Agenda and draft minutes

Health and Wellbeing Overview and Scrutiny Committee - Thursday, 4th November, 2021 7.00 pm

Venue: South Essex College, High Street, Grays, RM17 6TF – Room W1.22

Contact: Jenny Shade, Senior Democratic Services Officer  Email: Direct.Democracy@thurrock.gov.uk

Items
No. Item

20.

Minutes pdf icon PDF 262 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 2 September 2021.

Minutes:

Kim James asked that on page 7, paragraph 3 of the agenda, HealthWatch could be replaced with Thurrock CVS as they managed the recruitment.

 

Kim James stated that social prescribing offer was ran by the voluntary services and community resources with recruitment being managed by Thurrock CVS

 

Following this change, the minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 2 September 2021 were approved as a correct record.

21.

Urgent Items

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972. To agree any relevant briefing notes submitted to the Committee.

Minutes:

No urgent items were raised.

22.

Declarations of Interests

Minutes:

No interests were declared.

23.

HealthWatch

Minutes:

No HealthWatch items were raised

24.

Community Inpatient Beds in Mid and South Essex pdf icon PDF 210 KB

Additional documents:

Minutes:

Present for this item were:

 

Claire Hankey, Director of Communications

Tania Sitch, Integrated Care Director

Andy Vowles, Programme Director

James Wilson, Transformation Director

Dr Sarah Zaidi, GP and Ageing Well Lead

 

The following PowerPoint was presented to Members:

 

(Public Pack)Item 6 - Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 04/11/2021 19:00 (thurrock.gov.uk)

 

Councillor Ralph thanked officers for the presentation and stated he was fully supportive of the stroke side of this service and appreciated that the best care for some residents may mean having to go outside the borough. Councillor Ralph stated it would be a good idea to have all the specialists in one place. Councillor Ralph also raised his concern and objection to Joint HOSCs as not all size fitted all and Thurrock could easily be out-voted and power could be easily be given to other HOSCs.

 

Jo Broadbent referred to the stroke rehab beds and whether there was an early supportive discharge service within Mid and South Essex and whether the evidence based around stroke early supportive discharge had been taken into account in the calculation around the number of stroke rehabilitation beds. James Wilson stated that early thinking around volumes would need to be developed and embedded from views as part of the engagement process and ultimately be in the pre-consultation business case and confirmed there was an early supportive discharge service across Mid and South Essex and would be complimented to those requiring bed based rehabilitation. Dr Sarah Zaidi stated that the modelling being undertaken was aligning everything to best practice in terms of optimising outcomes and that early supportive discharge had been included as part of the modelling exercise.

 

Councillor Holloway thanked officers for the presentation and asked that the committee be informed of the specific impacts on Thurrock’s care and Thurrock’s residents. Andy Vowles stated that at this point in the process there was not any definitive set of options that could come to committee. The paper had come to committee to start exploring through engagement on what those potential options were and the criteria would be known once assessed. It would be at that point when a more definitive view on what would impact Thurrock’s residents. Councillor Holloway questioned what elements would be looked at when drawing all this together and making those final decisions to which James Wilson stated that the elements would be criteria, evidence based, patient experience and financial component. It was important to get the criteria right before moving from engagement of issues to the options.

 

Councillor Holloway stated the report was very general and hard to comment on but agreed that everyone wanted the best care for patients and was mindful that the best care could sometimes be configured outside of Thurrock but it was key that those stroke beds were kept in Thurrock.

 

Councillor Fish questioned what patients would be considered suitable for those beds and how the capacity would be worked out for those needing the beds. Dr Sarah Zaidi stated  ...  view the full minutes text for item 24.

25.

Adults, Housing and Health - Fees and Charges Pricing Strategy 2022/23 pdf icon PDF 388 KB

Additional documents:

Minutes:

Catherine Wilson presented the report that set out charges in relation to services within the remit of the Health and Wellbeing Overview and Scrutiny Committee. Any new charges would take effect from the 1 April 2022 subject to consultation and Cabinet approval unless otherwise stated. In preparing the proposed fees and charges the Adult Social Care Directorate had worked within the charging framework and commercial principles set out in section three of the report. It had also taken into account the effect that Covid-19 had and would continue to have on services, residents and the local economy. Further Director delegated authority would be sought from Cabinet to allow fees and charges to be varied within the financial year in response to commercial or legal requirements. Members were referred to the full list of proposed charges as detailed in Appendix 1. At this stage there were no proposals to increase charges for 2022/23 other than the proposal that had already been agreed and currently being implemented which was the three year incremental increase to the domiciliary care charges.

 

Councillor Ralph thanked Catherine Wilson for the report.

 

Councillor Holloway thanked officers for the breakdown of the fees and charges but would also have liked to have seen the wider directorate breakdown of finance. Asked for clarification that the Appendix 1 was for information only and requested some financial context in which the financial charges sat. Members agreed to add to recommendation 2 that any such changes would be brought back to the Health and Wellbeing Overview and Scrutiny Committee for scrutiny. Ian Wake reassured Member that such changes would be consulted with service users and then back to committee. Ian Wake stated this was a challenging time for the Council with a deficient of £3 million for 2022/23 with a lot of work being undertaken in the background and further proposals were being put in place to close that deficient. In Ian Wake’s directorate there was a transformation programme in place to transform services with a target savings of just under £5 million over two years.

 

RESOLVED

 

1.     That Health and Wellbeing Overview and Scrutiny Committee noted and agreed that a consultation should be completed for the proposals to revise fees and charges for Adult Social Care.

2.     That Health and Wellbeing Overview and Scrutiny Committee noted that Director delegated authority will be sought from Cabinet to allow Fees and Charges to be varied within a financial year in response to commercial and legal requirements. That any such changes would be brought back to the Health and Wellbeing Overview and Scrutiny Committee for scrutiny.

 

Catherine Wilson left the meeting at 7.42pm.

 

26.

Thurrock Health and Wellbeing Strategy Refresh pdf icon PDF 145 KB

Additional documents:

Minutes:

Jo Broadbent presented the report that provided an update on progress in refreshing the Health & Wellbeing Strategy for 2021-26. That an eight week consultation exercise had commenced on Wednesday 13 October 2021 which was due to close on Friday 3 December. Members were briefed on the domains and specifically domains four to six which were more focused on health. On the variety of ways residents could get involved to provide their views on the proposals. Members were briefed on the materials used to develop a consistent, recognisable approach for raising awareness of the consultation exercise. The live communication activity grid to ensure the opportunities were captured. Examples of branding, text and questionnaires used were referred to in the Annexes to the report.

 

Councillor Ralph questioned who had written the questions and whether these had been seen by members prior to the consultation exercise commencing to which Jo Broadbent stated this had been a team effort through the steering group, stakeholders and engagement teams looking at topics which could be turned into priorities. That Councillor Halden as chair of the Health and Wellbeing Board had seen and signed off the questions. That due to the September Health and Wellbeing Board being cancelled this was undertaken after the consultation had gone public. That a lot of replies had already been received with several 100s of hits on the web site and over 50 individual responses received. The CVS continued with attending places of engagement and engaging with stakeholders. Kim James stated that CVS would lead on this with the help of HealthWatch. That this was a massive piece of work and would be too much for someone to complete all at once. It had been identified on what group were being engaged would depend on which domain was most appropriate to discuss. That stakeholders needed to be talked through each domain which was very time consuming and confusing for many. Councillor Ralph stated that more information was required against each domain and agreed it would be better verbally delivered rather than residents having to struggle with completing the consultation on-line. Councillor Holloway stated this was a brilliant piece of work but the consultation had not been written for residents, it was too jargonised and would take too long for people to complete and questioned whether the length of the consultation could now be reduced. Councillor Sammons agreed it was too technical for some residents. Councillor Piccolo questioned whether another shortened version could be provided. Councillor Snell stated that lessons were not learnt from previous consultations and that this consultation was too long and would be a chore to complete. Councillor Ralph stated this was a missed opportunity and too late to change and whether the strategy needed to be rethought. Ian Wake stated the strategy was board and that it needed to be, it had to address equality in its entirety and was statutory to have one in place. That member’s criticism was well made and ideally this consultation would have been  ...  view the full minutes text for item 26.

27.

COVID Update Presentation

Minutes:

Jo Broadbent provided Members with an update on the latest Thurrock COVID Data and Intelligence:

 

·         Current Picture, Rate per 100K Population and Positivity – Thurrock’s positivity rate for the last seven days was 358 per 100K residents. In comparison to January 2021 when the positivity rate was about 1500 per 100K.

·         Current Picture, Positive Tests, Testing and Positivity – Rates fluctuated between 50 and 100 cases a day and had stayed at this level and not fallen back down to the low levels we had in April and May. The test rates and positivity rates mirrored each other so no peaks had been seen with the positivity rate about 8%.

·         Total Tests by Age – Breakdown of tests by age and gender with consistently higher testing amongst female residents with low levels of testing across all age groups. The rate of 10 to 19 year olds back in September was much greater due to testing amongst school children at the start of term.

·         Current Picture – Positive Tests by Age Band – Over the past couple of months the highest rates had consistently been in the 10 to 19 age group and about two weeks ago that positivity rate in that age group was over 1000 per 100K. This was now down to 650 which had been due to the impact of half term. Work had been undertaken with schools to try and stop spread between year groups through sibling transmission. A number of actions taken with schools had brought the positivity rate down. The age group 40 to 49 for the past few weeks had been the second highest group and over the past month rates had been increasingly slowly in the over 60s.

·         BTUH bed occupancy by type – Thurrock and Non Thurrock residents – Lower and more consistent rates now when compared to earlier in the year. A consistent number of Covid beds occupied with a few with mechanical and non-invasive ventilation although most were just oxygen therapy.

·         Vaccinations – Uptakes in the various different age and risk groups. The uptake of the vaccine in the over 18s had stalled with very slow increases. The vaccination rollout continued for the younger groups of 16 to 17 and 12 to 15 age groups. School based programmes were in place to book vaccination and bookings could be made through the National Booking Service.

·         Confirmed Cases – Map identified the distribution of cases of unique postcodes within the borough who had at least one case in the latest seven days data. Highest case rates were within Purfleet and Grays with much of the rest of the borough with low number of cases. There were only a handful of schools with an outbreak, 13 schools recovering from an outbreak and one care home with a live breakout which was all good. That the community transmission had begun to decrease and much lower activity in the educational and care home settings.

 

Jo Broadbent concluded that:

 

·         Thurrock’s overview rate of positive tests had  ...  view the full minutes text for item 27.

28.

Adult Social Care - Consultation feedback on the meal delivery and day care services pdf icon PDF 381 KB

Minutes:

Ian Wake presented the report that following a meeting of the Health and Wellbeing Overview and Scrutiny Committee on 17 June 2021, proposals were discussed regarding the closure of the Council’s meal delivery scheme and the consolidation of the three existing day care centres into one at Cromwell Road. At this meeting, members requested a further service user consultation be undertaken which started in July 2021 and involved face-to-face and telephone discussions with service users and their families.

 

Dawn Shepherd outlined the outcomes of that consultation and highlighted that:

 

·         Out of the 47 service users who attended the two closing day care centres only five would not be willing to attend Cromwell Road centre because of the distance but all five had alternative support in place; and

 

·         Out of the 89 service users receiving meals from the delivery scheme, only 24 had no alternative support in place and would need a service in the future.

 

Members were informed the second phase would commence undertaking a more detailed assessment and tailoring of packages and options for those who still needed a service. That one service would not take over the entire meal delivery scheme it would be introducing multiple options in order to find bespoke outcomes in line with our desire to be person-centred and to offer choice and control to service users. Members were reassured that the meal delivery scheme would only cease when all current service users had an alternative suitable service in place. This would be communicated to service users and their families in due course.

 

Councillor Ralph thanked officers for the positive outcome of the consultation and commented that those 24 service users would further down the line need to have those reassurances that the service would not cease. Councillor Ralph also commented that he was pleased to hear of the other ways of support and meals delivered.

 

Councillor Holloway thanked officers for the work undertaken on the consultation and questioned whether there were any plans in place for the 24 services users to be assessed. Councillor Holloway also had concerns that some older people would not be aware that this support and the offer of hot meals would be still available. Dawn Shepherd stated this would start on Monday 8 November and anticipated this would take six to eight weeks to complete and hoped to provide a briefing note to members by the end of December. In regards to people knowing about the service, at present users come through the assessment process and could still come through the single point of access. Also that Thurrock First was a point of access but there were a lot of options available which people were aware of. That advertising or making people aware would be down to those individual groups out in the community and the council would encourage them to continue to advertise and make people aware.

 

Members discussed the bespoke services available and how quality and nutrition checks could be undertaken but all agreed that meals would  ...  view the full minutes text for item 28.

29.

Work Programme pdf icon PDF 119 KB

Minutes:

Councillor Ralph referred to the Briefing Note provided on the Update Position on Basildon University Hospital Maternity to which members noted the key achievements, improvement plans and challenges and agreed that this item be added to the 2022/23 work programme to enable time for a benchmark exercise to be undertaken.

 

Councillor Ralph referred to the Mental Health Review, which the committee agreed to undertake as part of the Scrutiny Review Project but as the Mental Health Member Engagement Group would be meeting to receive an update on the mental health transformation programme, he suggested a change of focus and to look at Alcohol Addiction in the borough. Councillor Ralph would contact members to discuss the topic and scope of any future review. Ian Wake advised the committee that there was insufficient capacity within the Public Health Informatics Team to undertake any additional local analyses of alcohol data prior to the new financial year but offered to share nationally collected Thurrock alcohol profile dataset with Councillor Ralph.

 

Councillor Fish questioned when the Update on the Whole Systems Obesity Strategy Delivery and Outcomes Framework would come to committee to which Jo Broadbent stated that a briefing note was currently being prepared and would be send out to members in the next week.

 

Councillor Holloway requested that the Overview of Responsibilities of Portfolio Holder for Health item for Councillor Mayes be removed from the September Committee and added to the 13 January 2022 meeting. Also to add the Overview of Responsibilities of Portfolio Holder for Adults and Communities item for Councillor Huelin.