The Health Overview and Scrutiny Committee met to discuss the performance of St George's University Hospitals NHS Foundation Trust, the annual report from Healthwatch Wandsworth, an update on the Care Technology Service, and the committee's work programme. Key discussions included financial pressures on the Trust, potential changes to services at Queen Mary's Hospital, and the future of Healthwatch.

St George's Trust Report

Kate Slemack, Managing Director of St George's University Hospitals NHS Foundation Trust, provided an update on the Trust's performance and financial situation. She highlighted that while the Trust is performing relatively well against operational metrics, it faces significant financial pressure with a £95 million savings programme. Challenges include long waiting times, particularly in maternity services, where leadership issues have been addressed with the appointment of a new group chief midwifery officer.

Regarding Queen Mary's Hospital, Roehampton, Ms. Slemack stated that the Enhanced Primary Care Hub (EPCH) is under review, but closure is not the intention. The Trust is exploring options to reshape the service to retain it while balancing it across St George's and Queen Mary's sites, potentially involving staff rotation. A petition with over 8,000 signatures opposing changes to the EPCH was noted. Councillor George Crivelli raised concerns about the EPCH being appointment-only, suggesting it could be made a walk-in service to improve utilisation, similar to other minor injuries units. The Trust confirmed that no decision has been made and stakeholder and patient views will be considered.

The St George's Carmen Birthing Centre is also under review due to underutilisation. Ms. Slemack explained that St George's is a high-risk birth centre, and mothers who give birth there are often not suitable for a birth centre environment. Alternative options are being explored, including potentially moving the activity to another part of the organisation, to ensure resources are used productively.

The Trust reported a deficit of £14 million, which is on plan, with an expectation to clear this deficit over the following year by delivering a £95 million cash-releasing savings programme.

Stephen Hickey, Chair of Healthwatch Wandsworth, raised concerns about corridor care nationally and locally, sharing his own experiences. The Trust acknowledged this is a significant issue and that they are focused on reducing and eliminating it. They are increasing their Same Day Emergency Care (SDEC) service and have a winter plan focused on reducing length of stay.

Councillor Crivelli also inquired about high-intensity users attending the Emergency Department, particularly those with mental health issues. The Trust confirmed they have a high-intensity users group and are working with community partners to provide better alternatives and more joined-up care.

Healthwatch Wandsworth Annual Report

Stephen Hickey, Chair of Healthwatch Wandsworth, presented the organisation's annual report. He highlighted that Healthwatch is a statutory organisation providing an independent voice for patients. A significant announcement was made regarding the government's intention to abolish Healthwatch, with its functions to be moved into the NHS and local authorities. This change will require primary legislation and is not expected to take effect before 2027. Mr. Hickey expressed concern about the loss of independence this move might entail.

Councillor Jessica Lee, Cabinet Member for Health, acknowledged the shock of the announcement and confirmed that the council is committed to supporting independent patient scrutiny, regardless of the future structure. She noted that the Penny Dash review, which recommended these changes, focused on improving patient safety and ensuring a coherent and consistent system.

The report detailed Healthwatch Wandsworth's achievements, including engaging over 1,350 people in sharing their experiences, providing advice and information to 103 individuals, and producing six reports on areas such as community mental health services and autism diagnosis waiting times. The report also outlined priorities for 2025-26, including access to general care, complaints and advocacy, and experiences of community mental health services.

Verbal Update on the CQC's Local Authority Assessment of Adult Social Care

Claire Tew, Assistant Director of Assurance and Innovation, provided a verbal update on the Care Quality Commission's (CQC) assessment of Wandsworth's adult social care services. The service received a Good rating, which was praised by councillors as a significant achievement, particularly given the current challenging climate for adult social care.

The CQC report highlighted a preventative approach, assessments focusing on people's strengths, and positive joint working. Areas for improvement identified included longer waiting times for some services, insufficient care provision for those with complex needs, and difficulties for unpaid carers accessing short-term emergency care. Plans are in place to address these recommendations through the Transforming Social Care programme. Councillor Crivelli asked about the possibility of achieving an Outstanding rating in the future, to which Ms. Tew responded that this would be the ambition.

Care Technology Service

Claire Tew also presented the Care Technology Strategy, aiming to mainstream care technology to support residents in living more independently. The strategy will expand the service to reach more people with diverse needs, including those with learning disabilities, mental health needs, and unpaid carers, and across various care settings. The service aims to be flexible, person-centred, and strengths-based.

The report highlighted the financial benefits of care technology, with projected annual efficiency benefits of £0.7 million from 2026/27. An investment of £0.550 million is requested to support the expansion of the service, which is expected to increase the number of people receiving care technology from 650 to around 1,100 over five years.

Stephen Hickey raised concerns about the balance between compassion and technology, and the importance of human oversight. Ms. Tew assured the committee that the technology is intended to support independence and well-being, not replace human interaction, and that there are provisions for those who are not comfortable with technology.

Work Programme

The committee reviewed its draft work programme for the upcoming year. A key development is the establishment of a Task and Finish Group to focus on Violence Against Women and Girls (VAWG). Councillor Juliana Annan, Councillor Caroline de La Soujeole, Councillor Daniel Ghossain, Councillor Sana Jafri, and Councillor Jessica Lee are members of this group. The group aims to review how the council can improve prevention strategies for VAWG, with a report and recommendations expected by February. Councillor Geoffrey asked for clarification on the age group covered by the VAWG review, and it was clarified that the focus is on prevention and addressing root causes, encompassing all women and girls.

The work programme also includes updates on St George's Trust, Healthwatch Wandsworth, and the Care Technology Service, as well as a briefing on the Violence Against Women and Girls Task and Finish Group. Future items include reports on SWL & St George's Mental Health Trust, the Public Mental Health Action Plan, and the Annual Statutory Complaints Report.