Agenda and draft minutes

Health and Social Care Scrutiny Commission
Tuesday 10 November 2020 6.30 pm

Venue: Zoom

Contact: Julie Timbrell  020 7525 0514

Items
No. Item

1.

Apologies

2.

Notification of any items of business which the chair deems urgent

3.

Disclosure of Interests and Dispensations

    Members to declare any interests and dispensations in respect of any item of business to be considered at this meeting.

    Minutes:

    Councillor Sunny Lambe disclosed that his daughter works for London Ambulance Service and Councillor Bill Williams disclosed his partner is a director at Great Ormond Street Hospital.

     

4.

Update on Care homes and impact of COVID 19

    The item on Care homes will be focusing on two issues:

     

    ·  How Southwark can work together to protect and treat people in Care Homes with COVID 19,

    ·  Enabling Care Home residents to stay in touch with friends, family and the outside world.

    A briefing has been provided by council social care officers and NHS Southwark on how residents will be protected and treated from Covid 19, and work with homes to enable residents to stay in touch with friends and family.

    The item on Care homes will be focusing on two issues:

    -  how Southwark can work together to protect and treat people in Care Homes with COVID 19,

    -  enabling Care Home residents to stay in touch with friends, family and the outside world.

    A briefing and presentation at the meeting  has been requested from council socail care officers and NHS Southwark on how residents will be protected and treated from Covid 19 work with homes to enable residents to stay in touch with friends and family.

    The following partners have been invited to contribute to this item, subject to confirmation:

    • Care Home providers : Anchor Hanover and HC One
    • Lewisham and Southwark Age UK and the Lay Inspectors
    • Southwark Carers
    • Link Age Southwark
    • Entelechy Arts

     

    A scrutiny review on Care Home quality assurance, completed July 2020, is enclosed as background information.

     

    Supporting documents:

    Minutes:

    The item on Care homes focused on two issues:

     

    ·  How Southwark can work together to protect and treat people in Care Homes with COVID 19,

     

    ·  Enabling Care Home residents to stay in touch with friends, family and the outside world.

     

    Genette Law, Southwark Councils’ Director of Commissioning,  presented the briefing on how council social care officers and NHS Southwark are protecting residents from infection  and treating Covid 19, and working with homes to enable residents to stay in touch with friends and family.

     

    Genette Laws, Jin Lim, Acting Director of Public Health and Sam Hepplewhite, Director of Integrated Commissioning NHS Southwark,  took questions.

     

    The following points were made:

     

     

    ·  Visitation to residents to care homes by friends ad family is usually for compassionate reasons -  either for end of life care of where residents are unable to stay in touch using technology.

     

    ·  There have been further deaths from Covid  in Care Homes over and above the 60  previously advised in July; however the situation is much more under control with only occasional outbreaks in homes, or  a single resident testing positive. Care Home cases tend to be asymptotic cases picked up by routine testing. Information on Covid mortality and survival rates will be supplied

     

    ·  Vaccination of care home residents and staff will be a priority, delivered by the commissioned GP services. There will be ‘max ‘vaccination sites, being prepared in advance,  and local sites.

     

    ·  Most care homes have a stable supply of PPE .There is a portal as a backstop - which is working well. The council are also keeping a mutual aid supply as another back up.

     

     

     

    RESOLVED

     

    Officers will provide

     

    ·  A briefing on the vaccine programme

     

    ·  An update on recent Care Home resident  deaths from Covid ,  and total survival numbers.

     

     

    Christen San Pedro, Area Director for Care Home provider HC One,  provided an update on how Tower Bridge Care Home has dealt with the pandemic.

     

    The Area Manager started by explaining that from day one of the first admission of person who was positive from Guys and St Thomas Trust the Care Home has been provided with excellent daily support via a WhatsApp group from Social Care and NHS colleagues. One unit was impacted by Covid, however this was contained.  Loneliness was a problem. Staff are equipped with tablets to help keep residents in touch with the outside world. Tower Bridge has been very stable recently.

     

    The following points were raised in the subsequent discussion:

     

    ·  Family visits to residents with dementia have been important.  

     

    ·  Tests are now available if a resident is symptomatic and to screen for asymptomatic cases. The home is able to get medical advice on the best treatments plan, given frailty. Some residents will go to hospital, but the home can also provide fluids and antibiotics in the home.

     

    ·  Staff were initially quite scared. The weekly testing of staff (a pilot) was a relief as this provided reassurance that they were not going to bring the virus home to loved ones.  There were some issues  ...  view the full minutes text for item 4.

5.

COVID 19 infection rates and NHS capacity

    Jin Lin,  Acting Director of Public Health, will  attend to outline what the Council is doing on in relation to outbreak prevention control.

    Minutes:

    Jin Lin, Acting Director of Public Health, gave an outline what the Council is doing on in relation to outbreak prevention control, and then answered questions with Sam Hepplewhite, Director of Integrated Commissioning, and Southwark NHS CCG.

     

    The following points were the made:

     

    ·  The Peckham Covid testing centre is a walk up centre, with booking online preferred. There is some local parking. Burgess Park is designed as drive through. Both are centrally located as the north is very dense and no suitable location could be found, whereas the south is difficult to travel to. Home testing kits are available. Additional sites are being investigated for vaccination

     

    ·  Figures for infection are going down, and were starting to go down prior to lockdown, possibly because of media messaging about rising numbers and London moving to Tier 2. It is hoped numbers will go down further by Christmas.

     

    ·  The current PCR testing is for symptomatic cases; Lateral flow tests could be useful for asymptotic testing.

     

     

    ·  There are currently 123 people in ITU, with a  1/4 with Covid, in South East London. ITU use has gone up by 11%, with no massive increase in ITU presentation. There are 128 beds available.

     

    ·  Capacity has been increased, and the Nightingale in reserve. There is also scope to flex the ICU.

     

    ·  There are no current alterations to provision of elective and cancer care.

     

    ·  111 activity is stable.

     

    ·  A and E presentation is back to normal.

     

    ·  The local NHS is seeing an increase in mental health presentation. This includes underlying anxiety and unhappy people in primary care and arriving at secondary care in urgent need. There is an increase in people never seen before without treatments plans.

     

     

     

6.

Update on the proposed merger between Royal Brompton & Harefield NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust.

    Jackie Parrott (Chief Strategy Officer for GSTT and KCH) and Robert Craig (Director of Development and Partnerships, RBHT) will attend the meeting to present the enclosed paper.

     

    Supporting documents:

    Minutes:

    Jackie Parrott (Chief Strategy Officer for GSTT and KCH) and Robert Craig (Director of Development and Partnerships, RBHT) attended the meeting. The chair invited answered questions on the changes outlined in the paper circulated in advance.

     

    ·  A member said a previous merger of King’s Collage Hospital (KCH) and the Princess Royal University Hospital (PRUH) had a knock on financial impact, and asked if there was a similar risk with this merger? The NHS officers said that GSTT and RBHT are two strong organisations in a  good financial position choosing to come together , whereas the merger of KCH and PRUH came about after the TSA breakup of a previous Trust,  with one struggling hospital being  rescuing by the other .

     

    ·  What are the benefits for Southwark? The two organisations are pursuing a merger,  which is a strategic realignment.  Service changes may flow from this which could realise benefits over the longer term, subject to consultation.

     

    ·  What will be the impact on staff? There is a TUPE process for staff - and no plans to make redundancy, other than very senior posts. The merged organisations will need the same number of people. By coming together the respective organisations think that positions that are harder to fill will be easier to recruit to.

     

    ·  Will cancer provision at Guy’s be moved or other services change made? Service changes will not arise out of this merger .There are no plans to change cancer services at Guy’s,  or other  plans for moving services in the immediate term; the new organisation will need to deliver at the sites for some years. There is a need to create more facilities at the Evelina Hospital, if the consultation on potential service changes were to result in this; however this is a separate process to the merger.

     

    ·  Would you consider selling some of the sites? Certainly the services at Harefield would continue, however we are thoughtful about older estates. Presently there is no room at St Thomas.

     

    ·  Has an equalities or community impact been done? As there are no services changes this is not required .The merger is a legal transaction and administrative change, rather than a service change.  Any service changes down the line would be subject to equality impacts  and community consultation; however the NHS would lead on that.

     

     

7.

Health Inequalities

    The previous Health & Social Care scrutiny commission undertook a review on the Mental Health of Children and  Young People (CYP), which particularly looked at the cross cutting  issue of the disproportionate mental ill health amongst Black And Minority Ethnic (BAME)  CYP. A letter sent to the cabinet lead summarising that work is enclosed.

     

    A follow up review is proposed focused on addressing the causes of health inequalities amongst BAME CYP.

     

    A report by Baroness Doreen Lawrence on: AN AVOIDABLE CRISIS The disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities is enclosed.

    Supporting documents:

    Minutes:

    The letter sent to the cabinet lead summarising the work of that the previous Health & Social Care scrutiny commission undertook on the Mental Health of Children and  Young People (CYP), which particularly looked at the cross cutting  issue of the disproportionate mental ill health amongst Black And Minority Ethnic (BAME)  CYP, was noted.

     

    The report by Baroness Doreen Lawrence on: AN AVOIDABLE CRISIS, The disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities was noted

     

    RESOLVED

     

     A review will be continued addressing the causes of health inequalities amongst BAME CYP. This will include the issue of Domestic Abuse and mental health.

     

     

     

8.

Work Programme

    Minutes:

    RESOLVED

     

    ·  Southwark NHS CCG will be invited to the next meeting to discuss progress of the merger across 6 South East London CCGs to better understand the balance of decision making and the local engagement and decision making processes for Southwark services.

     

    ·  Keep Our NHS Public will be invited to attend and outline research and key issues on the CCG.  

     

    ·  Interview Cllr Helen Dennis Cabinet Member for Social Support & Homelessness

     

    ·  Request a report on Vaping and possible dangers from Public Health.