Agenda and minutes

Mr J Povey advised that he was a partner in a GP practice which was part of a Primary Care Network.

To confirm the minutes of the previous meeting.

RESOLVED – that the minutes from the meeting on the 13 July 2020 be approved by the Chair.

None.

To review and agree the Terms of Reference of the Health & Wellbeing Board.

The Board were presented with the updated Terms of Reference. The document was similar to previous years, with changes in relation to job titles. In response to a query from a Member, it was confirmed that there were no addendums to the document and erroneous asterisks would be removed. 

RESOLVED – that, subject to the removal of the erroneous asterisk, the Terms of Reference be approved.

To receive a presentation on COVID-19 in Telford & Wrekin from Liz Noakes, Director for Public Health, Telford & Wrekin Council.

The board received the report of the Director of Public Health, which provided an update on the work that the Council had taken during the Covid-19 pandemic and to update on the latest local infection rates. The board noted that there had been a fourfold increase in the number of infection compared to the previous week, the majority of cases could not be traced to a particular outbreak.

In response to a question, it was confirmed that media materials would be made available to Members for them to circulate. It was also confirmed that residents would be able to use one of the newly established walk in testing centres in the district centres, even if they did not live in that area.

Members discussed reports of visitors to the town centre not wearing face masks, despite their being security on the entrances, and asked if anything could be done to enforce the rules around wearing masks. The Director of Public Health advised that she had contacted the Town Centre management about this issue.

A discussion was held in regards to the national Track and Trace system, Members discussed their experiences of residents having to travel as far as Oldham to obtain a test and were encouraged by the opening of walk in centres in district centres.  Members discussed the lab capacity for processing tests and noted that the Council were reinforcing the guidance on who should get tested.

To receive a presentation on health inequalities in Telford & Wrekin from Louise Mills, Service Delivery Manager for Health Improvement & Libraries, Telford & Wrekin Council and Helen Potter, Research & Intelligence Manager, Telford & Wrekin Council.

The Board received the presentation on reducing health inequalities in the Borough. The presentation focused on a range of issues, which showed the work that was being done by the Council and partner agencies to reduce inequalities in the Borough.

Members of the Board discussed previous schemes that had taken place to provide support for residents in the Borough. Members noted that it was vital that the work to reduce inequalities were practical steps, rather than just token gestures.

To receive a report on mental health services in Telford & Wrekin in response to COVID-19 by Steve Trenchard, Executive Director for Transformation (Interim), Shropshire, Telford & Wrekin Clinical Commissioning Groups, Steph Wain, Commissioning Specialist in Mental Health, Telford & Wrekin Council and Francis Sutherland, Head of Commissioning Mental Health and Learning Difficulties, Telford & Wrekin Clinical Commissioning Group.

The Board received an update from Executive Director for Transformation (Interim), Shropshire, Telford & Wrekin Clinical Commissioning Groups. The impact of the pandemic had really shown the importance of localism and the effect that the third sector could have for communities. The service did not want to return to old ways of working, as it was recognised that some services did need improvement. Lockdown had highlighted issues around how some residents struggle to access services. It was noted that some boards had re-established following lockdown and that the service had a strong sense of partnership working.

Members discussed that they were pleased to see the emphasis on partnership working.

To receive a report on Primary Care Networks from Nicky Wilde, Primary Care Network Programme Director, Shropshire, Telford and Wrekin Clinical Commissioning Groups.

The Board received an update on Primary Care Networks (PCNs). The Board were informed that all practices in the area continued to hold individual contracts and would continue to deliver the majority of care. PCNs had been established to enable various practices to work together to provide additional support, for example, to aid the recruitment of a wider range of staff to work across the practices. There had been a few changes to previous years, as two networks had merged together and several practices had decided to no longer be part of a PCN. It was noted that some of the PCNs worked across CCG boundaries.

RESOLVED – that the update on Primary Care Networks and the ongoing programme of work be noted.

To receive a report on the System Winter Plan from Sam Tilley, Director of Planning, Shropshire, Telford & Wrekin Clinical Commissioning Groups.

The Board noted that the winter plan had been an established piece of planning for several years and was normally a complex and challenging piece of work, and this had been enhanced due to the Covid-19 pandemic. The health service was currently restoring services that had ceased or been scaled back during the lockdown and it was noted that the winter plan was a strand in this restoration work.  It was noted that communications with the public would be very important to inform them of how best to use services and that multi-agency communications would continue.

In response to a question, Members were advised that Public Health England had offered assurances that there would be enough flu vaccines available and it was noted that the vaccination scheme had been expanded.

Members raised their concern that some services were not functioning as they should, for example, phlebotomy and physiotherapy. Members raised that the pandemic should not be used as an excuse for not delivering services in the way that they should be. The Board were assured that the service would be vigilant in how services were restored to ensure that the right services were provided in the right way. It was noted that the restoration of services was highly complex and that appointments took longer than previously due to the cleaning required between patients and other measures. The Board noted that the pandemic had provided the opportunity for some services to start to work in a new way and offered an opportunity for reflection.

A discussion regarding potential further spikes in COVID cases, Members were reassured that health services were ready and would be able to cope. Step down plans had been built into services as part of their restoration so that this could be actioned should the need arise.

To receive a report from Paul Shirley, General Manager and Engagement Manager, Healthwatch Telford and Wrekin.

The Board received the presentation by Healthwatch Telford & Wrekin. The presentation summarised Healthwatch’s survey into the effects of the Covid-19 pandemic on the people of the Borough. Lockdown had brought anxiety for many residents and there had been a huge impact on people’s emotional wellbeing and mental health. The responses showed that many did not feel they had been kept well informed about cancelled appointments and new procedures. Many respondents reported struggling to obtain basic necessities.

Members stated that they were pleased that the efforts of the Council and the voluntary sector had been noted by the respondents to the survey, the Council and partner organisations had put in a huge amount of work to support and guide residents throughout the pandemic.

Members considered that although the local response to the pandemic had been good, the national response had not been as effective and there were lessons which could be learnt.

To receive a verbal update on Adult Social Care from Sarah Dillon, Director: Adult Social Care, Telford & Wrekin Council.

The Committee received a verbal update from the Director of Adult Social Care, who advised that the Council had continued to complete its’ duties under Care Act throughout the pandemic, however, there had been some flexibility in how these duties were met. Visits and support to residents continue to be made in person where required, but online and telephone support had also been provided. Keep In Touch calls had taken place with groups of service users, such as recipients of direct payments. The team continued to work with partner agencies to ensure the right care was provided.

Hospital discharge guidance had been updated and the Council continued to contribute to the discharge team, ensuring a speedy discharge for residents.

In respect of supporting residents with learning difficulties, a multidisciplinary team was in place to ensure that those individuals who needed additional support were identified. Following government guidance, two building based services had been reopened, but at a reduced capacity.

A Member asked what support had been provided to individuals with additional needs and their families, and raised concerns regarding some residents feeling isolated. The Director of Adult Social Care stated that a conversation had been held with each affected service user and their family and other ways to provide support were identified that were appropriate for each family, this could be one to one support at home or in the community, virtual support or respite in other ways.

A question was asked in regards to discharge in the community, had all assessments been kept up to date. The Director for Adult Social Care confirmed that assessments had been taking place when they should, some assessments had taken place virtually which had helped to ensure that all members of the multidisciplinary team could attend.