Agenda item

Head of Podiatric Medicine, Homerton University Hospital NHS Foundation Trust and Clinical Commissioning Group representative to be heard.

The Committee received the verbal update from the Head of Podiatric Medicine, Homerton University Hospital NHS Foundation Trust, and the Clinical Commissioning Group representative.

The Committee was advised that the services are now back up and running but had to make a significant adjustment to ensure that the building was covid-secure.  This means that the patients are being managed safely, but it is time-consuming compared to the past. The services continued to provide critical and emergency care as well as making urgent home visits when required during the pandemic. This was followed by the Head of Podiatric Medicine, clarifying that at the moment, the service which is provided is a podiatrist specialist service and not chiropody services. Moreover, the Head of Podiatric Medicine assured the Committee that the vulnerable patients who required a chiropody provision were being serviced through partner organizations such as Hoxton Health.

The Committee was further informed that as CCG, the Group had increased its home visits for the extremely vulnerable patients. Since the last meeting, health centres such as the John Scott Health Centre, Kenworthy Road Health Centre, and the Neaman Practice have resumed its operations.

Additionally, the Committee was informed that urgent priority cases of 1000 patients who were at risk of having the legs amputated were contacted and offered appointments for them to be seen. It is anticipated that by the end of November 2020, most of the outstanding appointments will be provided to the patients. At present, the Podiatric team visits the Neaman Practice every six weeks for a podiatrist’s services and has a list of 44 patients who are being treated. For all the other services, patients, young and elderly, have to go to the specialist services based in St Leonard's Hospital for dedicated services. A lot of patients do not turn up to their appointment after confirming their appointments, and as a result, the service is seen a lot of missed appointments too.

A Member raised concerns that for patients to be seen at Neaman Practice for footcare, they are first required to be seen at  St Leonard's Hospital and for patients from the City of London, this is a far away for elderly patients, and as such, doctors at the Neaman Practice should be able to make the decision to see patients. The Member was advised that for an assessment to be carried out, a senior clinician would have to see the patients. At present, the Neaman Practice is serviced by a Junior Clinician to carry out low-risk work.  The Member was further assured that a transport system is also offered to the patients for those who are not able to travel afar. This was followed by a discussion around the need to address the complexity of ensuring that the patients are informed appropriately about the services, which are available as an alternative solution. This was followed by another Member who spoke of their experience around the services and acknowledged that elderly patients do need to be taken care of as many are resorting to a private service, which is costing them a lot of money in the long run.

The Deputy Chairman commented that the City of London is in a far better position to assist its local residents in comparison to other local authorities. And as such, the matters raised are more of social care rather than a health care matter, and as such, if the possibilities of exploring the ideas to the Grand Committee (CCS) and see if additional funds can be made available to fill the gap in the service.  The Chairman agreed that a resolution is to be agreed upon and be presented to the Grand Committee (CCS) in its future meeting.

This was followed by a second question from the Member asking about the current monthly service activity and waiting time were covered till the month of  July 2020, around 2500 activities were seen to be taking place monthly, and if the Committee can be provided with an update since post-July 2020.

The Committee was informed that at present, the service is seeing between 500-1000; in September 2020, there were 2400 patients were seen; it was noted that due to COVID-19, the referral to the services has been low, although the self-referral for patients remains open.

A Member raised a point that Hoxton Health is part-funded by Hackney Council and does not operate within the City as it is not funded by the City of London and as such if the possibilities can be explored to see if the City of London were to fund the Hoxton Health, and have its Chiropody services extended to the City. The Clinical Commissioning Group representative agreed that this an idea that can be explored but at the same time reassured the Committee that the way the Clinical Commissioning Group has commissioned its current services, is that Hoxton Health should be working to meet the needs of the patients who are registered with the Neaman Practice too.

RESOLVED – that, the verbal update be received.