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.

There were no declarations of interest made on this occasion.

To agree the minutes of the special meeting held on 28 September 2021 and the minutes of the last meeting held on 14 October 2021 as a true and correct record.

The Committee agreed that the minutes of the special meeting held on 28 September 2021 and the minutes of the last meeting held on 14 October 2021 be signed by the Chairman as a true and correct record.

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

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

To consider the content of the Council’s Forward Plan, December 2021 to March 2022, relating to the remit of the Committee.

The Committee considered the contents of the Council’s Forward Plan December 2021 to March 2022, relating to the portfolios of the Cabinet Members whose responsibilities fell within its remit.

Councillor Jo Farrell, Cabinet Member for Adult Social Care and Health, informed the Committee that in relation to the Domestic Abuse Reduction Strategy, that a joint meeting between it and the Children’s and Young People Scrutiny Committee. The date for this meeting had yet to be confirmed but would be used to consider a draft of the plan before its agreement. Members of the Committee queried in connect with the plan what the ambitions were for the White Rose Campaign in Blackpool and if any training was available to support it. Councillor Farrell replied that the campaign was ongoing and that they would check to see what information could be provided to the Committee.

To provide a comprehensive report on sexual health service provision in Blackpool informed by the ‘Enhancing the value of sexual health, reproductive health and contraception services through council scrutiny’ guide.

Ms Judith Mills and Ms Janet Duckworth, Consultants in Public Health, presented a report on sexual health services in Blackpool. The Committee was informed that the report had been written to include all the information recommended by the “Enhancing the value of sexual health, reproductive health and contraception services through council policy” guide.

Ms Mills reported that in Blackpool responsibility for sexual health services was split across a number of commissioners, both public and private. As a result of this partnership working between commissioner, to ensure that the best quality service possible was required. A joint strategic needs assessment was therefore in place to drive the development of sexual health services. This assessment was reviewed every four years to ensure it addressed the relevant priorities for Blackpool.

The report showed that levels of chlamydia had been reducing and becoming closer to the national average. In addition, the transmission of Human Immunodeficiency Virus (HIV) had fallen and it was hoped that it could be prevented in Blackpool by 2030. Instances of teenage pregnancy had also reduced and Blackpool was narrowing the gap with the England average.

Despite this, instances of abortions and syphilis had risen. Although figures were in line with national trends, partners were looking at how to address both issues, in particular through the promotion of contraception.

Following the restrictions experienced by the Covid-19 pandemic Ms Mills informed the Committee that services had returned to normal but that work was needed to understand how sexual behaviours had changed during lockdown.

Ongoing work to improve service delivery included the greater use of digital platforms to order tests for Sexually Transmitted Infections (STI) and the ordering of contraception. It was hoped that this would make it easier for some individuals to engage with services. Although this had been undertaken in response to a high level of digital demand for sexual health services, Ms Mills informed Members that it had been recognised that the use of such platforms should be balanced against the demand for traditional access to services. Talks were therefore ongoing with Public Health and Blackpool Teaching Hospitals NHS Foundation Trust to determine service provision.

Work was also being undertaken with schools to put in place effective sex education practices and programmes to teach healthy behaviours in relationships. This would include the introduction of the ‘Green Dot bystander intervention programme’.  The programme involved the use of workshops and training to create cultural changes that aimed to reduce harassment and inter-personal violence amongst young people, encouraging them to respond when they noticed unhealthy behaviours and to engage in behaviour that benefited the community. Members queried if the Relationships and Sex Education Curriculum, highlighted in the report, would be rolled out to all schools, including faith based ones. Ms Duckworth confirmed this was the case and that it was hoped that all schools would eventually adopt the Green Dot programme, but that a place based approach would be undertaken to ensure it matched the needs of each school.

Ms Mills also reported  ...  view the full minutes text for item 5.

To consider the mid-year performance of the Blackpool Clinical Commissioning Group (April 2020 – August 2021) and also a more in depth look at the impact of the COVID-19 pandemic on current performance and ongoing recovery planning.

Ms Jeannie Harrop, Head of Commissioning, Blackpool Clinical Commissioning Group (CCG), Ms Janet Barnsley, Executive Director of Integrated Care and Performance, Blackpool Teaching Hospitals NHS Foundation Trust (BTH) and Dr Neil Hartley-Smith, Executive Clinical Director, CCG, presented the Blackpool Clinical Commissioning Group Mid-Year Report (2021/2022).  Ms Barnsley reported that since the last report long-term waiting for patients had reduced, although figures remained high, and cancer referrals had increased. The North West Ambulance Service was also reported as having experienced reduced levels of performance.

The Committee noted that the performance monitoring report included many instances of performance marked in red, indicating that targets had been missed. It was therefore queried how the Accident and Emergency department (A and E) was coping, in light of increased levels of Covid-19 and the challenging winter period. Ms Barnsley replied that the department was undergoing a challenging period and that delays in discharge caused by local Adult Social Services not having care packages in place had added to pressures being experienced. She also added that there had been an increase in the acute nature of people presenting to A and E which had resulted in an increase in admissions. Dr Hartley-Smith stated that, where appropriate, people were encouraged to use alternative health services and that a system was in place to filter out people who did not require emergency treatment on presentation. He added that efforts were being made to increase discharges but that recruitment issues in social care had made this challenging, combined with the ongoing increase in Covid-19 cases presenting at A and E.

The Committee discussed the demographics of breast cancer screening in Blackpool, noting that regular screening was offered to women over the age of 47, but that cancer could affect women much younger than this, with early diagnosis often leading to improved outcomes. It was queried if the screening age could be lowered if insufficient women came forward from the 47 years old and over group and if lower age groups in specific areas could be targeted. Dr Hartley-Smith advised that breast cancer screening was offered to older age groups because cancer tissue was more visible on breast scans in older women. In younger women scans were less effective in identifying cancer and could provide false reassurance. He therefore stated that rather than lowering the age for scans, that all women should regularly undertake self-examination and contact their GP if they had concerns.

The level of face-to-face appointments available to patients at GP surgeries was queried by the Committee, with Members noting that for some people telephone or online appointments were not appropriate. In response, Dr Hartley-Smith informed the Committee that all surgeries should be triaging patients’ appointments based on individual need.

Members queried if ambulance crews had been trained to determine if individuals should be admitted to A and E. In reply to which Dr Hartley-Smith stated that from the initial emergency phone call a patient was assessed to determine the best course of action. Each ambulance crew also  ...  view the full minutes text for item 6.

The purpose of the report is to provide an update in relation to Blackpool Teaching Hospitals Trust Restoration of Services including continuing improvement.

Ms Janet Barnsley, Executive Director of Integrated Care and Performance, Blackpool Teaching Hospitals NHS Foundation Trust (BTH), presented a report on the restoration of services following the Covid-19 pandemic. She informed Members that the hospital had fully reopened and that services were at 95 per cent of their pre-Covid levels.  Ms Barnsley reported that this was considered a good level considering the difficulties faced during the pandemic and the additional pressure it had created. She advised that going forward BTH did not want to increase pressure on staff and therefore a number of providers had been appointed to outsource and insource services where the hospital lacked staffing resources. This had included the use of extra bed space at facilities such as The Spire, where up to forty patients could be accommodated. BTH had also implemented ongoing infection control procedures subject to ongoing review to ensure patient safety.

In response to a query, Ms Barnsley explained that insourcing of services was a method of service delivery whereby an outside provider would be used to offer services in the hospital where BTH’s resources were unavailable. This had the benefit of maximising the use of BTH’s assets whilst reducing pressure on its staff.

The Committee queried the number of operations and/or procedures that had been cancelled as the result of a patient testing positive for Covid-19. Ms Barnsley replied that the number was very low, but that the information could be provided in writing following the meeting.

It was noted that the tourist nature of Blackpool meant that the hospital needed to accommodate visitors as well as local residents and the Committee queried how this could impact services. Ms Barnsley explained that this could create issues and highlighted that increased visitor numbers had been recorded following the lifting of Covid restrictions in the summer of 2021. However, she noted that the number of visitor and resident patients was reviewed daily and where possible long-term patients were transferred to a hospital closer to their home.

The Committee noted that delays in discharging patients had in some cases been the result of either Blackpool Council or Lancashire County Council’s Adult Social Care (ASC) teams not having care packages in place. Members therefore asked if a breakdown of how many delays each ASC team had been responsible for could be provided. Ms Barnsley reported that staffing pressures within the care sector had also contributed to delays, highlighting that there had been a move towards domiciliary care and away from residential care. Domiciliary care providers had experienced an ongoing loss of staff due to a number of factors, including vaccine hesitancy and other misleading information about the pandemic.

The increase in cases nationally of the Omicron variant of Covid-19 was raised by the Committee, who queried if a plan was in place to deal with its impact. Ms Barnsley replied that BTH had preparations in place but that the impact of the variant was as yet unknown. The hospital was therefore working with Public Health to model  ...  view the full minutes text for item 7.

To review the work of the Committee, the implementation of recommendations and note the update on the Pathology Collaboration briefing, the Supported Housing and Meals on Wheels Scrutiny Reviews and the upcoming topics for review.

The Committee considered its work programme for 2022and requested that reports on the following be added:

·       a report on the issues of delayed discharge by brought to the June 22 meeting, containing an update on progress to reduce delays and care plan issues.

·       A report on the Impact of Alcohol during Lockdown. Specifically levels of alcohol consumption, deaths related to alcohol, the role of the new Alcohol Lead (and details of the strategic needs assessment they are developing), how services can be target at women (it was noted that uptake among women is traditionally very low) and what sobriety services are available.

·       A report on Long-Covid providing information on the impact in Blackpool and what services are available. It was noted that this could be either an independent item or delivered in connection with the population health management item planned for March 2022.

To note the date and time of the next meeting as Thursday, 3 February 2022, commencing at 6pm.

The date and time of the next meeting of the Committee was noted as Thursday, 3 February 2022 at 6.00pm.