Agenda and minutes

Members are asked to declare any interests in the items under consideration and in doing so state:

(1) the type of interest concerned either a

(a)   personal interest

(b)   prejudicial interest

(c)    disclosable pecuniary interest (DPI)

and

(2) the nature of the interest concerned

If any member requires advice on declarations of interests, they are advised to contact the Head of Democratic Governance in advance of the meeting.

Councillor Rick Scott declared a personal interest in Item 5 ‘Health System: Covid-19 Update and Impacts’, the nature of the interest that he was a member of the Blackpool Teaching Hospitals Trust Board.

To agree the minutes of the last meeting held on 26 November 2020 as a true and correct record.

The Committee agreed that the minutes of the last meeting held on 26 November 2020 be signed by the Chairman as a true and correct record.

To consider any applications from members of the public to speak at the meeting.

There were no requests from members of the public to speak on this occasion.

To consider the Cabinet Member decision taken within the remit of the Adult Social Care and Health Scrutiny Committee since the previous meeting.

The Committee noted the Cabinet Member decision, PH16/2021 ‘Adult Services Fees and Charges 2021/2021’ taken since its last meeting.

To apprise members of the current position with the Covid-19 pandemic and associated impacts.

Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group (CCG) introduced the report to the Committee and invited questions.

Members referred to vaccinations in care homes and Dr Neil Hartley-Smith, Executive Clinical Director, Blackpool, Fylde and Wyre CCGs advised that the most recent data, of 15 March 2021, indicated that 91.2% of Blackpool care home residents had received their first vaccination. Ms Karen Smith, Director of Adult Services added that Blackpool was in the top five of vaccination rates nationally for older care home residents.

It was reported that the vaccination programme as a whole in Blackpool had been very successful to date with 94.1% of over 80 year olds, 94.5% of over 75 year olds, 88.4% of over 70 year olds and those clinically extremely vulnerable, 88.2% of over 65 year olds and 62% of those aged 60 to 64 year olds or those with other conditions having already received the first dose of the vaccination. The Committee and those in attendance praised the work of everyone involved in the vaccination roll out to date.

Members referred to the recent concerns raised regarding the Astrazeneca vaccine and blood clots and queried whether it was expected that the concerns would have an impact on update. Dr Hartley-Smith advised that the reports were unfortunate and that blood clots were a routine occurrence. He added that medical regulators had determined that there was no correlation and that millions of vaccinations had been given in the UK with no concerns identified. Dr Arif Rajpura, Director of Public Health highlighted that almost 50% of the UK adult population had been vaccinated and that the lockdown and successful vaccination programme had made a significant impact on the number of deaths.

In response to a further question on vaccinations, Dr Hartley-Smith advised that marketing and communications would be utilised to provide assurance to the public on the safety of the vaccines.

The Committee raised concerns that only 43% of staff from black and minority ethnic communities had received the vaccination. Mr Kevin McGee, Chief Executive, Blackpool Teaching Hospitals NHS Foundation Trust reported that the Trust had worked with all staff groups and delivered personal messages to all those with concerns about the vaccination in order to increase uptake. He noted that overall, 7,500 staff had been vaccinated which was a great achievement.

It was noted that there were currently 1,301 patients recorded as waiting over 52 weeks for treatment and Members queried what the usual figure would be. In response, Mr McGee advised that pre-Covid the target for 52 week waits was zero and numbers were usually very low. He noted that the significant increase was a consequence of a severe reduction in the level of work undertaken outside of Covid and that restoration work was due to commence shortly in an ambition to recover the position, however, it would take time.

Dr Hartley-Smith advised that the primary and secondary care worked closely together in order to review all ‘long waiters’ and mitigate risks with the most  ...  view the full minutes text for item 5.

To provide an overview of the whole directorate including financial performance and impact of the pandemic.

Ms Karen Smith, Director of Adult Services presented the report to Committee and highlighted that services continued to operate in response to the pandemic and work was ongoing to ensure they were in a position to transition to recovery when appropriate. She advised that social workers had been working from home and within the office as necessary and that all urgent assessments that could not be undertaken by phone or online were being carried out face to face.

It was reported that Deprivation of Liberty Standards (DOLS) assessments had continued to be carried out albeit at a reduced level and that there had been a reduction in the number of placements into residential care, with an increase in demand for care provided at home. It was considered that an increase in demand for care at home could be due to the speed at which older people were being discharged from hospital once there was no longer a clinical need for them to remain. It was noted that an extra 2,000 hours of care at home had been provided during the previous year.

Ms Smith also provided an overview of the work carried out to support shielders, the CoronaKindness hubs and learning disability and other support services.

In regards to the financial position of the service, it was reported that the core budget of the service was as stable as it had always been with an additional £16.5 million of funding provided by Government in Covid support grants and other funding to address specific issues such as infection control.

Members referred to the increase in the number of safeguarding reports and queried whether there were any identifiable themes. In response, Ms Smith advised that there had been issues around consent for vaccinations and that there was a lack of clarity around the process for declining and the Mental Capacity Act. She added that some reports reflected the pressures around staffing and the provision of the right help and support at the right time. It was noted that the majority of reports were not upheld, however, sometimes indicated matters that could be improved.

The Committee queried the uptake of vaccinations amongst care home staff and Ms Smith advised that there had been high levels of uptake with one to one conversations taking place with individuals who had chosen note to have the vaccination in order to discuss their reasons for declining. It was noted that national discussions were ongoing to determine whether or not the vaccination should be mandatory for care staff. Dr Arif Rajpura, Director of Public Health added that all religious groups had expressed support for the vaccine and there were no evidenced concerns regarding impact upon fertility, which were two of the key reasons for vaccine hesitancy. He advised that advice and multiple opportunities were being provided to all staff.

Concern was raised that unvaccinated staff would be a threat to residents’ health and that families were worried regarding their safety. In response, Ms Smith advised that should workers  ...  view the full minutes text for item 6.

To receive a verbal update from the Director of Public Health on the response to the pandemic and the impact of the pandemic on services.

Dr Arif Rajpura, Director of Public Health provided an overview of the latest epidemiology data highlighting that cases nationally had dropped significantly from a recorded high of approximately 51,000 down to 5,000 cases per day. During the peak, up to 77 cases per day had been recorded in Blackpool, which had now reduced to less than 10 each day. The levels of testing in Blackpool had been consistently higher than the North West average and consequently the high levels of testing resulted in a low positivity rate. Blackpool had one of the lowest rates per 100,000 of population in the North West at 43.7 and the rate of the virus in the over 60s age group had also reduced. This in turn should have a positive impact on the number of hospital admissions and severe illness as the virus was known to particular affect people in older age groups. It was noted that the vaccination were being targeted at the most vulnerable groups, however, that resulted in transmission largely occurring in those of working age and older teens.

Dr Rajpura presented a detailed breakdown of death rates across the North West and it was noted that it was important to consider the age standardised mortality rates which took into account the age of the local population in each area. When considering this statistic it demonstrated that the death rate in Blackpool was significantly lower than other areas in Lancashire such as Blackburn with Darwen.

The Committee was advised that it was important that members of the public continued to follow the rules within each stage of the Government’s easing of lockdown. It was noted that the ongoing focus of the Public Health directorate was the vaccination programme, test, track and trace which was to be led by Public Health locally moving forward, outbreak management, supporting schools, care home and the voluntary sector and communications and engagement.

Ms Liz Petch, Consultant in Public Health provided assurance to the Committee that the vast majority of Public Health commissioned services had continued during the pandemic and where necessary had adapted to working in more virtual ways. She highlighted that health visitor checks continued both by phone and face to face where required. An example of an impact on service provision was the inpatient stop smoking offer as workers had been unable to access the hospital during the pandemic, however, smoking cessation support had continued to be delivered by pharmacies and through GPs.

Ms Judith Mills, Consultant in Public Health added that there had been a significant impact on sexual health services and it was expected that a recovery plan would be required. Drug and alcohol treatment services had continued with positive feedback received resulting in the agreement that some changes implemented during the pandemic would be continued post pandemic.

Members thanked the Public Health Directorate for their work during the pandemic and requested that a Covid recovery plan update be provided to the Committee in due course.

To set out the interim findings and recommendations of the Supported Housing Scrutiny Review.

The Committee approved the Supported Housing Scrutiny Review Interim Report subject to the amendment that 84% of new housing claimant benefits for all forms of accommodation had been from out of the Blackpool area. It was agreed that the relevant recommendations be forwarded to the Executive for consideration.

To review the work of the Committee, the implementation of recommendations and note the update on the Fulfilling Lives informal meeting.

The Committee approved its workplan subject to the inclusion of the items identified during the course of the meeting.

To note the date and time of the next meeting as 1 July 2021 commencing at 6pm, subject to confirmation at Annual Council.

The date and time of the next meeting was noted as 1 July 2021, commencing at 6pm, subject to confirmation at Annual Council.