The Health and Adult Social Care Scrutiny Panel met on Thursday 5 March 2026 to discuss the draft Addiction Strategic Plan and receive an update on primary care services in Greenwich. The panel considered the comprehensive Addiction Strategic Plan, which aims to address harms from drugs, alcohol, tobacco, and gambling across the borough, and noted an update on improvements and access to primary care services.

Addiction Strategic Plan

The panel considered the draft Addiction Strategic Plan, which consolidates strategies for tobacco, alcohol, drugs, and gambling into a single, comprehensive plan. The plan is supported by an addictions profile that details the harms and impacts of these issues across Greenwich, highlighting a significant financial cost of £394 million per annum to the borough. The strategy aligns with national initiatives such as the Government's From Harm to Hope drug strategy and the Smoke Free Generation strategy.

The plan has been developed through extensive consultation with system partners, service users, and residents with lived experience. It addresses the intersectionality of addictions, particularly in areas of deprivation, and aims to improve access to support, reduce health inequities, and build a borough where residents can live safer, healthier lives. Key areas of concern identified in the addictions profile include rising drug and alcohol mortality, the surge in synthetic drug use, increased alcohol-related violence, high smoking prevalence among specific groups, and the emerging challenges of gambling harms.

The panel was asked to consider the draft plan and make recommendations to the Executive if necessary. The report outlined the purpose of the plan, its links to the Council's missions, and the extensive consultation process undertaken. It also detailed the Cross-Cutting Issues and Implications, including legal, financial, equalities, community engagement, climate change, risk management, community safety, and health and wellbeing considerations. The panel was invited to review the information and provide feedback to strengthen the plan before its final adoption later in 2026.

Access and Improvement in Primary Care Services in Greenwich

The panel received an update on the ongoing efforts to improve access and services within primary care in Greenwich. This update focused on initiatives aligned with NHS England's Fit for the Future: 10-year health plan and the Delivery Plan for Recovering Access to Primary Care.

Key areas of progress and ongoing work included:

• NHS App Uptake: Registration for the NHS App in Greenwich had increased to 66.4% of the eligible population, exceeding South East London and London targets, though still below the national target of 72%. While app usage for booking appointments, requesting prescriptions, and reviewing medical records had seen a decline, efforts are underway to investigate these drops and promote app features. Partnerships with local organisations are also being developed to support digitally excluded residents.
• Self-Referrals: Practices are actively promoting self-referral options through their websites and during consultations, with patients being signposted to suitable services as part of the triage process.
• Pharmacy First: A significant majority of community pharmacies in Greenwich (53 out of 57) were delivering all three national NHS England services: Pharmacy First (clinical pathways, urgent repeat medicine supply, and minor illness referrals), the Hypertension Case-Finding Service, and the Pharmacy Contraception Service. The Pharmacy First Plus scheme has also been extended locally.
• Digital Telephony: All practices are utilising reporting functions within their digital telephony systems to improve call handling responsiveness. Data from November 2025 indicated that three-quarters of calls were answered within five minutes, with over 29,000 calls responded to in under a minute. Meetings with Primary Care Network (PCN) leaders are planned to review progress against Capacity and Access Improvement Plans (CAIP).
• Online Consultations: All 29 Greenwich practices are using digital consultation tools, with most utilising AccuRx. Patient feedback on the ease of use of these online consultations showed that 64.9% found them Easy or Very Easy to use.
• Appointment Data: Between January and November 2025, Greenwich practices provided approximately one million appointments, with over half being face-to-face and closely followed by telephone appointments. GPs provided over half of all appointments. Work is ongoing to ensure consistent care navigation across all contact methods.
• Risk Stratification: Practices are being supported to use digital tools like Ardens Manager to risk stratify patients, aiming to identify those who would benefit most from continuity of care and reduce unnecessary hospital admissions.
• Enhanced Access: All Greenwich PCNs have exceeded the required provision for Enhanced Access services, delivering approximately 9.8% more hours than mandated.
• National Practice Level Support Program: Four practices have participated in this program, focusing on Quality Improvement projects to enhance efficiency and standardise systems.
• Long Term Workforce Plan (LTWP): Refinement of the draft General Practice Workforce Plan is ongoing with support from NHS England's London Workforce Transformation team.
• Primary, Community, and Secondary Care Interfaces: Efforts are underway to improve connections between primary and secondary care clinicians, enhance the use of Advice and Guidance services, and streamline discharge processes. Initiatives include an Inappropriate Requests Letter and joint work to reduce delayed discharge summaries.
• Immunisations: Greenwich's vaccination uptake for COVID-19 and flu is performing moderately compared to other South East London boroughs. Campaigns are being reviewed, and targeted pop-up events are planned for areas with historically low uptake.
• Care Quality Commission (CQC) Update: The CQC is increasing the frequency of practice reviews. Seven practices in Greenwich have been reviewed in the last 12 months, with some rated as 'Good' and others 'Requires Improvement'. Support is being offered to address identified areas for development.
• Investment in Primary Care Estates: Local Improvement Grant (LIG) and Utilisation and Modernisation Funding (UMF) are being used to support premises development and repurpose existing space to increase clinical capacity. Section 106 funding is also contributing to healthcare infrastructure.
• Expansion of Phlebotomy Services: An increased number of practices are now offering in-house phlebotomy services, with remaining patients accessing services through Lewisham & Greenwich NHS Trust.
• Integrated Neighbourhood Development: Development of integrated neighbourhood working is progressing across four areas, focusing on proactive care for frailty, long-term conditions, children, and prevention. An 'Integrator' organisation, Oxleas, is coordinating efforts, and recruitment for Integrated Neighbourhood Teams is underway. A launch conference was held to discuss progress and priorities for each neighbourhood.

The panel noted the importance of addressing digital exclusion, engaging with the public at a grassroots level, and the need for robust data to monitor progress. They requested a future report to include detailed progress updates, performance data, evidence of resident outcomes, information on health inequalities, community engagement impact, social prescribing, digital inclusion support, and case studies of patient journeys.