Apologies received from John Morgan, Executive Director of Adut Social Care, Integrated Care and Public Health, with Graham Terry, Assistant Director, standing in.

There were no declarations of pecuniary interest.

The minutes of the previous meeting were approved.

Councillor McGrath asked about page 5 visit to St Helier and update on consultant’s report commissioned by Cabinet on St Helier. Chair responded that the visit has not yet taken place and will get back on the report. Councillor McCabe said the report is in its final stages and will be circulated shortly.

The Chair welcomed the Young Inspector, Lola Kareem, to the meeting.

Mark Creelman introduced the report and introduced Dr Worthington and Dr Ganaseratnam. He drew particular attention to the pillars of Access, Prevention, Continuity of Care and Multidisciplinary Teams, all under the umbrella of tackling Health Inequalities. Dr Ganaseratnam spoke on evolving ways of capturing data. Dr Worthington spoke on cloud-based telephony services and the rollout to all practices, and also that practices are focussing on care navigation roles because they recognise that not everyone can be digital. Dr G talked about Primary Care Networks including proactive care plans for people in care homes. Award-winning social prescribing service in Merton – expanding it into children and young people. SW London investment fund – Inequalities and Innovation – funding for piloting new ideas and improving sustainability. Dr W talked about Integrated Neighbourhood Teams. Want to use Merton pilot new ways of working.

Councillor Attawar asked about GP appointments and how difficult it is. Are GP practices still operating under Covid rules? MC responded that the data we receive now shows that we provide more appts than we did before Covid. Combination of face to face and online. We want to get to a standard where there are multiple routes of access and take specific examples that are brought to us and learn from them. Dr G confirmed surgeries are not operating under Covid rules, and according to the data over 90% or appts are being made available for within two weeks (which meets national targets), and 40-50% on same day. We are always working to understand needs and demand, and Primary Care Networks listen to the experience of patients and surgeries. Dr W said we also need to consider wider Primary Care Team and making sure patients are also accessing eg Community Pharmacists. Merton benchmarks quite well on GP appts. MC says there is need to communicate options to patients more clearly.

Councillor Gould said that she has residents who have had a 2 or 3 week wait for appointments for their children. Is there any prioritisation for GP appts? What is Merton Health Limited? MC responded that the data might be slightly misleading as they have gone up so we need to refine to reflect this. In terms of children and young people can we please look into this incident offline as that is unacceptable. Planned appts are valuable too. Merton Health is the federation of all our GP practices – a mechanism to work at scale and to respond eg during Covid. It is not technically an NHS organisation, but neither are GP practices, but it does hold NHS contracts.

Lola Kareem asked about the app – not being able to book another appt when you already have one. She also asked about pharmacy closures impacting on access to healthcare for young people. MC confirms it is about using GPs and pharmacists, not one or the other. Need to map any gaps there are in delivering through pharmacists. He will take away the question on the app, but he does  ...  view the full minutes text for item 4.

Mark Creelman introduced the report, paying specific attention to the rise in the cost of building materials and therefore the challenged finances and finding value for money, and therefore how the projects are being prioritised. NHS is committed to all these projects but need to prove value for money at every stage of the process.

The Chair expressed deep concern especially around the delay to The Wilson and the impact on health services for the east of the borough. MC acknowledged this.

Councillor Attawar expressed disappointment about installing a third floor at Colliers Wood despite it having been previously successfully challenged. MC confirmed it has not been agreed, it is just one of the options that has been proposed.

Councillor Gould asked for the committee to receive monthly updates on the progress of these projects rather than only ever 6 months at a time. MC agreed and said they have committed already to give monthly updates to the Leader and Cabinet Member and other stakeholders. Councillor Gould also asked that breast cancer screening facilities be included in the plans for the Wilson. MC confirmed that the process for breast cancer screening coming to Merton is continuing including deciding where the best location would be (incl the Wilson in this).

Councillor Henry asked about the budget for the Rowan Surgery site. MC clarified that the funding mechanism are different across different sites. The Wilson is capital funding. With the other two the developer is putting the capital in and then the services are revenue. Key is working with the PCN about what services can be delivered from there. Decision on services will ascertain where the money comes from.

Councillor McGrath asked about the decision making around the Nelson, historically. MC is unaware of how the Nelson was funded.

Councillor McCabe expressed concern that colleagues in the east of the borough are being continually let down and frustrated. In his role he is very clear with the NHS that any talk around tackling health inequalities will only be judged by actual action. MC responded in acknowledgement of this frustration. Concern also around conflicting demands for finances nationally due to the RAAC issue.

Chair requests to add in monthly reports and also to invite NHS colleagues back to the January meeting.

Councillor McGrath requested that the consultants’ report on St Helier be added to the next meeting. On the update to St George’s could we request they also include information on maternity services.

Councillor Henry requested the visit to St Helier be followed up.