Agenda item

The presentation from the NHS representatives provides an update on the North Central London Integrated Care Systems and Borough Partnership Programme and impact on the London Borough of Enfield.

Deborah McBeal, Director of Integration, Enfield Borough Directorate, NHS North Central London Integrated Care Board and Stephen Wells, Head of Enfield Borough Partnership Programme spoke to the presentation which provided an update on the North Central London Integrated Care Systems and Borough Partnership Programme and impact on the London Borough of Enfield.

During the discussion which ensued and, in response to questions from the Members of the Panel, the following points were made and addressed.

The Chair expressed the view that, as he was not aware that this was part of the current governance structure, he would like to see greater involvement of elected representatives on the Integrated Care Board (ICB).

An active partnership working group were working to create a detailed plan to increase the take up of immunisations. This follows the reduction in the take up of all immunisations, but particularly polio and tuberculosis (TB).  The polio virus had been recently found in a sewage works plant and was an area of concern.  The plan would include an approach to work with various community groups, including schools and voluntary sector organisations, and to deliver a positive message about the benefits of immunisations.

There had been an increase in the number of reported cases of Strep A, a seasonal occurrence, which were higher this season and there were no vaccines available.  The focus of the proactive work had been to inform and advise schools and partnership organisations of the preventative measures to take.  Individuals with symptoms were excluded from school for 24 hours.  The good relationships built up with all schools across the Borough throughout the Covid pandemic had been maintained, this had resulted in a good response from schools to the advice issued.

It was essential that work continued on smoking cessation programmes, as smoking, together with obesity, had a significant impact on health.  New ways of reaching out and encouraging individuals to join the cessation programme had been found, for example there was online support through the telephone portal.  Residents were made aware of the schemes available to help them to stop smoking.  The partnership was working with the Council to bring together the offer in a coordinated manner.

Members acknowledged there was a huge need and work to be done across the Borough, principally around smoking (including vaping) but also adult social care and care homes.  With regards to vaping the Council was responsible for the licensing of premises and the prevalence of fast-food restaurants which were contributary factors to smoking and obesity. 

Work was currently underway to identify options and alternative ways of integrated working to reduce pressure on the stretched health services and to provide better outcomes for residents now and in the future. 

Members welcomed the information that a further report would be brought to the Panel on the future development of Integrated Teams and the service offer available to residents across the Borough.  The NCL was working to improve the long-term conditions with GPs, who were working over and above their contractual arrangements.                                                        ACTION

At the invitation of the Chair, Nusrath Jaku, Programme Manager, One-to-One (Enfield) raised concerns regarding patients being able to access GP services, when necessary, in a timely manner.  Many patients felt frustration when trying to telephone the surgery at 8.30am to make an appointment for that day in the prescribed manner only to be told when eventually getting through to the receptionist at 9am that there were no appointments left for that day as the doctors were fully booked.  On occasion the telephone had not been answered.

The Panel asked that GP representation be invited to attend the meeting when it considered access to primary care.                                        ACTION

The Director of Integration, Enfield Borough Directorate, NHS North Central London Integrated Care Board recognised the difficulties experienced by patients in securing an appointment with a GP and assured the Panel that GPs were working harder than ever and that patients had alternative routes to access health care, such as urgent care centres, dialling 111.  Vaccine nurses were now located within GP surgeries.  The NHS were working hard with GPs and Primary Care to address the pressure faced by the NHS at this current time, where demand was greater than capacity.

A core aim of the partnership was to address health inequalities. The Public Health Director chaired the sub-group of the Inequalities Development Group, which had a wider membership, including the voluntary sector stakeholders. There were a number of factors which affected the delivery of services to residents.  The recruitment and retention of staff and staff shortages had been a catalyst of the identification of new ways of working and expansion of job roles, such as pharmacists, who could now administer injections and prescribe some types of medication in order to take the pressure off GPs.

Work continued regarding the hard-to-reach communities.  There was an active programme in Enfield to address food insecurities. The Council was working with the Enfield Food Alliance, a collaborative forum which involved 40 organisations.  A further report for consultation would be presented to the Panel for approval, which would detail the strategic approach for the draft delivery food action plan involving the strategic groups.                    ACTION

Officers were working with the voluntary sector organisations to ensure that information was disseminated in an appropriate way to the communities in Enfield.  Communication Champions were also working with Enfield Voluntary Action Faith Forum to ensure information was available and accessible by residents with English as a second language.                           ACTION

AGREED that:

1. The update on the North Central London Integrated Care Systems and Borough Partnership Programme and impact on the London Borough of Enfield be noted;

2. There should be greater involvement of elected representatives from the participant Local Authorities on the Integrated Care Board (ICB); and

3.    GP representation be invited to attend the meeting when it considered access to primary care.                                                        ACTION