Agenda and minutes

Councillor Ann Edgeller declared an interest as Partner Governor of the Midlands Partnership Foundation Trust (MPFT).

The minutes of the meetings held on 31 January 2022 be approved and signed as a correct record.

Update from the UKHSA and Environment Agency

The Head of Unit UKHSA provided a detailed report and presentation relating to the health risk assessment for Walley’s Quarry Landfill Site. He advised that the odours within Silverdale and the surrounding areas continued to be a complex and long running incident for UKHSA.

The Chairman welcomed the quality of the assessment and data in the report and presentation which was based on the monthly UKSHA risk assessments of the site. The report considered air quality data and health data going back to the inception of this incident and presentation slides further detailed the position of the mobile monitoring stations around the Landfill Site and data from the monitoring stations.

The Committee noted that high concentrations of hydrogen sulphide (H2S) were first recorded in March 2021, levels of H2S had decreased monthly towards December 2021 and at that time there was anticipation that the measures put in place were having the desired effect. However, UKHSA informed Committee that increases in concentration of H2S were recorded in December 2021 and January 2022 with the highest concentrations of H2S recorded at station MMF9 located in the Galingale residential area. This had raised new concerns that some of the measures on site were not continuing to have the desired effect. UKHSA reported concern for the toxicological effect on individuals’ physical health and also the psychological effect on residents. It was explained that only the Environment Agency (EA) could determine the effectiveness of the interventions on the site. 

It was explained that from January 2022 onwards, UKHSA was only comparing the monitoring results with the United States Environmental Protection Agency long-term (lifetime) health based guideline (2 µg/m3).

•     (MMF1 and MMF2) concentrations were below the long-term (lifetime) health based guidance value, as they have been since June/July 2021

•     (MMF6) concentrations have been below the long-term (lifetime) health-based guidance value since July 2021, In January 2022, showed a slight exceedance; the overall cumulative average is below the long-term (lifetime) health-based guidance value

•     (MMF9), concentrations in January 2022 remained above the US EPA RfC. In this location concentrations were also above the World Health Organisation(WHO) odour annoyance guideline value for 16% of the time.

At MMF9, located in the Galingale residential area, concentrations had remained above the recommended guideline value for the duration of the incident and currently, whilst any risk to long-term (lifetime) physical health is likely to be small, UKHSA could not exclude long term health impact if they remained so.

The Committee noted the following comments and responses to questions:

·       Data measurement – concerns were raised that monitoring data would not show seasonality without a full year monitoring data.  Assurance was provided that monitoring data went back to March 2021 and would be in place until December 2022 and there would be more than a years’ worth of data to compare.

·       Concerns were highlighted about H2S concentration levels at MMF9 in the residential area and the health impact on people who lived there. Psychological impact, although not in  ...  view the full minutes text for item 67.

Report of the Clincical Commissioning Groups

The Accountable Officer, the Head of Transformation at Staffordshire and Stoke on Trent CCGs and the Communications and Engagement Service Partner NHS Midlands and Lancashire Commissioning Support Unit were in attendance to provide an update report and presentation on the system-wide transformation programme. The Accountable Officer also gave a verbal update on the Cannock Minor Injuries Unit (MIU).

The Cannock MIU was closed temporarily at the start the pandemic and was yet to re-open. Members were assured that the CCG was fully committed to re-opening Cannock MIU and was considering options.  The Royal Wolverhampton Trust was not in a position to resume staffing it and a procurement exercise would be required to find a provider. CCG had faced challenges because there were widespread workforce issues due to Covid sickness and the skill set required to staff MIU’s was in short supply and in great demand.  CCG aimed to re-open Cannock MIU in June 2022, Members noted that the future of all Urgent and Emergency Care Services would be consulted on later in the year. An update report would be provided to the next meeting 11 April 2022.

In terms of the system wide transformation programme, an update was provided and detail about the processes and timelines were shared. Committee understood that since reporting on involvement activity Autumn 2021 there had been further changes to the transformation programme:

• As a result of new Government guidance, development of community diagnostic centres had been added and residents had been engaged.

·       Some projects had been uncoupled from the programme to enable them to progress.

• Some projects were still paused
• Some projects were being sense checked to ensure consultation feedback from July 2019 was still relevant post Covid, that new guidance had been taken into account and that feedback on changes during Covid was included.

The Committee noted the following comments and responses to questions:

·       Members felt that the number of consultation responses were relatively low. CCG advised that it was working to encourage better uptake and that digital and social media involvement activity would be taken forward. Also, that CCG aimed to work with Healthwatch and voluntary organisations and welcomed suggestions from members for other methods to encourage uptake, including the suggestion to engage service users.

·       In terms of the Urgent and Emergency Care Programme all emergency care portals would be considered as part of the options appraisal.

·       Members highlighted the need for mental health providers to share details of pathways, to signpost where to access mental health support both direct and via voluntary sector support.

·       The Case for Change (2019) set out the clinical model for Integrated Care Hubs (ICH) which were focussed on long term conditions. Consultation on ICHs in North Staffordshire was starting soon.

·       It was understood that good community involvement required a connection to trusted voices in communities. During the pandemic community leaders had been working closely with partners. CCG was exploring with HW and VSCE colleagues both how to connect with communities and how to identify funding to  ...  view the full minutes text for item 68.

Report of the Integrated Care System (ICS)

The Accountable Officer and Transformation Manager, CCG presented a report and performance dashboard to provide an overview of CCG performance against key constitutional standards and targets.The report updated committee on referral to treatment times, diagnostic test waiting times, cancer waits, accident and emergency provider and general practice.

The Accountable Officer advised that the high level of infections and staff absence across the winter months of late 2021 and early 2022 had been a particular challenge. He indicated that many of the targets on the dashboard were not being hit and were showing as a red rating.

Members were advised that there was an increase in numbers of people in hospital with Covid, over 8,000 in hospital in March 2022 which was a 20% increase since February 2022. In many cases Covid was not the reason for admission, many were testing positive after being hospitalised with a different condition. The high Covid numbers in hospitals had put significant pressure on the recovery programme.

Committee noted the following comments and responses to questions:

·       Concern was raised about monitoring Covid cases once restrictions were lifted. Members were advised that during the pandemic only 1 in 6 lateral flow tests (LFT) had been reported, indicating that only a proportion of positive cases were reported.  It was confirmed that the Office for National Statistics (ONS) data across the Country showed that 1 in 25 people were testing positive and data gathered would also show any new variants.

·       Covid was considered endemic, there were still high numbers, but the population would need to follow Government guidance on ‘Living with Covid’.

·       Concerns were highlighted about breast cancer; histopathology testing and diagnostic waits which were longer than desired. There were also issues for rectal and skin diagnostic waits. Staffing was identified as a big problemwhich could not be resolved by additional funding, there were just not enough trained clinicians to carry out diagnostic tests and procedures in certain specialisms; and there was a shortage of trained clinicians to recruit. The Chairman advised that workforce issues would be looked at in the work programme for 2022-23.

·       Members were concerned that it would take years not months to work through the backlog lists and address staffing resources. Members were re-assured that CCG was making some progress to reduce the backlog, but people were still presenting to add to the list.

·       CCG was mindful that the consequences go far beyond the dashboard rating, this was about real people with real lives that were being affected by the long wait times and whilst dealing daily with the symptoms of their condition.

·       CCG indicated that although changes were being made to areas of the pathway, when a redesign could make a difference, this was not going to resolve the bigger issues.

·       CCG advised that it would take a long time to train people in clinical roles, and with more people were leaving the NHS than were joining it there was a need to retain people and make the NHS a place  ...  view the full minutes text for item 69.

Presentation from Covid Defence Lead, SCC

The Covid Defence Lead provided an update report. She advised that the ‘Living with Covid’ paper was announced 21 February 2022, there were two significant changes one relating to the legal duty to isolate following a positive Covid test was replaced with guidance to limit contact from 24 Feb.  The second was the intention to cease pre-public testing from 1 April 2022.

Main messages from the presentation were:

• That activities will focus on supporting high risk settings.
• A Covid helpline would be retained.
• Case rates were starting to rise.  All age groups were rising but most increase was in the 35-39 age group.
• Hospitalisation rate was steadily reducing.
• Death rates remained below average.
• Vaccination drives continued.  There was a significant increase in 12-16 year old take up of second doses.

Committee noted the following comments and responses to questions:

• The ‘Living with Covid’ paper focussed on an individuals’ personal responsibility and personal accountability.  The new local outbreak plan encompasses the paper but also looks at how to support local businesses to encourage public to take responsibility.
• The Lateral Flow Test (LFT) free public tests would cease from 1 April 2022.
• A review of the outbreak management response was taking place and communities that were considered to be at risk were being looked at to consider how to support them when free public testing ceased. A community impact assessment would be completed as part of review to understand who would be affected and how to support them.
• Members welcomed the success of the vaccination programme and indicated it was key to get back to normal with people taking personal responsibility. When assessing the effectiveness of some of the precautions during Covid restrictions they would be a need to look at the negative impact on mental health, the economy and take a balanced approach.  They would continue to get the vaccination message out to public to be vaccinated and to get the message out.
• 119 system was a health number and could not be confirmed how long that would be in place. Assurance was provided that the Staffordshire County Council SCC Covid helpline would remain and would be manned until March 2023.
• New entrants entering from abroad were able to help them enter safely and to get support and be tested.

The Chairman concluded that as Covid was now classed as endemic in the environment there would be no requirement for a regular update on each agenda moving forward.  The Chairman thanked the Covid Lead for attending committees and for her input over the duration of the pandemic. He asked that should any situation emerge that required a report to committee the Covid Lead would be invited to update the Committee.

Resolved:

1. That the update report be received and noted

Report of the District and Borough Representatives

District and Borough representatives presented update reports and highlighted the following matters being considered at District and Borough meetings.

East Staffordshire Borough Council representative offered to send links to a scrutiny review report submitted to Cabinet on 14 March 2022, relating to Engaging and Supporting Communities. The Chairman welcomed sharing best practice between District and Borough Councils.

Staffordshire Moorlands meeting for 9 March had been postponed to Thursday 17 March 2022.

Resolved:

1. That the District and Borough Updates be noted.

Report of the Scrutiny and Support Officer

The Chairman introduced the work programme. 

The wider determinants of health session led by Vice-Chair Scrutiny had been delayed to enable attendance of the new Public Health Consultant who joins Staffordshire County Council in April 2022.

The Mental Health Support Team report led by the Vice-Chair Overview had been delayed to 30 May 2022 to enable key witnesses to attend and to take account of the Draft Mental Health Strategy which was delayed to Spring 2022. Members were assured work was progressing.

The next meeting of the Committee takes place 11 April 2022.

1. That Committee note the work programme update