The Healthier Communities Select Committee met to discuss dentistry services, primary care access, integrated neighbourhood teams and adult social care performance in Lewisham. The committee noted reports on each of these topics. They also approved the minutes of the previous meeting, and confirmed there were no declarations of interest, or responses from the Mayor and Cabinet.

Primary Care Access

The committee noted the report on primary care access in Lewisham. Ashley O'Shaughnessy, Associate Director for Community Based Care and Primary Care (Lewisham), South East London ICB, gave a presentation on the Delivery plan for recovering access to primary care, which was published by NHS England in May 2023.

The presentation included data showing that in June 2025, Lewisham GP practices delivered 111,636 appointments, 75.74% of which were face-to-face.

The presentation covered:

• Empowering patients by increasing use of the NHS app, improving practice websites, and promoting self-referral pathways for audiology, podiatry, minor eye care services, talking therapies, and stop smoking services.
• Modern general practice access, including cloud-based telephony and online consultation systems.
• Building capacity through the Additional Roles Reimbursement Scheme (ARRS) and enhanced access, which provides additional appointments on weekday evenings and Saturdays.
• Cutting bureaucracy by improving communication between primary and secondary care, implementing a process for inappropriate requests, creating a WhatsApp group for quick issue resolution, and launching a podcast to share learning and build relationships.

A Better Access Lewisham communications campaign strategy has been developed to educate and inform the public on the ways of working in general practice, the services available, how to access them, and manage expectations around triage¹. The campaign will focus on the NHS App, access and triage, Pharmacy First, and GP teams.

Dr Simon Parton, a local GP, added that access, capacity and demand need to be considered together. He said that the transformation to a more digital approach is an evolution, and it has to be done with patients, not to patients.

Councillor John Muldoon asked how many practices are currently rated as requiring improvement by the Care Quality Commission (CQC), and what plans are in place to remedy that. Ashley O'Shaughnessy said that they would provide the exact number to Councillor Muldoon, but that some practices have now moved off requires improvement.

Councillor Muldoon also raised the issue of different IT systems not talking to each other, such as the NHS app, Guy's and St Thomas's Hospital's MyChart, SwiftQ and Dr. Doctor. Ashley O'Shaughnessy responded that the vision is for the NHS app to be the single front door, and that the direction of travel is towards a more standardised national approach to IT.

Councillor Rosie Perry asked how the complexity of GP appointments is likely to change as more patients are directed to pharmacies for minor ailments. Dr Simon Parton responded that GPs are trained to investigate and manage complex conditions, and that the pharmacy first model should free up GP time to focus on these patients.

Councillor Aliya Sheikh asked how patients will be told about the alternatives to seeing a GP, and how data will be shared between different services. Ashley O'Shaughnessy responded that there are governance pathways in place for directing patients to the right service, and that the responsibility for care lies with the provider who delivers it.

Integrated Neighbourhood Teams

The committee noted the report on developing integrated neighbourhood teams in Lewisham. Laura Jenner, Director of System Development, NHS South East London, and Fiona Kirkman, System Development Lead, NHS South East London, gave a presentation on the Integrated Neighbourhood Programme, which aims to bring health, social care, voluntary and community services together to support different population groups.

The programme is based on four geographical neighbourhood areas in Lewisham, which align with primary care networks (PCNs). The goal is to support people in a holistic way, looking at their wider support needs, such as housing, access to work and education, as well as their physical and mental health issues.

Alex, Chair of Merv Dalli Solutions Participation Group, spoke about their experience of being involved in the co-design of the Integrated Neighbourhood Teams (INTs). They said that the NHS has become very disjointed, with people being treated for one condition at a time, and that the INT project is with this concept in mind of treating people holistically.

The presentation covered:

• The core INT team, which will be co-located in each neighbourhood and made up of staff from across the council, Lewisham and Greenwich NHS Trust (LGT), and the voluntary sector.
• The wider teams that are already in place, and how they will be integrated to offer holistic support.
• The community hubs that will provide access to information, advice, services and support.

Fiona Kirkman explained that the co-design work had led to a number of key changes to the model, including renaming the holistic assessment to a 'getting to know you assessment'.

The INTs will initially focus on supporting people with multiple cardiovascular long-term conditions, with the plan being to scale up to include all long-term conditions over time.

The presentation also covered the shift towards population health management, which emphasises prevention over cure, and the stakeholder engagement that has informed the development of the INTs.

Councillor Perry asked how the INTs will support people through what can be quite an upsetting or challenging process. Fiona Kirkman responded that the first contact is very important, and that it needs to be done in a sympathetic and supportive way.

Councillor Sheikh asked if any mental health support will be provided as standard as part of the package. Laura Jenner responded that this is just the beginning, and that there is a lot more to come.

The committee requested a follow-up update in 12 to 18 months to review progress.

Dentistry Services

The committee noted the report on dentistry services in Lewisham. Jeremy Wallman, Head of Primary Care Commissioning; Dentistry, Optometry and Pharmacy, London ICBs, gave a presentation on dental services in Lewisham, within the context of service delivery across South East London and London as a whole.

The presentation included an overview of the amount that the NHS pays dentists, and dispelled the myth that patient charges are in addition to what the NHS pays them. He explained that if dentists deliver less than 96% of their contracted activity, the associated value of that activity is clawed back in the next year.

The presentation also covered:

• Urgent dental care across London, which is accessed through NHS 111 and operates 7 days a week.
• The different levels of complexity in dentistry, from mandatory services delivered by any dentist to complex treatment delivered by specialists and consultants in the secondary care setting.
• Community dental services provided by King's NHS Trust, including services for adults with special care needs, domiciliary services, and services for homeless people and rough sleepers.
• Secondary, community and specialist dental services, including the fact that paediatric referrals into community dental services have increased by 40% from pre-pandemic levels.

Councillor Perry asked if there is NHS transport to secondary dental care. Jeremy Wallman responded that some patients are eligible for patient transport, but in most cases people have to find their own way.

Councillor Perry also asked if there is a steer towards getting activity rather than preventative work. Jeremy Wallman responded that the General Dental Services contract does not really reward prevention.

Councillor Sheikh commented on the annual dental check-ups, and how they seem to be the very foundation of good dental health. She also commented on the lack of registration with NHS dentists, and how this can become a barrier for people who have had treatment and then find it difficult to find a new dentist.

Jeremy Wallman responded that the dental budget is split across the five ICBs in London, purely because that practice happens to be in their ICB, and that there is no link to residency or postcode. He added that anybody from within England can access that practice.

Adult Social Care Performance

The committee noted the report on adult social care performance. Denise Radley, Executive Director of Adult Social Care and Health, and Joan Hutton, Director of Operations for Adult Social Care, shared some highlights of adult social care.

Denise Radley said that the Care Quality Commission (CQC) will be visiting Lewisham the week of 13 October to inspect the services. She added that the council is holding its Recovery Day on 17 September, to recognise the achievements of residents who have faced addiction problems.

Joan Hutton touched on the National Neighbourhood Health Implementation Programme, and said that the council has applied to be part of it. She added that the council is currently seeking support from organisations with expertise in technology-enabled care, and that it has just closed its engagement and co-production work looking at day centres and day opportunities for people with dementia.

Councillor Bell asked if the unpaid carer involvement is just adult unpaid carers, or if young unpaid carers come under a different committee. Denise Radley responded that it is just the adults who are unpaid carers.

Councillor Bell also asked about Swallows, a local organisation.

Councillor Sheikh requested that future meetings include 5-10 minutes for adult social care highlights and follow-up on savings reviewed.