The Health Scrutiny Committee met to discuss the progress of Salisbury Avenue General Practice following an 'inadequate' CQC rating, and to review the final version of the Joint Local Health and Wellbeing Strategy 2023-2028. The committee also agreed appointments to the Outer North East London Joint Health Overview and Scrutiny Committee and approved the work programme for the upcoming year.

Salisbury Avenue General Practice Update

Alison Goodlad, Deputy Director of Primary Care NHS, North East London, provided an update on Salisbury Avenue General Practice, which was rated 'inadequate' by the Care Quality Commission (CQC) following inspections in late 2022 and early 2023. The practice has been implementing a range of improvements, supported by subject matter experts in quality, safeguarding, and medicines management.

Key areas of focus have included:

• Management and Leadership: A new practice manager has been appointed to address issues around poor practice management and staff turnover.
• Infection Control: A full audit has been completed, with the practice showing compliance, though an action plan with recommendations is in place.
• Medicines Management: Policies and systems have been reviewed and implemented to improve the monitoring of high-risk medicines, prescription requests, and drug monitoring for patients on medications like Warfarin.
• Safeguarding: A robust safeguarding policy is now in place, with laminated contact lists and guidance for staff. A central log of vulnerable patients is maintained, and regular monitoring is occurring. The safeguarding team is expected to formally sign off compliance shortly.

Councillor Manzoor Hussain asked if the inspection was scheduled or prompted by complaints, and if there had been any impact on patient services. Ms. Goodlad confirmed it was a formal inspection due to concerns and that patient services had not been significantly impacted, with no notable change in patient list size.

Councillor Muhib Chowdhury raised concerns about the practice not consistently using complaints to improve care and asked about improvements to the complaints process and the implementation of the Patient Safety Incident Response Framework (PSIRF). Ms. Goodlad explained that systems are being put in place to review complaints and learn from them, and that the practice is implementing incident reporting and learning from complaints. She was unable to provide specific response rates for complaints.

Councillor Chris Rice inquired about staff morale and well-being, and the impact of management turnover. Ms. Goodlad stated that a peer review framework indicated staff morale was above average, and the new practice manager was expected to have a positive impact. She also noted that GPs are taking on more clinical leadership roles.

Concerns were also raised about the adequacy of the safeguarding policy, with councillors emphasising that it should have been in place and robust from the outset. Ms. Goodlad acknowledged this, stating that safeguarding leads had worked closely with the practice to ensure a satisfactory policy was in place and that the practice was not deemed unsafe.

Regarding medicines management, councillors highlighted the importance of training for all staff, including non-clinicians, on handling high-risk medications. Ms. Goodlad confirmed that the medicines management team had ensured staff received relevant training and that robust systems were being implemented.

The committee was informed that a follow-up inspection by the CQC is anticipated in autumn, with expectations that the practice will move from 'inadequate' to 'requires improvement'. The local primary care team is proactively supporting practices at risk of CQC ratings by offering webinars and mock inspections.

Joint Local Health and Wellbeing Strategy 2023-28 Refresh Framework for Delivery

Councillor Maureen Worby, Cabinet Member for Adult Social Care, Health and Housing, presented the final version of the Joint Local Health and Wellbeing Strategy 2023-28. She highlighted that significant effort had been made to make the document accessible to the public while remaining comprehensive. The strategy outlines actions to address major health challenges faced by residents throughout their lives.

The Health and Wellbeing Board and the Place Board now meet as a Committee in Common, and their joint sign-off signifies a commitment from all parts of the system. Councillor Worby expressed confidence that the new governance arrangements would facilitate better accountability. She acknowledged that progress would not be rapid but stated that the strategy provides clear pathways for improvement. The committee noted the content of the strategy.

Joint Health Overview and Scrutiny Committee Appointments Report

The committee noted the report on the arrangements for the Outer North East London Joint Health Overview and Scrutiny Committee (JHOSC). Councillors Paul Robinson, Michel Pongo, and Muhib Chowdhury were appointed to the JHOSC for the 2023-24 municipal year.

Work Programme

The committee agreed the draft Work Programme for 2023-24.