The Leader of the Council, Cllr Jeremy Newmark has written to the Secretary of State for Health and Social Care raising 'serious concerns regarding the insufficient capacity of our local NHS services, particularly in primary care'..
Here's Cllr Newmark's letter to The Rt Hon Wes Streeting MP in full:
Dear Wes,
I am writing to convey the Council’s serious concerns regarding the insufficient capacity of our local NHS services, particularly in primary care. Without swift attention, it will not meet the current and growing demand in the near future.
Hertsmere is home to a spectrum of communities, with significant disparities in levels of deprivation alongside pockets of relative affluence. Hertsmere borders three London boroughs (Harrow, Enfield and Barnet), which means that the majority of residents access services in London, rather than locally.
Within the Hertsmere locality, there are nine GP practices, which have sixty practicing GPs. Herts Five Primary Care Network (PCN), which covers Borehamwood, Radlett and Bushey, ranks 20th out of 35 for deprivation levels across Hertfordshire and West Essex (HWE) (35 being the most deprived). However, three GP practices in Borehamwood are among the nine most deprived GP practices across HWE. They cover wards that score very high on regional and national indices of multiple deprivation. Over a quarter of the Herts Five population have at least one long-term condition and almost 6% have five or more.
Hertsmere residents often struggle to access primary care and ICB’s own data shows that there are just 0.56 GPs per 1,000 population in the locality, which is lower than our neighbouring boroughs, and the wider South West Herts area, which averages 0.64. This is further exacerbated by the absence of any urgent care facility in the borough. As a result, Hertsmere residents have to rely on lengthy and arduous public, or private transport to access Accident and Emergency services in neighbouring areas such as Watford, Barnet and Harrow. A consequence of this is increasingly inefficient and uneconomical use of these hospitals’ services.
Despite the necessity of travel outside of Hertsmere to access urgent care, Hertsmere consistently stands out in South and West Hertfordshire for its low acuity of A&E services. These cases could be more appropriately managed in alternative local settings, which crucially, Hertsmere does not have. Despite a number of assurances over the years by the local ICB, there has been no progress whatsoever on this front.
Data shows that 55% of all A&E activity by Hertsmere residents are for low-acuity conditions, with around 60% of these relating to minor illnesses. Notably, 64% of all A&E activity originating from Hertsmere takes place within the Royal Free London NHS Foundation Trust (RFL) largely at the Barnet Emergency Department (ED) and Barnet and Chase Farm Urgent Treatment Centre (UTC).
In primary care, the demand for same-day appointments has been steadily increasing since 2017, with between 45% and 56% of primary care activity requiring same-day appointments. Due to the above-average population growth in Hertsmere, this upward trend will continue in the future and there is serious risk that the health infrastructure system will not be able to meet demand without adequate and urgent action.
Under the recent revised National Planning Policy Framework (NPPF) targets, Hertsmere Borough Council, as the local planning authority, is required to deliver 1,034 homes annually, which is a 41% increase over the existing housing delivery target. This growth will lead to a substantial increase in the local population, placing further pressure on an already stretched health service infrastructure.
As a Local Planning Authority, we are making every effort with developers to prioritise the ICB’s involvement in operating new medical facilities. Indeed, these efforts have continued over several years. However, these efforts have been met with resistance due to the ICB’s ongoing difficulties in funding GPs and the healthcare professionals needed to staff such facilities.
Despite two planning applications (Shenley Hill and Bushey), where developers have, at our instigation, offered to provide land and construct medical facilities to be made available at a peppercorn rent; and despite the Council’s own commitment to fully fund the internal fit-outs, there has been a reluctance to take these opportunities forward, even after numerous meetings where the ICB has recognised serious shortfalls in primary care provision in Hertsmere. Similarly, despite the Council’s offer to make fully fitted out premises available to the ICB at no-cost in South Borehamwood which currently lacks any primary care provision whatsoever, the ICB continually actively resists even satellite GP provision in this area of significant and growing population, suggesting that it is not required.
Therefore, I urge your intervention in this matter, to encourage the local ICB to take up the opportunities Hertsmere is offering for much-needed medical centres in Shenley Hill, Borehamwood and Bushey. An opportunity to discuss this further with members of your team would be greatly appreciated. I know how busy you are delivering the reforms required to ensure the NHS is there for people when they need it. I felt it particularly important that you were personally aware of the way in which ICB engagement with councils like our own at a local level appears out of alignment with that mission.
I look forward to any advice, input and intervention you are able to provide to ensure that Hertsmere residents get the healthcare access they need.
Yours sincerely,
Jeremy Newmark
Leader of the Council
