Agenda and minutes

The Chairman welcomed everyone to the meeting. Apologies had been received from Cllrs Akbar, Baxter, Monk and Smith.

None.

Members of the public wishing to take part should notify the Assistant Director for Legal and Governance in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 2 November 2021). Enquiries can be made through the telephone number/email listed in this agenda and on the website.

None.

To follow

This item was deferred until the next meeting.

(indicative timing 2:05 – 3:15pm)

In attendance for this item were:

·         Matthew Hopkins, Chief Executive at Worcestershire Acute Hospitals NHS Trust

·         Chris Cashmore, Senior Programme Director, Urgent Care, NHS Herefordshire and Worcestershire Clinical Commissioning Group

·         Sharon Buckley, Assistant Chief Operating Officer at Herefordshire and Worcestershire NHS Health and Care Trust

Chris Cashmore, representative for NHS Herefordshire and Worcestershire Clinical Commissioning Group (CCG) referred to the Winter Plan for 2021/22, which had been circulated to members of the Committee  and highlighted the following main points:

·         The context of planning for this winter were extremely challenging and unique in the careers of the representatives present due to the legacy of the Covid pandemic and very high activity levels.

·         The most pressing challenge was the workforce.

·         The Winter Plan had been developed across the system and been verified by national experts.

·         There was particular focus around:

Ø  maximising alternatives to prevent patients going to the Emergency Department (ED) where appropriate

Ø  the 2-hour response teams which went out to people’s homes, had been allocated over £2million investment and saved five admissions per day, however this was running at around 30% capacity due to problems in finding staff

Ø  delivering patients’ discharge requirements, which had received £8million investment across health and social care, with numbers discharged each week rising from 17 to 30.

·         A stress test would take place the following Monday, with a view to making any final amendments to the system before going live with the Plan.

·         Circumstances were challenging for all of the organisations involved but everyone was working very hard – it was clarified that the number of Covid-19 positive inpatients being cared for by Worcestershire Acute Hospitals NHS Trust (WAHT) had increased to 62, from the figure of 41 at the time of the Agenda publication.

The Chairman invited discussion and the following main points were made:

·         When asked about the biggest challenges for the system this winter and the aims of the stress test, the representatives explained that the test would last 10 days and was designed to test the resilience and safety of plans and pinpoint how processes could be improved; for example a potential area may be around patient flow which was under further pressure from rising Covid cases and it would be important to work with partners to prevent delayed patient discharges. WAHT was aware that it needed to ensure 30% of patients were ready for discharge by lunchtime, and the current figure was 24%.

·         A further challenge was the need to make plans against a virus which was affecting children, although fortunately so far this had not impacted in Worcestershire.

·         Regarding capacity within individual wards and any flexibility, the WAHT Chief Executive (CE) confirmed that the greater need for flexibility this winter was due to the complicated mix of the pandemic as well as potential Norovirus sickness bugs. Throughout the pandemic WAHT had tried to ensure adequate capacity was available for a rise in Covid cases, by making the most effective use of acute and community hospital beds.

·         A  ...  view the full minutes text for item 1039.

(indicative timing 3:15 – 3:45pm)

In attendance for this item were:

·       Karen May, Cabinet Member with Responsibility for Health and Wellbeing

·       Kathryn Cobain, Director of Public Health

·       Steph Simcox, Head of Finance

The Head of Finance provided a summary of the Council’s Public Health function, which, nationally, had transferred to local authorities in 2013. The Council received an annual Public Health Ring-fenced Grant (PHRFG) of approximately £30m, with a typical increase of 1% over recent years. Attached to the Grant were some very strict criteria and specific mandatory requirements of a preventative nature, including:

·       open access sexual health services

·       NHS health checks 5 yearly for those aged 40-74

·       weighing and measuring of children

·       Healthy Child Programme

·       public health advice service

·       protecting the health of the local population

The budget announcement for 2022/23 was awaited, and the annual increase totalled around £30,000, although this was not sufficient to cover pay increases and inflationary uplift in contracts. The budget of approximately £30m was allocated at the start of the year against strategic functions, which included preventative work in Adult Services, Children’s Services and some in Community Services, with examples including support to trading standards in preventing disease and the role of libraries in helping people to interact. Additional funding received for Covid-related activities had enabled a more rounded support to be provided.

The Chairman invited questions and the following main points were made:

·       A 1% increase in the PHRFG had been typical of recent years although increases in other financial years had been 2-5%.

·       When asked how the typical increase of 1% was managed since it did not match inflation, the Officers explained that an overall view was taken of planned activity and priorities, and that some contracts had zero inflation.

·       Regarding the impact of the Covid pandemic on Public Health, the Director explained how in the early days responding to the pandemic had been the overriding need, and the staff from Public Health had been mobilised to boost workforce capacity. Over the past six to nine months, there had been a return to business as usual. Staff had been very stressed but had absolutely risen to the challenge and the additional funding had really helped.

·       The Cabinet Member with Responsibility (CMR) for Health and Wellbeing praised the Council’s phenomenal response to the pandemic, of which she was very proud, and whilst no one would want to go through the experience, there had been important learning points to take forward.

·       In terms of which services were of most concern, the Director explained that obesity was an area of concern  and needed more focus and that a whole system approach was important. It was noted that consultation was due to start on the new Health and Wellbeing Strategy.

·       The HOSC requested the opportunity to review the new Health and Well-being Strategy at a future meeting.

·       There had been no specific prevention services which had seen funding decreases but some had been increased.

·       It was explained that the Supporting People grant had been phased out some time ago, which  ...  view the full minutes text for item 1040.

(indicative timing 3:45 – 4pm)

The Committee discussed the current Work Programme and the following were noted:

·         an additional Task Group style meeting had been arranged to look at ambulance hospital handover delays, on 18 November

·         the current item on Staff Turnover would be broadened to include workforce and training

·         information on a patient’s pathway of admittance via the Emergency Department would be added to the data already requested for the Task Group meeting on ambulance handover delays on 18 November

·         school readiness was suggested – Cllr Nathalie McVey to suggest to Children & Families Overview and Scrutiny Panel.