Agenda and minutes

None.

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None.

The Chair advised that an additional meeting of the committee had been scheduled for Thursday 30^th July 2020 commencing at 10.00am. This would consider proposals from the clinical commissioning groups (CCGs) for the recommencement of services post-covid and to receive an update on the CCG merger proposals.

The Chair reported on the proposal to expand the terms of reference of the Horton Health OSC. It had agreed to amend its scope to be able to scrutinise a masterplan for the Horton Hospital. In order to do this, it may require all three councils to agree the revised scope within their health scrutiny powers.

To receive the minutes of the committee meeting held on 19 February 2020.

The minutes of the committee meeting held on 19 February 2020 were approved as a true record.

Seven public questions were submitted. The questions are attached at Appendix A to these minutes and summaries of each item and responses are provided below.

Question from Dr. Sharon Hancock.

Dr Sharon Hancock had submitted a question on test, trace and Isolate and the support contacts were being offered in the Coventry, Solihull and Warwickshire (CSW) beacon area.

Dr Shade Agboola, Director of Public Health (DPH) provided a verbal response. Strong links had been established with the voluntary and community sector and she spoke about the support being provided to those who needed to isolate, which would continue to be built upon. This included practical support e.g. with shopping. There were plans for an engagement session with neighbourhood level groups and making best use of community development workers was also touched on. Further details would be provided later in the meeting on the outbreak control plan. Specific work was being undertaken with homeless people and victims of domestic abuse.

Question from Councillor Jacky Chambers

The DPH was asked to report on progress made so far in making test data from the national test and trace system (pillar two) available to local public health teams; how quickly test results were being returned, and whether or not this information had been used to identify and investigate recent outbreaks in the county.

Shade Agboola responded that significant progress had been made. There was direct access to the pillar two data at both the county and district/borough level. She spoke about test turnaround times which were between one to three days for pillar two tests. The data on incidents/ outbreaks was provided in a variety of ways, including through Public Health England (PHE), the national test and trace service (NT&T) and in relation to an outbreak amongst police officers, from the police themselves. It was expected that the NT&T service would report more data as it gained momentum. Reference was also made to the good working relationships with schools, which ensured that early notification was received, often before the NT&T service reported cases.

Question from Professor Nick Spencer

Professor Spencer spoke of plans amongst retired GPs, public health and community doctors and nurses, to establish a locally based contact tracing initiative, sensitive to and embedded within local communities. He asked if the DPH would meet with them to discuss how their expertise could be deployed to contribute.

Dr Agboola confirmed she was happy to meet with Professor Spencer and colleagues. She described the local role in the test and trace programme, managing complex cases and compared this to the role of the NT&T service in dealing with non-complex contact tracing. Local authorities had a brief from national government which included the development of outbreak control plans. To date existing resources had been utilised to respond to outbreaks, working in conjunction with PHE. The additional government funding may need to be used to provide increased capacity, especially with the easing of lockdown measures. Dr Agboola spoke of the local Health Protection  ...  view the full minutes text for item 2.

This paper aims to provide an overview of the Council’s approach to recovery from the Covid-19 pandemic, as set out in the attached paper, considered by Cabinet on the 11 June. 

A report was introduced by Nigel Minns, Strategic Director for People Directorate, to provide an overview of the Council’s approach to recovery from the Covid-19 pandemic. A key aspect was the development of a recovery plan which would be submitted to Cabinet for approval in September. This Committee’s comments were sought on the approach to the development of the recovery plan.

Following its approval there would be an ongoing scrutiny role, particularly over the longer-term delivery phase. This would feature in the planned review of the scrutiny function.

The key elements of the recovery approach were summarised within the report and provided in more detail in the appended report approved by the Cabinet on 11 June. This set out the three phases to recovery. The Council was now in the foundation stage and an outline was given of the key focuses and the output for the recovery plan being presented to Cabinet in September.

The report included a section on the focus of the response and plans for recovery. The Council had worked flexibly and adapted in many ways to ensure that key services were delivered, and people were supported to cope with the effects of Covid19. Examples were provided of the responsiveness and actions taken by Public Health, Adult Social Care and People Strategy and Commissioning for services within the remit of this Committee.

As the Council moved into the delivery phase of its recovery plan, there would be a role for this committee to consider aspects of recovery relevant to its remit, particularly health and social care and aspects of community recovery.  It was proposed that further reports be brought to the Committee for its consideration.

Nigel Minns focussed on key sections of the report, giving examples of the work undertaken over the last three months. He referred to the isolation arrangements for Covid patients leaving hospital before retuning to a care home setting. He referred members to the appended Cabinet report and the recovery principles set out within it. There were close working arrangements with health colleagues and the voluntary sector on the recovery actions.

The following questions and comments were received with responses provided as indicated:

• In response to a question from the Chair, Nigel Minns gave an outline of how the County Council had assisted care home providers especially with the provision of personal protective equipment (PPE). Reference was made to a webpage containing further information. This link would be provided after the meeting and can be viewed here. A workforce recruitment plan had also been established, leading to over 100 additional staff being employed. Finally, he spoke about the financial offer to care providers to meet all additional costs associated with the pandemic. The government infection control fund was passported to care providers within a week of receipt. This had already exceeded £4.1m and was continuing to increase. A further update on distribution of funding, including the second tranche of £2.7m of government funding would be provided shortly. The Chair considered a good  ...  view the full minutes text for item 4.

The Director of Public Health will hold a question and answer session to update members on the national and regional approach to test, trace and isolate.

Shade Agboola, Director of Public Health gave a presentation to the Committee, which had also been provided to the Covid19 member engagement board held the previous week. This outlined the Outbreak Control Plan, its aim, the eight key priorities and respective roles of national and local government especially in regard to contact tracing. The presentation included Covid19 case number estimates, the sub-regional response arrangements and the governance structure for Warwickshire. Detail was then provided on each of the eight priority areas:

·       Community engagement to build trust and participation

·       Preventing Infection

·       High risk settings and communities

·       Vulnerable People

·       Testing Capacity

·       Contract Tracing

·       Data: dynamic surveillance and integration

·       Deployment of capabilities including enforcement

The presentation concluded with resource requirements and priorities. The following questions and statements were submitted, with answers provided as indicated:

• People who were infectious but not symptomatic. Currently only people with symptoms could request to be tested. Work was ongoing with Public Health England (PHE) to see how this could be addressed, so those who potentially could be contagious were tested.
• It was planned to provide pillar two test data to elected members along with the pillar one information.  Sharing this data periodically with the public would help to ensure appropriate behaviours. It was asked if this data could be disaggregated for each district/borough area. Officers confirmed that the numbers of cases were small.
• The number of cases at the George Eliot Hospital (GEH) seemed disproportionately high. It was questioned if these were community acquired cases or could have been transmitted at the hospital. The number of cases at GEH was reducing. Research had shown a mixed picture with some cases being transmitted in hospital. A postcode breakdown was awaited on the location of residents who had acquired covid in the community. 
• A comparison was sought on the proportion of cases acquired at GEH to those in other hospitals. Frequent and detailed information was provided, which confirmed that the rate at GEH was higher. A video had been posted on the County Council’s website to show the measures implemented to control infection at GEH.
• In response to a related question about the four wards involved at GEH, the DPH stressed that people should not be discouraged from going into hospital.
• Decisions about local lockdowns and how they would be triggered. It would be crucial to give the correct messages to the public and elected members, as community leaders would be able to provide information in their locality. It was expected that lockdowns would be required, but the size of the lockdown area was presently unknown. The DPH advised that this was currently not under the control of the local authority.
• It was questioned if plans were being put in place in anticipation of such powers being granted. Lockdown action plans would be developed for each part of the beacon area.
• Arrangements for the rollout of antibody testing were questioned. It was available to NHS and some social care staff. However, this was not the solution as it did not  ...  view the full minutes text for item 5.

Up to 30 minutes of the meeting is available for members of the Committee to put questions to the Portfolio Holder: Councillor Les Caborn (Adult Social Care and Health) on any matters relevant to the remit of this Committee.

A question was submitted regarding covid deaths, the higher proportion of people affected from BAME communities and the links to social and health inequalities too. It was questioned if this could be added to the work programme. Councillor Caborn referred to the new Health, Wellbeing and Social Care Covid Recovery Group. Such items could be included within its remit. There was an aim to embed all the learning from the pandemic in designing future services. The Chair suggested that this could be added to the Committee’s work programme too.

The Committee’s work programme was reviewed by the Chair and party spokespeople at their meeting on 29 April. The updated programme is attached for the Committee to consider.

The Committee reviewed its work programme.

The Chair suggested that an update be sought from UHCW on actions outstanding from its previous Care Quality Commission inspection. He proposed that more use be made of briefing notes to keep the committee updated and acknowledged the suggestion under the previous item regarding covid deaths and the higher proportion of people affected from some communities.

Changes were being made to healthcare in response to the covid pandemic. In terms of future funding for health services, reference was made to developer contributions and it was suggested an item on where these monies would be allocated would be useful for the committee.  The Chair suggested a briefing note for all members in the first instance.

The Warwickshire North Place Board had received a presentation on smoking in pregnancy. The data for the north of the county showed that one in five expectant mothers smoked. A briefing with data and the actions being taken would be useful.

Chris Bain of HWW spoke about the expected legacies of the pandemic. Examples included increased waiting lists and the mental health impacts for people either anxious to return to work, or spending lockdown whilst suffering from a mental health condition.  The Chair commented that use of more briefing notes would provide additional capacity to keep the committee informed.

Resolved

That the Committee updates its work programme as outlined above.