Appendix 2 London Assembly Health Committee – 16 March 2021 Transcript of Agenda Item 6 – Learning from the Pandemic: Health Inequalities and Healthcare in London – Panel 2 Dr Onkar Sahota AM (Chair): We will be now moving on to look at the health and care workforce in London and the impact of COVID-19 on that. Can I please welcome two new guests? Dr Coffey is staying on and two new guests have joined us: Lisa Elliott, London Regional Director of the Royal College of Nursing (RCN), and Martin Machray, Joint Chief Nurse in the National Health Service (NHS). Welcome to Lisa and Martin. Joanne McCartney AM: Because we have looked at the London Living Wage, can I make a declaration? Can I just declare that I am the Mayor’s representative on the London Living Wage Commission? I am very proud of the work we have done there to raise the living wage to now £10.85, which is £2.13 more than what the Government call their National Living Wage. Just to correct something as well, the living wage was brought into being by an amalgam of civil society, Citizens UK. It was introduced by the first Mayor, Ken Livingstone, not the previous Mayor. Thank you. Dr Onkar Sahota AM (Chair): Thank you, Assembly Member McCartney. Thank you for putting your interest on the record. Can I move on now to looking at health and the workforce? We are a little bit late but hopefully we will make up some time in this section. My first question is to Dr Coffey [OBE] and to Martin Machray. How should London-wide initiatives continue to support the workforce during the pandemic and in the aftermath? For example, could the Healthy London Partnership be more effective in recognising the mental health challenges posed by the COVID-19 for London’s workforce? Martin Machray (Joint Regional Chief Nurse - London, National Health Service): Thank you, Chair, and thank you all for inviting me along today. I will start by trying to directly answer that question. What more can we do systematically across London to support London’s workforce? I came in at the back of the evidence of Professor Marmot to you. Professor Marmot was talking about the living wage and about how employment opportunities are one way in which we improve the health of our population. The NHS would recognise that we are a significant employer across the city. We employ directly over 280,000 people working at all levels on healthcare provision. If you add in third-party organisations that support us and you add in the care sector, you have over 500,000 employees in London working in the health and care sector. Giving people real jobs with real opportunity is one way the NHS, as an anchor institution within the city, can make a real difference to the lives of people because if it has not already been said in your evidence this morning, wealth and health can sometimes be synonymous. We should think of the two together. As a nurse in the city, I know that I want to be able to provide for my family and to give opportunity to my family. That is what the 70,000 nurses and midwives in the city do every day. They work hard for their patients and work hard for their families. The two go hand in hand. We recognise though that over the past 14 months since the global pandemic was announced, the healthcare and care system of London has taken a significant wave, two waves, of the pandemic, which has really impacted personally on our staff. I am sure Lisa [Elliott] will talk about this as well. You cannot underestimate the impact this dreadful virus has had on the lives of nurses, porters, doctors, everyone working in the system. You only have to visit and talk to Intensive Therapy Unit (ITU) nurses to hear their experience of what it has been like. I remember, Chair, you asked me a question at a previous meeting, “Can you describe what it is like to have gone through that first wave?” I thought about that question a lot. I do not think my words do it justice. I am the son of journalists so the words should come easy to me, but I do not think I have words to describe what this pandemic has done to my colleagues in the NHS and in the care system. We have to do more to support them to recover from that. Some of that recovery is about letting people go back to the jobs they chose to do: the diabetic nurse to go back and be the diabetic nurse rather than a helper on an ITU, a general practitioner (GP) to be able to go back and provide population-led healthcare for their list, not just be a telephone answering service. They have done more than that, but you know what I mean. It is the point I am making. That is part of recovery. Across London, we also set up five Health and Wellbeing Hubs because we know that some of our colleagues need more than just that permission to go back to normal duties. They need time off, they need to recuperate, they need to reflect and some of them need a lot of support. That mental health support that was in your question is part of that. We have a whole raft of services now wrapped around our staff in healthcare, in the NHS but also in social care, which means that everyone should have access to the services they need, given the 14 months this virus has put them through. I will stop at that point, Chair, but happy to take the questions that will come. Dr Onkar Sahota AM (Chair): Martin, let me also declare an interest that I am also a frontline doctor and GP. Martin Machray (Joint Regional Chief Nurse - London, National Health Service): I appreciate that. Dr Onkar Sahota AM (Chair): The NHS and the staff have worked tremendously. When we talk about the NHS, we talk about the people who work for the NHS, otherwise it is just buildings and equipment. It is on record, the tremendous work they have done and what they have gone through. At some times, it was a like a warlike zone. I put on record of the gratitude of all the people for all the hard work the NHS staff has done. Martin Machray (Joint Regional Chief Nurse - London, National Health Service): Thank you. Dr Onkar Sahota AM (Chair): Dr Coffey [OBE], did you want to add anything? Dr Tom Coffey OBE (Mayoral Health Advisor): Just to complement some of the remarks Martin [Machray] has made. Sadiq [Khan] wants to do what he can as Mayor to assist and our Good Thinking website, which has launched, has a special page in helping care staff, to offer support, to help the care staff. Pride in London has a health and care webinar series to make sure that people, who are now more and more using digital tools to access their healthcare, can use those webinars. Thirdly, Sadiq has launched Capital Nurse, which is a campaign to try to address the nursing shortages in London so that people choose to work in our capital city. Fourthly, the Adult Education Budget has been devolved to the Greater London Authority (GLA) and to the Mayor of London. That programme is trying to see how we could use the budget to develop skills from Londoners that perhaps do not have large numbers of formal qualifications to go on to the pathway to become nurses. I know in Newham a literacy project is working on that to get people without General Certificate of Secondary Education (GCSE) to start some work to allow them to become qualified nurses. It is so important. As Martin has identified, the NHS is the biggest employer in London. London has the most enormous resource of young people. How can we match those two together? Sadiq Khan would like to be part of the catalyst, part of the solution that allows that to happen, as well as supporting the existing nursing workforce, medical workforce and all the health and social care staff. Dr Onkar Sahota AM (Chair): Thank you. Can I go over now to Lisa from the RCN? Lisa, what further support do you think a professional requires as we move out of the pandemic into recovery? What is the morale like at the frontline? How do nurses feel in the ward? What is the morale like in the profession? I put it, in a way, with my next question after this, but what is the morale like in the profession at the moment? Lisa Elliott (London Regional Director, Royal College of Nursing): Thank you, Chair. It is important to realise where we were before COVID-19 and before we had started dealing with the pandemic. There was already a crisis in nursing. We had a chronic shortage of nurses. We are currently 8,500 nurses short. Some of what has contributed to that has been the cost of living in London, which does push some nurses out of the capital. The fact is that we do not have a domestic supply that meets our demand. We do not train enough of our own nurses to meet the need we have. The removal of the bursary did impact on that when that was taken away a few years ago. That pay has not kept pace with the cost of living.