To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 5 November 2020.

Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 5 November 2020 were approved.

Councillor Muldowney referred to the Clinical Commissioning Group update on the 2019/20 financial assistance provided to Cambridge and Peterborough STP and questioned whether the letter referred to in the minutes of the 5 November 2020 meeting had been sent out on behalf of all HOSC members. Councillor Muldowney stated that it was unacceptable that this item was not on the agenda and that no representative had attended this evening to answer Member concerns. Mark Tebbs stated that the letter sent to Members from Maria Wheeler, the Chief Finance Officer to Thurrock Clinical Commissioning Group, had set out the position, the commitment made to return the money and had been perused as far as it could. Following a discussion between members it was agreed that the letter referred to in the 5 November 2020 minutes should be sent out from the Chair on behalf of all HOSC members, with the item being added to the 4 March 2021 meeting agenda. Members requested that any responses received should be shared with them. Members also requested that the appropriate persons be available at this meeting to answer their questions.

Councillor Holloway rasied her concerns that no budget report had been presented to this committee. Councillor Holloway stated that she had raised her concerns and had made several requests for this at previous HOSC meetings. She had also sent emails to the Chair requesting that this committee had the opportunity to overview and scrutinise the budget.

Councillor Holloway also raised her concerns that there was no report on Fees and Charges item on the agenda for HOSC members to scrutinise. Roger Harris confirmed that this would be discussed under Item 7 of the agenda.

Councillor Holloway raised concern that items on the work programme had been removed or added without the consent of all HOSC members. Roger Harris stated that the work programme had been re-profiled up to March 2021 and into the new municipal year as officers had been dealing with COVID for the last three month and it had not been possible to prepare reports. Councillor Holloway stated she understood the pressure that officers were currently experiencing but it was vital that a fees and charges report be brought to this committee to ensure the appropriate scrutiny was carried out.

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.

No urgent items were raised.

No interests were declared.

No items as Kim James from HealthWatch had sent her apologies.

Ian Wake, Director of Public Health, provided Members with an update on the latest Thurrock COVID-19 Data and Intelligence:

·         Current Picture, UTLA Rate per 100K Population and Positivity – Thurrock overall rate as of yesterday of positive tests per 100K population was 1334.7 with Thurrock ranking out of all the upper tier local authorities the highest during the period just up to and after Christmas. Thurrock were now ranking fifth which was still a high absolute rate. Rates that increased rapidly due to the new variant of COVID that was more transmissible than the original strain of COVID. Thurrock’s positivity rate, the proportion of COVID tests that were positive stood at 22% and although this rate was high it was not as high as some of Thurrock’s neighbouring authorities.

·         Current Picture – Positive Tests, Testing and Positivity – The latest test data was explained on the absolute number of tests and the absolute number of positive tests. There had been a surge and demand for testing in the run up to Christmas, this then fell back down over the Christmas week and following the Christmas period had seen an increase in demand for testing. In this demand of testing it had seen the number of positives drop off with the test positivity rate over the proportion of tests that had been positive fallen. In regards to what was happening in terms of underlying community incidence and prevalence it was plateauing. Not to mislead members into a sense of complacency there had been some promising signs that the measures in place were keeping the community transmission at a stable rate.

·         Current Picture – Positive Tests by Age Band – Between 1 January 2021 and 7 January 2021 – One thing that had changed over the last few weeks was the age groups in terms of where most positive tests were occurring. Up until the closure of schools before Christmas the age group with the greatest number of tests was for the 10 to 19 year olds. The age group with the greatest number of positive tests were now in the age group of 22 to 59.

·         Current Picture – COVID Positive, Unique Postcodes by LSOA – Between 27 December 2020 and 12 January 2021 – There were sustained community transmission in all parts of the borough. The highly transmissible variant was an issue in terms of care homes with a significant reduction in activity in education settings as more children were accessing remote learning.

·         Current Picture – Bed Occupancy BTUH – Bed occupancy at Basildon Hospital showed figures had rapidly increased from mid-December as the new variant hit with a major incident being declared on the 27 December. There had been good coordination between partnership working to try to stabilise and share with health care system across Essex which had made some efforts in terms of slowing the growth rate.

Ian Wake concluded that:

•      Some evidence that overall prevalence was plateauing, albeit at a high level of incidence.

•      There  ...  view the full minutes text for item 86.

Roger Harris introduced the report that had been presented to this committee on two other separate occasions and stated the only discretionary charge where there was any increase proposed for 2021/22 charges and had the biggest impact in terms of finances was domiciliary care. That the Council needed to look at possible ways to maintain the current level of service which had the least impact on those people who received the service. 

Catherine Wilson detailed the outcome of the consultation that had been supported by the Health and Wellbeing Overview and Scrutiny Committee on the 3 September 2020 and agreed by Cabinet on the 16 September 2020, together with the three options for charging for domiciliary care and asked for any comments on the recommendation to introduce a phased increase in charging for domiciliary care.

Members agreed that the response rate was good and had highlighted the good work that carers undertook and the value of the services being paid for. It was also noted that by all members that it was sad that the Council had to raise these charges and that it was inappropriate and unfair this had been put on Thurrock residents at this time of their lives.

At 9.15pm, Councillor Ralph suspended standing orders.

Members discussed the recommendations and how this transition could be made smoother and suggested that this could be phased over four years. Members agreed to add a further recommendation which would be put forward to Cabinet. That recommendation read as follows:

“For the Health and Wellbeing Overview and Scrutiny Committee to recommendation the introduction of a phased increase over four years”.

RESOLVED

1.     For Health and Wellbeing Overview and Scrutiny Committee to review the results of the Consultation regarding proposed charges for Domiciliary Care Services detailed in section 2.4.

2.     For Health and Wellbeing Overview and Scrutiny Committee to review the three options for charging for Domiciliary Care detailed in section 3.1. 

3.     For Health and Wellbeing Overview and Scrutiny Committee to comment on the recommendation to introduce a phased increase in charging for Domiciliary Care Services detailed in section 4.1.

4.     For the Health and Wellbeing Overview and Scrutiny Committee to recommendation the introduction of a phased increase over four years.

Mark Tebbs provided Members with an update on the changing aspects of access to health care services as a result of COVID and the report had focussed on Think NHS 111. This was a national program which had been developed for residents to book attendances through the 111 system and to avoid the risk of infection in overcrowded GP waiting rooms. With the necessary requirements being met the service went live on the 1 December 2020. 

Councillor Ralph thanked Mark Tebbs for the report and although he had concerns at the start as possibly somethings may get missed this was now a good decision that had taken the pressure of A&E over the Christmas period.

Councillor Redsell stated she had nothing but praise for the GP surgeries within her ward.

Councillor Muldowney questioned who had requested for this report to be presented this evening and stated she had received some good feedback about the 111 program and asked what the process of the Think 111 First would be. Mark Tebbs stated that if a resident was thinking of going to A&E they should ring 111 first, if they were able to do so. That resident would then be accessed over the telephone and could be redirected to alternative or a better pathway. If that resident was required to go to A&S a time slot would be booked for them. An alternative pathway could be for that resident to be referred to their GP. Anil Kallil stated that GPs had slots allocated for 111 patients. Members were informed that GP surgeries were open for business with more telephone and video conferencing appointments being made, this was for the safety of patients and surgery staff. Councillor Ralph stated that GPs were very quick to stop face to face appointments even though pharmacists were continuing to see patients and stated his concern that long term illnesses were not being identified and possibly being missed.

Councillor Holloway thanked Mark Tebbs for the report but questioned the appropriateness of the report to this committee as no analysis on the impact of this new service had been undertaken.

Councillor Holloway questioned why residents would be asked to go to Basildon Hospital for blood tests to which Anil Kallil stated this would be for those patients who would need to have an abnormal blood test and the hospital would be the only place to send them.

Members discussed the unacceptable bus services to Orsett Hospital especially for those patients attending blood tests and how this committee should continue to put pressure on Basildon Hospital and the Bus Company to get this service improved.

The following statement was provided by Tom Abell and Margaret Hathaway on the proposed closure of Orsett Hospital:

“Mid and South Essex NHS Foundation Trust remain committed to the long term closure of Orsett Hospital and fully support the programme to develop four integrated medical centres in Thurrock. The Trust Board approved the Programme Business Case at its meeting in December.

Prior to the COVID pandemic a detailed service mapping exercise had commenced to inform the intended location(s) where services currently delivered from Orsett Hospital would be transferred to. The Trust commits to ensure all services will continue to be delivered in a community setting giving local access to the Thurrock occupation. As a result of the COVID pandemic this work was put on hold to allow Trust resources to be dedicated to urgent operational requirements. It was intended to review this position in January 2021 but due to the second spike this has not been possible. The position will be reviewed again in March 2021.

Following the first phase of the COVID pandemic, Orsett Hospital has been utilised to transfer non-COVID services from the main Basildon Hospital site in order to support compliance with COVID Guidelines to ensure continuity of all services. This will give an opportunity to explore an increased range of services, including more outpatient clinics, diagnostics and minor procedures that could be delivered away from the main site giving further improved local access for the Thurrock population.

It is still intended that the principle location for Orsett services will be at the Grays Integrated Medical Centre, planned for the Thurrock Hospital Site.  Some outpatient’s clinics and phlebotomy services will be delivered from the other three centres.”

Councillor Ralph stated that it was encouraging to see that work had commenced on the Corringham site and requested to see the new drawings. Councillor Ralph stated he still had concerns on the Tilbury and Grays sites and COVID had identified the need for a new hospital in Thurrock and this had to be addressed for any future planning in the borough.

Members agreed that the report “Update on Orsett Hospital and Integrated Medical Centres” scheduled for the 4 March 2021 committee would be removed and brought back in the next municipal year when a detailed report would be available.

Members reviewed the work programme and made the following recommendations:

·       Remove the report “Update on Orsett Hospital and Integrated Medical Centres” from the 4 March 2021 and members agreed that this report should only be presented when a detailed report would be available in the next municipal year.

·       Add a report on the “Impact on Services post COVID” to the 2021/22 list of reports.

·       The report “Worklessness and Health Joint Strategic Needs Assessment” be reinstated back onto the 2021/22 list of reports.

·       The report “Safeguarding Strategic Plan 2020/23” be reinstated back onto the 2021/22 list of reports.

·       Add a report “2019/20 financial assistance provided to Cambridge and Peterborough STP” to the 4 March 2021 meeting.

·       Rename the report “Male Domestic Abuse Update” to “Domestic Abuse” to include analyse of all services.