Agenda, decisions and minutes

Health and Social Care Overview and Scrutiny Committee
Tuesday, 18th August, 2020 4.30 pm

Contact: Jane Lythgow 

Items
No. Item

12.

DISCLOSURES OF INTEREST

(Members Code of Conduct - Part 4A of the Constitution)

 

To receive disclosures of interests from members and co-opted members on matters to be considered at the meeting. The disclosure must include the nature of the interest.

 

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

 

Notes:

 

(1)       Members may remain in the meeting and take part fully in discussion and voting unless the interest is a disclosable pecuniary interest or an interest which the Member feels would call into question their compliance with the wider principles set out in the Code of Conduct.  Disclosable pecuniary interests relate to the Member concerned or their spouse/partner.

 

(2)       Members in arrears of Council Tax by more than two months must not vote in decisions on, or which might affect, budget calculations, and must disclose at the meeting that this restriction applies to them.  A failure to comply with these requirements is a criminal offence under section 106 of the Local Government Finance Act 1992. 

 

(3)       Members are also welcome to disclose interests which are not disclosable pecuniary interests but which they consider should be made in the interest of clarity.

 

(4)       Officers must disclose interests in accordance with Council Standing Order 44.

 

Minutes:

Councillor Lintern disclosed, in the interest of transparency and in relation to Minutes 17 & 18, that she was employed as a manager by Dementia Friendly Keighley.  

13.

MINUTES

Recommended –

 

That the minutes of the meetings held on 25 June and 21 July 2020 be signed as a correct record (previously circulated).

 

(Jane Lythgow – 01274 432270)

Minutes:

Resolved –

 

That the minutes of the meetings held on 25 June and 21 July be signed as a correct record.

 

14.

INSPECTION OF REPORTS AND BACKGROUND PAPERS

(Access to Information Procedure Rules – Part 3B of the Constitution)

 

Reports and background papers for agenda items may be inspected by contacting the person shown after each agenda item.  Certain reports and background papers may be restricted. 

 

Any request to remove the restriction on a report or background paper should be made to the relevant Strategic Director or Assistant Director whose name is shown on the front page of the report. 

 

If that request is refused, there is a right of appeal to this meeting. 

 

Please contact the officer shown below in advance of the meeting if you wish to appeal. 

 

(Jane Lythgow - 01274 432270)

 

Minutes:

There were no appeals submitted by the public to review decisions to restrict documents.

 

15.

REFERRALS TO THE OVERVIEW AND SCRUTINY COMMITTEE

CALLED-IN DECISION – QTR. 1 FINANCIAL POSITION STATEMENT FOR 2020-21 – EXECUTIVE DOCUMENT “BT”.

 

At the meeting of the Corporate Overview and Scrutiny Committee on 23 July 2020 it was resolved, amongst other things,

 

“That the Health & Social Care Overview & Scrutiny Committee be requested to consider aspects of the Impower Contract that relate specifically to Health and Well Being”.

 

Members are requested to consider how they wish to deal with the referral. 

 

Any additional referrals that have been made to this Committee up to and including the date of publication of this agenda will be reported at the meeting.

 

Minutes:

 

Members were requested to consider how they wished to deal with a referral from the meeting of the Corporate Overview and Scrutiny Committee on 23 July 2020 where it was resolved, amongst other things,

 

“That the Health & Social Care Overview & Scrutiny Committee be requested to consider aspects of the Impower Contract that relate specifically to Health and Well Being”.

 

It was acknowledged that the Impower Contract had been discussed as part of the budget scrutiny last year and it was proposed that it be considered in the same manner at the end of the current year.

 

A Member who had attended the Committee meeting making the referral reported that Members, at that time, had wished to know more about the benefits that the contract would make to the health and social care agenda and were concerned that its value was not clear. 

 

It was explained that the issue would be considered again by the Corporate Overview and Scrutiny in three months-time and acknowledged that the Committee would want to understand more about the contract as Impower moved into additional Council departments.  

 

For the benefit of Members who were not on the Committee last year it was clarified, by the Overview and Scrutiny Lead, that the Committee had requested and had considered a specific report on the transformation programme which Impower were undertaking. In addition, the Committee had scrutinised the contract through regular performance reports provided from Adult Services which included performance data including outputs and outcomes.   The financial aspect of the contract would be scrutinised through the budget process.  As the Committee were having a COVID-19 focus at the current time the cycle of performance reports had not yet been scheduled but would be considered later in the municipal year.

 

 

Resolved –

 

That aspects of the Impower Contract relating to Health and Social Care be scrutinised through the receipt of regular performance reports and budget analysis scheduled to be provided by the Strategic Director, Health and Wellbeing. 

 

ACTION: Overview and Scrutiny Lead

 

 

 

16.

HEALTH INEQUALITIES IN THE BRADFORD DISTRICT pdf icon PDF 520 KB

Members will be aware that health inequalities existed in Bradford District before COVID-19.  The impact of COVID-19 has shone a light on inequalities in terms of poor outcomes relating to deprivation and ethnicity. 

 

The Director of Public Health will present a report, Document “C” which describes health inequalities, provides national and local data on health inequalities in relation to COVID-19, and discusses what actions have been taken to date and actions which are planned.

 

Recommended –

 

That the report be noted.

(Kathryn Ingold - 01274 437041)

 

Minutes:

Members were aware that health inequalities existed in Bradford District before COVID-19, however, the impact of COVID-19 had shone a light on inequalities in terms of poor outcomes relating to deprivation and ethnicity. 

 

The Director of Public Health presented a report, Document “C” which illustrated health inequalities in the District, provided national and local data on health inequalities in relation to outcomes relating to deprivation and ethnicity and discussed what actions had been taken to date and actions which were planned.

 

The Leader of Council, whilst acknowledging the measures outlined in Document “C”, stressed the necessity for structural inequalities in the city to be solved; she reported her belief that living in poverty limited life choices and that health inequality was the most important issue of the time.

 

Information included in the report revealed that all deaths would identify COVID-19 as the cause of death if life was lost within 28 days of a COVID-19 diagnosis and the rationale for that decision was questioned.  The Director, Bradford Institute for Health Research, explained that this was to provide international standardisation as previously a number of countries had been recording deaths differently. 

 

A Member referred to data suggesting that the South Asian population death rates were similar to Caucasian deaths and it was confirmed that was the case.  Data revealed that the risk of transmission was greater among people living in crowded places or those in low paid work.  Some blood groups had been identified as having a very small genetic component but the greatest risks were environmental factors. 

 

Increases in positive test results were questioned with one Member suggesting that decisions to lock down communities should be based on the number of serious disease as opposed to positive tests.  It was acknowledged that high levels of COVID-19 were being identified in the community as the number of tests increased but stressed that people were still getting seriously ill.  It was explained that more positive cases were being identified amongst young people.  As Bradford had the youngest population in the country the positive test results would be high.  Reductions in serious illness may be due to the effectiveness of social distancing or more herd immunity than was first thought.  It was felt that there were some signs of hope but caution against complacency was advised.

 

The Director of Public Health confirmed that younger members of the population were statistically more likely to recover but cautioned that they could still pass on disease to other people who may not.  Assurances were provided that the Government did not base lock down decisions on the number of positive tests alone but considered a number of factors. Bradford had a higher positivity rate than the rest of Yorkshire and Humberside and the goal was to reduce the positivity rate to 1 % or below.

 

A view was expressed that some Government measures were making people unhealthier as their impact on young families, education and the economy was causing intense suffering.

 

The Leader of Council confirmed  ...  view the full minutes text for item 16.

17.

HEALTH AND CARE SYSTEM UPDATE pdf icon PDF 703 KB

The report of the Health and Care System Executive Board, (Document “D”) explains that the challenge posed by COVID-19 has amplified the health needs of our population.  Document “D” highlights the existing strengths and weaknesses of our health and care system and reveals future actions required to meet the needs of the people in the District.

 

Recommended –

 

That the report be noted.

(James Drury - 07970 479491)

Minutes:

The report of the Health and Care System Executive Board, (Document “D”) explained that the challenge posed by COVID-19 had amplified the health needs of the local population.  Document “D” highlighted the existing strengths and weaknesses of the health and care system and revealed future actions required to meet the needs of the people in the District.

 

The summary of the report explained that the challenge posed by COVID 19 had amplified the needs of the population and equalities between people.  Health, care and wider system relationships had come into their own; differences had been set aside and better results had been achieved by working together.  Plans to ensure that those ways of working would continue were outlined. A Member questioned if those plans involved the establishment of new forums or groups and it was explained that integration would be through service design and joined up governance.

 

It had been acknowledged that optimising supply alone would not meet demand and better ways of avoiding and addressing needs were required. All teams would include a number of clinical leads and a community lead to link and challenge

 

To avoid and address needs arising in the first place, prevention would include an end to end approach.  An example was provided with regard to pollution which would consider everything from air quality to the need for ventilation and everything in between. 

 

 A Member questioned if the Health and Care System Executive Board were supportive of the ‘Act as One’ approach and if funding would be in place. It was confirmed that the planned approach had received a warm reception by the Health and Wellbeing Board. 

 

The Chief Executive, Bradford Teaching Hospitals NHS Foundation Trust, reported that the opportunity to transform had come from necessity through COVID-19.  It had provided a renewed impetus to make tangible progress. It was explained that the collective intelligence of all who were representatives of health care in the district had been valued and the benefits of those partnership had been the speed with which issues could be addressed during the pandemic.

 

 

Members questioned how physically tired the staff were and what measures were in place to bolster their mental health.

 

The report revealed that there had been a significant increase in the demand and acuity in mental health services and a Member questioned what measures were in place to help people who had regressed during the pandemic and to address the needs of people who were struggling but not known to care services.  In response it was explained that it was essential to keep communicating and to work with organisations to allow people to live a good life.  There was a good network in place and communication, including social media, made people aware of services to help.  It was acknowledged that the Voluntary and Community Services (VCS) had experienced an increase in demand and it was important to ensure that the VCS  were not put under too much pressure.

 

Members questioned how much confidence there was  ...  view the full minutes text for item 17.

18.

COVID-19 - LESSONS LEARNT AND IMPLICATIONS ON ADULT SOCIAL CARE SHORT, MEDIUM AND LONG TERM PLANS. pdf icon PDF 123 KB

The Strategic Director, Health and Wellbeing, will present a report

(Document “E”) which provides a summary of the key lessons and experiences of Adult Social Care faced during the COVID-19 pandemic and implications on the departmental plan for the future.

 

Members are requested to note and provide feedback on the key issues raised and the direction of travel set out in Section 4 of Document “E”.

 

(Imran Rathore - 01274 431730)

 

 

 

 

Minutes:

The Strategic Director, Health and Wellbeing, presented a report

(Document “E”) which provided a summary of the key lessons and experiences that Adult Social Care services had faced during the COVID-19 pandemic and the implications on the departmental plan for the future.

 

It was explained that the report built on the presentation to the Committee on 21 July 2020 which had set out, in detail, the Adult Social Care response to COVID-19.

 

The report revealed that planning for a possible lockdown had begun in early March and included a business continuity risk assessment ensuring that the department was able to step down some services to continue providing core services to the most vulnerable.  This had enabled the service to take a targeted and needs based approach to the people who were currently supported and to deploy resources to respond and manage Covid-19 specific additional demand. 

 

The key learning from the service’s approach and experience over the last few months was outlined in the report and included that staff had been flexible and positively embraced the virtual working environment; there had been issues with Information Technology but this had also provided benefits to some residents by facilitating additional contact with distant relatives; there had been insufficient Personal Protective Equipment but this had been rectified and stocks were  closely monitored and that relationships with the Independent Care Sector were enhanced due to a greater understanding and increased communication. The psychological impact of the pandemic had been acknowledged; particular actions needed to be intensified and it had been recognised that some carers needed a break.

 

It was explained that the situation was seen as an opportunity to listen and to define what was needed in the district.  A survey of learning disability service users had revealed that 25% of those people missed the service they previously had whilst other people wanted other things.

 

It was confirmed that what had worked well was keeping people well and in their own homes.  It was explained that prior to the pandemic there were high levels of vacancies in care homes.  The service had invested heavily in the care sector but it was recognised that some care workers suffered with poor working conditions including zero hour contracts and a lack of sick pay and holidays.  The need to consider a fair deal for the care market and to value those people on the front line of care was stressed. 

 

A representative from the Bradford Care Association addressed the meeting and reiterated those concerns.  She believed that the care sector was reaching crisis levels and urged the Government to provide more funding for pay and to allow a move away from zero hour contracts.

 

A Member referred to the impact of lockdown on people with mental health issues and requested reassurance that those people could re-energise and control would be given back to those service users.  In response the Strategic Director acknowledged that the Members concerns were shared by all.  Assurances were provided that efforts were  ...  view the full minutes text for item 18.

19.

HEALTH AND SOCIAL CARE OVERVIEW AND SCRUTINY WORK PROGRAMME 2020/2021 pdf icon PDF 78 KB

The report of the Overview and Scrutiny Lead, Document “F” presents the Work Programme 2020-2021.

 

Recommended –

 

1.    That the Committee comments on the information in Appendix 1 and 2 to Document “F”.

 

2.    That the Work Programme 2020/21 continues to be regularly reviewed and updated on a rolling three month basis up to March 2021.

 

(Caroline Coombes - 01274 432313)

 

 

Additional documents:

Minutes:

The report of the Overview and Scrutiny Lead, Document “F” presented the Committee’s Work Programme 2020-2021.

 

Members were advised that reports to be considered at the meeting in September; a primary care medical update and a presentation from Healthwatch Bradford and District on people’s experiences of heath and care services during COVID-19, would provide them with a deeper understanding of those issues and key developments. 

 

The status of a report which had been postponed from the meeting scheduled for April 2020, Assessment and Diagnosis of Autism in Adults, was questioned and it was explained that due to the focus on COVID-19 related issues that had not yet been rearranged. It was planned to hold an informal meeting for Members  with Healthwatch Bradford and District and officers on that topic. The informal meeting would provide the opportunity for Members to raise questions and to inform  a formal report.

 

In response to a Members belief that Autism should not be defined as a single condition reassurances were provided that the focus of the report would be across the spectrum of conditions.  For the benefit of Members who had not been involved with the Committee when the issue had been considered in June 2019 it was explained that there had been a backlog of referrals for assessment.  Delays in receiving a diagnosis, and other issues, had been a cause for concern. It was questioned if the issue should be considered by the Children’s Services Overview and Scrutiny Committee.  In response it was explained that adults and children’s services were commissioned separately, however, it had been suggested that the Children’s Services Overview and Scrutiny Committee could consider the topic. 

 

Resolved –

 

That the Work Programme 2020/21 continues to be regularly reviewed and updated on a rolling three month basis up to March 2021.

 

ACTION: Overview and Scrutiny Lead

 

20.

CHAIR'S NOTE

Minutes:

The Chair thanked Bev Maybury, the Strategic Director, Adult Services, as she left the Authority, for her commitment and support to the Committee and for postponing her departure to assist through the current COVID-19 pandemic.

 

Bev was wished well for the future and her replacement, Iain MacBeath, was welcomed to the District and the Committee.