Agenda item

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 60.

The Board received an update on recent changes to the provision of health services from Chris Bown, Chief Executive of North West London Healthcare NHS Trust, Simon Crawford, Director of Strategy of North West London Healthcare and Dr MC Patel, Chair of Brent CCG.

The Board heard how the pandemic had disrupted the NHS and it was unlikely to return to normal. The elective care waiting list was the highest it had been in 30 years. Knowledge of how to handle the disease was increasing but there was still more to learn. Communication with the public needed to be improved; around 40% of patients were not presenting. Some services had become more efficient as a result and there were benefits to telephone or video conferences for outpatients.

The peak of the pandemic had come in mid-March to early-April. Critical care was expanded from 20 beds to 58 beds and the number of ventilated beds had increased. Around 1500 staff had been absent at the peak. A GOLD command structure had been set up to coordinate access to PPE, drugs and equipment and had worked well.

95% of patients had begun their care in Northwick Park Hospital before being transferred to Central Middlesex hospital for rehabilitation. Due to a reduction in attendance and the cancellation of elective surgeries, a decision was made to close all beds at Central Middlesex and move all staff to Northwick Park Hospital. The move was temporary and would be re-evaluated. As there was no A&E at Central Middlesex it was felt protecting patient pathways may be easier for the restart of elective surgeries.

Dr MC Patel updated the Board on the changes to the ways primary care services were operating. Following advice from NHSE all patients were required to be triaged remotely before attendance at GP surgeries to prevent cross infections. Access to primary care had been difficult for some in the community and a review would be carried out to assess the full impact. Some services had benefited from the new ways of working, for example dermatology had adapted to provide virtual consultations based on photographs, with specialist advice easy to access. The voluntary sector had worked well with the NHS, providing support for mental health services and delivery of oxygen monitors and prescriptions. A hot hub had been established up for those suspected or confirmed of having COVID, and the staff were continuing to monitor oxygen SATS of those discharged as part of a pilot programme for the Medipad device.

Preparations for a second wave included a review of the placements for discharged patients, the production of actions to minimise deaths in BAME communities and work to tackle the inequalities agenda. Review for the care of shielding residents would be undertaken as this had been a significant resource on the district nursing service. The upcoming high demand for secondary and elective care would need to be managed.

In response to a question from Councillor McLennan regarding access to health services for those in digital poverty it was acknowledged that COVID had increased inequalities in this regard. Carolyn Downs reported that a request from government to make the test centre booking online only had been refused. Some funding was still available from the government hardship fund and would be used for digital support.

Councillor Johnson queried whether there would be a re-evaluation of the moving of the APMS GP practice at Central Middlesex hospital, and noted there had been no communication or consultation with residents on the issue. Dr Patel reported that there would be a review, and a decision would be made on the basis of whether a suitable method of blocking the practice off from the rest of the hospital was found. A letter had been received from Dawn Butler, MP, expressing concern on the same issue.

Regarding the writing-off of the historical debt for NHS trusts it was reported that this was seen as a technicality that would not affect future deficits.

It was noted that not all Brent residents attended Northwich Park and that Imperial and Royal Free should always be included in the discussion.

In response to a question concerning Willesden Court care home Dr Halai (Brent CCG) reported that care homes were contacted every day and that visits were conducted if needed, but were avoided if possible. Contact was maintained with families to reassure them.

In response to a question from Councillor Long the Chief Executive committed to find out about the progress of street widening programmes in the borough.

(ACTION)

As an outcome of the discussion it was AGREED that Dr MC Patel would meet with Julie Pal (HealthWatch) outside of the meeting to discuss how best to disseminate to residents the changes to primary care that the NHS had made locally.