Agenda item

• Kay Isaacs, Director of Operations, North Central Division, CLCH
• Beverley wilding. Deputy Director, Urgent and Emergency Care, NCL CCG
• Dawn Wakeling, Executive Director, Adults & Health, LBB

Finchley Memorial Hospital and Edgware Walk-In Centre

Ms Issacs reported that Edgware Community Hospital (ECH) had closed during the Covid-19 pandemic. It was chosen as the centre to close due to its limited capacity to retain social distancing whereas Finchley Memorial Hospital (FMH) remained open throughout the pandemic, with reduced services. The ECH reopened on 25^th February 2022 and prior to this in October 2022 before being forced to close in December 2021 due to another wave of the pandemic.

Ms Isaacs reported that currently ECH sees approximately 76 patients daily, just over half the number who attended prior to the pandemic. FMH sees 133 daily, 86% of the attendance prior to the pandemic. Ms Isaacs reported that waiting room capacity and staff recruitment continued to be challenges faced by the ECH, but work was ongoing on these. The staff vacancy levels are causing some difficulties with resuming usual services. She added that some Covid restrictions remain in place, but as national infection prevention and control (IPC) guidance is updated, adjustments are made.

A Member enquired about whether health inequalities appeared to have worsened due to the pandemic. Ms Isaacs responded that there remained gaps in some services, so this is possible. She offered to report back with more detail on the WICs if helpful.

A Member enquired why ECH rather than FMH was chosen to be closed during the pandemic. Ms Isaacs stated that this was due to redeployment of staff and also the nature of the building being less amenable to safely caring for patients during the pandemic. Ms Wilding noted that the decision had to be made quickly due to the speed of the pandemic. It remained closed as staff were redeployed to support the recovery programme. Ms Wakeling added that staff supported care homes and later on the Covid vaccination programme, including for housebound patients. There were high levels of absence across health and care staff nationally and staff had had to be prioritised in this way. She added that there are no plans to close ECH.

A Member enquired about the current staff vacancy rates. Ms Isaacs responded that FMH has 20% of vacant positions and ECH is slightly higher. Agency staff are being deployed whilst substantive recruitment is an ongoing process. There is a dedicated focus group working to attract staff. Due to the long closure of ECH, some staff had left, so efforts were being made to attract staff back in.

Alternative Personal Medical Services (APMS) Contract

Ms Wilding reported that the GP Practice which had been reprocured in December 2021, would move to a new premises a small distance over the border into the Borough of Brent, on Edgware Road, between Barnet, Brent and Camden Boroughs. The Practice currently has 4000 patients registered and the new premises would give them capacity to expand to cater for population growth in the area, up to at least 6000 patients.

A Member enquired how to ensure that patients who used the previous site would be served during the transition to the new premises. Ms Wilding noted that this would be offering GP services only; the previous site also had a WiC which had closed further to an engagement process with Brent CCG. 

A Member commented that patients from outside Brent had asked what the implications are of the move for them. Ms Wilding noted that the contract would be overseen by NCL CCG and would not move to NWL CCG, which Brent sits under, so there would be no change for patients from Barnet or Camden.

A Member asked whether more GPs would need to be recruited, to cater for an additional 2000 patients. Ms Wilding noted that this would be the practice’s decision as they may use a different skill mix to cover services. The workforce constraints with GPs currently are a factor, although the practice currently has a pool of GPs available.

A Member noted that there had been controversy over the closure of Cricklewood WiC. The out-of-hours could be helpful for residents – would these be accommodated elsewhere? Ms Wilding responded that the GP Practice has responsibility for delivering services until 6.30pm and within Barnet there are arrangements around the Borough to provide these services. Extended GP hours services are run by the GP Federation. In addition Barnet has FMH and ECH with FMH open until 10pm. She noted that Barnet is the only borough in NCL with two WiCs.

A Member noted that it could take pressure from GP services if patients are aware when they can go to FMH and ECH WiCs. Ms Wilding agreed that there is probably a population who don’t know when they can use the WiC although in Barnet they are generally well known, according to engagement work that had been carried out. However this could be strengthened further. In addition the 111 service can direct residents to the WiCs. 

A Member asked who patients are seen by at WiCs. Ms Isaacs responded that they are seen by Nurse Practitioners, whereas at the GP Practice they can either be seen by a GP or Nurse Practitioner.

A Member asked about patient records and how treatment is communicated if they visit a WiC. Ms Wilding noted that all information from WiCs will be forwarded to the patients’ GP.

RESOLVED that the verbal updates were noted.