Agenda and draft minutes

The Vice Chairman, Cllr Christine Wild, welcomed everyone and advised that she would be chairing the meeting in the absence of the Chairman. 

The Chairman then advised that the meeting would be recorded and uploaded to the County Council website after the conclusion of the meeting.

Apologies had been received from Cllrs Brandon Clayton, Lynn Denham, Antony Hartley, Kit Taylor and Tom Wells.

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 15 April 2024). Enquiries can be made through the telephone number/email listed in this agenda and on the website.

None.

Previously circulated

Subject to the following amendment, the Minutes of the Meeting held on 15 March 2024 were agreed as a correct record and signed by the Chairman.

Minute 1191 (pages 8-9) – Update on Outcomes of Care Quality Commission Inspection of Herefordshire and Worcestershire Health and Care NHS Trust (including Hill Crest Mental Health Ward). With regard to the discussion about Hill Crest Mental Health Ward and within the 4^th bullet point, the Minute was changed from “……A challenge was that access to the County Council’s Reablement service would no longer be available which had historically helped people with severe mental health illness” to read ….. “A challenge was that the Trust had been given notice by the County Council that the funding to support its Reablement service would no longer be available.  This had historically helped people with severe mental health illness”.

(Indicative timing 10:05 – 11:05am)

The Herefordshire and Worcestershire Integrated Care Board (HWICB) Director of Delivery and Operations introduced the Item by highlighting key points from the Agenda Report. Around 38% of cancers were preventable and raising awareness and providing a good screening programme was of national focus. The HWICB focus was to support earlier diagnosis, although Worcestershire benchmarked well nationally in this area. Following the Covid-19 pandemic, all screening had now been restored and there was no backlog in the County. Although local and national targets for diagnosis were being met, there was increased focus on more timely diagnosis. Cancer was sometimes a complex area, with over 100 Cancers known, often involving multi-disciplinary pathways.

In the ensuing discussion, the following points were made:

·         The Committee was pleased to receive the Report and learn of the position in Worcestershire. As prevention and early diagnosis was key to survival, Members were keen to share information with their residents on health promotion. It was agreed to provide the HOSC with details of any current national and local campaigns in order that they may share it with residents and moving forward, it was agreed to share any future promotional campaign activity

·         HWICB recognised that further work with GPs was needed. It was noted that although some screening and tests could be uncomfortable or embarrassing, it was important that residents were encouraged to attend appointments

·         The Acting Chief Medical Officer of Worcestershire Acute Hospitals NHS Trust (the Trust) reported that acute hospitals tended to see patients later in the process, so anything that could be done to detect cancer earlier was a positive step

·         The Trust had managed the backlog following the Covid-19 pandemic and had established Staff Teams which now had more resource to provide screening and support, prevention

·         A Member suggested that there needed to be more joined up thinking, especially when it came to supporting the family and carers of cancer patients. The Trust’s Chief Operating Officer explained that there was a national programme of living beyond cancer, with partners working to knit together the support available, including how colleagues, friends, neighbours as well as family can support the patient through their journey

·         There had been a 12% increase in the incidence rate of cancer since the 1990s, explained by a number of factors, including better diagnosis, earlier diagnosis, additional screening and wider age range invitations. In addition, it was noted that media attention in high profile cases promoted increased activity, which was welcomed. Anything to assist early detection was positive as treatment could therefore begin earlier and survival would increase. The impact of the Covid-19 pandemic pause on screening would also contribute to the figure

·         A Member asked whether blood cancers, such as lymphoma, were included in the Pathway

·         A Member suggested that there was a lack of support to patients in areas such as debt, employment or housing support. The Trust ensured that a Team wrapped around a patient but reported that employment advice was beyond the remit of the NHS. There was recognition  ...  view the full minutes text for item 1198.

(Indicative timing 11:05 – 12:05pm)

Members had received a comprehensive Report on Routine Immunisation in advance of the meeting and key points were referred to.

Vaccinations were a very effective and successful way of reducing illness and death from vaccine-preventable diseases. A number of delivery programmes were universal, such as MMR (Measles, Mumps and Rubella) given to all children, and some for those at increased risk, such as Flu vaccine in pregnant women.

NHS England was the current commissioner, however from April 2025, the responsibility would transfer to Integrated Care Systems. Providers included GP Practices, School Age Immunisation Services (SAIS), Community Pharmacies and Maternity Services.

Nationally, the level of confidence in vaccines was high, however, there had been a steady decline in uptake over the last decade, although this was less pronounced in Worcestershire. School age services had been paused during the Covid-19 pandemic whilst schools were closed, however, GPs had continued to administer vaccines throughout.

Vaccine hesitancy included reasons such as complacency, lack of confidence in the vaccine or lack of convenience in receiving it.

There had been a huge increase in Measles cases during Autumn 2023, predominately in Birmingham and the West Midlands. Coverage of 95% or more of 2 doses of measles-containing vaccine was needed for herd immunity, yet coverage nationally had fallen to its lowest level in a decade. Despite Worcestershire having one of the highest uptake rates in the West Midlands, there were still around 4,000, or 8-10%, primary school-aged children who had not been vaccinated. Outreach clinics had been held in various parts of the County, which had resulted in an additional 144 people being vaccinated.

The Autumn 2023 Covid-19 and Flu vaccination programme had been provided by GPs and Community Pharmacies and administered at a range of venues, including the mobile ‘Your Health Your Wellbeing’ vans. Uptake across the County was high.

Pertussis vaccine was administered to pregnant women to help protect their baby from whooping cough once born. Uptake in Worcestershire was reported at around 65% which HWICB was investigating as the figure appeared low.

The HWICB focus included further work to develop a vaccination workforce and work with hospital trusts to encourage Covid-19 and Flu vaccines among those employed in the health and social care sector as uptake was currently low.

The Chairman invited questions and the in ensuing discussion, the following key points were made:

·       A Member asked why eligible patients were not routinely called for a Shingles vaccine to be informed that it was not part of the GP contract. Some vaccinations required GPs to summon patients but Shingles was not mandated, rather opportunistic. Many GP Practices did however administer Shingles to patients aged 70 to 79 and often at the same time as the annual Flu vaccine

·       National guidelines for the Covid-19 ‘Spring Booster’ would be followed, with adults aged over 75 being the main target group. Evidence would be gathered to inform the national guidance for the Autumn programme

·       In relation to hesitancy, although the Covid-19 vaccine was shown to be very  ...  view the full minutes text for item 1199.

(Indicative timing 12:05 – 12:15pm)

Members considered the Work Programme and no changes were made.