Agenda and minutes

Councillor Daniel Maycock declared an interest in item 4 relating to George Bryan Centre as a former service user.

Councillor Richard Cox declared an interest in item 4 George Bryan Centre a family member was a former service user.

That the minutes of the meeting 5 July 2021 be approved and signed as a correct record.

Report of the Clinical Commissioning Groups

The Committee received a report and presentation relating to the temporary closure of George Bryan Centre (GBC) in Tamworth following a fire in February 2019. The Operations Manager MPFT outlined the background and current position for GBC and mental health services that previously were provided there. 

The Committee considered the proposals for engagement events and the process for deciding the long-term solutions for mental health serviceswhich would be based on the best balance of clinical evidence and evidence gained through public involvement.

The Committee noted that:

·       Since the fire, services had been provided at St George’s hospital in Stafford or through community mental health services, which had been developed during the closure to expand expertise and provision in the community. Staff from GBC had been either redeployed or re-trained. Work was underway to determine the future of the mental health services through engagement events and an options appraisal.

·       Previous engagement had informed the business case alongside the clinical evaluation, further engagement events, and equality impact assessments.All information gathered through listening and engagement was used to develop the Clinical Service Model which would be evaluated, and services shaped. 

·       The Clinical Service Model would also take into consideration the Integrated Care Strategy (ICS) programme for adult and older people’s mental health services across Staffordshire and Stoke on Trent.

The following comments and responses to Members questions were noted:

·       The GBC had been insured by the Midlands Partnership Foundation Trust (MPFT), detail of the insurance funding had been calculated on the damage extent and reasoning for the fire, this information was not available at the meeting but would be sent to Members.

·       MPFT consultation events included service users from GBC, other mental health services across Staffordshire and members of the workforce. A link to the survey was available on the website and would be shared with members alongside more detail on qualitative data requested.

·       It was confirmed that all service users were over 18 years old.

·       Members highlighted the need to hold face to face events to bring on board service users or carers who could reach out to people who had used or intend to use services. They indicated that the information would bring perspectives to shape services to what people want and need, and in doing so people would feel included. MPFT welcomed the opportunity to talk with Staffordshire Healthwatch about the co-production group, to engage face to face with individuals who had experience of services.

·       There had been no significant increase in serious mental health incidents drawing on other services such as police and ambulance in the communities during the lockdown period. It was noted that the way services were delivered during this period was different and not comparable to other periods. A ward had been available at St Georges hospital for short term stays and average length of stay during this period was 23 days, this benchmarked well across the country.

·       Members requested further data about re-admissions to make a useful comparison and highlighted the  ...  view the full minutes text for item 21.

Report of the Clinical Commissioning Groups

The Committee received an update report and presentation relating to the Temporary Closure of Free-Standing Midwife-led birthing Services.

At the request of the Chair, the Lead Midwife Maternity Transformation Programme gave a brief overview of the Ockenden Review of maternity services at Shrewsbury and Telford Hospitals and of the Better Births Report published in 2016.

Ockenden Review - The interim report had been received and a second report was due later this year. The report raised themes which reflected recommendations of other reviews of maternity services across the Country.  The Ockenden report highlighted the need for safe staffing, good foetal monitoring training, regular risk assessments and the need for learning from incidents and to include families in what we need to learn.

Better Births Report – This resulted in a national maternity transformation programme which had been translated to regional transformation programmes. Recommendations from the report had highlighted safe staffing, training and how we include our women and families when planning maternity services.

The Lead Midwife provided an overview of the presentation and report relating to the temporary closure of freestanding midwife-led birthing units (FMBUs) at Samuel Johnson Hospital in Lichfield and County Hospital in Stafford which provided low risk care maternity services.

The Staffordshire and Stoke-on-Trent Sustainability and Transformation Partnership (STP) undertook engagement activity in summer 2019, information was utilised to develop and refine the Clinical Model of Care. An options appraisal process took place between November 2019 and February 2020, but the transformation programme was paused in March 2020 due to the beginning of the pandemic.  At this time the birthing element at the two FMBUs were suspended in order to consolidate resource into the main maternity units. Due to current pressures, the need for safety in maternity services and that the Delta Variant was having more of an impact on pregnant women the FMBUs remain temporarily closed. The impact of the suspension of birthing units was being monitored and consultation was ongoing with families to understand what was needed for future maternity services in Staffordshire.

The following comments and responses to questions were noted:

·       The engagement process to recap and sense check the previous involvement work would help understand any potential negative impact of the proposed model of care.

·       Patient and staff safety was at the forefront of future maternity services to ensure a professional and safe service was being provided.

·       When considering the online maternity survey, it was considered that there was a need to consult families and to reach out to minority communities. Also, to be mindful of the need for compassion in maternity care when working with families and individuals care. Healthwatch Staffordshire would offer support with this engagement.

·       There was a need to communicate information about vaccination safety for pregnant women.

·       The Trusts would provide revised business cases on how they could reinstate the birthing services to the Staffordshire and Stoke-on-Trent Maternity and Neonatal Programme Board in Autumn 2021 which would include development and workforce training. The earliest the on-demand model of care  ...  view the full minutes text for item 22.

A presentation will be given as an update on the current COVID situation at the meeting.

The Committee considered an update relating to Covid-19 which included detail of the current position, case rates, hospitalisations, death rate and infection rates.

The Committee noted that the data revealed the start of a downward trend and plateau phase in infection rates. The highest infection group in 7 day case rates was 18-34 age group, which was continuing to rise. Hospitalisations were stable and death rate was down. Additional pressures were highlighted to be workforce shortages in health and social care.

The following comments and responses to questions were noted:

·       Vaccination rates had increased but were slowing down particularly for 18-34 year olds, this may be partly due to the rise in infection rates in younger age groups, once diagnosed with Covid there was a need to quarantine for 28 days before they could access their next dose.

·       The local outbreak management plan had been updated recently.

·       There was a need and a role for members to keep sharing the message in communities to be cautious and respectful of others. Key messages were to maintain sensible precautions to limit spread of infection, get tested regularly and get vaccinated as soon as possible. 

·       The pressures in UHMN NHS Trust were real with 40-50 people in hospital and some in ITU including pregnant women. NHS was seeing increased demands on all NHS services and there was a pressure to catch up on backlog lists.

·       There were consistently higher testing rates in Staffordshire, people were being encouraged to get lateral flow tests if showing any signs of infection.  There were plenty of opportunities to get tested with pop up testing centres and LFT available on request.

·       In terms of vaccination programme work with employers was ongoing to set up vaccination centres. Full guidance for vaccinating under 18’s was awaited before they could be rolled out in the same way other elements had been.   A variety of approaches and incentives were being considered to encourage younger age groups to get vaccinated.

·       It was considered there were other seasonal illnesses to prepare for this winter and that there was a role for members to promote the need to immunise against all illnesses not just Covid.

·       The Cabinet Support Member requested that the Committee consider a report relating to the take up of childhood immunisations during the pandemic to a future meeting in the work programme.

·       By law Care workers had to be fully vaccinated by 11 November 2021 to continue to work in the care sector.  The Council was working with care home providers and other providers.  There was a projected 20% gap in care workers who would not be vaccinated by 11 November and the Council was working with providers to ascertain if was a true gap.

The Chair highlighted the need to get the message out that care workers must start vaccinations by 18September 2021 if they wanted to continue to provide front line services and that the role of Members was to promote the messages in the Districts and Boroughs.  ...  view the full minutes text for item 23.

Committee noted the update report and received verbal updates from District and Borough representatives as follows:

·       Ref. minute 11: Cannock Chase District Council had written to Royal Wolverhampton Hospital NHS Trust relating to an update on Cannock Chase MIU.

·       Ref. minute 12: East Staffordshire District Council representative was to attend a meeting with the Chair and CCG partner to consider GP access at Gordon Street Surgery.

The Chair invited members to share outcomes from scrutiny carried out in the Districts and Boroughs which may be of wider relevance for Staffordshire.

Resolved:

1. That East Staffordshire District Council be invited to provide a paper sharing the outcomes of scrutiny work it is carrying out to assess the impact of voluntary sector work during the pandemic.
2. That Tamworth Borough Council be invited to share the outcomes of scrutiny work on food vulnerability and healthy eating at the Committees ‘Wider Determinants of Health’ inquiry day in November 2021, and also to share outcomes on discussions in Tamworth relating to work with voluntary sector and communicating about mental health locally.

Report of the Scrutiny and Support Officer

Committee received the work programme and noted the following:

1. The date of the next meeting was 20 September 2021 at 10am.
2. The proposed date for the Mental Health Awareness Session was 28 September 2021 at 10am.