The Health and Social Care Scrutiny Commission met on Wednesday 17 November 2021 to discuss the impact of the pandemic and Brexit on the NHS workforce, the development of the South East London Integrated Care System (SEL ICS), and access to GP appointments. The Commission also began scoping reviews into domestic abuse and the health and social care workforce.

Impact of Brexit and the Pandemic on the NHS Workforce

The Commission heard from representatives from Guy's and St. Thomas' NHS Foundation Trust (GSTT) and King's College Hospital Foundation Trust (KCH) regarding the impact of Brexit and the pandemic on the NHS workforce. While Brexit has not yet had a significant impact on hospitals, concerns were raised about potential future effects on the healthcare pipeline. The immediate concern for the Trusts is the impact of mandatory vaccinations for health and social care staff, with around 56 staff at GSTT needing redeployment due to vaccination status. Vaccine uptake among staff mirrors general population hesitancy, with rates in the late 80s to early 90s. Collaborative work on workforce issues is underway across the South East London Integrated Care System (SEL ICS).

Integrated Care System (ICS)

Ben Collins, ICS Director of System Development, presented on the development of the South East London (SEL) Integrated Care System (ICS), which is set to be operational by 1 April 2022. This new structure aims to improve integration between health and social care. The ICS will work alongside borough-based Local Care Partnerships, with Partnership Southwark being the local entity for Southwark. Concerns were raised about the ICS potentially being another top-down reorganisation, moving away from local accountability. However, it was argued that the model of Local Partnership Boards offers an opportunity to bring in local accountability, and that the voluntary and community sector will have an important role in innovation. The Health and Well-being Board will remain within the new governance arrangements.

GP Appointments

Sam Hepplewhite, Southwark CCG Place Director, provided an update on access to in-person GP consultations. While patient feedback is generally positive, some patients are experiencing significant difficulties in securing appointments. The number of GPs per capita in Southwark is higher than the national average, but the overall number of GPs has decreased. The government is providing additional funding to increase capacity for face-to-face appointments and improve telephone systems, with Southwark set to receive approximately £1 million. However, concerns were raised that this funding is short-term and may not address long-term staffing issues. The NHS is also focusing on recruiting associated professionals, such as paramedics and mental health workers, to support GPs. Discussions also touched upon the challenges of adapting to new consultation methods, the digital divide, and the need to improve the efficiency and attitude of some reception staff.

Review: Domestic Abuse

The Commission discussed the scoping document for a review into domestic abuse. It was noted that Southwark has one of the highest rates of domestic abuse nationally, and that child-to-parent abuse is a significant and increasing concern. The review aims to gather insights from a wide range of community organisations working on the frontline and to understand the involvement of the police in domestic abuse incidents, including their training and protocols.

Review: Health & Social Care Workforce

The scope of the review into the health and social care workforce was noted by the Commission.

Work Programme

The Commission's work programme was also noted.