The Health Overview and Scrutiny Panel met to discuss the proposed merger of Kingston Hospital NHS Foundation Trust and Hounslow and Richmond Community Healthcare NHS Trust, and to review the current state of dental services in Kingston. The panel also received an update on public health matters, including vaccination programmes and the rise in measles cases.

Kingston Hospital and Hounslow and Richmond Community Healthcare Partnership

The panel received a verbal update on the proposed merger between Kingston Hospital NHS Foundation Trust and Hounslow and Richmond Community Healthcare NHS Trust (HRCH). Joe Farrar, Chief Executive of Kingston Hospital and HRCH, explained that the merger is intended to address the increasing demand and complexity of patient care, as well as staffing shortages. The current model of health and care was described as challenged, if not unsustainable. The partnership has been in place since 2020, with a single executive leadership team and integrated corporate functions. The preferred option of merger was decided upon in September last year, with a target merger date of 1st October 2024.

Key benefits of the merger highlighted include:

• Improved patient experience through integrated pathways with fewer barriers to care.
• Increased focus on preventative measures and investment in community infrastructure.
• Greater opportunities for staff development and career progression.
• Enhanced system-wide working to deliver seamless and joined-up care.

Tara Ferguson-Jones, Director of Communications, outlined the extensive communication and engagement plan, which has involved staff, local authorities, GPs, and patient groups. The panel provided feedback on communication, suggesting the use of clear language and examples, community notice boards, and addressing resident anxieties about potential service changes or increased travel.

Dental Services in Kingston

The panel received a comprehensive report on dental services in Kingston, with a particular focus on children's oral health. Charlotte Klass, Consultant in Dental Public Health at NHS England, presented data from the National Dental Epidemiology Programme (NDEP), highlighting that tooth decay remains the most common preventable disease affecting children in England and the leading cause of hospital extractions for children aged 6-10.

Key points from the presentation included:

• Oral health is intrinsically linked to general health and wellbeing, impacting children's development, school readiness, and social interactions.
• Inequalities in oral health persist, with children from more deprived backgrounds experiencing higher rates of decay.
• Kingston has a relatively high percentage of children who have seen a dentist compared to other London boroughs, but there is still a significant proportion of children not receiving regular dental care.
• The main modifiable risk factors for dental caries are diet, excessive sugar consumption, and lack of optimal fluoride exposure.
• Current work in Kingston includes a Schools Oral Health Promotion Programme in ten priority schools, oral health promotion through the Health Visiting Service, and training for early years staff.
• A Pooled Prevention Fund (jointly funded by Kingston Council and the NHS) will expand the oral health promotion offer to an additional ten primary schools and introduce a Supervised Toothbrushing Programme in nursery settings.

The discussion also touched upon the challenges of accessing NHS dentistry, the impact of the COVID-19 pandemic on dental backlogs, and the unique urgent dental care system available in London. The panel expressed interest in understanding the specific needs within Kingston and how they compare to national figures, as well as exploring the potential for flexible commissioning and the development of advertising policies to restrict the promotion of high-sugar foods around schools.

Public Health Verbal Update

Iona Lidington, Director of Public Health, provided an update on public health matters, focusing on:

• COVID-19 and Flu Vaccinations: A final push was underway for eligible individuals to receive their vaccinations, with flu vaccinations available until 31 March 2024. The importance of vaccination in reducing hospital admissions was emphasised.
• Rise in Measles Cases: An increase in measles cases across England, particularly in London, Birmingham, and the West Midlands, was highlighted. The panel was urged to encourage uptake of the MMR vaccine, which is the most effective protection against serious illness. Catch-up campaigns are targeting older teenagers and young adults who may have missed vaccinations in childhood.

The meeting concluded with thanks to all contributors and a declaration that the meeting was closed.