Agenda and draft minutes

Health and Adult Social Care Overview and Scrutiny Committee - Monday, 8th March, 2021 6.00 pm

Venue: Virtual Meeting

Contact: Democratic Services  Email: democratic.services@bcpcouncil.gov.uk

Media

Items
No. Item

113.

Apologies

To receive any apologies for absence from Councillors.

Minutes:

Apologies were received from Cllr D Farr.

114.

Substitute Members

To receive information on any changes in the membership of the Committee.

 

Note – When a member of a Committee is unable to attend a meeting of a Committee or Sub-Committee, the relevant Political Group Leader (or their nominated representative) may, by notice to the Monitoring Officer (or their nominated representative) prior to the meeting, appoint a substitute member from within the same Political Group. The contact details on the front of this agenda should be used for notifications.

 

Minutes:

Cllr L Fear substituted for Cllr D Farr.

115.

Declarations of Interests

Councillors are requested to declare any interests on items included in this agenda. Please refer to the workflow on the preceding page for guidance.

Declarations received will be reported at the meeting.

Minutes:

The following Cllrs made declarations of interest:

 

Cllr L-J Evans declared, for transparency, that she is an employee of the University Hospitals Dorset NHS Foundation Trust.

 

Cllr C Matthews declared, for transparency, that he is a governor of The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.

 

Cllr C Johnson declared, for transparency, that she is employed as a staff nurse at The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.

116.

Minutes pdf icon PDF 249 KB

To confirm the minutes of the meeting held on 18 January 2021.

Minutes:

The minutes of the meeting held on 18 January 2021 were approved as a correct and accurate record.

117.

Public Issues

To receive any public questions, statements or petitions submitted in accordance with the Constitution, which is available to view at the following link:

 

https://democracy.bcpcouncil.gov.uk/ieListMeetings.aspx?CommitteeID=151&Info=1&bcr=1  

 

The deadline for the submission of a public question is 4 clear working days before the meeting.

 

The deadline for the submission of a public statement is midday the working day before the meeting.

 

The deadline for the submission of a petition is 10 working days before the meeting.

Minutes:

There were no public questions, statements or petitions received for this meeting.

118.

Action Sheet pdf icon PDF 206 KB

To note and comment as required on the action sheet which tracks decisions, actions and outcomes arising from previous Committee meetings.

Minutes:

The Committee noted the Action Sheet.

119.

Homelessness Strategy - Summary of Health Aspects pdf icon PDF 663 KB

(18:15 – 18:30*)

 

To receive an overview of the health aspects of the Draft Homelessness Strategy from the Council’s Lead Member for Homelessness. The Committee will then have an opportunity to formulate comments and questions that the Chair can take to the O&S Board meeting on 1 April 2021 where the Draft Homelessness Strategy will be considered in full.

 

The sections within the Draft Homelessness Strategy, as seen in Appendix 1, concerning health and healthcare are as follows:

 

Within Part 3

·       Focus on health and wellbeing

·       Partnership approach

 

Part 4 – Covid-19 pandemic

 

Part 6 –Commitments from the 3 Core Aims have particular health and wellbeing focus. There will be further detail and breakdown of all these commitments in the Action Plan which is being drafted currently.

 

Minutes:

The Council’s Lead Member for Homelessness gave an overview of the health aspects of the Draft Homelessness Strategy. The Committee heard that there were thirty-three references to ‘health’ in the Strategy and that health and wellbeing was a core aim. Members were informed that: there is a clear link between homelessness and poor health that poor health can be a contributing factor to losing a job and/or losing your home. This includes poor mental health. Mental health issues are a common factor in homelessness and up to 45% of housing applicants cite poor mental health. Rough sleeping is at the more extreme end of homelessness and often involves substance abuse. The life expectancy of rough sleepers averages at 46 years old for men and 46 years old for women.

 

The Committee heard that there was the potential to save lives through the strategy, with specific emphasis on the health aspects. The health risks of homelessness range from dehydration, poor diet, stress, damp and cold, poor mental health, substance abuse, overdoses, blood borne viruses. There are visibly more health issues among the homeless cohort than the general population.

 

Members were told that the strategy encouraged rough sleepers to move of the streets and gain tenancies. This aim required a holistic approach that coordinates a wrap around care system to meet all the interrelated needs of the individual. Health plays an essential part of this and must be upheld alongside the other support mechanisms, such as benefits, housing, food and toiletries. The ultimate aim was for this to lead to meaningful activities for those individuals within the community and for the individual to receive skills, training and friendship. This is where health and wellbeing are inextricably linked.

 

It was explained that this was often a slow process and that the services must build trust with homeless individuals. The strategy would feature a joined-up approach alongside the housing services and prevention services. This would include an out of hospital model with provision in community working, alongside housing teams and a new dedicated group of housing officers. It is hoped that this approach would help prevent homeless related deaths including suicide, being the victim of crime, poor health and substance abuse. The ‘package of tailored care’ would also include access to GPs and dental care.

 

Members were informed that COVID19 had impacted the work on the strategy but had also encouraged services to work more closely together in a collaborative style. This multidisciplinary approach would enable the service area to safeguard individuals, prevent homelessness, intervene earlier and stop early deaths.

 

The Committee asked several questions following the update. Answers were provided by the Lead Member for Homelessness and the Housing Services Manager. The questions and responses included:

·       A member asked if the strategies focus would be on rough sleeping, to which the Committee were informed that a bespoke provision to all individuals facing or experiencing homelessness would be offered.

·       A member referred to the use of multidisciplinary teams and community hubs, to which it  ...  view the full minutes text for item 119.

120.

Dorset ICS New Hospital Programme - Strategic Outline Case

(18:30-19:00*)

 

To receive a presentation from the Transformation Director of the University Hospitals Dorset NHS Foundation Trust New Hospitals Programme on the Strategic Outline Case.

Minutes:

The Transformation Director for the University Hospitals Dorset Foundation Trust (UHDFT) introduced the Strategic Outline Case. The main points raised during the presentation were as follows:

 

Stephen Killen – Transformation Director for UHD FT

Mike Kelly Dorset Healthcare – Head of MH

Jonathan Kempton – Head of Dorset Healthcare leading on this programme.

 

·       The Strategic Outline Case was a £350 million capital opportunity. Following the clinical services review in 2017, the aim for better care and pathways of access, including care closer to home went through the local scrutiny process, a judicial review, an independent review panel and judgement from the Secretary of State.

·       Members were reminded that the Dorset healthcare system and its work alongside the local authorities was in the top 10 nationally and was a Wave 1 care system.

·       At the heart of the project was prevention, community investment, community services and care closer to home.

·       £250 million funding would go toward the maternity and children’s services at the Royal Bournemouth Hospital and the advance theatre complex at Poole. This was alongside investment in pathology.

·       The Health Infrastructure Plan (HIP) saw between £350-£500 million invested in the Dorset healthcare program.

·       The HIP2 scheme would be another ambitious program that seeks to develop hubs in the BCP area.   

·       £90 million investment would go toward refurbishment in wards and hospital beds, with Poole Hospital receiving £80 million for wards, theatres and beds. St Anne’s hospital would also receive refurbishment of wards and beds.

·       The HIP2 program builds upon the 2017 review and the extensive modelling of patient flow over a 5 year period. The first scheme focused on demand, capacity and division of beds across Dorset. Modeling identified that there were too many acute Mental Health beds in the West and not enough in the East. The outcome of the consultation and review was that the that Linden Unit should be closed (this site had 50 beds) and capacity moved to the St Anne’s Site. The review further identified that an additional 16 Mental Health beds were needed (4 in the West and 12 in the East). The Second scheme highlighted the issues faced by young people needing to access children and adolescent mental health services (CAHMS). The long waiting list, imbalance between supply and demand and the high number of of young people not able to access beds locally. Psychiatric intensive care beds for young people was a specific problem. The 2017 review identified low bed base in the South of England as a region wide problem. There are currently 8 beds available at the Psychiatric Intensive Care Unit Pebble Lodge. Pebble Lodge has an education provision rated outstanding by OFSTED. The Second Scheme would provide PICU beds for Dorset, Sussex, Hampshire and Isle of Wight. Unfortunately, a 2017 planning application for a new Bournemouth site was not successful but plans are being redrawn to submit soon.

·       HIP3 is the redevelopment of the Thorston site in Dorchester which has 18 beds but doesn’t currently meet  ...  view the full minutes text for item 120.

121.

Healthwatch Dorset Draft Workplan for 2021/22 pdf icon PDF 118 KB

For the Committee to consider and comment on the Healthwatch Dorset Draft Workplan 2021/2022, as attached at Appendix 1.

Additional documents:

Minutes:

The Manager of Healthwatch Dorset introduced the Draft Workplan for 2021/2022 and provided update for the Committee. The main points raised during the update were as follows:

·       Feedback had been obtained and assessed in order to draft the work plan for the next year.

·       Access to primary care was a key item for Healthwatch last year and it had to adapt due to COVID. The project was successful despite the necessary changes and has enabled virtual consultations to be utilised in the year ahead. Healthwatch were conscious that a lot of people were still not accessing primary care and assessments need to be made on how to make it easier for those not accessing primary care whilst not necessarily using virtual equipment.

·       Accident and emergency care was another key issue throughout 2019 with a 2019 review on A&E performance measures. 111 First was a program that saw people call 111 first before visiting A&E. Via Poole Hospital, Healthwatch had made 120 calls to A&E users to see if there were any prevailing themes in the feedback. Any learning would be taken and adapted to use at Dorset County hospital in summer.

·       A key project for the coming year would focus on marginalised young people. It was acknowledged that Healthwatch would need to be proactive on listening to young people. Therefore, a Young Listeners groups of 16-25 year-olds would be supported and trained over Summer 2021 to develop an engagement project to find out what young people think about health across Dorset. There had been numerous applicants for this role throughout January/February and there are now 13 young people in the group. This group will now be trained and supported to design their own engagement program.

·       Transport was another key theme of focus for the coming year. A survey on accessing the COVID vaccine and what could be improved showed that transport was a concern as people were worried about how they would get to vaccine centres. Those shielding for a year were now scared to go vaccine centre.

·       Additionally, Healtwatch were working on a commissioned project with Wessex council alliance and Wessex voices, funded by the NHS England and NHS Intelligence on developing creative engagement tools for young children living with cancer. Feedback would be gathered until June.

·       There was still scope to work on other projects throughout the year, as last year Healthwatch had to adapt to numerous situations and therefore flexibility was required to ensure that the local concern/requirements was met.

·       One area that raised a lot of interest was dentistry and Healthwatch were conscious that there couldn’t be much changed locally but that they could input to Healthwatch England and aim to improve dentistry at a national level.

The Committee asked several questions following the update and presentation. Answers were provided by the Manager of Healthwatch Dorset. The questions and responses included:

·       A member referred to vaccine hesitancy and asked if Healthwatch were going to look into this. Members heard that Healthwatch  ...  view the full minutes text for item 121.

122.

COVID-19 Update

(19:30 – 19:45*)

 

For the Committee to receive an update from Adult Social Care Services on COVID-19, to enable the Committee to monitor the ongoing pandemic and scrutinise the ongoing response to COVID-19.

Minutes:

The Director of Public Health for BCP Council introduced the progress report on Public Health and Adult Social Care Response to the COVID-19 Pandemic. The main points raised during the Public Health section of the presentation were as follows:

·       Infection rates had continued to fall in the BCP Council area; lockdown 3 has been very effective at reducing transmission.

·       The 7-day infection rate for BCP Council had fallen below the rate for England at 57 per 100,000 as of Feb 21 – 28.

·       The transmission rate in Over 60s was also declining rapidly, with the current figure of 38 per 100,000. The South West regional rate for the same period was 44 per 100,000, with England standing at 81 per 100,000 population

·       Testing positivity was 3% across BCP. This was an improvement on the figure in early January 2021 where positivity reached 19%.

·       Although there had been improvements there was no room for complacency as some parts of the country, including the Midlands, North West and parts of London were showing increases in infections.

·       More than 300,000 people in Dorset and BCP Council areas had received their first dose of the vaccine.

·       Hospital admissions were reducing more quickly than predicted. The national evidence showed that the vaccination rollout was helping to reduce hospital admissions and reduce deaths; this was compared with modelled estimates.

·       The Government’s roadmap provides a clear framework for how Public Health England will provide support whilst lockdown restrictions begin to ease.

·       There is a national requirement to refresh the local outbreak management plan, as of 12 March.

·       This revised plan will include preparations for how to live safely with COVID-19, providing assurance on local capability and capacity to respond to future outbreaks. This involves the mobilisation of rapid community testing and closer working with the Test and Trace scheme to identify contacts of those who are infected.

·       Enhanced surveillance will be introduced to inform rapid suppression of cases.

·       A vaccine coverage assurance was underway to close gaps in uptake among cohorts within the community that are as yet not taking up the vaccine offer.

·       There were plans underway for surge testing of Variants of Concern.

·       There was now also an opportunity to show learning from the past 9 months, with the ultimate aim to progress to a business as usual COVID mitigation strategy.

·       Maintaining confidence in public adherence to social distancing and hygiene measures was imperative along with supporting schools to open safely which relied upon the lateral flow testing of secondary pupils and household bubbles.

·       Clear communications around vaccination and rapid testing must be upheld. Neither receiving the vaccine or engaging in testing programs means that people can stop social distancing and practising good infection prevention and control measures.

·       Getting infection rates down further would be key to prevent the risk of a resurgence.

·       Public Health Dorset were monitoring the take up of community asymptomatic testing.

 

The Director of Adult Social Care Services introduced the social care services aspects of the presentation. The main points of  ...  view the full minutes text for item 122.

123.

Portfolio Holders' Update

(19:45-19:55*)

 

To receive any updates from the relevant Portfolio Holders on key issues or actions that have been taken since the last meeting, as appropriate.

Minutes:

The Portfolio Holder for Adults and the Portfolio Holder for Covid

Resilience, Public Health and Education provided an update on the work

that had taken place since the last meeting of the Health and Adults Social

Care O&S Committee.

 

The main points of the update from the Portfolio Holder for Covid

Resilience, Public Health and Education were as follows:

 

·       Primary Care Networks and the BIC vaccination hub had both been successful in the vaccine rollout. There had been an incredibly high take up of vaccinations among the elderly population and this was in-part due to the use of Primary Care Networks in the local area. It is expected that the BIC vaccination centre will serve the lower age groups once the rollout reaches the relevant phase.

·       It was key that trusted voices reach out into the community and advocate the vaccine to ensure equal take-up across all groups in BCP.

·       Testing in schools was ramping up and a significant step up had been made in the capacity of testing. The plan would be for children to be tested at several times during school hours and for home testing to be introduced.

·       11,000 people in BCP are classed as extremely clinically vulnerable.

·       The Together We Can programme continues although requests for help has decreased and there now appears to be a higher level of resilience in the community.

 

The main points of the update from the Portfolio Holder for Adults were as

follows:

 

·       Single visitors could now visit relatives in care homes.

·       Free PPE was being offered to carers.

·       A live consultation was underway from the that CQC rates in social care are set.

·       Another live consultation was underway regarding Mental Health Act legislation.

·       The Adult Social Care contact centre had merged between Poole’s help desk and Bournemouth’s Care Direct teams and the opening times were now 9am-5pm Monday to Thursday and 9am-4:30pm on Fridays.

 

The Committee were given the opportunity to ask questions following the Portfolio Holders’ Updates. Answers were provided by the Portfolio Holder for Covid Resilience, Public Health and Education and the Chief Executive of Public Health Dorset.

 

·       A member asked how parents of school children had been informed about access to tests. The Committee were informed that the individual schools were sending out letters and information on testing.

 

The Committee noted the Portfolio Holders’ Update.

 

 

 

124.

Forward Plan pdf icon PDF 242 KB

To consider and comment as appropriate on the development of the Committee’s Forward Plan.

Minutes:

The Committee considered the Forward Plan.

The Chair updated the Committee on an upcoming item: the Carer’s Strategy. Members were informed that this item concerned the carer’s vision and strategy which had been developed pan-Dorset. The Strategy ended in 2020 and due to COVID there have been no further updates on the Carer’s Strategy. BCP Council and Dorset Council will have their own respective strategies. It was suggested that the Committee may seek to commission a small working group with officers on this issue so as to provide appropriate strategic input and scrutiny. The Committee noted this and the matter would be considered further at a later date.

Several members requested information on dentistry provision in the NHS. The matter would be looked into further by officers in consultation with the Chair and Vice-Chair of the Committee

 

RESOLVED that the Forward Plan was agreed and approved by the Committee.