Apologies for absence had been received from
County Councillors Andy Jenns and Chris Mills, from Councillors
Colin Cape (Nuneaton and Bedworth Borough Council), Pam Redford
(Warwick District Council) and from Nigel Minns.
Disclosures of Pecuniary and Non-Pecuniary Interests
The Chair thanked Councillor John Holland for
chairing the previous meeting. She referred to the useful
pre-committee briefing on performance monitoring and a bespoke
software application Power BI. In her view, the overarching
priority for the Committee was integrating health and social care
with a focus on prevention rather than cure and addressing health
inequalities. The Chair suggested that this Committee and the
Children and Young People OSC meet jointly to undertake a local
Covid inquiry. This would look at the learning which could be drawn
from the pandemic to assist with responding to any future pandemic.
It could also provide a focus on activity now to respond to
differences seen over the last two years.
Minutes of previous meetings PDF 131 KB
To receive the Minutes of the committee
meeting held on 27 September 2023.
The minutes of the Committee meeting held on
27 September 2023 were approved as a correct record and signed by
The Chair welcomed Karen Skinner to the
meeting. She was aware of the topic on which Ms Skinner would speak
and undertook to write to Stratford-upon-Avon District Council on
this matter, should that be the Committee’s conclusion.
Karen Skinner addressed the Committee. A copy
of the submission is attached at Appendix A to these Minutes. She
provided additional background on the concerns being raised on
behalf of tenants of an Orbit Housing independent living scheme at
Rosalind Court in Stratford-upon-Avon. She spoke about housing and
care, the overnight care service and the mandatory charges being
levied to tenants on which clarity was being sought.
Points of clarification were that the housing
provider was Orbit Housing and the service charges related to the
District Council. The Committee would take advice and a written
reply would be provided to Karen Skinner. The Chair reiterated that
she would lobby the District Council to look at this
Questions to Portfolio Holders
Up to 30 minutes of the meeting is available
for members of the Committee to put questions to the Portfolio
Holder: Councillor Margaret Bell (Adult Social Care and Health) on
any matters relevant to the remit of this Committee.
Questions to the NHS
Members of the Committee are invited to give
notice of questions to NHS commissioners and service providers at
least 10 working days before each meeting. A list of the questions
and issues raised will be provided to members.
Palliative and End of Life Care Strategy 2023-2028 PDF 91 KB
The Coventry and Warwickshire Integrated Care
System is developing a joint all age strategy for Palliative and
End of Life Care, on which the Committee’s formal support and
endorsement is sought.
The Coventry and Warwickshire Integrated Care
System (C&WICS) was developing a joint all age strategy for
Palliative and End of Life Care, on which the Committee’s
formal support and endorsement was sought. At its meeting on 27
September, the Committee received a comprehensive presentation and
report on this matter. Kathryn Drysdale from the C&WIC Board
was in attendance to respond to any further questions from the
The Committee was asked to approve the
recommendations shown in the document pack, specifically to give
its support to the final version of the five-year strategy and
associated two-year delivery plan for the strategy.
The following questions and comments were
submitted, with responses provided as indicated:
- Several members raised concerns
about the shortage of care staff to fulfil the aims of the
strategy. This was a significant project requiring considerable
investment. Kathryn Drysdale acknowledged the concerns. A system
approach would be taken to look at the workforce requirements,
planning and having clear pathways to make the most efficient use
of staff. There was not yet an identified funding stream. She
touched on some of the ways the system might work differently, with
a needs analysis, assessing the costs of someone going into
hospital against using a community care option. It was not yet
possible to give a clear answer on the two key questions of staff
and budget, but examining individual aspects and then designing a
system approach would show how this could work more effectively. An
example was provided of the palliative and end of life care options
being implemented in the north of the County.
- Members questioned how this could be
taken forward without the resources or staffing to achieve the
strategy aims. Staff were already stretched, and it was anticipated
that the shortage of carers would place even more pressure on
- Members acknowledged the
aspirational but challenging proposals without the allocation of
additional funding. As well as needing frontline staff, additional
resources would be needed to undertake a data gap analysis. A
concern was frontline resources being redeployed to do this work,
impacting on service delivery. The concerns raised at the previous
- Clarification was provided on the
reasons why this item had been resubmitted, to assess whether the
Committee was supportive of the strategy and associated delivery
- Members had found the documents easy
to read and informative. The services provided currently were very
good and it was questioned what would be changed as a result of the
strategy. Kathryn Drysdale agreed that the services provided were
excellent. There was no intention to change service levels, but to
work more effectively in shaping the pathway of care and provide a
range of options for palliative and end of life care. The current
arrangements worked for many people, but there were some
- A point about choice and preference
at the end of life. Some people did not have close family. In the
north of Warwickshire, there was no bedded end of life care
view the full minutes text for item 5.
Quarter 2 Integrated Performance Report PDF 144 KB
For the Committee to consider and comment on
the Quarter 2 Integrated Performance Report (period covering April
- September 2023).
The Committee received the Integrated Performance Report, which gave a
retrospective summary of the Council’s performance at the end
of Quarter 2 (April - September 2023) against the strategic
priorities and areas of focus set out in the Council Plan
2022-2027. Key sections of the report focussed on:
· Performance against the
Performance Management Framework
· Progress on the Integrated
· Management of
· Management of Risk
The Chair referred to the
pre-committee briefing session on performance and the Power BI
platform. Questions and comments were submitted on the following
- Clarity was provided
on the target and actual data for people supported in residential
or nursing care, both for people aged under and over 65 years of
age. In both cases this was an area where the current target was
being exceeded, so it was ‘not on track’. This was an
area where it would be useful to provide additional context in the
report and an offer was made to circulate a briefing
- Referring to the
above point, it was questioned if there was an increasing trend in
service demand. Pete Sidgwick said there had been an increase in
the number of people being supported and of those, a higher
proportion were in residential or nursing care placements. There
was a financial impact and currently, the cost per placement was
also higher. A perceived contributor was the worsening health and
wellbeing of an aging population. Reference also to the national
datasets, against which Warwickshire had historically compared
favourably. It was reported that the local data had increased but
all areas were seeing a similar growth in data for these
indicators. Increases in NHS activity also had an impact on the
number of people requiring onward care.
- A member asked if
increases in the cost of living was a contributor. This view was
not shared by officers, it being seen more as the worsening health
and wellbeing of the older population with significant care and
support needs. The Chair added that people were living longer with
acuity of need and increased frailty.
- It was noted that the
strategic risk register had been refreshed, with three areas
relating to Adult Social Care. Clarity was sought on the
classification of risk which differed in two sections of the
report. It was agreed that this be researched, and clarification
would be provided to members.
- Reassurance was
sought on the falling data for number of carers receiving support
each month. There had been no change in policy or procedures in
this area delivered by the Carers’ Trust. The data did
fluctuate with factors such as school holidays having an impact.
There had been a lot of work to improve performance in this area
and it was expected that the data would now level out.
- There was concern at
the forecast budget overspend for Adult Social Care, it being asked
if the forecast was realistic or if the end-of-year position could
be even worse. Officers responded that
the position would become clearer as the financial ...
view the full minutes text for item 6.
Update on Covid and Flu
The Committee will receive a presentation from
The Committee received a presentation from Dr
Shade Agboola, Director of Public Health. She provided context that
there was no longer a requirement for Covid testing and that adults
who had Covid were asked to stay home and to avoid contact with
others. For children with any winter illness, those feeling well
enough could attend school. The presentation covered the following
- National Covid update – a
slide with data on the people testing positive for Covid in the
last seven days and patients admitted to hospital. Overall, there
had been a reduction of 1903 cases representing 21.8% for positive
tests and a reduction of 327 hospital admissions, which was a 9.7%
reduction. A government website contained updated information.
There was no national testing, so the reported figures were from
tests at hospital.
- The Covid data for Warwickshire
showing numbers of cases, the change in data over the past week,
first episodes and reinfections. As testing was no longer
mandatory, the case data was from testing in healthcare settings.
Overall, the number of cases had reduced by 41, a 34%
- A Covid vaccination update was
provided for each of the five district and borough areas. This
showed the number of vaccinations, the eligible population and the
percentage uptake in each area. Residents in all but one of the
care homes had been vaccinated.
- A flu vaccination update showing the
eligible cohorts, number of vaccinations and respective population
numbers, the uptake to date, targets, and remaining numbers of
vaccinations to achieve the target for each cohort. Particular
reference to the low uptake of flu vaccination of children aged 2-3
years, and those at primary and secondary school.
Discussion took place on the following
- The Chair asked if flu vaccinations
took place in school and whether there was a refusal from parents
for the vaccine to be administered. She asked for the age profiles
for vaccination of primary and secondary school children. Shade
Agboola confirmed that eligibility was for all primary school
children and for secondary school children in years seven and
eight, but this was being increased each year. Parental consent was
required which remained a key challenge despite schools offering an
easy way to give consent digitally. There was choice whether to
have the vaccine by injection or nasal spray.
- A member considered the low uptake
of Covid booster vaccinations was disappointing. It would be
interesting to compare the data from when the vaccine first became
available. A point about providing reminders via text message.
- The member asked if there had been
any Covid deaths in Warwickshire recently, and the impact of the
latest Covid strains. Dr Agboola would research the position on
Covid deaths. People who had been vaccinated would still be
protected against the newer strains of Covid. The virus would
continue to mutate, and people would catch Covid, but the
vaccination reduced the risk of serious illness and death.
- There had been a reduction in uptake
of Covid vaccination. Points about herd immunity, and that
view the full minutes text for item 7.
Work Programme PDF 83 KB
For the Committee to review and update its
The Committee reviewed its work programme. The
Chair provided details of the items added to the programme
recently, also confirming her wish to focus on prevention and
wellbeing. Discussion took place and it was agreed that the
following items be considered at the February Committee
- Care needs for people aged under 65
and the placements they were supported in.
- Development of the Adult Social Care
- The preparedness for the Care
Quality Commission inspection. This would report the feedback from
an upcoming peer review.
- Children’s continence
That the Committee updates its work programme
as outlined above.