Agenda and minutes

In accordance with the Council’s Constitution, Members are asked to declare any interest they may have in any matter which is to be considered at this meeting.

There were no declarations of interests.

The minutes of the meeting held on 8 December 2020 were agreed as a correct record.

The Cabinet Member for Health and Social Care Integration presented a report on the Health and Wellbeing Board’s (HWB) role in tackling health inequalities, noting that the Covid-19 pandemic had highlighted the importance of this issue, due to the very different health outcomes faced by minority communities. Therefore, some of the priorities and targets set by the Board previously were likely to be reviewed going forward. Local government was making a strong case to increase health and wellbeing boards’ powers to include a statutory duty to improve public health and drive the whole health inequalities agenda. The Board had three main priorities under its health inequalities workstream, namely, best start in life, early diagnosis and intervention, and building resilience.

The Cabinet Member stated that in order to reduce health inequalities, a whole system approach would need to be adopted, which meant considering the wider detriments to health such as deprivation and other issues, such as the lack of access to outdoor space and Wi-Fi networks. The Council’s Community Solutions team had undertaken some very positive work with the local Clinical Commissioning Groups (CCGs) around ‘social prescribing’, which was about holistic, preventative work to address the issues that were causing health inequalities. The Cabinet Member then highlighted some of the most challenging areas for the Borough, such as cancer screening rates and high morbidity, which had been exacerbated by some health services being closed at the start of lockdown. She referred to the Director of Public Health’s Annual Report, stating that his next one would focus on health inequalities to support the Board to understand the patterns and shape its response. She did not feel the full extent of the Covid-19 lockdown on mental health would be known until the autumn of this year and expressed concern as to the magnitude of this. The Director of Public Health echoed the Cabinet Member’s comments and emphasised that the country would be dealing with Covid-19 for years to come. He felt it was time for all local bodies to work together to press the health reset button- future pandemics could not be ruled out and it was essential to think about investing in services in the most holistic way possible. 

In response to a question, Dr John, Chair of the Barking and Dagenham CCG, stated that the local CCGs did not have control over which groups to vaccinate against Covid-19 first and were obliged to follow national guidance on this. The over 70 and ‘clinically extremely vulnerable’ groups were currently being worked through and in the next few weeks the over 60s and those with conditions which made them vulnerable to would be vaccinated, followed by the over 50s. The NHS would contact people via text, or their GP practice would contact them to inform them of how to get vaccinated when the time came. Discussions around vaccinating the homeless were ongoing, with a view to vaccinate them in the next week or so, and those in care homes who had not  ...  view the full minutes text for item 18.

The Council’s Head of Commissioning, Adults (HCA) delivered a presentation on the Council’s perspective on the extent to which the Integrated Care System helped deal with the Covid-19 pandemic, which covered the following areas:

·  Impact on providers;

·  Strengths of the system;

·  Actions taken;

·  Areas for Improvement; and

·  Impacts on recovery.

In response to questions, the HCA stated that:

·  The Borough did not have a designated site to accommodate care home residents with Covid-19 who had been discharged from hospital because the designated sites in the boroughs of Redbridge and Havering had enough capacity to take in Barking and Dagenham care home residents. The Borough had fewer care homes than Havering and Redbridge, and the strict guidelines around which provisions could act as a designated site, particularly around layout, meant that many of the Borough’s care homes would not be adequate. Furthermore, one of the cares homes had an insurance issue which would prevent it from acting as a designated site, and the others that were approached declined. The current arrangement, nonetheless, had worked well, as there had been a seamless process between brokers and commissioners which meant that the Borough’s affected residents had moved through the provisions smoothly;

·  All care home staff had access to Covid-19 testing on a weekly basis, which could be increased if there was an outbreak within a care home;

·  As to whether a plan had been drawn up to address the areas identified for improvement by the Social Care team following the third wave, much of this was incorporated into the Council’s Winter Plan, which was presented at the last meeting of this Committee. Additionally, the Council and its partners regularly examined, as a system, how processes could be improved, for example, via the weekly discharge improvement working group which involved key partners; and

·  The local brokerage and hospital discharge teams were working closely together to support local residents who were being discharged from hospitals that were further afield, and whilst this process initially involved some learning, it was now working well and these residents were being supported to transfer into a designated site or their care home, whichever was appropriate.

The Operational Director for Adults Social Care confirmed that during the midst of the pandemic the Borough’s discharge figures remained steady, and currently it was very low (approximately five) which was very manageable.

In response to a question around the vaccination figure for care home residents, the Managing Director for the Barking and Dagenham, Redbridge and Havering (BHR) CCGs stated that 87 % of care homes residents had been vaccinated now (it was 83% at point the slide was drafted). The remaining 3% who had not yet been vaccinated included residents who had declined (or their families had declined on their behalf because they did not have capacity); residents who wished to defer being vaccinated as they wanted to see the impact it was having within the general population in terms of side effects first; and residents who could not be given the vaccine  ...  view the full minutes text for item 19.

The Chair stated that this report was withdrawn and an update on the Joint Health Overview and Scrutiny Committee would be provided at the next meeting.

The Chair referred to the agenda items on the Work Programme that had been scheduled for the meeting on 28 April 2021 and explained that requests from North East London Foundation Trust and BHR CCGs to move their agenda items to the meeting on 30 June 2021 had been received. In recognition of the impact the current situation around the pandemic was having on these organisations, the Committee agreed to the requests. Following discussion around the potential items that could be presented at the 28 April meeting, the Council’s Director of Public Health agreed to provide a Covid-19 update, to include the latest infection rates and the progress of the local vaccination programme, with a key focus on the most vulnerable including those with learning difficulties.