Agenda item

The Board will receive a presentation on Covid 19 to include arrangements for recovery.

The Chairman reported that Covid 19 had led to deaths in the BCP local area and she acknowledged the loss and pain of everyone who had been personally affected and thanked all key workers across all Board partners including NHS staff, care sector staff, police, fire, Council and the voluntary sector who had supported the public through the period.

The Chairman introduced the item and called on Health and Wellbeing Board Partners to outline their response to the pandemic.

The Director of Public Health reported on the number of cases and deaths in the area.  He explained that the local outbreak was characterised by ongoing transmission in clusters associated with high risk settings such as hospitals and care homes – not widespread community transmission. The Board was advised of the Covid 19 command and control structure, how the local approach fed into the regional and national response to the pandemic and in particular the role of the Local Resilience Forum Strategic Co-ordinating Group.

The Vice-Chairman of the Board echoed the comments of the Chairman about the sad loss of life due to the pandemic and the fantastic work done by key workers across Dorset.  He highlighted the focus nationally in terms of the surge in demand for hospital carewhich was being foreseen for the NHS and the need to protect acute hospitals and create critical capacity.  The Board was informed that routine elective care had been stopped but was now beginning to restart.  The Vice- Chairman reported on the temporary building work which had been undertaken in acute settings to manage the flow around sites and keep social distancing in place as much as possible.  The Board was informed of the plans to create additional critical care capacity in Dorset.  The Vice-Chairman reported that outpatient appointments and training had been stopped during the pandemic period. Members were informed that Community Hospitals had played a part in discharging some patients to increase capacity.  The Vice-Chairman referred to ‘hot’ and ‘cold’ sites, the role of primary care GP sites which had all remained open and the support provided to care homes.  The Board was informed of the huge demand for PPE and the requirement to provide equipment for staff to undertake their day to day procedures with supplies being shared across Dorset where needed. The Vice-Chairman reported that PPE had not run out, but it had been ‘close to the wire’ due to demand.  He reported on the testing requirements and the increase in focus with the introduction of public testing and mobile sites across Dorset.  The Board was informed of the level of transformation including the use of technology which had provided the opportunity for staff to work remotely where appropriate, e-consultation and the huge take up of the 111 website.  The Board was informed of the NHS’ concerns relating to the dramatic drop in referrals to non Covid 19 related services such as cancer, children’s and cardiac and the focus to promote the message that the NHS was open and people should make contact with their GP if they needed to access such services.  The Vice-Chairman explained that it was evident that there had been a prescribing surge at the start of the pandemic which had now settled down and was back to normal levels.  The Vice-Chairmen referred to the reduction in the level of mental health contacts and emphasised that the NHS wanted to see patients who needed to access services as concerns had been expressed about the long- term implications. The Board was informed that the NHS was now moving into phase 2 with diagnostic and elective work being switched on and the private sector being used to support this work.  Members were advised that the Primary Care Networks had worked really well and supported practices with staff and equipment and the creation of hot and cold sites with hot sites offering services to people with Covid 19 symptoms.  The Vice-Chairman explained the importance of keeping the public engaged to promote the message that the NHS was open for business and reported that community groups had also been used to disseminate this message.  The Board was informed that nationally and across Dorset there was still a major incident, but the NHS was starting to look at recovery planning.

Debbie Fleming reported on the current level of patients with Covid 19 in the two trusts. She explained how hugely disruptive the pandemic had been to existing services and how proud she was of both trusts and partners across the BCP area and Dorset. She referred to the level of transformation that has been achieved and how positively staff had responded.   Ms Fleming emphasised that it would be a long time before anything that looks like normal across the acute area would be seen. She reported that both patients and the public were frightened and as an employer ensuring the provision of services and looking after staff who were at risk was a priority.

Julian Radcliffe, Service Director Inclusion and Family Services, BCP Council reported on the approach taken to protect the most vulnerable children and how the Council was fulfilling its responsibilities working with schools so that vulnerable children could have access to education.  In respect of the safeguarding systems schools in the BCP area provided good intelligence on vulnerable children.  He reported that staff had been redeployed into priority areas including into the community with link workers sending out as much communication as possible.  The Service Director commented on the Council’s statutory responsibilities in respect of annual reviews.  He explained that the service had created consultation lines which had resulted in excellent feedback from parents and carers. The Board was advised of school attendance levels and that 90% of schools were open in the BCP area.

Jan Thurgood, Corporate Director Adult Social Care, BCP Council outlined the approach taken by Adult Social Care and the collective work undertaken to ensure that hospitals had capacity.  She explained that the service had changed the way it worked and the level of contact from the public to Adult Social Care had increased in relation to referrals relating to financial hardship and access to essentials such as food. The Board was informed that safeguarding had seen an increase in referrals and there had been a focus on supporting carers through the pandemic including the introduction of group video contact. The Corporate Director reported on how the adult social care services had provided support across the whole adult social care sector and particularly to care homes.

Kate Ryan, Corporate Director Environment and Community, BCP Council updated that Board on the work undertaken with partners to ensure that no one was having to sleep rough during the pandemic.  She reported that 193 council places had been found together with 300 B&B places.  The Board was advised that some people may be ‘sofa surfing’ and potentially a small group of people rough sleeping.  The Corporate Director reported on the limited number of rough sleepers registered with a GP.  She commented on referrals to other services with positive improvements in mental health and increased take up of methadone prescriptions which would be a challenge going forward.  The Corporate Director reported on the Homelessness Reduction Board and the work with partners to learn lessons and to exceed expected outcomes.

Julie Fielding, Assistant Chief Constable reported on activity including the weekly Partnership Co-ordinating Group and the fortnightly Community Safety Partnership Board explaining that the Board had temporarily amended its emphasise to Covid19 and the impact.  She commented on the reduction in crime at the start of the pandemic which had now started to level off.  The Board was advised that there were now increases in ASB some of which was related to the Covid restrictions and increases in domestic abuse which was primarily in lower risk groups.  The ACC reported on the specific response to the domestic abuse plan which included the provision of safe accommodation, bringing perpetrators to justice, early intervention and safeguarding for children and vulnerable adults.

Seth Why, Dorset and Wiltshire Fire and Rescue Authority, outlined activity.  He explained that there had been low levels of sickness within the service and core services were still being delivered though business continuity planning.  The Board was advised of the Wareham fire and the impact on the service. The surge in the use of disposable barbecues which in some cases had not be disposed of safely was highlighted and in particular how to communicate the message to the local population and visitors to be aware of the dangers.  Mr Why also explained that the safe and well service was continuing via a triage method. 

Sam Crowe, Director of Public Health updated the Board on the impact on wellbeing.  He referred to a new Public Health review and provided a weblink for Board Members to access.  The Director reported that there had been a disproportionate impact in some groups including on going concern for the BME Group which was covered by the new Public Health review.  He explained that the true impact of the indirect impact on inequality was still awaited.  The Board was advised of an ONS survey and the national levels of wellbeing explaining that people were feeling anxious due to their economic circumstances and concerns about housing tenure.  The Director reported on the increase in the access to services such as LiveWell Dorset and that fewer people were exercising.  In conclusion he stated that more people believe the UK would be more united and kinder after the outbreak than before.

Karen Loftus reported on the huge response across the voluntary sector to Covid 19.  She commented on the phone exercise to understand the state of the sector and that her organisation had spoken to 50 bodies. The Board was informed that people had been directed to the Dorset Community Foundation who distribute funds to charities across the County. Members were advised of the huge surge in volunteers and the collaboration in the sector. It was acknowledged that a quarter of organisations furloughed staff and there was concern about the long-term sustainability.  Louise Bate, Healthwatch commented on access to GP services, pharmacy, mental health and hospital services.

The Board was advised that all partners were beginning to work as single agencies and in partnerships on a recovery and reset agenda with the intention to learn from positive innovations made in response to Covid 19.

The Board was informed that it was proposed that the BCP Health and Well-Being Strategy would be considered for approval at its next meeting.

The Board was reminded that its Annual theme for 2020/21 was agreed to be promotion of physical activity for all local people.  The Board’s views were invited on how to progress in light of the pandemic.  The Board noted that the issues of mental health and well-being had been highlighted in the reports to the board and so a view was given that this was an important theme to address while acknowledging that physical activity was a key component in supporting mental well-being.

Jenni Douglas-Todd Independent Chair of the ICS Dorset highlighted the need to capture the lessons on how partners were currently working but felt that the recovery and reset phase would be more challenging including infection control, social distancing and budget implications.

The Board commented on the differing levels of infections across the UK and the R figure.  The Director of Public Health reported that advice had been sought from Public Health England on estimating the R figure and whether this was achievable for a particular local area.  He referred to the development of Local Outbreak Management Plans.

RESOLVED that the Board notes the current position and update from partners on the response to Covid 19 and progresses the theme of mental health and wellbeing for 2020/21.

Voting – agreed