Agenda and draft minutes

Health and Wellbeing Overview and Scrutiny Committee - Thursday, 13th January, 2022 7.00 pm

Venue: South Essex College, High Street, Grays, RM17 6TF, rooms W1.23 and W1.24

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

Items
No. Item

30.

Minutes pdf icon PDF 397 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 4 November 2021.

Minutes:

Councillor Holloway referred to page 14 of the minutes and requested the last paragraph be removed from the minutes to avoid any confusion that Councillor Mayes had actually attended that meeting.

31.

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 received.

 

Members discussed the Integrated Medical Centre briefing note sent to Members on the 17 December 2021 and all Members agreed the briefing note had raised some concerns. The Chair had invited Councillor Alan Mayes, Portfolio Holder for Health and Air Quality to the meeting to update members on the current position. Councillor Holloway questioned why Councillor Mayes was presenting this item and this was not appropriate at this scrutiny meeting. Councillor Ralph welcomed Councillor Mayes to the meeting and asked him to read out his statement from Cabinet this week. Councillor Mayes took this opportunity to thank members for inviting him this evening to talk about this issue as he knew it was very important to everyone on this committee.

 

On Tuesday I met with Anthony McKeever who is the Chief Executive Designate for Mid and South Essex Alliance, Thurrock CCG, Alliance Director, Chief Finance Officers of the five CCGs and Mid and South Essex ICS along with Councillor Coxshall and Council officers to discuss the current issues with the IMC programme. All present at this meeting reaffirmed their commitment to delivering the four IMCs in Corringham, Tilbury, Purfleet and Grays with all services relocating from the old Orsett Hospital site before its closure in 2025. There was no cold feet from all sides on delivering this plan and although issues could arrive with a project that was ambitious and complex we, the chief executives designate of MSE ICS had said he will remove every barrier on the NHS side to get the outline business cases for Tilbury and Purfleet IMC signed off by the 31 March 2022. This will allow the IMC to progress to the next stage of full business case and then delivering them by 2025. The current IMC is due to open in the second quarter of 2022 and the Grays IMC is due to open in 2025. Everybody in the meeting on Tuesday acknowledged that Thurrock health needs were growing and integrated medical centres had a vital role in improving health care for our residents”

 

Councillor Holloway referred to the three specific areas the SFLG committee have asked for and that the work would be led by the CCG, questioned how far forward were they on points 1, 2 and 3 of information gathering. Mark Tebbs introduced Kerry Harding, MSE Estates Director who had undertaken an enormous amount of work on the medical centres. Mark Tebbs stated that as part of the internal process before it went to NHS England and England HSI we had taken the financial elements to the system finance leaders group who had asked for further clarification on a number of issues relating to affordability. It was agreed to go back to SFLG in January for the Purfleet OBC and then in February for the Tilbury OBC. By splitting them out enabled the focus on the specifics of each case to be undertaken to look at the commercial aspect. Whether there could be any other  ...  view the full minutes text for item 31.

32.

Declarations of Interests

Minutes:

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

33.

HealthWatch

Minutes:

In the absence of Kim James, no HealthWatch items were raised.

34.

CQC - Mid and South Essex NHS Foundation Trust - Inspection Report - Verbal Briefing

Minutes:

The Chair had requested this item following concerns on the “requires improvement” rating of the recently undertaken inspection report and invited Hannah Coffey, Deputy Chief Executive, Mid and South Essex NHS Foundation Trust, and Diane Sarker, Chief Nurse and Quality Officer, to present a verbal update to Members. Members were referred to some of the items raised in the final report: had the skills and abilities to run the trust; recognised strategy had been focused on improvement and sustainability of services; working with providers within the wider health to improve patient pathways; focused on needs of patients receiving care; had effective governance processes throughout the trust and partner organisations although it had been recognised this required further embedding; recognition leaders and teams managed performance of staff; good engagement with patients, staff, equality groups, public and location organisations to plan and manage services; recognition leaders were encouraged and innovated to improve patient outcomes; continue to learn from incidents and sharing across the trust. It had been identified work was needed in terms of responses and accountabilities for managing risk across the organisation. Members were referred to the inspection rating for maternity at Basildon Hospital had moved to required improvement with care and treatment being observed based on national guidance and evidence based practice, the effectiveness of care and treatment and that staff worked together for the benefits of the patient. Improvements on mandatory training and appraisal rates had been noted and  an improvement plan had been reviewed and updated.

 

Councillor Ralph stated this item had been received at the committee twice before and had hoped for better improvements. It appeared that no lessons had been learnt from previous inspections as it was the same issues being raised every time.

 

Councillor Holloway questioned why she had not had sight of the inspection report prior to the committee and requested this item be added to the 3 March 2022 committee and requested a full report be added to the agenda. Councillor Holloway requested the report should include copies of the inspection report and any relevant reports or documents. Councillor Fish echoed Councillor Holloway’s comments. Councillor Ralph also agreed and requested this item be added to the work programme for the 3 March 2022 committee.

 

Hannah Coffey and Diane Sarker left the meeting at 7.50pm.

 

35.

Overview of responsibilities of Portfolio Holder for Health - Verbal Briefing

Minutes:

Councillor Ralph welcomed Councillor Mayes to the committee in his role as portfolio holder for health and air quality. Councillor Mayes thanked Members for inviting him this evening and stated his portfolio of health and air quality had been heavily dominated by the COVID pandemic which had reached every area of the health system and council. Some of the items covered by his portfolio were: working cross party with Brighter Futures on drug and alcohol support, obesity, tobacco and health and wellbeing strategies, mental health steering group, the importance of air quality; working with partners including the Alliance Director and working with partners on broader strategic view to ensure all was being done to ensure the best outcome for residents was achieved. Councillor Mayes was happy to then take any questions from Members.

 

Councillor Ralph questioned whether there was anything outside of the portfolio holder’s remit that could be added that would make his job easier and have more control. Councillor Mayes acknowledged one of the frustrations for residents was general practitioner appointments and acknowledged primary care was essential in the health and wellbeing of all residents and more importantly for this care to be best it could be in Thurrock to prevent serious illnesses at an early stage. So having more control and commented on the ongoing work by officers on the ICB Strategy where community leaders would have more input in that which would be fantastic.

 

Councillor Holloway referred to the Lower Thames Crossing and asked what interventions had the portfolio holder made to ensure air quality was measured to which Councillor Mayes stated the dedicated Air Quality officer would feed into modelling, especially traffic modelling, so get a better understanding and this would then feed into the future years. Looked into what could be done and delivered. Councillor Holloway asked for clarification as to whether any interventions had taken place with the Lower Thames Crossing people, such as meetings being held or letters sent, around air quality to which Councillor Mayes stated the Lower Thames Crossing was not within the remit of his portfolio, but air quality was and were doing what we could and what we had control over. Councillor Mayes referred to the work being undertaken by the Lower Thames Crossing Task Force and would continue to challenge where possible on the health impact assessments.

 

Councillor Holloway asked for a progress update on the Air Quality Strategy to which Councillor Mayes stated the Council did have an Air Quality Monitoring Strategy and had sensor testing units around the borough and were actively monitoring and checking levels. The full air quality review refresh was coming through and would be presented to this committee and to the Cleaner Greener Safer committee as well. Councillor Holloway stated this was some 12 months ago that Councillor Mayes had promised this refresh and questioned when the committee would finally see the report. Councillor Mayes stated that in his portfolio holder report to Council he had said this was not the  ...  view the full minutes text for item 35.

36.

Commissioning Report - Advocacy pdf icon PDF 309 KB

Minutes:

Catherine Wilson presented the report that detailed the proposed commissioning of statutory and non-statutory Advocacy services and detailed the legislative framework required to operate to safeguard vulnerable people. The report also outlined the proposed changes to existing arrangements to ensure they were more responsive and streamlined. The new approach would also address current issues with securing advocacy for those service users placed in a neighbouring borough.

 

Councillor Ralph thanked officers for the report.

 

Councillor Fish questioned what this arrangement would mean for individual service users to which Catherine Wilson stated this would be an easier referral process with advocates being trained in all areas so there would only need to be one advocate for an individual.

 

Councillor Ralph stated his concern around ease of access and how users would benefit and questioned the process if a resident were to move locality would that advocacy continue to help them through the process. Catherine Wilson stated where people did move locality they would absolutely ensure they kept the same advocate, as long as they moved within Thurrock.

 

Councillor Ralph referred to the consultation and whether those needing help to complete their forms would receive a follow-up conversation and the help required to which Catherine Wilson stated they would be telephoning people to ask if they could have a discussion about their experiences of advocacy and asking whether they would like a face-to-face meeting as it was important to talk to people and understand about their experiences.

 

Councillor Holloway referred to paragraph 3.7 of the report “currently unsure whether Thurrock CCG will wish to access the contract when LPS is introduced” and asked for some clarification. Catherine Wilson stated CCG colleagues or health colleagues could refer people to the advocacy services. This was a section within the contract where CCG or health colleagues can utilise the contract with the service definitely being available for them. Councillor Ralph agreed this was an easier access point for the CCG.

 

Councillor Polley referred to paragraph 2.8 of the agenda and questioned how many individuals were receiving advocacy services to which Catherine Wilson stated she did not have the figures to hand but would find out and circulate to Members.

 

Councillor Polley questioned apart from the people that were currently being supporting at the moment whether the number of users would increase rapidly due to the new legislation to which Catherine Wilson stated it was always hard to know how many people would need this service but felt there may well be an increase in number.

 

Councillor Ralph asked for reassurance again that those people requiring help with the consultation would receive it to which assurance was given by Catherine Wilson.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee commented on the proposals and recommend to Cabinet that the new Advocacy contract was procured in line with the contents of this paper. 

 

37.

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 compared to some of our near neighbours had the highest rate. The overall rate is 1800 per 100K residents which was higher when compared to last January.

·         Positive Rates had been over 40% in the first couple of weeks of the year which again had been the highest positivity rate we had seen, highest rate amongst nearest neighbours, Thurrock was 69th in the country out of all the upper tier local authorities.

·         Current Picture, Positive Tests by Age Band – Rates currently highest in younger adults aged between 20 and 40. Period before Christmas the highest rates were in the 10 to 19 age group with very high rates circulating amongst the secondary age young people. Since then Under 18s rates have fallen. Rates in all the adult age groups had increased over new year but have now started to decrease with a low rate in the over 60s.

·         BTUH Bed Occupancy by Type – Massive spike in January 2021 with a lot of people in hospital requiring ventilation compared to rates. There had been an increase of hospitalisation in 2022 but nowhere near to the same extent with the numbers requiring ventilation and not just oxygen therapy being much lower.

·         Vaccinations, First and Second Dose – Over 50s had very high rates of uptake and very very high in the over 65s but with lower rates in younger adults. Those aged between 16 and 40 the percentages had not changed that much over the past few months.

·         Vaccinations – Boosters – Very high rates of uptake of the booster in over 65s and high numbers in the over 50s. Lower vaccination uptake in adults is a typical pattern seen with vaccination rates in Thurrock.

·         A lot of work had been carried out about engagement and communications with a lot of social media activity targeting different age groups. Working with EPUT to provide local non primary care vaccination clinics to look at other locations in the borough, having weekend pop up clinics at various locations around the borough. Weekend pop up clinics would be supported by the national surge Rapid Response team. Secured funding from the Community Vaccination Champions Fund and would work with CVS colleagues to develop an action plan around community vaccinations and recruit champions to engage with particular groups in the community.

·         Highlights – Confirmed Cases – 11 schools with a live outbreak, 16 care homes with a live outbreak or in recovery from outbreaks, community transmission had decreased in recent week, evidence of high activity in care home settings and evidence of high activity in educational settings.

 

Jo Broadbent concluded that:

 

·         Thurrock overall rate of positive tests had decreased over the past few days but remained towards the higher end of those seen throughout the pandemic.

·         Test positively remained towards the highest levels recorded during the pandemic and well above  ...  view the full minutes text for item 37.

38.

Update on the New Primary Care Mental Health Service Offer in Thurrock (to follow) pdf icon PDF 663 KB

Additional documents:

Minutes:

Members were provided with an update of the work undertaken in Thurrock to transform the community mental health service offer. This update report focused on the Primary Care Networks (PCN) Mental Health Integrated Teams and the Severe Mental Illness (SMI) Psychological therapies service offers. A PowerPoint presentation was presented and can be viewed from the link below:

 

(Public Pack)Item 10 - Integrated Primary and Community Care Mental Health Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 13/01/2022 19:00 (thurrock.gov.uk)

 

Members were encouraged to view a video described the existing transition service offer, the platform on which the 18-25 offer would be co-produced and implemented.

 

http://www.youtube.com/watch?v=7wLOUMiGHO

 

Councillor Ralph questioned whether this had made a real impact on where it was needed to which Mark Foster stated absolutely that real changes were being made where there had previously been massive gaps in the past. This transition period would enable people to learn the functions of adult services, changes in rules and understanding their changing responsibilities and to get the support to make those changes has had a real impact. Also with the increase of communications between services, professionals talking together in ways they had never talked before, had been a game changer and had a significant impact on patients.

 

Councillor Ralph questioned whether there were anything fundamentally different in how you prepare people to move into the next stage of their transition. Wendy Robertson stated this was very much around personalised care, to personalise the service around the individual. To be able to support people with their wellbeing approach so conversations could take place to find out what they really wanted and what they needed. To have the time to work with someone to help them establish their goals and what their aspirations were and what they wanted to achieve.

 

Councillor Holloway thanked officers for a fantastic piece of work and the report and presentation had been excellent.

 

Councillor Ralph thanked officers for the report and all the hard work that had been undertaken and appreciated those efforts.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee noted the contents of this update report.

 

39.

Work Programme pdf icon PDF 119 KB

Minutes:

Members discussed the work programme and agreed the following:

 

To add CQC - Mid and South Essex NHS Foundation Trust - Inspection Report to the 3 March 2022 committee.

 

To add a Progress Report on the Integrated Medical Centres to the 3 March 2022 committee and to invite Anthony McKeever to attend to present the report.