Agenda and draft minutes

Adults and Health Select Committee - Wednesday, 3 March 2021 10.00 am

Venue: REMOTE MEETING

Contact: Ben Cullimore, Scrutiny Officer 

Media

Items
No. Item

11/21

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

    Purpose of the item: To report any apologies for absence and substitutions.

    Additional documents:

    Minutes:

    None received.

12/21

MINUTES OF THE PREVIOUS MEETING: 19 JANUARY 2021 pdf icon PDF 256 KB

    Purpose of the item: To agree the minutes of the previous meeting of the Adults and Health Select Committee as a true and accurate record of proceedings.

    Additional documents:

    Minutes:

    The minutes were agreed as a true record of the meeting.

13/21

DECLARATIONS OF INTEREST

    Purpose of the item: All Members present are required to declare, at this point in the meeting or as soon as possible thereafter:

          I.        Any disclosable pecuniary interests and/or

        II.        Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting.

     

    NOTES:

    ·         Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest.

    ·         As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner).

    ·         Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.

    Additional documents:

    Minutes:

    None received.

14/21

QUESTIONS AND PETITIONS

    Purpose of the item: To receive any questions or petitions.

    NOTES:

    1.    Due to the Covid-19 pandemic all questions and petitions received will be responded to in writing and will be contained within the minutes of the meeting.

     

    2.    The deadline for Members’ questions is 12:00pm four working days before the meeting (25 February 2021).

     

    3.    The deadline for public questions is seven days before the meeting(24 February 2021).

     

    4.    The deadline for petitions was 14 days before the meeting, and no petitions have been received.

    Additional documents:

    Minutes:

    Witnesses:

    Ruth Hutchinson, Director of Public Health, Surrey County Council

    Dr Sally Johnson, Clinical Lead for Covid Vaccinations, Surrey Heartlands

    Sinead Mooney, Cabinet Member for Adult Social Care, Public Health and Domestic Abuse

     

    1.    A member of the public asked the following question in advance of the meeting: “How many of Surrey's care home residents have tested positive for COVID-19 since the Government lifted the last national lockdown on 2 December 2020?”

     

    2.    The following response was issued by Surrey County Council Public Health in advance of the meeting: “The Public Health England line listing of case data derived from our Power BI platform identifies 1,647 records of care home residents testing positive for COVID-19 since 2 December 2020 (up to 28 February 2021). Data included on the National Capacity Tracker estimates that the total number of care home residents in Surrey is approximately 9,799.

     

    Please note: due to data quality issues related to provider input, this data is subject to change.”

     

    3.    Having received this response, the questioner asked the following supplementary question at the meeting: what impact had the level of infections indicated in the response above had on COVID-related hospitalisations and deaths of care home residents during the same period, as well as on the rollout of the vaccine, since it was understood that vaccinations could not occur in care homes where there was an outbreak taking place?

     

    4.    It was agreed that a written response would be provided after the meeting.

     

    5.    The Clinical Lead for Covid Vaccinations stated that it was in fact possible to vaccinate residents and staff even when there was an outbreak in a care home. A risk assessment would have to be conducted, and vaccinations for people who had tested positive for the coronavirus would have to be delayed, but outbreaks in care homes had not hampered the vaccination programme significantly.

     

    6.    Members enquired whether the figure for Covid-19 cases in care homes was particularly high in Mole Valley and whether there were any other pockets across Surrey that had similarly high figures. The Select Committee requested to see comparative figures for each district and borough. The Director of Public Health agreed to include information on the prevalence of Covid-19 in care homes and the population as a whole in each district and borough in the written response.

     

    7.    The Co-Chair of the Surrey Coalition of Disabled People emphasised that domiciliary care should also be taken into account, not just care homes. The figures for domiciliary care were often ignored, yet domiciliary care clients and staff were impacted significantly by Covid-19. The Cabinet Member for Adult Social Care, Public Health and Domestic Abuse agreed to provide, where possible, data on the cases of hospitalisation or death of Adult Social Care clients in a domiciliary setting.

     

    Actions/further information to be provided:

    1.    The Director of Public Health to provide a written response to the questioner’s supplementary question, including information on the number of hospitalisations and deaths in care homes and domiciliary care  ...  view the full minutes text for item 14/21

15/21

COVID-19 VACCINATION PROGRAMMES

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    Additional documents:

15/21a

SURREY HEARTLANDS COVID-19 VACCINATION PROGRAMME pdf icon PDF 578 KB

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    Purpose of the item: To provide an update on the delivery of the Covid-19 Vaccination Programme in Surrey Heartlands to date and future plans for the continued roll out of the programme.

    Additional documents:

    Minutes:

    Witnesses:

    Jane Chalmers, Covid Director, Surrey Heartlands

    Ruth Hutchinson, Director of Public Health, Surrey County Council

    Dr Sally Johnson, Clinical Lead for Covid Vaccinations, Surrey Heartlands

    Giselle Rothwell, Associate Director of Communications and Engagement, Surrey Heartlands

     

    Key points raised during the discussion:

    1.    The Covid Director provided an update on the data since the report had been published. The total number of vaccinations to date within the Surrey Heartlands area stood at approximately 330,000. Approximately 320,000 of these were first doses. About 27% of the Surrey Heartlands population had received at least the first dose of the vaccine. The roving model of vaccination used by the programme included administering vaccinations to homeless people and hard-to-reach groups. An important part of the programme now was understanding why some of the people who had been offered the vaccine had chosen not to take it up.

     

    2.    A Member asked what was being done to appeal to people who had been offered but declined the vaccination. The Director of Public Health emphasised that the programme was long-term. Whether people took up the vaccination when it was offered to them depended on the ‘three Cs’: confidence, convenience and complacency. The Director agreed to send a link to the Select Committee containing intelligence on vaccine hesitancy data. There was clear evidence on which population groups were less likely to take up the vaccine; these included black, Asian and minority ethnic (BAME), Gypsy, Roma and Traveller, and Pakistani and Bangladeshi communities, as well as people coming from certain economic backgrounds. As the vaccination cohorts were worked through and younger age groups came to be vaccinated, it was anticipated that patterns might also emerge of age groups that were less confident in taking the vaccine. Regarding the convenience of being vaccinated, it was important to understand the barriers to access and to work with affected groups to minimise barriers. This might involve making the vaccination experience accessible for people with disabilities, or ensuring vaccination sites were easy to reach by public transport. Regarding complacency, there was a need to understand complacency in some groups and develop solutions. Young people might be more likely to be complacent about taking up the vaccine. There was a comprehensive action plan and Equalities Impact Assessment (EIA) for the three Cs.

     

    3.    The Associate Director of Communications and Engagement added that a video had been produced in Urdu with the help of the imam at a mosque in Woking, and it was hoped that a trusted, local leader would help encourage people to come forward for the vaccine. A vaccination site had also been set up at this mosque. There was a Gypsy, Roma and Traveller community service lead, who was working to develop a video of someone from within that community having their vaccine. Moreover, Surrey Heartlands was working with Surrey Care Association to dispel some common misconceptions and answer questions for care home staff. There were care homes that had vaccinated every member of staff, and those could be used  ...  view the full minutes text for item 15/21a

15/21b

FRIMLEY HEALTH AND CARE COVID-19 VACCINATION PROGRAMME pdf icon PDF 519 KB

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    Purpose of the item: To update the committee on the status of the Frimley Integrated Health and Social Care System Covid-19 Vaccination Programme

    Additional documents:

    Minutes:

    Witnesses:

    Sarah Bellars, Executive Director of Quality and Nursing, and Director of Infection, Prevention and Control, Frimley Collaborative

    Paul Corcoran, Senior Quality Manager, Frimley Collaborative

    Ruth Hutchinson, Director of Public Health, Surrey County Council

     

    Key points raised during the discussion:

    1.    A Member noted that it had recently been announced in the media that the Pfizer/BioNTech vaccine could be stored at standard pharmacy freezer temperatures (originally, it had been thought that it had to be stored at extremely low temperatures). Would this discovery affect the rollout of the vaccine? The Executive Director of Quality and Nursing replied that the Frimley Collaborative received its direction from NHS England, and it had not received any direction regarding a change in the Pfizer/BioNTech storage temperature, so the vaccine continued to be stored at very low temperatures in accordance with official guidance.

     

    2.    A Member asked what the response of BAME communities had been to the vaccination programme. The Executive Director of Quality and Nursing stated that the Frimley Collaborative had been working on uptake and health inequalities from the start of the vaccination programme. It was important to adapt to different communities. The Frimley Collaborative had been successful in its work with BAME communities with regards to the vaccine so far.

     

    3.    A Member enquired how successful the programme had been in care homes in the Frimley area. The Executive Director of Quality and Nursing said that Frimley had been part of the national pilot in care homes and that all care home residents in the area had been offered the vaccine by the end of January 2021, well before the deadline of 15 February 2021.

     

    4.    A Member asked what Frimley’s approach was to vaccinating people with learning disabilities and autism. The Executive Director of Quality and Nursing responded that steps had been taken such as simplifying settings for people with learning disabilities, utilising national tools such as easy-read materials and making the vaccination sites a comfortable, safe environment.

     

    5.    A Member requested more information on how hard-to-reach people were being reached for vaccination. The Executive Director of Quality and Nursing replied that a meeting had been held in a community hall to understand vaccine hesitancy amongst the Gypsy, Roma and Traveller community, and insights from that meeting had been taken on board. Also, vaccines for homeless people were being brought forward in terms of priority, in order to offer vaccinations to homeless people when they were more accessible during the period of cold weather. The Senior Quality Manager added that in the Surrey Heath area (at the Lakeside site), special clinic sessions with fewer attendees and more allocated time had been set up especially for clinically extremely vulnerable people who might be concerned about attending busy clinic sessions.

     

    6.    A Member stated that there had been some publicity encouraging people who were not registered with a GP to come forward for a vaccination; this message seemed to have fallen away recently. Should this message be reintroduced? The Executive  ...  view the full minutes text for item 15/21b

16/21

GENERAL PRACTICE INTEGRATED MENTAL HEALTH SERVICE OVERVIEW AND SERVICE MODEL pdf icon PDF 1 MB

    Purpose of the item: To provide the Adults and Health Select Committee with a detailed report on the General Practice Integrated Mental Health Service (GPIMHS).

    Additional documents:

    Minutes:

    Witnesses:

    Georgina Foulds, Associate Director for Primary and Community Transformation, Surrey and Borders Partnership

    Rebecca Isherwood-Smith, Interim Mental Health Programme Lead, Surrey Heartlands

    Dr David Kirkpatrick, Clinical/Managerial Lead (Integrating Primary and Mental Health Care), Surrey and Borders Partnership

    Dr Maria Nyekiova, GP Partner and Mental Health Lead for COCO Primary Care Network

    Paris Wilson, GPIMHS Service User

     

    Key points raised during the discussion:

    1.    The Clinical/Managerial Lead introduced the report, emphasising the importance of configuring mental health services in a way that was not harmful itself to service users’ mental health (for example, a high threshold for access to the service could cause deterioration of the mental health of someone who has just failed to meet the threshold). The introduction of the General Practice Integrated Mental Health Service (GPIMHS) aimed to help resolve this. The quality of service users’ experience of accessing care was as important as the quality of the care that they were accessing. Social determinants of mental health could not be resolved by the mental health foundation trust alone; this must also involve the community. Surrey was fortunate to have a high standard of mental health services in general and strong links between partners, including the voluntary sector and primary care.

     

    2.    The Clinical/Managerial Lead continued to explain that it was important to have good mental health services in place in GP surgeries so that mental health issues could be recognised at the first point of contact and in order to ensure primary care staff felt supported with the skills to provide mental health support. GPIMHS would allow residents to go to a GP surgery and quickly have access to a mental health professional or Community Connector without having to reach a high threshold. GPIMHS was part of a vision for a ‘no wrong door’ system; in other words, the idea that residents would be able to access consistently high-quality mental health services by presenting initially anywhere in the system. The Clinical/Managerial Lead showed a case study, which illustrated the experience of a GPIMHS service user who was able to access help quickly and felt well-informed. Also, carers were an important part of mental health services, and were often not taken into account as much as they should be. Whether the service user had a carer or was a carer – including a young carer in particular – would always be taken into account as part of GPIMHS.

     

    3.    The GP Partner and Mental Health Lead for the COCO Primary Care Network (PCN) stated that prior to GPIMHS, many patients would experience a disconnect between the criteria for different services, meaning they would become stuck in a cycle and struggle to access the support they needed. GPIMHS, on the other hand, provided a useful bridge between primary care, secondary care and the community, and would hopefully resolve this disconnect. GPIMHS allowed for communication between multiple agencies – including, for example, substance abuse services and housing services – and could therefore be tailored to service users’ individual needs.  ...  view the full minutes text for item 16/21

17/21

UPDATE ON THE IMPLEMENTATION OF MENTAL HEALTH TASK GROUP RECOMMENDATIONS pdf icon PDF 272 KB

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    Purpose of the item: To provide the Adults and Health Select Committee with an update on progress in implementing the recommendations of the Mental Health Task Group, which was established to map the individual and carer’s journey through adult mental health services in Surrey.

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adult Social Care, Public Health and Domestic Abuse

    Stephen Murphy, Head of Mental Health Commissioning (Adult Services), Surrey Heartlands

    Liz Uliasz, Assistant Director of Mental Health, Surrey County Council

     

    Key points raised during the discussion:

    1.    The Chairman of the Select Committee informed those present that she had sent a letter to the Secretary of State for Health and Social Care on the work of the Mental Health Task Group and the possibility of further progress in this area. The letter is annexed to these minutes.

     

    2.    A Member asked how voluntary sector organisations were responding to the work that had arisen from the work of the Task Group, and whether they had seen any changes arising from it. The Assistant Director of Mental Health replied that the work of the Task Group had focused attention on what needed to be delivered and raised the profile of mental health. The Cabinet Member for Adult Social Care, Public Health and Domestic Abuse added that the Task Group’s focus on the issue of commissioning of voluntary sector mental health services was important and had ensured a better approach.

     

    3.    The Chief Executive Officer of the Mary Frances Trust emphasised the usefulness of the Task Group’s recommendations and stated that voluntary sector organisations were now being included more widely in work with NHS- or Council-run mental health organisations. However, there was still more work to be done, particularly around the commissioning of services; sometimes contracts and conditions were still not adequate from the point of view of voluntary sector organisations. Overall, though, a change had been made and voluntary sector organisations wished to see a continuation of this direction of travel. The Cabinet Member stated that it was important to note that longer-term contracts did not suit all providers; some providers preferred the flexibility of shorter-term contracts. In future, there would be a tailored approach to all contracts.

     

    4.    The Head of Mental Health Commissioning (Adult Services) emphasised the value of voluntary sector organisations, particularly with regards to patient experience. The possibility of a forum of providers was being considered.

     

    5.    A Member requested an update on the workforce resilience hub mentioned in the report. The Head of Mental Health Commissioning responded that the hub had originally been set up to in response to the Covid-19 pandemic, during which many health and social care staff had experienced extreme stress. The hub had started by primarily offering psychological therapies and had since been expanded to offer peer support. It was important to acknowledge that people often sought mental health support after the event and the service was mindful of the need to prepare for this. Also, the IAPT (improving access to psychological therapies) service offered mental health support to as many people as needed it.

     

    6.    A Member enquired whether there would be mental health training for Members during the induction after the May 2021 local government election. The Cabinet Member acknowledged the importance of keeping the  ...  view the full minutes text for item 17/21

18/21

ADULT SOCIAL CARE DEBT pdf icon PDF 156 KB

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    Purpose of the item: To update the Adults and Health Select Committee on Surrey County Council’s Adult Social Care Debt position as at the end of December 2020.

    Additional documents:

    Minutes:

    Witnesses:

    Toni Carney, Head of Resources, Adult Social Care

    Pamela Hassett, Lead Manager (Financial Assessment and Income Collection), Adult Social Care

    Sinead Mooney, Cabinet Member for Adult Social Care, Public Health and Domestic Abuse

     

    Key points raised during the discussion:

    1.    The Head of Resources gave an overview of the report. Income from collection of care charges from clients represented a significant section of the Adult Social Care (ASC) budget. There had been a reduction on income collected in this area this year compared to last year, which was largely due to the impact of the Covid-19 pandemic and the new discharge to assess model. It was important to note that the majority of people paid their care charges promptly. Direct Debit was the service’s preferred method of collection, which was more popular with people whose charges were regular and consistent, and less popular with those whose charges fluctuated. The rate of Direct Debit use to pay care charges had remained static at 64%. The actual amount of debt overdue currently stood at circa £17m, but a large proportion of that amount was secured against property.

     

    2.    The Head of Resources continued to explain that the ASC income collection team had good working relationships with the Legal services, with whom they worked to recover debts. The Council had started using Money Claims Online, a service provided by HM Courts and Tribunals for claimants and defendants to make or respond to a money claim, and had had good results so far. This service would continue to be used for debts under £10,000. Also, the Council had employed Judge and Priestley Solicitors to work on 10 cases. The firm’s specialist skills would help the Council with probate work, and the early indications were that the work with Judge and Priestley was going well.

     

    3.    A Member requested that officers report back on the work with Judge and Priestley Solicitors once this had progressed.

     

    4.    A Member asked what could be done to increase the proportion of people who paid by Direct Debit above the 64% figure. The Head of Resources stated that, when conducting a financial assessment with a resident at the beginning of the care charges process, the officer conducting the assessment would always mention the Direct Debit option to the resident. Often people did not actually sign up to a Direct Debit at that stage, as they did not yet know the charges they would pay, but it was mentioned then and continued to be mentioned at every stage in the process. There were understandable reasons why someone might not want to pay by Direct Debit; for instance, if someone’s care charges fluctuated, they may not want to use Direct Debit, and for some people having to pay a Direct Debit every month could be a financial worry. Residents could now pay care charges over the telephone, and the Council was looking at this and other ways to encourage payment in instances when residents preferred not to use Direct  ...  view the full minutes text for item 18/21

19/21

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 24 KB

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    Purpose of the item: For the Select Committee to review the attached recommendations tracker and forward work programme, making suggestions for additions or amendments as appropriate.

    Additional documents:

    Minutes:

    The Select Committee noted the Recommendations Tracker and the Forward Work Programme.

     

    The Chairman of the Select Committee requested that, as much as possible, the recommendations and actions were responded to within this Council term (before 6 May 2021).

20/21

DATE OF THE NEXT MEETING

    The next public meeting of the committee will be held on 14 July 2021 at 10:00am.

    Additional documents:

    Minutes:

    The next meeting of the Adults and Health Select Committee would be held on 14 July 2021.