2025/26.