Agenda and minutes

Councillor Ann Edgeller declared an interest in any item of the agendas 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 7 June 2021 be approved as a correct record and signed by the Chairman.

Report of the Clinical Commissioning Group (CCG)

The Committee received a presentation from CCG and NHS providers to outline the restoration and recovery plans for services across three provider organisations, University Hospitals Midlands North (UHMN), University Hospitals Derby and Burton (UHDB) and Royal Wolverhampton Trust (RWT) Acute Trusts and also welcomed representatives from mental health and community health services.

The Accountable Officer for the 6 Staffordshire & Stoke on Trent CCGs assured the Committee that it was the right time to consider restoration and recovery in light of progress with the vaccine programme, he indicated that there was a need to look forward, whilst living with Covid and the pandemic to give confidence to the public to use the services available to them.

The Director of Strategy UHMN presented an overview of the current position referring to the planning guidance to stand services back up. She indicated that services had been re-introduced in summer 2020 temporarily before second lock down resulted in services being stood down again, and that this had provided useful experience moving into this restoration and recovery phase.

The Director of Strategy presented the challenges for restoration, highlighting the demand for urgent and emergency care at the front door, capacity in critical care, work force resilience, winter pressures and mental health service demand. She indicated that the three biggest risks to recovery were workforce resilience, ability to restore activities and widening health inequalities.

It was reported that providers were starting to see increased referrals and were tackling the backlog list for procedures. All three provider organisations were looking at services that had been temporarily closed to agree what needed to happen next to stand them back up. In relation to Minor Injuries Units at Leek and Cannock which were temporarily closed due to the pandemic and staffing issues.  Leek MiU was now open with limited hours, but Cannock Chase MIU remained closed. The Director of Strategic Planning & Performance at The Royal Wolverhampton NHS Trust gave a commitment to attend Cannock Chase DC to provide an update.

It was noted that the following processes were in place:

·       Partners were working collaboratively across various Trusts to facilitate recovery. 

·       Work was ongoing to ensure existing workforce and facilities were deployed efficiently.

·       It was important to look after staff, to ensure support mechanisms and communications were in place. 

·       Patients in need of care the most were prioritised and communication with patients on waiting lists was ongoing to advise if care could be deployed to independent sector and also to validate that patients still wanted to proceed with procedures.

Additional data was requested from each of the three provider organisations relating to:

• People waiting longer than 62 days for procedures
• Staff vacancies
• Restoration and recovery action plans
• Specialist services action plan on backlog

It was agreed that a letter be sent from Staffordshire County Council to thank the NHS for the work that had been carried out through the pandemic and to congratulate the NHS for being awarded the George Cross.

RESOLVED: 

a)           That Committee note the progress and risks  ...  view the full minutes text for item 11.

Report of the Clinical Commissioning Group (CCG)

The Committee received a report and presentation from the Director Family Care and Medicines Optimisation Strategy and Deputy Director of Primary Care to consider access to General Practice (GP) and respond to concerns in relation to access to GP surgeries. The presentation provided context, activities and actions put in place during the pandemic to support general practice, key activities in June 2021 and a detailed action plan for general practice access updated on 1 July 2021.

It was reported that GP surgeries had remained open 08:00 – 18:30 during the pandemic and that business continuity plans were upgraded during pandemic to include extended hours and total triage. Total triage was introduced to assess, using clinical criteria, if a face to face consultation was required or whether the issue could be addressed remotely.

At the peak of the pandemic 80% of consultations had been held remotelyand it was noted that the ratio between telephone and face to face appointments at that time 20-80 was being addressed, and currently in the region of 50-55% of consultations were face to face. It was reported that there had been a variety of public responses to the use of telephone consultations and remote access to services, some patients had expressed a preference for telephone consultations. Members raised issues and concerns relating to equity of remote access for some people, the cost of long waits on telephone calls and that that many people wanted a face to face appointment with a GP.

In response to concerns raised, members were informed that practices in Staffordshire were currently dealing with a substantial increase in demand caused by a variety of issues, such as delayed demand for services and people contacting the GP when they were not able to get through to other services such as 111. The increased demand had led to an additional 100,000 phone calls a week and an additional 15,500 appointments per week across Staffordshire. The increased numbers had left some practices struggling to meet demand.

It was considered that public expectation was for access to be ‘back to normal’ on 19 July in terms of people receiving same day appointments and access to practices. It was reported that many GPs wanted to do more face to face consultations but there were constraints and different issues for each practice to address, such as the time taken to clean and change PPE between consultations which limited the number of consultations per day and the size of rooms when socially distancing.  Members were advised that some remote access measures would remain,additional telephone lines were being added and some surgeries were moving to cloud based solutions to reduce call waiting times.  

It was explained that there were a range of healthcare professionals available at practices, other than GPs, who may better suit the needs of patients.  In the last 12-18 months an additional 225 healthcare professionals had been recruited into practices in Staffordshire and patients could contact a clinical pharmacist for advice, however people preferred  ...  view the full minutes text for item 12.

Report of the Clinical Commissioning Group (CCG)

The Programme Director Vaccination Programme presented an update report and presentation on the progress of the phases of the COVID-19 Vaccination Programme and the latest position.

The Programme Director highlighted that the programme was moving toward the end of first phase of the programme, 83% adults had been vaccinated and two thirds of all adults had been fully dosed. She provided detail on the response to the new variant, the work with Public Health to identify outbreaks and measures in place to deliver the vaccinations,  such as targeted vaccination service, walk-in weekend, locations and second doses pulled forward to 8 weeks.

The Committee noted the following comments and responses to questions raised:

·                Inequalities were particularly relevant in relation to the difference in uptake rates and access.

·                Targeted vaccination for homeless people in Staffordshire – The CCG carried out vaccinations of homeless people earlier than national guidance advised, they were carried out as part of the winter plan and took place in sheltered accommodation before people dispersed.  The second vaccine dose data for homeless people was lower, and this was because they could not be located. 

·                A vaccine webinar was planned for all members across Staffordshire on 8^th July 2021 to provide a COVID Vaccination update.

·                A report relating to the Winter Flu and vaccine booster programme was scheduled for a meeting of this Committee 13 September 2021.

The Chair thanked officers for an excellent representation of the vaccine programme and he encouraged all Members to share this widely.

RESOLVED:

That the COVID-19 Update be noted.

Report of the Director for Health and Care (Pre-decision scrutiny) 

The Cabinet Member Health and Care presented the report highlighting that the report outlined the commencement of an options appraisal for the future provision of replacement care services for people with learning disabilities in Staffordshire, including engagement with service users, carers, and stakeholders. The results of which would be presented to Cabinet in the third quarter of 2021.

The Cabinet Member indicated that this was an opportunity to review and redesign services and carry out an options appraisal to find the best model for the future for people with learning disabilities. She advised that the report highlighted the process to be followed, the severe restriction of the premises and that the CQC had highlighted the need to review the care service at Douglas Road.

In response to questions the following comments and responses were noted:

• SCC aspire to support as many people as possible to live at home and independently.
• There may come a time when it was impossible for some people to stay on their own and it was no-longer viable to provide care from in-reach services or from relatives. At this time options would need to be looked at for their care, but care homes would be as a last resort.
• For people with learning disability that required a care home place, it would be in a main stream facility with specialist beds, rather than specialist homes. 
• There was a lot of analysis to do in the future to consider the wider care market. A report was included in the committee work programme to look at the issue.
• In terms of the Community Impact Assessment, there was a need for regular engagement in the community and with relatives to move forward,  to consult, talk, help parents and carers, and to help them to make a decision.
• Page 49 of the report – there was a table that indicated variability of cost between Woodlands Road and Silver Birch, the next report would carry a full impact assessment.  Whichever option was the preferred option should be affordable.
• The costs were disproportionately high at Douglas Road due to the significant reduction in capacity but the need to carry paying the full overhead costs.  

RESOLVED:

1.    That the Health and Care Overview and Scrutiny Committee endorse the commencement of an options appraisal for the future provision of replacement care for people with learning disabilities in Staffordshire, including engagement with service users, carers, and stakeholders. The results of which are to be presented to Cabinet in the third quarter of 2021.

Reports of District and Borough Representatives

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

RESOLVED: That the update report was noted.

Report of Scrutiny and Support Officer

The work programme 2021-22 was presented and the following changes to work programme noted:

·       The item relating to Care Market – Care Home Services would be presented to Health and Care O&S Committee in January 2022.

·       There would be an additional meeting in July 2021 to consider health impacts arising from Walleys Quarry, the meeting will be held in Newcastle under Lyme.