Agenda and minutes

Councillor Ann Edgeller declared an interest in any item of the agenda that related to mental health as a Partner Governor for the County Council on the Midlands Partnership NHS Foundation Trust MPTF.

RESOLVED: That the Minutes of the meeting held on the 16 March 2021 be approved as a correct record and signed by the Chairman subject to an amendment to page 2 paragraph 2 line 2 to include ’in Staffordshire’ in the sentence,  to read ‘in response to a questions the clinical lead confirmed that supplies of vaccines in Staffordshire were currently sufficient to meet needs’.

Presentation by the Scrutiny and Support Manager

The Chair introduced the item and highlighted the need for members to understand the context of the role and scope of the Health and Care Overview and Scrutiny Committee, particularly its relevance in light of the Mid Staffordshire NHS Trust issue relating to excess deaths in Stafford Hospital between 2005-08.  He advised that the Francis report on Mid Staffordshire NHS Trust  had brought about fundamental changes to how health scrutiny was undertaken, and that it was important to be clear on health scrutiny arrangements  from a District and Borough Council perspective as well as from a County Council perspective.

The Scrutiny and Support Manager provided a presentation to outline the following:

·       The Health Environment

·       Relationships and roles

·       CCG and boundaries

·       Health Scrutiny Regulations

·       Powers of a health scrutiny committee

·       Health bodies statutory duties

·       Health scrutiny arrangements in Staffordshire

·       Health and Care Overview Scrutiny Committee

·       Health and Care Overview and scrutiny work

·       Training and Development

The Committee noted the following comments and responses to questions:

·       It was confirmed that officers were contactable via email if phone contact numbers were not operating.

·       Members were pleased to hear there would be wider scrutiny of health and care services included in the work programme in addition to scrutiny of the NHS.

·       In relation to scrutiny of public health in its wider sense a member made suggestions for scrutiny to consider:

o   Whether leisure centre and gym closures had an impact on health during lockdown.

o   Encouraging walking and a project on the Staffordshire Way.

o   Potential sport pitches on a quarry site and encouraging sports bodies to deliver on projects that help the health of people in Staffordshire.

o   Healthy schools – consider healthy food and activity sharing good practice.

·       The Chair highlighted the need for members to consider health and wellbeing, healthy life expectancy, living healthier longer and the role between district and county scrutiny to ensure we work closer to scrutinise the right things at the right level to add value for people in an integrated approach.

·       District and County scrutiny

o   Members highlighted that the support for scrutiny in District and Boroughs was not at the same level as at the County Council and the need to make recommendations at both County and District levels was recognised. 

o   The Chair suggested that members take a role as ambassador at a local level to work with County scrutiny to consider where value could be added and to consider best practice in different areas of Staffordshire. It was acknowledged that there was a need to know where scrutiny was taking place and at what level as that was a key outcome of the Francis report.  The Chair highlighted the importance for Members to read the Francis report to be aware of the key themes of joint working between County and District scrutiny.

·       The Committee felt it was important to scrutinise Adult Social Care matters to inform CQC Social Care assessments.

·       It was clarified that there was a legal requirement for NHS to consult  ...  view the full minutes text for item 4.

Report of the Scrutiny and Support Officer and Presentation at the meeting

The Chair introduced the presentation and advised that the work programme planning report had been circulated with the agenda for members to consider.

The presentation highlighted the statutory role for NHS scrutiny and its role to scrutinise Adult Social Care, Public Health and Health and Wellbeing Board and it provided an outline of the work planning process for the Health and Care Overview and Scrutiny Committee.  The Chair advised that when setting the work programme members should consider the time to scrutinise matters, different ways to scrutinise and to consider what to scrutinise in more detail.

The Chair highlighted that there were major changes for the health landscape and encouragement from Government for partners and the Council to integrate and work more closely. He invited presentations from NHS and County Council.

The Accountable Officer for 6 Staffordshire & Stoke on Trent CCGs welcomed the opportunity to join the meeting as a hybrid meeting. He provided an overview of the NHS in Staffordshire.

• It was confirmed that the NHS family locally had a commitment to scrutiny.
• It was confirmed that there were some significant national changes happening around the way NHS was organised and where various responsibilities sat, and that the NHS in Staffordshire was split into ‘Commissioners’ and ‘Providers’.
• Commissioners overview

o   In 2018 the 6 Clinical Commissioning Groups (CCGs) had been encouraged to merge on the basis of Integrated Care System (ICS) footprint. At the beginning of the year 147 member GP practices voted to merge (84% majority). There would be no more CCG merges due to the pending legislation for the ICS. In the interim CCGs were using the time that would have been spent planning CCG merges to work with partners around the creation of the ICS.

o   As a result of the 2018 restructure there was a reduced leadership structure with one accountable officer over 6 CCGs, one executive team and a single management team. A management of change process had also taken place in 2018.  Many of the benefits of having a single CCG had already been delivered through streamlining arrangements. There were 6 Governing bodies that met in common and there were shared roles across CCGs (executive, clinical and lay member roles). All CCG committees met in common.

o   The benefits of the merger included that running cost savings were delivered over 2 years and that CCGs were well placed to make the transition from CCGs into ICS.

• Provider organisations

o   The main acute provider was University Hospitals of North Midlands UHNM with bases in Stoke and Stafford County hospital. Staffordshire and Stoke on Trent areas were unusual in that about half of acute activity (people who need to go to hospital for operation, cancer services,  diagnostic or emergency appointments) tended to go outside of Staffordshire and Stoke on Trent, which meant CCGs were working closely with neighbouring authorities in terms of care. Whilst Queens hospital Burton was within Staffordshire it was part of the University Hospitals of Burton and Derby, which was part of  ...  view the full minutes text for item 5.

Report of the Clinical Commissioning Group (CCG)

The Committee considered the report and a presentation from the Programme Director Vaccination Programme and Clinical Lead Vaccination Programme relating to the Covid-19 Vaccination Programme update.

The presentation detailed the following information:

·       Progress so far – the statistics for number of vaccines delivered and percentages for uptake were presented. There was high vaccine uptake in Staffordshire and Stoke on Trent, everyone over 50 (92%), in next cohort (86%) and in 330 care homes all residents had received vaccines (100%).  Housebound people were being visited in their homes and the Programme Director was particularly proud of the delivery to harder to reach residents and people with learning disability. Staffordshire had been selected as one of 21 sites nationally to deliver the Moderna vaccine, Tunstall now delivered three vaccines on site Moderna, AstraZeneca and Pfizer Vaccines. The vaccine supply had been sporadic, but it was confirmed that no vaccines had been wasted. 

·       Phases of the Vaccination Programme – there were four phases to the programme,  there would also be a refresh of the programme structure and modelling roll out to include flu vaccine, possible booster vaccine and secondary school children age 12-18. In the long term there would be a strategy for flu and Covid vaccines and immunisations.

·       Responding to the new variant and priority areas – it was confirmed that second doses had recently been moved forward from 12 weeks to 8 weeks.  Double doses were more effective against new variants.

·       Ongoing work with Public Health to identify outbreaks of new variants. It was identified that there had been a low uptake in areas of Stoke on Trent and Burton, which were being specifically targeted. They were extending the vaccination in Leek to include everyone over 18 (cohort 12) and it was confirmed that there was sufficient moderna vaccine to facilitate this with no impact on programme delivery.

·       Second doses – There were enough vaccines available to deliver.

·       Site locations – There were 23 local vaccination centres, managed by GPs in Primary Care Network (PCN), 1 pharmacy site and three large scale vaccination centres, and some were delivered via GP surgeries. There was good local access to vaccines. Some PCN sites had opted out of cohort 10-12 younger age groups.

·       Targeted vaccination service – This was about working differently with partners, Staffordshire Fire and Rescue take NHS teams to sites, mosques, fruit farms, afro Caribbean society, and some large employers to put on pop-up clinics. Also, Universities have been targeted before students leave for the summer. There was focussed work on inequalities due to lower uptake in Bangladeshi communities and other groups, which was showing an increase in uptake.

·       Myths and challenges – Vaccine hesitancy amongst some of the population. They were working to respond to questions raised, such as impact of vaccine on fertility, pregnancy and similar concerns, also work was ongoing to encourage hesitant people to get vaccination. There has been a lot of myth busting, but as an approach it was working. 

·       AstraZeneca – Risk of blood  ...  view the full minutes text for item 6.

Reports/or reports of District and Borough Representatives

The report was submitted, there were no updates provide verbally at the meeting.

RESOLVED: That the update report was noted.

The Chairman to move:-

That the public be excluded from the meeting for the following items of business which involve the likely disclosure of exempt information as defined in the paragraphs Part 1 of Schedule 12A Local Government Act 1972 (as amended) indicated below.