The Health Scrutiny Sub-Committee of Bromley Council met on Tuesday 8 April 2025 to receive updates on hospital performance, dental services, and the work of the South East London Integrated Care Board (ICB). The committee also reviewed the latest patient experience report from Healthwatch Bromley.

Update from King's College Hospital NHS Foundation Trust

Angela Helleur, Site Chief Executive for the Princess Royal University Hospital (PRUH) and South Sites, provided an update on the King's College Hospital NHS Foundation Trust. Key points included:

• Elective Recovery: Efforts are ongoing to reduce long waiting lists, with a national focus on ensuring all waits are under 52 weeks from referral to treatment.
• Emergency Care: The PRUH is currently achieving around 70% performance against the 4-hour emergency care standard, despite challenging winter periods. Efforts are being made to reduce corridor care and long waits in the Emergency Department (ED).
• Cancer Performance: The Trust has maintained the 28-day faster diagnostic standard and shown consistent performance against the 31-day standard for cancer treatment.
• Workforce: The Trust has limited vacancies, and the PRUH and South Sites have successfully managed the transition of three Care Groups (Dental, Radiology, and Women's Health) from Denmark Hill. The National Staff Survey showed a response rate of 52.59% for the PRUH and South Sites, indicating areas for improvement in staff morale, engagement, and wellbeing.
• Estates: Construction of the Endoscopy Unit is progressing well and is expected to be completed by September 2025, supporting new cancer standards. The ward refresh programme is also continuing.
• EPIC and MyChart: The digitisation of hospital processes through EPIC has improved patient safety. Over 230,000 King's patients have signed up for MyChart, which provides direct access to patient records and has significantly reduced the 'did not attend' (DNA) rate. MyChart users have a DNA rate of 5%, compared to 11% for those not using the system. The system also provides immediate access to blood test results.
• Finance: The Trust achieved its control total for the financial year and has a financial strategy in place to reach a breakeven position within five years.

The committee noted the benefits of MyChart for timely access to information and requested a breakdown of MyChart user ages in future reports. It was confirmed that pathology systems had been outsourced to Synnovis, with initial teething problems now resolved. Discussions are ongoing to improve communication between MyChart and the NHS App.

Update on Dental Services

Kelly Nizzer, Regional Lead for Primary Care Commissioning: Dentistry & Optometry Services for NHS South East London ICB, provided an update on dental services. Key points included:

• Access and Targets: Dental practices have targets to meet by the end of March, which can affect availability. New targets commence from 1 April, potentially increasing availability. Bromley has 39 General Dental Services (GDS) providers with a contract value of approximately £12.8m, covering 397,000 units of dental activity (UDAs).
• Contract Delivery: Practices are required to deliver a minimum of 96% of their UDAs. Bromley is expected to deliver around 77% of UDAs for 2024-25, with potential for this to increase.
• Urgent Dental Care: Urgent dental care hubs and services have been procured until 2029. Bromley's urgent care hub is located at Beckenham Beacon, offering 24-hour telephone triage and face-to-face emergency dental services from 8:00 am to 10:00 pm.
• Secondary Care Dentistry: This is delivered in hospitals and is consultant-led, with patients able to be referred across boroughs based on provision.
• Community Dental Services (CDS): Bromley Healthcare delivers the CDS contract, providing services for paediatrics, special care patients, older people, and homeless individuals. Oral Health Promotion is also delivered, including supervised tooth brushing and fluoride varnish. Paediatric referrals to CDS have increased by 40% since pre-pandemic levels.
• Current Position: Urgent Dental Care Hubs and Triage are secured until 2029. General dental activity has returned to pre-pandemic levels. A 3-5 year roadmap for dental services is in place, and commissioning of dental, optometry, and pharmacy services has been delegated to ICBs since April 2023. The National Dental Recovery Plan was implemented in March 2024, though the financial landscape remains challenging.
• Additional Capacity: £2.5m has been commissioned to increase provision within dental practices, and further funding has been approved. Information on uptake from Bromley practices will be provided.

The committee requested further information on oral health initiatives for older people in care homes and a needs assessment for dental access across London. An annual update on dental services was requested for the work programme.

South East London (SEL) ICB Update

Dr Angela Bhan, Place Executive Lead for SEL ICB, provided an overview of the One Bromley collaborative. Key points included:

• Integrated Neighbourhood Teams (INTs): Bromley is divided into four neighbourhood teams to facilitate more integrated service delivery.
• Long-Term Conditions and Frailty: Work is underway to manage residents with multiple long-term conditions and frailty. This involves identifying vulnerable patients, assessing their needs through multidisciplinary teams, and providing tailored care packages. This approach has shown improvements in wellbeing and reduced hospital attendances.
• Diabetes: Nearly 19,000 people in Bromley live with diabetes, with a significant number at risk of developing Type 2 diabetes. Various prevention, weight management, and education initiatives are in place.
• Blood Pressure@Home Service: This service has been successful in improving blood pressure control through remote monitoring and patient self-management.
• Medicines Optimisation: The team is reviewing guidelines for prescribing weight loss drugs, with a focus on tiered weight management and exercise programmes. An overview of weight loss drug prescriptions across SEL will be requested.

The committee noted the success of the Blood Pressure@Home service and requested further information on weight loss drug prescriptions.

Healthwatch Bromley - Patient Experience Report

Charlotte Bradford from Healthwatch Bromley presented the Quarter 3 Patient Experience Report (October-December 2024). Key findings included:

• Volume of Feedback: 598 reviews of health and care services were collected, with 58 visits conducted across various locations.
• Service Type Feedback: GPs received the most reviews (238), followed by hospitals (182).
• Positive Review Trends: Positive feedback for GP practices increased by 2% and for hospital services by 8% since Quarter 1. However, positive experiences for dental services decreased to 77% and for pharmacy services significantly by 20%.
• GP Services: 59% of reviews were positive. Strengths included staff attitudes, telephone appointments, online booking systems, and quality of treatment. Areas for improvement were appointment availability, communication with patients, and booking appointments.
• Hospital Services: 79% of reviews were positive. Strengths included quality of treatment, staff attitudes, and appointment availability. Areas for improvement were waiting times, communication with patients (including discharge plans and MyChart information), and communication between services.
• Pharmacy Engagement: Healthwatch Bromley found it difficult to engage directly in pharmacies due to low footfall but encouraged feedback on pharmacies during engagements at other locations. They are considering a deep dive into pharmacy services.
• Data Limitations: It was noted that the report provides a snapshot, and the numbers are often small, making it difficult to draw significant conclusions. The data indicates trends and areas for further investigation.
• Digital Inclusion: Bromley's work on digital inclusion was shared as best practice across London primary care.

The committee discussed the challenges of gathering feedback, particularly for pharmacies, and the importance of both quantitative and qualitative data. Dr Bhan noted that while the data provides direction, the numbers are small, and face-to-face appointments in general practice have improved.

South East London Joint Health Overview & Scrutiny Committee (Verbal Update)

Councillor Mark Brock provided a verbal update on the South East London Joint Health Overview and Scrutiny Committee meeting held on 25 March 2025. Topics discussed included Sickle Cell Services in SEL ICB, the reconfiguration of children's cancer treatment services in south London, and oral health across South East London. The committee noted that papers for this meeting are available on the Bromley Council website.

The meeting concluded with the scheduling of future meeting dates.