Agenda and minutes

Minutes of the meeting held on 12 March 2020 (previously circulated)

RESOLVED that the Minutes of the Meeting held on 12 March 2020  be signed as a correct record.

Items which in the opinion of the Chairman should be considered at the meeting as matters of urgency.

There was no item raised as a matter of urgency.

Members of the public may make representations/presentations on any substantive matter listed in the published agenda, as set out hereunder, relating to a specific matter or an examination of services or facilities provided or to be provided.

In accordance with the Council's Public Participation Rules, the Committee received and acknowledged representations from Councillor C Gardener (East Devon District Council) read on her behalf by the Scrutiny Officer (near the conclusion of the meeting) on a matter to be considered by the Committee, namely ‘Covid-19 Response’ (Minute *194 refers).

(a) Introductory Comments

Chief Executive (Devon County Council), Chief Officer for Adult Care and Health; Chief Officer for Communities, Public Health, Environment and Health; and the Interim Accountable Officer NHS Devon CCG to report.

(b) System Response

Report of the Associate Director of Commissioning (Care and Health) and the Director of Commissioning (Devon CCG), attached

(c) A Public Health Overview of the Pandemic

Report of the Chief Officer for Communities, Public Health, Environment and Prosperity (PH/20/01), attached

(Councillor A Leadbetter attended in accordance with Standing Order 25 (1) and spoke to this item at the invitation of the Committee highlighting and thanking the County Council officers   and staff working with NHS and partners across health and care for their exceptional work during this pandemic).

(a) Introductory Comments

The Chief Executive (Devon County Council) with the Director of Public Health and Accountable Officer (NHS Devon Clinical Commission Group) and the Chief Officer and Adult Care and Health (Devon County Council) reported on the previous and current measures being undertaken by the County Council with the NHS and the private/voluntary care sector to safeguard the public and mitigate the wider impacts of the COVID-19 virus.

The Officers responded to Members’ questions relating to:

·         the effective work of the Council with NHS partners and the relatively low incidents of infections and mortality in the County both in hospitals and in the community including care and nursing homes which was a tribute to all Health and Care staff across the system;

·         the support for key workers across the County;

·         governance and local decision making and planning arrangements and the County Council’s designation as a Beacon Council, leading in the South West;

·         the approach of the recovery phase including assessment and mitigation of the wider economic, societal and health impacts including the suppressed other health demands and their implications;

·         the procurement arrangements to ensure proper supply of personal protection equipment (PPE), redeployment of staff across to support the 111 service, Devon Doctors and local hospitals;

·         new joint crossing working arrangements led by Public Health and the ongoing planning through for example a Pandemic Incident Management Team;

·         support provided to all CQC registered care homes with close working between the CCG and the County Council to ensure adequate PPE supplies, infection control and testing;

·         partnership working with Public Health on the local deployments of the national Test and Trace service and the Local Outbreak Management Plan;

·         Lessons were to be learned from discharge from hospitals into community settings  and the need for early testing, trace and isolate processes; and

·         the need for and development of local control to manage effectively any further local outbreaks and with low levels of incidents the chances of success would be enhanced.  

(b) System Response

The Committee considered the Report of the Associate Director of Commissioning (Care and Health) (Devon County Council and NHS Devon CCG) and Director of Commissioning – NHS Devon CCG on the background to the pandemic, planning and preparation, the ongoing response, restoration and transformation, and activity and performance.

The Directors and the Chair of the Devon CCG and Dr D Jones (GP) responded to Members’ questions relating to:

·         the quick effective roll out and use of digital technology for remote consultations to help ensure safety for GP surgeries and the public across the County and the anticipated  increase of such use in the future;

·         the possible impact of the pandemic and its indirect consequences on the Long Term Plan across the health and  ...  view the full minutes text for item 194.

Joint Report of the Associate Director of Commissioning (Care and Health) and Director of Commissioning (Devon CCG) (ACH/20/124), attached

The Committee considered the Joint Report of the Associate Director of Commissioning (Care and Health) and Director of Commissioning (Devon CCG) (ACH/20/124) on an update on activity and performance across the wider health and care system based on performance data as at April 2020 (Month 1) including later data where available.  The focus covered  acute and community hospital settings, primary care and social care selected by system leaders to provide a whole system view.

The Directors and the Chair of Devon CCG responded to Members’ questions relating to:

·         diagnostics within 6 weeks and performance against the range of national cancer standards targets (correction of the figures in section 5.6 of the Report was reported) and the need for a wider Devon/Cornwall and Peninsula approach with specialised services and diagnostic techniques which were being developed, the single hospital solution was not appropriate;

·         the socio-economic impacts and safeguarding issues as a result of the pandemic and  work to add capacity and investment to support vulnerable people;

·         the success of the ‘proud to care campaign’ and the need for more capacity across health and social care noting the complex training required with increased acuity within personal care in the community;

·         the ongoing planning for restoration of elective activity levels for treatment and diagnostic testing;

·         streamlined processes for improving delayed transfers of care and the need to build resilience in the personal care market; and

·         the need to review the long Term Plan as a result of the pandemic and its ongoing impacts across health and social care. 

The Committee noted the Report on the impact of COVID-19 on health and social care and the consequent need to review the Long Term Plan.

Report of Associate Director of Commissioning (Care and Health) (Devon County Council and NHS Devon CCG) and Director of Commissioning – NHS Devon CCG, attached

The Committee considered the Report of Associate Director of Commissioning (Care and Health) (Devon County Council and NHS Devon CCG) and Director of Commissioning – NHS Devon CCG (ACH/20/125) on activity and performance over the winter period of October 2019 to March 2020 and a comparison to the previous year was available. It was noted that preparations to respond to the Covid19 pandemic commenced during late February and into March impacting upon the Urgent Care Winter performance. The Report covered 3 areas: 

•  Pre-admission to hospital;

•  Hospital performance; and

•  Discharge and post hospital

The Officers and Dr D Jones (GP) responded to Members’ questions relating to:

·         the need to promote the flu vaccinations programme which in accordance with the national strategy was planned to be implemented earlier and to cover more people with a proposed reduction in the age limit; the social distancing and other current measures if continued would mitigate the impacts;

·         improved access to primary care now provided total cover for the Devon population with access to primary care services at evenings and weekends with more digital assessments and less face to face contacts;

·         analysis of the number of adult social care assessments and the impact of the pandemic cover and ensuring; and

·         the national ongoing review of the ‘Nightingale’ hospitals and the remaining uncertainties in regard to the pandemic.   

The Committee recognised the ongoing pressures faced by the Health and Care system over winter 2019/20 and noted the COVID-19 pandemic impact on review arrangements for last winter.  

Below is a list of information previously circulated for Members, since the last meeting, relating to topical developments which have been or are currently being considered by this Scrutiny Committee.

(a) Regular Adult Social Care Briefings (from …..to June 2020).

(b) Information and invite to an  NHS Devon CCG and COVID-19 Councillor Webinar on 27 May on g a virtual session on their response to COVID-19 in Devon.  

(c) Torbay and South Devon NHS Foundation Trust 17 April, 1 May and 15 May 2020 Update - Health & Adult Care Scrutiny Committee;

(d) Newsletter: South West Academic Health Science Network April 2020 Newsletter.

(e) Personal Protection Equipment (PPE) Update -  letter from Matt Hancock and Robert Jenrick outlining the latest position.

(f) Stakeholder update from Northern Devon Healthcare NHS Trust: May 2020.

Information previously circulated for Members relating to topical developments included: 

(a) Regular Adult Social Care Briefings (from May to June 2020).

(b) Information and invite to an  NHS Devon CCG and COVID-19 Councillor Webinar on 27 May on giving a virtual session on their response to COVID-19 in Devon. 

(c) Torbay and South Devon NHS Foundation Trust 17 April, 1 May and 15 May 2020 Update - Health & Adult Care Scrutiny Committee.

(d) Newsletter: South West Academic Health Science Network April 2020 Newsletter.

(e) Personal Protection Equipment (PPE) Update -  Letter from Matt Hancock and Robert Jenrick outlining the latest position.

(f) Stakeholder update from Northern Devon Healthcare NHS Trust: May 2020.