Agenda and draft minutes

Adult Social Care & Health Overview & Scrutiny Committee - Thursday, 30th July, 2020 10.00 am

Venue: Microsoft Teams. View directions

Contact: Paul Spencer  Senior Democratic Services Officer

Media

Items
No. Item

1.

General

Additional documents:

1(1)

Apologies

Additional documents:

Minutes:

Councillor John Cooke, Councillor Tracy Sheppard replaced by Councillor John Beaumont (Nuneaton and Bedworth Borough Council). Vicky Castree (Coventry City Council), Becky Hale (Assistant Director) and Nigel Minns (Strategic Director).

1(2)

Disclosures of Pecuniary and Non-Pecuniary Interests

Members are required to register their disclosable pecuniary interests within 28 days of their election of appointment to the Council. A member attending a meeting where a matter arises in which s/he has a disclosable pecuniary interest must (unless s/he has a dispensation):

 

·         Declare the interest if s/he has not already registered it

·         Not participate in any discussion or vote

·         Must leave the meeting room until the matter has been dealt with

·         Give written notice of any unregistered interest to the Monitoring Officer within 28 days of the meeting Non-pecuniary interests must still be declared in accordance with the Code of Conduct. These should be declared at the commencement of the meeting.

Additional documents:

Minutes:

Councillor Keith Kondakor declared a non-pecuniary interest as he was in discussions with a clinical commissioning group (CCG) regarding the provision of a new doctor’s surgery in Weddington.

1(3)

Chair’s Announcements

Additional documents:

Minutes:

The Chair welcomed new members to the Committee and thanked retiring members for their service. He confirmed that Councillor Margaret Bell had been appointed as the Committee’s Vice-Chair, also paying tribute to Councillor Clare Golby for her support as Vice-Chair.

 

The Chair provided an update on two actions raised at the previous meeting. The first concerned the council’s Covid-19 response and the 28 patients discharged to stepdown care at the Myton Hospice and Ellen Badger hospital. A response on test, trace, isolate was also provided, which concerned the lack of use of the nightingale hospitals to provide capacity at existing acute trusts and to isolate Covid-19 patients. A councillor commented that this matter was about infection control and the isolation of Covid-19 patients in the nightingale hospitals. The Chair offered to refer this matter again for a further response.

 

The Chair added that there would be a standing item on the committee’s agenda on Covid-19 going forwards.

2.

Public Speaking

Additional documents:

Minutes:

None.

3.

COVID-19 Service Changes pdf icon PDF 182 KB

To receive an update and presentation from the Coventry and Warwickshire health and care system.

 

Additional documents:

Minutes:

Adrian Stokes spoke to a circulated report and presentation. COVID-19 had created an unprecedented situation, which the Coventry and Warwickshire health and care system had responded to with significant pace.

 

The response to COVID-19 was being managed in four phases:

·       Phase 1 – Service change (immediate response to COVID-19)

·       Phase 2 – Restoration (6 weeks from May to July)

·       Phase 3 – Recovery (to March 2021)

·       Phase 4 – Reset (2021/22)

 

The covering report explained the role of the Reset Co-ordination Group (RCG) to oversee the Restoration, Recovery and Reset Programme. It listed the correspondence and guidance from NHS England and Improvement (NHSEI), which had been adopted, alongside the local decisions taken, with fast-track transformation initiatives, resilience measures and the need to suspend some services, whilst delivering other services virtually.

 

Looking to the future, maintaining the transformation would assist with meeting the short to medium term challenges of restoration and recovery, whilst providing for reset of the local health and care system to be more effective and sustainable.

 

The presentation included slides on:

 

        Context

        Ongoing backdrop of Covid-19

        Starting v stopping

        Productivity paradox

        Partnership working strengthened

        Locking in innovation

        The Health and Care Partnership graphic

        A flowchart showing the phased approach to restoration, recovery and reset

        Phase two priorities

        Essential services

        Test, track & trace

        Care homes

        Mental health

        Takeaway messages

        All phases happening simultaneously =

        complexity

        Level 4 response running into winter

        Partnership working – “fleet of foot”

        Communication is key

 

Anna Hargrave gave a precis of the circulated report, speaking about the service changes required, key learning points, the ability to respond quickly and the impact of these changes on communities. Currently, a period of evaluation of the quality and equality impacts of the required changes was taking place. This included drawing on the survey by Healthwatch Warwickshire (HWW) and through targeted work with specific groups. This would lead to the next phase of planning to look at service restoration, addressing inequalities, needs assessment and the establishment of a system-wide group to focus on addressing inequalities. It would include discussions with the NHS workforce and undertaking risk assessments for staff deemed at risk. There was a need to understand the impacts of Covid-19 and to lock in changes, whilst being mindful of both quality and equality.

 

Questions and comments were provided, with responses provided as indicated:

        Ensuring that the revised provision included traditional face-to-face services, as well as making use of technology. Some patients value the relationship with their GP and/or would be less comfortable discussing certain conditions remotely. This reflected the feedback commissioners had received and there was no target percentage for virtual appointments. This was about offering a choice and maintaining a balance.

        Noted that there had been 80,000 GP appointments online.

        Questions about the impact of the pandemic, in terms of waiting lists, demand and capacity.  This was an area for further detailed research,  ...  view the full minutes text for item 3.

4.

The Future of Health Commissioning in Coventry and Warwickshire pdf icon PDF 141 KB

To brief the committee on the future of health commissioning in Coventry and Warwickshire, the proposed changes to the structure of the clinical commissioning function and the future process.

 

Additional documents:

Minutes:

A report was introduced by Sarah Raistrick to inform the Committee of the future of health commissioning in Coventry and Warwickshire, the proposed structural changes to the clinical commissioning function and the committee’s support was sought to the application to create a single, merged Clinical Commissioning Group (CCG) in Coventry and Warwickshire.

 

Background was provided on the NHS long term plan, which outlined a new service model and as part of this, the formation of integrated care systems (ICS). The CCGs had considered how to support the move to an ICS and following a period of engagement, a case for change was developed, outlining the options available, which were reported.

 

It was noted that options which involved the strategic direction of the CCGs were reserved to the member organisations, who were asked to vote on their preferred option. Detail was provided on the process undertaken. The outcome of the vote was decisive in all three CCG areas, with members choosing the option of full merger. The next steps in this process were reported and CCGs were preparing to apply to NHS England and Improvement for authorisation to become a single merged organisation. If the application was successful, the three CCGs aimed to become a merged organisation by April 2021. Ongoing engagement with stakeholders and the population was an essential part of this process.

 

Questions and comments were provided, with responses provided as indicated:

        It was questioned if the deadline for the merger was realistic. There was confidence that it could be achieved.

        How could a merged Coventry and Warwickshire CCG (C&WCCG) give more local support? Detail was needed to evidence this. The allocation of funding across the merged CCG also needed clarifying, as there were differing needs in each of the areas and a concern that funding might not be distributed equitably.

        Dr Raistrick referred to health needs and inequalities for Coventry and Warwickshire as a whole, desired outcomes using an example of improving diabetes targets and the differing interventions that would be needed across each ‘place’ to achieve the target. 

        Adrian Stokes added that funding allocations would remain for each of the places they were earmarked for, for the next five years, subject to any financial changes imposed by the Treasury post-covid.

        This response gave reassurance, but conversely there was a need to address known inequalities and funding would be required to do this.

        A comment that average data for Warwickshire was generally good, but it hid issues in specific areas and there was a need to examine granular data for local areas. As a health and social care partnership local data was used, such as that from the joint strategic needs’ assessments (JSNA) and primary care networks (PCNs). It was equally important to maintain good outcomes in areas doing well.

        Adrian Stokes reminded that CCGs needed to reduce their running costs by 20%. The merger proposals would remove duplication and some overheads, avoiding the need to cut staffing in more  ...  view the full minutes text for item 4.