Agenda and draft minutes

Health and Wellbeing Overview and Scrutiny Committee - Thursday, 5th November, 2020 7.00 pm

Venue: Committee Room 1, Civic Offices, New Road, Grays, Essex, RM17 6SL. View directions

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

Media

Items
No. Item

69.

Minutes pdf icon PDF 404 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 3 September 2020.

Additional documents:

Minutes:

Councillor Muldowney referred to the recent Clinical Commissioning Group update on the 2019/20 Financial assistance provided to Cambridge and Peterborough STP and stated that this was unacceptable that Thurrock would not be getting this money returned and requested that a recommendation be added to this item for Councillor Ralph as Chair of the Health and Wellbeing Overview Scrutiny Committee or jointly with the Portfolio Holder for Health to reply to this update to seek further clarifications. Councillor Holloway stated that this was outrageous and that reassurances were required. Councillor Ralph agreed that this was totally wrong and would write a letter on behalf of all HOSC Members. Mark Tebbs stated that further discussions would take place with Maria Wheeler and suggested that further updates be provided at the next meeting when the right people would be available to answer Member’s concerns but Members agreed that updates were required before the next meeting in January.

 

Councillor Holloway raised her concerns on the absence of any appointment to Vice Chair and questioned what Councillor Ralph was doing to address this and whether Councillor Ralph had been invited to any meetings that he had been unable to attend that the Vice Chair may have been able to attend. Councillor Ralph stated the position of appointing Vice Chair was important and that no Labour nominations had been made at Council and questioned whether the Labour Leader had offered this position to his Members. Councillor Holloway stated that it was not just Labour Members who sat on this committee who could be nominated for this vacant post and again raised her concerns that the committee should have a Vice Chair as this provided a layer of security and would cover any absences of the chair. Councillor Holloway questioned Councillor Ralph whether he had spoken to the Leader of the Council about this vacant post. Councillor Ralph stated he had approached other Members and to which Councillor Massey stated he felt he did not have the experience yet and was not the right person at this time to fill that vacant post.

 

Councillor Holloway referred to paragraph 3 of the work programme minutes “Councillors Holloway, Muldowney and Massey requested a detailed Fees and Charges Report for November committee” had been inaccurately captured and this was not what had been requested. Members had asked for a line by line budget option providing the options that had been given to the portfolio holder, taking into account that the Council had to make £20 million of savings next year which was a very large amount of money that would not have had any scrutiny. Councillor Holloway stated it was unacceptable that there would be no financial scrutiny being undertaken at this scrutiny committee. Councillor Holloway referred to Councillor Ralph’s response in the minute which had also been inaccurately captured. Councillor Ralph had said “if appropriate” and questioned whether Councillor Ralph had thought this was now appropriate and why he had not pushed for a detailed financial report for this  ...  view the full minutes text for item 69.

70.

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.

Additional documents:

Minutes:

No urgent items were raised.

71.

Declarations of Interests

Additional documents:

Minutes:

Councillor Massey declared that through his employment provided Thurrock Mind with ICT hardware and services.

 

Councillor Ralph declared that he was a private tutor in mental health who had worked for other providers throughout Essex and the wider area including Thurrock Mind.

 

72.

HealthWatch

Additional documents:

Minutes:

HealthWatch had no matters to raise.

 

Councillor Ralph congratulated Thurrock HealthWatch on their recent award and asked Kim James to update Members on this achievement. Kim James stated that as part of the National HealthWatch Awards, Thurrock HealthWatch had submitted a piece of work around the work undertaken last year with Public Health on the loss of funding to the violence against women and girls agenda and had come second and highly commended which was really good for such a small HealthWatch out of the 153 across the country. Kim James was pleased of the outcome for the people concerned and for the residents of Thurrock and now that piece of work had been secured it would now be going forward. Councillor Ralph also thanked Councillor Holloway who had highlighted this and had pushed through. Councillor Holloway echoed Councillor Ralph’s kind words to HealthWatch to be rewarded for an excellent piece of work and that Thurrock was lucky to have this team locally that supported the work of the Council, supported the work of the team and more importantly supported residents to ensure their voices were heard.

 

73.

Basildon University Hospital Maternity Services pdf icon PDF 140 KB

Additional documents:

Minutes:

Clare Panniker presented the report that updated Members on the Care Quality Commission (CQC) inspection of the maternity services at Basildon University Hospital on Friday 12 June 2020. Following this inspection and a review of Trust incident reports, the CQC published its report on Wednesday 19 August 2020 which had rated the service as Inadequate. The Trust had been disappointed but had accepted the findings of the report and had taken urgent and significant action to improve the service. Residents were assured that Basildon Maternity Unit remained safe but had not kept pace with the increasingly complex demands being put upon the service. Claire Panniker stated that a number of changes had already taken place such as changes to the leadership team, investing in the recruitment of 29 midwives and two additional consultations, improving security, restructuring of ward facilities and had increased the bed capacity on the delivery suite and cedar ward. That time would be required to embed these changes to put in place an enhanced robust process so that the maternity unit could deliver to the highest standards.

 

Councillor Muldowney had concerns that some of the issues identified in this recent inspection had been the same issues that had been identified and signed off by the Trust in February 2019 and questioned what was being undertaken this time to ensure those changes made were for the better and stayed for the better. Clare Panniker stated that the Trust Board and Executive Team had asked the same questions and going forward a lookback exercise would be undertaken to see what could be learnt from their governance and assurance processes to ensure the same scenario would not happen again. That time was required for the changes to be embedded and for these to be implemented and evidenced as working. That the leadership team had received additional help with a director of midwifery to sit above the maternity services at all three sites and an Improvement Director to support and deliver the changes being made.

 

Councillor Muldowney thanked Clare Panniker for the response and understood that time was needed to embed these changes and recommended that this item be added to the work programme for the 4 March 2021 committee for a further update.

 

Members agreed that this report should return for a further update.

 

Councillor Ralph stated that this was a very damning report that had evidenced that basic errors were being made and this was unacceptable when dealing with people’s lives. Councillor Ralph stated he would like to see the second CQC report when this was available.

 

Councillor Redsell agreed that the report was very damning and the seriousness of some of contents of that report especially around the deaths of babies and also questioned why there was nothing in the report about home births. Clare Panniker referred to the report where it had stated that six babies had been classed as serious incidents and that following difficult births one of those babies had unfortunately some ongoing concerns with  ...  view the full minutes text for item 73.

74.

ManKind - Male Victims of Domestic Abuse - Presentation pdf icon PDF 423 KB

Additional documents:

Minutes:

Councillor Ralph introduced this item to the committee following the concerns of the Cabinet Member for Health as there were no refuges or safe houses for make victims in Thurrock or even in Essex. Mark Brooks from ManKind provided an update to the presentation on Male Victims of Domestic Abuse and highlighted:

 

·       1 in 6 men and 1 in 4 women would be a victim in their lifetime

·       800,000 men and 1.6 million women were victims of domestic abuse

·       5,988 men and 17,018 women reported to Essex Police in 2018

·       No refuge or safe house in Essex

·       Nearest was in Northamptonshire

·       Male victims 49% were nearly three times as likely than women (18%) not to tell anyone they were a victim

·       15% men and 18% women would tell the Police

·       53% men who had called the Mankind Initiative Helpline had never spoken to anyone

·       There was no stereo type of a male victim

·       Barriers such as masculinity, societal belief systems, lack of visible services and public policy & story

 

The full presentation can be found from the following link:

 

https://democracy.thurrock.gov.uk/documents/g5789/Public%20reports%20pack%2005th-Nov-2020%2019.00%20Health%20and%20Wellbeing%20Overview%20and%20Scrutiny%20Committee.pdf?T=10

 

Councillor Ralph thanked Mark Brooks for the update and stated his concern that there was no refuge or safe houses in Thurrock and had noted that even the safe house in East London was no longer available.

 

Councillor Redsell stated she would raise the committee’s concerns with the Police and Crime Commissioner as she was a member on the Essex Police Fire and Crime Panel.

 

Councillor Massey thanked Mark Brooks for the good work that was being undertaken and had been surprised that there were no safe houses in Thurrock or even in Essex. Councillor Massey asked Mark Brooks to explain the processes that had taken place with the Police and Crime Commissioner to which it was explained that a survivor had approached him with concerns and these were raised and had worked together with the Police and Crime Commissioner and with the unitary authority Cabinet Member to see how a refuge or safe house could be set up locally and urged the councils to move this forward. Councillor Massey asked whether the Chair could use his influences to get the first safe house in Thurrock. Mark Brooks stated that it would be the same organisations that funded women’s refuges and safe houses that would be used to fund this.

 

Roger Harris stated this would be picked up and had been discussed previously under the Community Safety Partnership and agreed that this would need to be looked at on a larger footprint not just in Thurrock and would raise with Julie Roger who would lead on this.

 

Councillor Ralph thanked Mark Brooks for the presentation and highlighting those concerns and requested that the safeguarding policy and literature should be all inclusive to include male victims. Councillor Ralph agreed to raise his concerns with the Cabinet Member for Health and would feed back to the committee at a later date.

 

75.

Mental Health Update pdf icon PDF 288 KB

Additional documents:

Minutes:

The following providers had been invited by the committee following the presentation of the Mental Health Transformation Programme at a previous meeting, to present and to provide information of their service provisions:

 

·       Nigel Leonard, Executive Director of Strategy and Transformation, Essex Partnership University NHS Foundation Trust

  • Jane Itangata, Associate Director of Mental Health Commissioning Mid and South Essex Health and Care Partnership
  • Robert Waugh, Manager, Thurrock Inclusion
  • Catherine Wilson on behalf of Thurrock Mind

 

These presentations formed part of the agenda pack and can be found from the following links:

 

https://democracy.thurrock.gov.uk/documents/g5789/Public%20reports%20pack%2005th-Nov-2020%2019.00%20Health%20and%20Wellbeing%20Overview%20and%20Scrutiny%20Committee.pdf?T=10

 

https://democracy.thurrock.gov.uk/documents/b17973/Integrated%20primary%20and%20community%20care%20mental%20health%2005th-Nov-2020%2019.00%20Health%20and%20Wellbeing%20Overv.pdf?T=9

 

Councillor Ralph thanked all the providers for their presentations and opened the item up to questions.

 

Councillor Muldowney questioned what was being done to address the digital inclusion / digital exclusion as this had been highlighted more now due to the COVID lockdown, to reach those people who were unable to access the services and how access to these services could be improved as we head into the second lockdown. Lynnbritt Gale referred to the care phone loan scheme that EPUT had and reassured Members that they were not just going digital appointments. It had become apparent from the first lockdown there were people who did not cope well without having face to face appointments so action had been taken to ensure those who had previously had face to face would receive this either at home or within their services and that those services would carry on.

 

Councillor Muldowney stated it was clear that everything was being done to help staff and users to make that digital change and questioned the decline in referrals and asked whether there had been any issues accessing services and whether any lessons from that could be learnt. Lynnbritt Gale stated that the number of referrals were being monitored which had dropped off considerably at the beginning of COVID by about 50% when compared to previous levels but with the main referrals normally coming from GPs but with those practices now working differently this may have been the reason for the decline in referrals. That levels were now up to pre COVID levels and would include within the winter pressures further welfare support.

 

Councillor Muldowney suggested whether any links could be made with the local COVID Community Action Group where a lot of volunteers had signed up with CVS if it became the case the Mind required more volunteers to run their services.

 

Councillor Ralph stated that the initial drop off in referrals may have also been down to those people with mental health or anxiety coming into a lockdown situation where they may have felt safe and secure and maybe they felt they did not need to access the services. Councillor Ralph asked providers where they felt they had got the most right and where they could have improved coming into lockdown period.

 

Robert Waugh stated that they could have done better with their IT, where the transition onto Microsoft Teams coincided with the Trust having problems with their network which had  ...  view the full minutes text for item 75.

76.

COVID Update Presentation

Additional documents:

Minutes:

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

 

·         Current Picture, 7 Days, Positives per 100K – Thurrock had continued to be ranked towards the bottom of the list and currently at 127.3.

·         Thurrock ranked 106 out of the 149 Upper Tier Local Authorities.

·         Historical: 7 Day, Positives per 100K and Rank – Good news that those figures had started to fall over the last week when compared to the historical rates and ranking.

·         Current Picture: 7 Day, Positives per 100K, Aged 60+ - There had been some concerns on the rate of positives per 100K of population aged over 60 with some thinking from Public Health England that might have moved Thurrock up to Tier 2. This had been resisted and referred Members to Pillar 1 which had been due to outbreaks in Basildon Hospital and in a care home which was now under control. The chart showed that Pillar 1 figures were now reducing where Pillar 2, outbreaks in the community, had started to rise and was the most concerning at this time.  Although numbers were relatively small the majority of those were related to young or middle aged adults.

·         Current Picture: Bed Occupancy BTUH – Bed occupancy at Basildon Hospital showed figures had dropped slightly over the last week or so. The number of patients on Mechanical Ventilation had risen and although the numbers were still quite small. Members were reminded that these were patients in Basildon Hospital so not necessarily all Thurrock residents.

·         Residents testing COVID-19 positive on admission or within two days of admission to Basildon Hospital – One positive element of the data had identified that community transmission in Thurrock at the moment and was not having a particularly high demand on Thurrock Hospital.

·         Current Picture: Outbreaks – Care homes remained the biggest concern. One outbreak in a Thurrock care home was now under control.

 

Ian Wake concluded that:

 

       Thurrock’s overall rate of positive tests and ranking had fallen in the last seven days.

       Pillar 1 rate of tests in those aged 60+ had fallen substantially, although positive tests amongst older people in the community continued to rise.

       Hospital bed use due to COVID-19 had declined but ITU use had increased.

       Numbers of Thurrock residents testing positive for COVID-19 in hospital on or within two days of admission had fallen and overall numbers remained low.

       Care home outbreaks remained a concern.

       The key priorities would be to enhanced measures for care homes including IPC and staff testing, communication messages to residents at higher risk including older people and those who were CEV and Contact Tracing at local level which was working well but under strain and was out to recruitment.

 

Councillor Holloway asked Ian Wake to elaborate on his concerns on care homes. Ian Wake stated there would always be a risk of worry for care homes as the setting was easy for COVID to spread, easy to  ...  view the full minutes text for item 76.

77.

Thurrock Adult Safeguarding Board Annual Report pdf icon PDF 401 KB

Additional documents:

Minutes:

Jim Nicholson, Independent Chair of Adult Safeguarding presented the report that highlighted the role of the Board was to ensure that robust safeguarding procedures were in place across the borough, to protect those adults more vulnerable to abuse and/or neglect. The Board provided a strategic and operational scrutiny of the three statutory core partners; these being the Local Authority, Police, and the Clinical Commissioning Group. Where abuse and neglect occurred the Board and its partners were committed to tackling this and promoting person-centred care for all adults experiencing such abuse or neglect. Members were provided with an overall of the report that presented them with some key data and the strategic priorities of the Board.

 

Councillor Ralph thanked Jim Nicholson for the very informative report and how evidenced it was that the workload had increased.

 

Councillor Redsell questioned what help was there for residents who had been scammed. Jim Nicholson stated there was excellent connections with the Police with regular updates and national information available to prevent such crimes. The Police had invested a lot of effort and time and stated that any contact made with them would be pointed in the right direction. Councillor Redsell questioned whether there was good communications with the Police and Members to which Jim Nicholson stated there was an absolute commitment with local level police and with the police crime commissioner being fully engaged.

 

Councillor Muldowney questioned where residents should report such crimes to which Jim Nicholson stated they should contact the Police in the first instant and this would then be forwarded on as necessary. Councillor Muldowney would speak to Jim Nicholson outside the meeting in regard to a member enquiry.

 

Councillor Ralph thanked Jim Nicholson for the report and wished him well.

 

RESOLVED

 

1.         That Members of the Health and Wellbeing Overview and Scrutiny Committee noted the report.

 

2.         That Members of the Health and Wellbeing Overview and Scrutiny Committed were presented with some of the key data and strategic priorities of the Thurrock Adult Safeguarding Board.

 

78.

Orsett Hospital and the Integrated Medical Centres - Update Report pdf icon PDF 254 KB

Additional documents:

Minutes:

Roger Harris provided an update on the Integrated Medical Centres:

 

Corringham – Good progress had been made with the building contractor being appointed. The expected start on site date had been slightly delayed until the New Year due to the impacts of COVID.

 

Purfleet and Tilbury – The program had progressed at pace but due to the impacts of COVID these had paused but was on course to be delivered by the end of 2023.

 

Grays – This IMC had suffered the impacts of COVID as discussions were taking place on what services would be moved out of Orsett Hospital.

 

Tom Abell provided Members with an update on the proposed closure of Orsett Hospital.:

 

·         The Board had met this month to look at processes for the next steps.

·         COVID had stopped all service mapping and had not restarted as yet.

·         COVID permitting, this work would recommence in January 2021.

·         The closure of Orsett Hospital would still be 2025.

·         Decisions needed to be made on how to keep Orsett Hospital up and running until 2025.

·         Changes to services had been made with more services being moved from Basildon Hospital into Orsett Hospital such as CT scanner and potentially an MRI scanner, Day Unit and more work on Outpatients.

 

Tom Abell stated there was a commitment to deliver working with all the partners involved and apologised that this had taken longer than had hoped but due to COVID the hospital staff had worked flat out and was trying to get services restarted.

 

Councillor Muldowney thanked Tom Abell for the update and appreciated the delays were due to COVID and was grateful to all the NHS staff for all the work undertaken and requested that this report come back to committee and to also reference the recommendations made by the Orsett Hospital Task and Finish Group. Tom Abell suggested that the 14 January 2021 committee would be a good time for this report to be presented again.

 

Councillor Muldowney referred to the potential IMC Phase 2 in South Ockendon as mentioned in the report and questioned why this was included in the report if this was not to be an IMC as this caused confusion. Roger Harris stated it was too early to say in regards to a Phase 2 and this item in the report referred to the health centre expanding onto the White Acres site which would provide a potential wider primary care service on that site.

 

Councillor Ralph referred to the Grays IMC and questioned what services would now be offered there. Roger Harris stated that an update would be provided at the January committee as discussions were still taking place. Councillor Ralph stated that it was good news on the progress of the Corringham IMC.

 

Councillor Redsell stated that the Grays IMC was not being built in Grays but in Stifford Clays and had concerns over the amount of vehicles that would need to be parked on that site and this had to be a priority when considering the  ...  view the full minutes text for item 78.

79.

Verbal Update Targeted Lung Health Checks

Additional documents:

Minutes:

Dr Donald McGeachy provided a quick update by stating that the program had been due to start in March/April 2020 but had been delayed due to the COVID pandemic. Plans had been looked into to start the scanning at the beginning of October 2020 with staff now on board who had received the appropriate training but unfortunately due to some technical difficulties at Luton Hospital this would probably now be delayed until January 2021. Members were informed there may be a small chance to start the scanning in Thurrock for two weeks in December before the Christmas Break. That the national program, due to the pandemic had now been extended to the end of March 2024. There was a national priority not to have screening for lung cancer shut down due to the pandemic and to get this up and running again and every effort had been made but with technical difficulties this had not been possible.

 

Councillor Ralph thanked Dr Donald McGeachy for this update and questioned that the program had been set up for 55 year olds and overs. Dr Donald McGeachy stated this would be for those between the age of 55 and 75, for those that had ever smoked and that a risk assessment would be undertaken to assess risks of lung cancer. Those at high risk of lung cancer would then have a Mobile CT Scan as part of that risk assessment. That the mobile CT scanner would be based at Thurrock Hospital and other supermarket sites around Thurrock.

 

Councillor Ralph questioned whether Vaping was still being encouraged instead of smoking. Dr Donald McGeachy stated that this did not form part of the program but for those existing smokers. Ian Wake stated Public Health were working very closely with this program to integrate the stop smoking services and that Vaping had been considered safer than smoking.

 

Councillor Holloway stated that a symptom of lung cancer was a cough which was also a symptom of COVID and questioned whether residents were being deterred from having checks or had the confusion of symptoms caused an increase in cases in Thurrock. Dr Donald McGeachy stated that as the program had not started yet it was unclear what the effects of COVID would be on those that come forward.

 

Councillor Holloway referred to the number of general practitioners who were registering smokers or those who had smoked in the past and questioned how many people had been registered and how many people had been screened to ensure that the data from general practitioners was accurate. Dr Donald McGeachy stated that a lot of work had been undertaken between the Clinical Commissioning Group and Public Health and the data presented now would be more accurate than that previously presented to the committee. Councillor Holloway stated that this item had now been presented to committee on several occasions and it was the committee’s commitment to keep an eye on the accuracy of the data to ensure those figures had improved. Ian  ...  view the full minutes text for item 79.

80.

Verbal Update on Detailed Fees and Charges Report

Additional documents:

Minutes:

Roger Harris referred Members to the recommendation to the report “Proposed Consultation on Adult Social Care (Non-Residential) Fees and Charges 2021/22” and agreed by HOSC Members at the 3 September 2020 committee to support the three options going out to public consultation. That the process of the consultation had been agreed with HealthWatch and commenced on the 5 October 2020. The consultation was due to finish on the 12 December 2020. That all domiciliary care service users had been written to, the consultation was available on the consultation portal website and as of two days ago there had been 120 responses. Members would be provided with an update on the outcome of the results at the January 2021 committee with any recommendations going to Cabinet for the budget Council in February 2021.

 

Councillor Ralph asked Councillor Holloway whether she would like this opportunity to comment on the report or to email the chair what exactly she would like to see brought to the committee. Councillor Holloway thanked the chair of the offer to speak but thought this update would be a wider financial update and had no further questions. Councillor Holloway stated the timing of the report to cabinet had not provided the opportunity for scrutiny committee members to comment on the financial update before the final report being presented to Council in February.

 

81.

Work Programme pdf icon PDF 124 KB

Additional documents:

Minutes:

Members reviewed the work programme and agreed that:

 

·         Add “Basildon University Hospital Maternity Services Update” to the 14 March 2021 committee.

·         Councillor Ralph would feedback in the new municipal year on the work being undertaken on refuges and safe houses for male victims of domestic abuse.

·         Add “Orsett Hospital and Integrated Medical Centres” and make reference to the recommendations made by the Orsett Hospital Task and Finish Group to the 14 January 2021 committee.