Author: Stu Hosker

The NHS in north east London will from today (3 April 2023) fund up to three cycles of in vitro fertilisation (IVF) for all eligible local people, as part of changes that make the funding of NHS treatment for people with fertility problems fairer across the area.

This change is one of a number in the new north east London fertility policy, which replaces the previous five different policies across the area. The new single policy was approved by the NHS North East London Integrated Care Board in November 2022 and will mean that all eligible people registered with a GP in north east London will be able to have the same fertility treatment, such as IVF – this was not previously the case.

Dr Anju Gupta, GP and Clinical Lead at NHS North East London, said: “Our new policy is good news for local people who need help to try to have a baby. We’ve increased the amount of treatment you can have and improved access to some treatments. I’m proud that the policy is fairer and that it recognises people’s different fertility situations and needs.”

“Fertility and fertility problems are a highly personal and emotive topic, and every person has different needs and expectations of what support the NHS should provide. With this in mind, we acknowledge that our new policy doesn’t address all of the concerns of some local people. However, we believe it does address inequalities across north east London, while prioritising treatment for people with proven fertility issues.”

There are many treatments that can support people to try to get pregnant, some of which are paid for by the NHS. The main treatment areas where NHS North East London has made changes in its policy are:

• Increasedaccess to IVF and the number of cycles available:
  • All eligible people aged under 40 are now entitled to up to three full IVF cycles. Previously people in Barking and Dagenham, Havering and Redbridge (BHR) were entitled to one embryo transfer only.
  • The upper age limit to access IVF treatment has been increased by one year. All eligible people aged 40, 41 and 42 are now entitled to one full IVF cycle. Previously this was not funded for people aged 40 and over in BHR nor for people aged 42 in other areas of north east London.
• Increased funding for intrauterine insemination (IUI) for eligible people:
  • Trying to get pregnant using donor insemination who have fertility problems. IUI was not previously funded for these people.
  • With some conditions and social, cultural or religious objections to IVF. IUI was not previously funded for these people.
  • With a physical disability or psychosexual problem.
  • With a condition that means they need IUI as part of their fertility treatment.
• Increased the length of time the local NHS will fund thestorage of eggs, sperm and embryos in cases of fertility preservation to:
  • Up to their 43rd birthday for people aged under 32.
  • Up to 10 years for people aged 32 and over.
  • Previously storage was funded for the first 10 years in Tower Hamlets and for the first five years in other areas of north east London.

The new policy is for both individuals and couples with a fertility problem, regardless of their sexual orientation, gender identity or relationship status, and applies to people who are registered with a GP in Barking and Dagenham, City of London, Hackney, Havering, Newham, Redbridge, Tower Hamlets or Waltham Forest.

Gwenda Burns, Chief Executive of national charity Fertility Network UK, said: “Fertility Network UK applauds NHS North East London for their new fertility policy, which will offer hope to so many people struggling to become parents. It is a fertility policy for the 21st century and we are pleased to have helped with their engagement work on it.”

NHS North East London used the latest national clinical guidelines from the National Institute for Health and Care Excellence, research and best practice to develop the new policy. Clinicians, including GPs and fertility experts also helped to shape it.

A public engagement period on the proposed new policy ran from 13 June to 22 August 2022 and overall the feedback received was positive. All the feedback was analysed and reviewed, and some changes were made to the final policy as a result. The engagement report and responses to the feedback received can be found on the NHS North East London website.

The full policy and other documents, including questions and answers, an information leaflet and a summary of the main changes can be found on the NHS North East London website.

Ground-breaking work to reduce waiting times and improve care for patients with stomach and digestive problems in north east London has won a national award.   

The initiative involving NHS North East London (NHS NEL), Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) and healthcare provider Medefer was named among the winners at the Health Service Journal (HSJ) Partnership Awards 2023.

Established in 2016, the partnership was set up to support the gastroenterology service at BHRUT which was then facing significant waiting times and referral backlogs in its outpatient department amid ongoing challenges recruiting consultants.

With Medefer’s input, a first-of-its-kind virtual outpatients service was set up to help local GPs manage gastroenterology referrals and ease pressure on the trust.

More than three-quarters of GP referrals (76%) are now managed by Medefer remotely and discharged, and only 25% of patients need to attend an in-person hospital appointment. This has freed up capacity at BHRUT, enabling consultants to focus on patients with more serious conditions, and its endoscopy service is now rated among the top three nationally[i].

These achievements were recognised at the awards ceremony in London yesterday (23 March) where the initiative won the ‘Best Provider Partnership with the NHS‘ accolade.

The HSJ Partnership Awards judges said:

“This ambitious partnership was the first time a truly virtual outpatients service was imagined and implemented to deliver a sustainable and flexible solution to reduce waiting times, support local hospital workforce capacity and support general practice in managing gastroenterology referrals.”

Tracy Rubery Director of Partnership, Impact and Delivery at NHS NEL, said:

“We’re delighted to win this award. It’s welcome recognition of the many hours’ hard work partners put into developing and implementing the virtual outpatients service and the positive impact it’s had for our patients, as well as supporting clinicians.

“As the judges acknowledged, the service is making a significant contribution by allowing many patients to be safely managed without the need to attend an outpatient appointment – saving them a hospital visit and helping cut waiting times for those who need to see a consultant. Our aim is to build on this work and deliver further improvements in care.”

Sas Banerjee, endoscopy and joint gastroenterology lead at BHRUT, said:

“This reward is great recognition of what working closely with our partners can achieve for our patients.

“Our relationship with Medefer helps to reduce our waiting lists by ensuring the referrals which reach our specialists are the patients which really need to be seen in our hospitals.”

Dr Bahman Nedjat-Shokouhi, CEO and Founder of Medefer said:

“We are grateful for this award. This has been a long term and ambitious partnership between Medefer, BHRUT and NEL that started in 2016. It was the first time a truly virtual outpatients service was imagined and implemented at scale.

“The partnership of the gastroenterology teams between Medefer and BHRUT has resulted in outstanding care for the patients. Medefer’s team have reduced the outpatient demand by almost 80%, enabling BHRUT’s team to deliver the best performance for outpatient in London and develop one of the top JAG endoscopy units in the country. We look forward to developing our partnership further to deliver even better care for the patients.”

[i] The endoscopy service at Barking Havering and Redbridge University Hospitals NHS Trust now rates among the top three in the country according to the Royal College of Physicians’ Joint Advisory Group (JAG) on GI Endoscopy.

To mark the three-year anniversary of the first Covid-19 lockdown, we spoke to Dr Adam Ainley, Consultant Respiratory Physician at BHRUT and Clinical Lead for Long Covid across north east London about the Long Covid clinics.

“What a three years they’ve been…

We’ve come a long way in north east London. As I reflect on our journey and the progress made, there’s a lot to be proud of.

The Long Covid clinics across north east London were set up in December 2020, to meet the needs of those patients who still had lingering Covid-19 symptoms, following discharge from hospital.

It was a chaotic, not to mention busy, time! During the first wave, it was becoming increasingly clear to front line clinicians, that a significant number of patients were developing a range of complex and potentially serious post-infection symptoms. We had to act to set up services at scale and with speed.

The patient impact of these symptoms was quite staggering and had a very real bearing on their day to day lives. Many couldn’t go back to work and symptoms such as breathlessness and losing their sense of smell and taste took a toll on many.

I also recall the pressure our hospitals were under. Demand had more than doubled across our part of London and due to safety restrictions, a number of outpatient clinics were closed. International travel bans also made it difficult to recruit staff.

From a patient perspective, there were challenges around how their needs were met – numerous physical, social and emotional challenges that all had to be factored in. All of this was compounded by the mass of conflicting patient advice flying around.

We’ve managed to adapt over the years to meet patient needs in a more holistic way by working alongside them. For example, we’ve been able to utilise data and digital rehabilitation tools to tailor care, including using a Virtual Ward model for some patients. Exciting collaborations with English National Opera and Age UK around tackling exclusion are quite novel too and provide innovative ways to further develop our services.

Setting up brand-new clinical services, across a large footprint, in the midst of a pandemic wasn’t without challenges! With clinical staff leading the way, and working closely with NHS England, primary and secondary care colleagues, local authorities, the voluntary sector and providers, I’m proud of the way we collaborated to set up services in a more defined, clinically-driven way. There have been many patient stories of full recovery and many of them returning to work and finding support where they didn’t have it before.

My advice for anyone who suspects they may have Long Covid would be to seek help. See your GP so you can be checked out.”

Watch this clip to learn more about the symptoms and see the comments section for the videos in commonly spoken languages: https://www.youtube.com/watch?v=fw6QwEtcSEY…

We are delighted to share our interim Integrated Care Strategy – the first for our Integrated Care Partnership.

This sets the vision and ambitions as we work together as a new ICS, and has brought together people from across north east London to ensure it reflects the needs of our communities.

The strategy highlights six crosscutting themes which are part of a radical new approach for working together across NEL; it sets out how we will improve quality and outcomes and address inequalities in relation to our four system priorities; and defines the key areas we need to secure as foundations for integrated working as a system.  

The strategy was signed off at a meeting of the Integrated Care Partnership on 11 January 2023 and formally adopted by the Integrated Care Board on 25 January 2023.  

The development of the strategy was a truly collaborative process involving colleagues from all parts of our system who, despite the challenging timescales, went above and beyond to come together to share their expertise and insights. We are very grateful to all across the ICS who have contributed to this work.

Companionship and a listening ear can do your health and wellbeing a world of good.

So says Brian Gribben, 79, whose life has been changed for the better since he started attending a local bereavement support group in Redbridge following a visit to his GP.

Brian, 79, was heartbroken when Sheila, his beloved wife of almost 59 years, died of cancer in 2021. He tried antidepressants but could not stand the physical side-effects.

Ultimately, it was meeting up with other people in the Healing Hearts group in Chigwell – all of whom are coping with the loss of a loved one – that has helped him most.

Brian was put in contact with Healing Hearts by social prescriber Simarone Sahota, from Wanstead and Woodford Primary Care Network. Her role – and that of other social prescribers – is to listen to people whose health is suffering due to problems that cannot be solved by doctors, and to connect them with groups and activities that can help.

Brian, who grew up in Bethnal Green and used to work as a meat porter at Smithfield Market, was initially a bit sceptical about joining the support group, but this quickly changed.

“I didn’t want to go,” he said. “I didn’t believe it would do any good, but it has cheered me up like mad. I don’t know why but I come out of there like I am dancing on my toes.”

“They are such nice people – I never miss a meeting.”

It is estimated that one in five visits to the GP are related to social needs such as stress, loneliness or relationship turmoil, rather than medical issues, so many patients attending their local surgery in north east London may now be referred to a social prescriber.

Social prescribers, also known as link workers, will take time to understand what matters to each patient and help them create a plan with information and ideas for next steps.

They can then connect patients with non-clinical services and organisations that can offer support, guidance, and opportunities for personal growth, and this may include helping them to start a new initiative such joining a local befriending group or gardening club.

Today (9 March), the impact of link workers, community groups and the organisations that support their work is being recognised as part of Social Prescribing Day, an annual celebration of the effect social prescribing can have on people’s health and wellbeing.

Angie Turner, a social prescriber based in Redbridge, said: “Over the last two years I can see the positive impacts of additional roles like social prescribers in GP teams.

“People come to me as I have the time to listen and support them with a personalised approach, promoting independence and supporting them with life journey hurdles and obstacles. I give people tools and tips to become more positive and take control of their own lives, encouraging self-worth and independence.”

Alex Trigg, a social prescriber based in Tower Hamlets, said: “I like to think of social prescribers as bridges that enable people to obtain the knowledge they need to improve the quality of their life.

“One thing I’ve learnt from this job is the fundamental importance of community groups, activities and services for the overall health of the people in our areas.

“Social prescribers would be nowhere without the voluntary, charity, health and wellbeing sector. We can help make improvements in people’s lives because there are places that can provide that extra level of support and compassion. I think these services should be celebrated every day.”

Social prescribing is part of the NHS Long Term plan to move away from a ‘one size fits all’ approach to healthcare and towards personalised care. This approach recognises that each person has unique needs and preferences when it comes to their health and wellbeing.

If you live in Barking and Dagenham, City of London, Hackney, Havering, Newham, Redbridge, Tower Hamlets or Waltham Forest and your physical or mental health is being affected by non-medical issues – such as a lack of green space, bereavement or housing – social prescribing might be able to help. To find out more, speak to your GP practice.

For more information, visit the North East London Health and Care Partnership website.

Ramadan begins on the evening of Wednesday 22 March and Muslim communities in Britain and around the world will soon be making plans to prepare for the month of fasting. Ramadan brings the opportunity to revisit routines and think about your health, as well as the wellbeing of others.

Over 500,000 Muslims call north east London home and the NHS is here to help you enjoy a healthy and safe Ramadan.

This advice is particularly important for anyone who has diabetes, takes prescribed medicines or who needs a medical appointment during the holy month.

If you have diabetes

If you have diabetes and want to fast during Ramadan, please speak to your GP or diabetes nurse about the safest way to do this. If you monitor your blood glucose levels you should continue to do so while fasting. Diabetes UK has lots of advice on fasting and managing your diabetes during Ramadan, including tips on healthy eating and a factsheet in English, Arabic, Bengali and Urdu.

Taking prescribed medicines

If you are taking prescribed medicines, you should continue taking them during Ramadan, but check with your GP or pharmacist if the doses need to be adjusted or the times that you take them need to be changed.

Attending medical appointments

If you have a medical or vaccination appointment booked during Ramadan, it is very important that you attend. You can change the time of your appointment if you need to. The vast majority of Muslim scholars state an injectable vaccine does not invalidate your fast.

What to do if you become unwell while fasting

If you become unwell while fasting, do consider breaking your fast as is permitted on account of avoiding harm. Your local pharmacy can offer advice and some medicines, and this can help you treat your condition yourself at home. Pharmacists can also help you see the right person, if you need to see someone else. If you have a more serious illness, you should visit your GP practice website or NHS 111 online for advice. If you cannot access the internet, call 111 or your GP practice directly.

Please remember: many groups are exempt from fasting on account of harm to their health – including people who are unwell with a physical or mental illness or have a poorly controlled long-term condition; people who are very frail and weak; those who lack mental capacity; and women who are pregnant or breastfeeding fearing harm to their child. Speak to your imam if you are not sure, as there are alternatives to fasting every day in Ramadan.

Generally staying healthy

Ramadan is a great time to build up your self-control and give up smoking. Talk to your GP or Pharmacist if you are interested. There is also the NHS Smokefree website www.smokefree.nhs.uk/

Some other ways to stay well during Ramadan include: eating as healthily as possible when breaking your fast and avoiding sugary, fatty and processed foods; staying hydrated before and after fasting by drinking plenty of water and avoiding caffeinated drinks; and if you are able to, keeping active with some light exercise such as walking.

The Mayor of London’s free annual festival, Eid in the Square 2023, also returns to Trafalgar Square on 29 April.

Ramadan Mubarak! 

Useful resources

• Ramadan fact sheet from the Muslim Council of Britain
• British Islamic Medical Association and Muslim Council of Britain Ramadan Safety Guidance
• British Islamic Medical Association advice on taking lateral flow tests during Ramadan
• British Islamic Medical Association advice on fasting and Covid-19 vaccinations
• Professor Partha Kar shares his advice about type 2 diabetes
• Diabetes UK advice on fasting and managing your diabetes during Ramadan and factsheet in English, Arabic, Bengali and Urdu
• Diabetes UK tips on healthy food and drink choices during Ramadan
• A selection of YouTube videos by Diabetes UK:

• Ramadan: Preparing and Participating if you live with diabetes feat, Lived Experiences | Diabetes UK – YouTube (40 mins)
• Ramadan if you live with diabetes with Moulana Azizur Rahman and Dr Waqas Tahir | 2023 | Diabetes UK – YouTube (25 mins)
• Ramadan: Preparing and Participating if you live with diabetes | 2023 | Diabetes UK – YouTube (13 mins)
• Ramadan: Preparing and Participating if you live with diabetes | Slideshow | 2023 | Diabetes UK – YouTube (slideshow only – 4.5 mins)

Dr Thomas Treibel, Cardiologist, Dr Tim Ferris, Jo Moss and Justin Creigh, Deputy CEO at St Barts

We were delighted to host Dr Timothy Ferris, National Director of Transformation at NHS England, and showcase some of the great work the ICS is doing on innovation and addressing health inequalities.

Tim spent the morning at Bart’s Hospital visiting the cardiac department and cancer acute assessment unit.  He then moved on to meet members of the women’s inclusive team in Tower Hamlets who are currently delivering some key initiatives to tackle health inequalities. 

During his four hour visit Tim was accompanied by Dr Paul Gilluley NHS NEL chief medical officer and Jo Moss, NHS NEL chief strategy and transformation Officer.  He also met Justin Creigh, Deputy Chief Executive of Barts Health and members of the cardiac team including cardiologist, Dr Thomas Treibel.

Tim will be returning to the ICS in April to see more of the good work taking place within our system.

This week is cervical cancer prevention week, and we are working hard to encourage people in north east London to attend their cervical screening appointments.

We have created a short, animated video which helps overcome some common myths and fears with cervical screening, cervical cancer and HPV. This is also available in 15 different languages.

Cervical screening is a free health test that helps prevent cervical cancer. It checks for a virus called human papillomavirus (HPV) and, if you have HPV, cervical cell changes (abnormal cells).

If you are due for cervical screening, you will receive an invitation to book an appointment. Please make sure you book, and attend, your appointment as soon as possible.

Cervical screening is not a test for cancer, it is a test to help prevent cancer. If you test positive for HPV it doesn’t mean you have cervical cancer or will develop cervical cancer. Cell changes are easily treated, and this prevents cervical cancer from developing.

Screening can prevent up to 75% of instances of cervical cancer and is estimated to save 5,000 lives per year.

You can request a female nurse or doctor. It may be a little uncomfortable but only takes a few minutes and could save your life. Anyone with concerns or questions should contact their doctor.

If you have received an invitation for cervical screening, please don’t wait. Call your GP practice to book an appointment as soon as possible.

For more information

Jo’s Cervical Cancer Trust is the UK’s leading cervical cancer charity, providing information and support to anyone affected and campaigning for excellence in cervical cancer treatment, care and prevention. Its national Helpline is free, confidential and on 0808 802 8000.

For more information, watch our short-animated video.

There is also useful advice for trans and non-binary people on attending cervical screening on the Cancer Research UK website. There is a dedicated service at 56 Dean Street for trans men and non-binary people.

More information on cancer screening is available on our webpage.

Great Mental Health Day 2023 is a London-wide initiative in its second year and will celebrate the power of community kindness, telling the story of how we’ve come together for one another across London.

The start of a new year is a time for setting goals and seeing it as a chance for positive change or action. But for many of us, this year may be challenging or lonely, particularly as increased cost-of-living pressures have an impact on many people’s mental health and wellbeing.

Great Mental Health Day is designed to get Londoners, including those in north east London, talk about mental health, destigmatise asking for help and to raise awareness of the great support available across the region. Check out the resources below:

• Our partners Thrive LDN, have put together this interactive map that shows what is happening in your borough.
• A range of online events are also planned, including a guide to looking out for those around you in tough times.
• Debt Free Advice is delivering a three-month advice bus tour to support Londoners through the cost-of-living crisis. The bus will visit over 35 London locations over a three-month period, providing signposting on other cost-of-living support, and host webinars on a range of topics including budgeting, debt options, and mental health.

Dan Burningham, Mental Health Programme Director, NHS North East London, said:

“In a year that’s remained difficult for many Londoners, it has been our communities, friends and families which have played the most important role in in getting us through difficult times together. 

“This Great Mental Health Day let’s commit to keep being there for each other, to support and look after one another in this difficult moment and to play our part in ensuring that we value mental health and physical health equally.”

“‘In North East London we are committed to building greater resilience by delivering personalised mental health care that is co-produced with the person, and draws on their surrounding community and support network.’

In north east London there are around 3,300 children and young people living with a life threatening or life limiting condition, and this is increasing year on year.

Through this work engaging with users of services and families led by Haven House and Richard House Children’s Hospices, the paediatric palliative care needs assessment demonstrates a better understanding of unmet care needs for the children and young people using end of life care services.

By exploring the current experiences of families receiving care, along with the experiences of professionals involved in delivering services in palliative and end of life care, the team undertaking this work evaluated the effectiveness of provision and identified key opportunities to work collaboratively to better meet needs in the future. 

Kath Evans, Clinical Lead for Babies, Children and Young People at NHS North East London says

“this work provided the opportunity to make sure we really understood how life limiting conditions and end of life care impacts the whole family. When the aim of care is not curative, insight and information for families about access to the range of palliative, end of life and bereavement care services is essential.

We are grateful to families who, by insightful conversations, confirmed the importance of professionals sharing information about services, and encouraged stronger connections across community, palliative and specialist services to ensure consistent access to symptom control, psychological support and choice in where and how care is received’. 

The Paediatric Palliative Care needs assessment report identifies a number of key themes along with actions to make improvements. Work will now start to implement these recommendations, as well as continuing to have discussions with children, their families and professionals on what more we can take forward together to ensure the best possible experience and care for all our babies, children and young people in north east London. 

Read the full report or watch the summary animation on our website.