Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 29 January 2020.

The Minutes (copies of which had been circulated) of the meeting held on 29 January 2020 were approved as a correct record and signed by the Chair.

Councillors and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

No declarations of interest were made.

To receive any announcements from the Chair on matters related to the activity of the Board.

The Chair welcomed everyone to the first meeting of the Health and Wellbeing Board for 2020/21 and thanked the previous Chair, Councillor McGee for his previous work and commitment for the last four years to the Board.

The Chair, also expressed thanks and gratitude on behalf of the Board to all the teams across Stockport for the response, work and commitment to the care and support of the residents during the period of the coronavirus pandemic.

The Chair, reminded the Board about the plans and priorities of the Board going forward and re-enforced the Board’s current position and its efficacy and partnership working across Stockport including health inequalities and those affected by the Pandemic including carers and local residents. She emphasised that there is a strategy in place and it was the responsibility of the Board to monitor this strategy.

To consider a summary of the current Covid-19 position.

The Director of Public Health and the Deputy Chief Executive made a joint presentation to the Board (copies of which had been circulated), providing a Covid-19 update.

Board members welcomed the Covid-19 update and appreciated the local information and data provided in the report. It was noted that the response in Stockport to the Covid-19 pandemic was quick, positive and well received by local residents and businesses and that the primary care sector also responded quickly and created a lot more collaborative work across the sectors.

Comments were made relating to local residents and patients not visiting GP surgeries at the moment due to the fear of contracting Covid-19 and plans were being put in place to raise awareness and encourage patients accordingly. It was also stated that consideration should be given to priorities and types of services across the integrated health and care system and what may be discovered post Covid-19 relating to the health and wellbeing of the residents and patients as they react differently.

RESOLVED – That the update be noted.

To consider a report of the Care Quality Commission relating to Stepping Hill Hospital.

The Director of Adult Social Care submitted a report (copies of which had been circulated) relating to Stepping Hill Hospital and the Care Quality Commission.

The following comments were made/issues raised: -

·         CQC identified failings at the Trust in 2017, as a result a new Chair was appointed and an interim Chief Executive in 2018 who put things in place to address those failings

·         The permanent new Chief Executive started at the Trust in January 2019 and immediate weaknesses were identified with some of the governance and corporate functions and an independent review was requested which pre-dated the CQC.

·         The Trust were in the process of making changes and the CQC shined a light on mental health, substance and drug abuse and a lot has been done to address the issues raised and a very detailed action plan is in place.

·         Quality Risk Summit had been held in February 2020 discussing mental health with vulnerable adults and children and young people. An improvement board was established with a wide improvement programme now in place.

·         Mental Health expert has been appointed working with the Trust and Pennine with a focused approach to training and understanding to build the skills to look after the patients.

·         Action plan has also been created for emergency services.

·         It was also noted that the good news stories should be advertised publicly in the wider press and social media to highlight the good work being done at the Trust.

RESOLVED – That the update be noted.

To consider a verbal update from the Chief Executive of Stockport NHS Foundation Trust.

The Chief Executive of Stockport NHS Foundation Trust provided a verbal update relating to Stepping Up Non-Covid work and highlighted the following: -

·         Kept urgent operating running throughout, with operating lists ongoing;

·         The focus is on Covid-19

·         Cancer patient operations have resumed and 20 have been completed to date in the ‘ultra green’ area of the Trust;

·         Risk assessing a multi-disciplinary team so patients go to where the capacity is needed;

·         There has been a suppression on demand, but it is slowly increasing;

·         Elective care has been a challenge but that is the case across the country;

·         Working through the best ways to bring back services on stream and looking at the risks and benefits in detail; and

·         Covid-19 was still dominating  the ways of working across the Trust.

RESOLVED – That the verbal update be noted.

To consider a report of the Accountable Officer, Stockport CCG.

The Accountable Officer, Stockport CCG submitted a report (copies of which had been circulated) relating to an update of the Primary Care and Neighbourhoods.

The following comments were made/issues raised: -

·         Links well with the ambition of the Council and the wider services around the community focus to bring it all together.

·         The opportunities it has presented for prevention for all the pathways to have a strong focus.

·         There was appetite for things to be done and to build the relationships to work together.

·         The impact of the voluntary sector has been phenomenal and have the willingness to do things and focus on the work.

RESOLVED – That the report be noted.

To consider a report of the Director for Adult Social Care.

The Director for Adult Social Care submitted a report (copies of which had been circulated) relating to the Care Home Support and Recovery.

The following comments were made/issues raised: -

·         The Council don’t own the Care Homes, they are all privately and independently owned, but the Council were responsible for commissioning support for individuals accordingly.

·         61 registered homes in Stockport providing 2,223 beds at any point, with 88% resource in Stockport being rated good or outstanding through the CQC rating, being the highest performer in Greater Manchester and 3^rd in the North-West.

·         Pre-Covid-19 pandemic the bed occupancy levels across was up to 97%, however, the latest position has reduced to 87% which has an impact on the individuals who are no longer in the care home and questions the financial sustainability of those care homes.

·         There was a national crisis with PPE, so Stockport worked with GM to  source PPE locally, with an emergency supply being kept at Stockport.

·         There was a single point of contact for care homes in terms of urgent care provided by ‘master call’.

·         Testing has now been established and was available to care homes who were symptomatic and now moved onto staff and residents having worked through 60 of the 61 care homes.

·         Occupancy levels and financial stability were a concern, but Stockport continued to received requests from care homes and on a daily basis addressed those requests for £1.5m additional costs incurred. The Council’s offer from Government to respond to Covid-19 was £16m across the full Council impact.

·         The Government’s announcement for aid for Care Homes was £600m for infection, protection & control with Stockport’s share being £3.1m.

·         The Council has written to Care Homes to honour and pay for the beds at the Council’s usual price which equates to 90% occupancy level of the Care Homes to ensure some financial stability.

·         There may be an opportunity to look at other models across the country involving technology to do things even better.

RESOLVED – (1) That the report be noted.

(2) The Board expressed its thanks to the partners across the sector and the care staff for the commitment and time taken looking after the residents of the care homes across Stockport.

To consider a report of the Director for Public Health.

The Director of Public Health provided a verbal update relating to the next steps of the infection control and managing track and trace and the following was highlighted:-

·         Expressed thanks to the staff from the CCG, Public Health and the Council who were involved in the setting up of the testing arrangements between the CCG and the Council and Public Health.

·         Management of the outbreak and track and trace is now well underway with testing in place and though there are restrictions, alternative options are being rolled out to include walk-ins and not just drive-through.

·         Responsibility for all agencies involved to self-isolate if symptomatic for the advised timeframe to reduce the spread of Covid-19.

·         Single point of contact established, with standing operating procedures and a management plan in place with scenario planning for every scenario.

·         Key messages should be adhered to including 2-metre social distancing and washing of hands which would reduce the risk and spread of Covid-19.

RESOLVED – That the update be noted.

To consider a report of the Director of Public Health.

The Director of Public Health submitted a report (copies of which had been circulated) relating to the emotional wellbeing and mental health support in Stockport.

It was noted that most people in any emergency would experience some sort of stress and it is currently a challenging time and would cause additional distress. As a result of the longstanding partnerships with other organisations across Stockport information has been collated and a booklet has been produced and would be available on the website with all the services available and accessible across Stockport.

It was also stated that consideration would need to be given to the demand on services late summer and early autumn and the type of response that would be required and how would that response would look that post Covid-19.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health

The Director of Public Health submitted a report (copies of which had been circulated) relating to the effect of the Covid crisis upon homeless people locally, across Greater Manchester and nationally.

It was noted that the focus was upon minimising infection risk within the borough’s temporary accommodation schemes and seeking to place as many rough sleepers as possible. Steps were also being taken to improve the support and address the areas of concern. It was also stated that Greater Manchester were trying to keep it together through a funding support programme and looking at the areas beyond rough sleeping including domestic abuse and homelessness which was being monitored by the Stockport Homes and Strategic Housing group as part of the Domestic Abuse Covid Group.

RESOLVED – That the report be noted.

To consider a report of the Director of Children’s Services.

The Director for Children Services submitted a report (copies of which had been circulated) relating to the SEND update.

The following comments were made/issues raised: -

·         The report was a high level report with a lot of detailed information that supported it;

·         There were initially twice daily briefings and governance discussions with senior leaders in the authority;

·         A new Wellbeing Hub and SEND Hub was launched to provide a single point of contact to access emotional wellbeing information; and

·         A detailed action plan has been created that identifies areas of action and detailed supported information.

·         Governors and headteachers were impressed with the feedback and reviews regarding EHCP.

 RESOLVED – That the report be noted.

To consider a report of the Director of Children’s Services.

The Director for Children Services provided a verbal update relating to return to school.

It was noted that the from the 22 March 2020, schools would have only remained open to vulnerable children or children with a EHCP and the vast majority of schools remained open over the Easter holidays and Good Friday and more recently a gradual introduction of Reception, Year 1 and Year 6 and then Years 10 and 12 for Secondary Schools. There is now a variety of different situations across the primary schools, but Stockport would be supporting the schools as best possible but respecting the decisions of the schools.

RESOLVED – That the update be noted.

To consider a report of the Accountable Officer, Stockport CCG.

The Accountable Officer, Stockport CCG submitted a report (copies of which had been circulated) relating to the Learning Disabilities Mortality Review (LeDeR) Annual Report for 2019/20 and highlighted the following:-

·         Most of the reviews were graded good or satisfactory care and there were only two reviews that graded carers below the acceptable standard of practice out of 15 reviews which were completed with another 15 reviews in progress.

·         Emerging themes include positive practice for good uptake of health checks for people with learning disabilities and evidence around the active medication reviews in primary care and co-ordinated works.

·         Challenges for people have been around the inconsistent application of the Mental Capacity Act, inconsistent documentation of assessment and care plans and the reasonable adjustments not being utilised or considered.

·         Communication challenges between agencies including delays in pathways.

It was commented that in light of the challenges and concerns raised how would it be monitored and what action would be taken. It was noted that there was a LeDeR Steering Group with different representation who own the action planning and seeks assurance from the various agencies relating to the actions.

RESOLVED – (1) That the report be noted.

(2) That an update on the progress of the actions relating to the LeDeR Review be submitted to the Board in six months.

To consider a report of the Director of Public Health.

The Director of Public Health submitted a report (copies of which had been circulated) providing an overview of the progress on delivery of the 2020 Joint Strategic Needs Assessment (JSNA) and proposed changes to the work plan and focus of this JSNA following the coronavirus pandemic.

It was noted that the results of the JSNA would continue to be impacted by Covid-19 and would have a direct impact and change the findings of the JSNA going forward. It was also stated that the results would be published as it is and an additional piece of work would be done relating to Covid-19, looking at future waves and different ways of working. This work would be collated and presented to the Board at a future meeting.

RESOLVED – (1) That the report be noted.

(2) That a report be submitted to a future meeting of the Board relating to the work being done with the impact of Covid-19.

To consider a report of the Deputy Chief Executive.

The Board is invited to give consideration to possible topics for further consideration during the 2020/21 municipal year.

Officer contact: Charles Yankiah, 0161 474 3206, charles.yankiah@stockport.gov.uk

A representative of the Deputy Chief Executive submitted a report (copies of which had been circulated) setting out planned agenda items for the Health and Wellbeing Board’s next meeting.

RESOLVED – (1) That the report be noted.

(2) That the Deputy Chief Executive be recommended to programme the following items into the Health and Wellbeing Board’s work programme for the 2020/21 Municipal Year:-

·         CQC Report

·         JSNA Update on the impact of Covid-19

·         LeDeR Review Action Plan update