The Greenwich Health and Wellbeing Board met to discuss emergency department attendances at Queen Elizabeth Hospital (QEH), and to review the work of the Anti-Racism for Health Equity Community of Practice. The board also noted the forward work plan for the meeting in December 2025, which will focus on the addiction strategy.

Emergency Department Attendances at QEH

The board reviewed emergency department (ED) attendances at Queen Elizabeth Hospital by Greenwich residents, and partner actions to reduce them. The Review of Emergency Department Attendances at Queen Elizabeth Hospital report was requested by the Health and Wellbeing Board as part of a prioritisation exercise for topics of interest.

Kate Anderson, Chief of Staff at Lewisham and Greenwich NHS Trust (LGT), presented the findings of the analysis, explaining that ED attendances for Greenwich residents have remained relatively stable, but that the ED was regularly seeing well over 400 patients a day, despite being built for a capacity of 200.

The key findings of the analysis were:

• The rate of people attending ED is highest in the youngest and oldest age groups.
• There are opportunities to reduce attendances for babies, children and young people, particularly the under-ones, as they have a high rate of attendance, but a lower acuity[^1] of presentation. [^1]: Acuity, in a medical context, refers to the level of severity or urgency of a patient's condition.
• Health inequalities are evident in the rates of attendance by ethnic group and the level of deprivation in the areas where attendees live.
• Most adults attending ED are presenting with urgent or very urgent non-injuries.
• People with long-term conditions (LTCs) have higher rates of attendance at ED, and the more LTCs a person has, the more likely they are to attend ED frequently.
• People who attend ED multiple times are also likely to attend general practice multiple times.

Samantha Bennett, Director of Public Health, RBG, noted that people living in the most deprived areas were more likely to attend the ED, and that some conditions, such as vomiting, backache, abdominal pain, and headache, were associated with higher attendances from people living in deprived areas.

Jessica Arnold, Director of Primary Care and Neighbourhoods within Greenwich ICB, spoke about initiatives to provide care in the community, including:

• Improving the general practice offer in Greenwich, by increasing the number of appointments available.
• Extended access to GPs.
• Social prescribing[^2]. [^2]: Social prescribing is a way for healthcare professionals to refer patients to non-medical services in the community to improve their health and wellbeing.
• Pharmacies delivering more health services.
• Urgent community response teams and virtual wards[^3]. [^3]: Virtual wards allow patients to receive the care they need in their own homes, rather than in a hospital.
• Enhanced care arrangements in care homes.
• A primary community and secondary care interface forum and programme in Bexley and Greenwich.
• The Same Day Emergency Care (SDEC) service at Queen Elizabeth Hospital.
• A proactive care pathway for patients in Greenwich.
• Re-procuring the 111 service to have a more Greenwich-based specific approach.

Councillor Mariam Lolavar, Cabinet Member Health, Adult Social Care and Borough of Sanctuary, asked about data sharing between the Urgent Treatment Centre (UTC) and GPs, and about referral routes to the frailty service. Jessica Arnold responded that UTC data does go back to GPs, and that the frailty service is accessed via referral from a professional in the system. She added that there were plans to incentivise GP practices to make more referrals to the service.

Councillor Lolavar suggested that the board consider access issues around community services as part of the Age Friendly Borough initiative, and asked whether the ethnicity data could be improved, as the 'other' category was not helpful. She also suggested bringing together UTC and GP data, and exploring the use of a measure to assess patients' confidence in managing their own health.

Other suggestions and recommendations included:

• Triangulating data on high intensity users of services.
• Using the magic question from the National Association of Primary Care (NAPC) to assess patients' confidence in managing their own health.
• Matching over-presenting groups against Live Well data.
• Considering the social care needs of people coming to ED.
• Sharing information around people commonly dealt with by Live Well or adult social care.

Anti-Racism for Health Equity Community of Practice

The board reviewed the progress of the Anti-Racism for Health Equity Community of Practice (COP). Nupur Yogarajah, South East London Integrated Care Board, and Catherine Hannafin, Associate Director in the public health team, presented the review.

The COP was established to address ethnic health inequities, and to provide a space for open and honest dialogue on race and discrimination. The COP has delivered webinars and events, and has been evaluated by Healthwatch Greenwich.

The evaluation identified five core themes:

• The purpose of the COP needs to be clarified.
• The concept of safe space and psychological safety means different things to different members.
• There is a need for more action planning and peer-to-peer learning opportunities.
• A resource hub should be developed, and forward planning of sessions ensured.
• There needs to be a clearer understanding of the COP's impact, governance, and how outputs reach senior levels.

Councillor Lolavar asked how the work would be measured, and at what pace. Catherine Hannafin responded that the work was aligned with the council's equality, diversity and inclusion (EDI) action plan, and that there was a commitment to tracking and measuring progress.

Other suggestions and recommendations included:

• Presenting to voluntary and community sector (VCS) organisations to encourage applications for health inequalities funding.
• Bringing in connections with borough of sanctuary networks.
• Considering joint work on mental health with sanctuary-seeking groups.
• Sharing information about a local pharmacy that has started a programme across faith organisations.

Health and Wellbeing Board Forward Work Plan

The board noted the forward plan for the meeting in December 2025, which will focus on the addiction strategy. The Public Health Team will present the newly developed addictions strategy for discussion, with the potential to develop system-wide working to support its recommendations. The strategy will include gambling for the first time.

Councillor Lolavar thanked Mark Delacour, Greenwich Action for Voluntary Services, for his contribution to the board, as this was his last meeting.