Agenda and minutes

Chairman of the Adult Social Care and Communities Scrutiny Committee, Cllr Stephen Hirst, and Chairman of the Health Overview and Scrutiny Committee, Cllr Brian Robinson, to welcome everyone to the committee and explain the purpose of the meeting.

To note any apologies

Chairman of the Adult Social Care and Communities Scrutiny Committee, (ASCC), Cllr Stephen Hirst, and Chairman of the Health Overview and Scrutiny Committee, (HOSC), Cllr Brian Robinson, welcomed everyone to the meeting. Making reference to the mutual interest of the two committees in considering the response to the Covid-19 emergency, Cllr Hirst outlined the purpose of holding a joint meeting.

Sarah Scott attended the meeting as Executive Director of Adult Social Care and Public Health at Gloucestershire County Council, (having taken over the role of Executive Director for Adult Social Care and Communities from Margaret Willcox, who had recently retired from the County Council). It was noted that Sarah Scott, (in her role as Director of Public Health), had also attended the HOSC meeting on 17 November 2020, giving scrutiny members an opportunity to ask questions on public health related issues at that meeting.

Apologies were received from Cllr Phil Awford, (a member of the Adult Social Care and Communities Scrutiny Committee).  Cllr Brian Tipper represented Cllr Awford at the meeting.

To declare any pecuniary or personal interests relating to specific matters on the agenda.

Please see the information section at the end of the agenda

No declarations of interest were made at this meeting.

To confirm the minutes of the Adult Social Care and Communities Scrutiny Committee meeting on 10 November 2020 (Members of the Adult Social Care and Communities Scrutiny Committee only)

The minutes of the Adult Social Care and Communities Scrutiny Committee meeting held on 10 November 2020 were confirmed and agreed as a correct record of that meeting.

An update from the Executive Director of Adult Social Care and Public Health at Gloucestershire County Council on the response to the COVID-19 Emergency.  

A Covid-19 intelligence summary update will be circulated prior to the meeting to provide members with the latest information.

Sarah Scott, Executive Director of Adult Social Care and Public Health, (Gloucestershire County Council), gave a detailed update on the Gloucestershire response to the Covid-19 Emergency.

A Covid-19 intelligence summary update, (detailing performance indicators for the period 14 to 21 January 2021), had been circulated on the morning of the meeting, providing members with the latest information. The intelligence document is attached to the minutes of the meeting.

Included in the summary information, were performance updates relating to; the number of Covid-19 confirmed cases for the county, the number of hospitalisations, including the number of patients in critical care; the number of death (Covid-19) registrations made during the past 7 days; the number of excess deaths in the county; the number of Covid-19 confirmed cases in care homes, (staff and resident), an update on the South-West R value range; and an overview of Gloucestershire and National Performance Indicators, including comparisons between Gloucestershire and its geographical neighbours.

The Executive Director ofAdult Social Care and Public Health, (with input from NHS staff), introduced the update report and clarified the following information: -

a)    Referencing the high number of Covid-19 cases in the Gloucester City area, a local member asked what was being done to manage the situation? It was confirmed that Gloucester City had experienced a high number of cases, but that this had started to reduce. Working with Gloucester City colleagues, local leaders and community representatives, the public health team hoped to gain a better understanding of some of the behaviours that may have created this surge, particularly among Black and Asian Minority Ethnic Groups (BAME). To address some of the challenges brought about by communication issues with people from BAME communities, it was agreed strong messages of support and reassurances would be vital in developing confidence and building trust.

b)    A member referred to reports via social media suggesting evidence of low transmission levels in outdoor locations. Questioning how this might impact on the easing of restrictions for the county, members were informed that, whilst ventilation helped to reduce the transmission of the virus, it was still important to adhere to hand washing/face mask and social distancing guidelines. Acknowledging concerns about the impact of the pandemic on the local economy, the Executive Director reinforced the need to balance decisions being taken to protect lives with the easing of restrictions to re-energise tourism.

c)    Another member stressed the need for more in-depth data to enable better understanding of the variances in infection rates, particularly in relation to specific age groups. The Executive Director reported that the public health team continued to work under very difficult circumstances to analyse the data available to them. It was not an easy task, particularly given the wide range of underlying factors and large numbers of asymptomatic people in the county. The work was ongoing and it was hoped additional funding would enable the council to invest more resources into this work.

d)    Enquiring about the levels of infection in school children,  ...  view the full minutes text for item 4.

A verbal update from the NHS Gloucestershire Clinical Commissioning Group (GCCG)

Mary Hutton, (representing GCCG and One Gloucestershire Integrated Care System), presented a summary of current issues relating to the Covid-19 virus.

Expanding on the update presented earlier in the meeting regarding the Covid-19 vaccination programme, it was confirmed that vaccinations were being administered via 10 Primary Care Network hubs located across the county, (including a fire station in Cheltenham), by Gloucestershire Hospital NHS Foundation Trust (GHT) and Gloucestershire Health and Care (GHC).

Based on data reported from the start of the roll out in December to 22 January 2021, 71,000 vaccinations had been administered to people from the first 4 national priority groups, including; care home residents and staff; people aged 70 and over; frontline health and social care staff; and people classified as clinically extremely vulnerable. 85% of residents aged 80 plus and all care homes, (excluding 3 care homes with a confirmed outbreak of Covid), had been vaccinated. Gloucestershire CCG was following the national directive of pausing the roll out of the second vaccination to enable more people receive their first vaccine.

At the time of the report, (22 January 2021), Gloucestershire had been at the top of the national league table as the top performing Sustainability and Transformation Partnership/Integrated Care System in England for administering vaccinations. The national target for the top 4 priority groups to be vaccinated was mid-February 2021.

Cllr Stephen Lydon commended the success of the roll out of the vaccine in Gloucestershire and asked how people not registered with a local GP would be vaccinated? Dr Andy Seymour, Clinical Chair for Gloucestershire CCG was able to confirm that a great deal of work, including work with the public health team, was involved in ensuring equitable distribution of the vaccine. NHS England was aware of the issue and hoped to resolve the problem in forthcoming weeks.

Prior to the meeting, Cllr Lydon submitted a couple of written questions, for which written responses had been provided after the meeting. In the first of two questions, Cllr Lydon referred to reports of unused quantities of the pfizer vaccine due to the limited shelf life of the vaccine. Cllr Lydon asked to what extent was this an issue in Gloucestershire and what was being done to address the problem. In a written response, members were assured that it was the CCG’s absolute priority not to waste vaccines and that processes were in place to minimise the risk. All vaccination sites held ‘reserve’ lists of people who could be called at short notice if it appeared, towards the end of the day, there might be a surplus of the pfizer vaccine

In a second question, Cllr Lydon reiterated concerns about people not registered with a Gloucestershire GP being eligible for vaccination. These included a large proportion of people working for the NHS and care staff from overseas. Cllr Lydon asked what proportion of Gloucestershire residents were not registered with a GP and what was being done to address the issue, particularly, in relation  ...  view the full minutes text for item 5.

An update from the Gloucestershire Health and Care NHS Foundation Trust

Representatives from Gloucestershire Health and Care NHS Foundation Trust (GHCFT) provided a detailed briefing note on the response to the pandemic. The update was circulated with the agenda and included information on the response to Covid-19, including the care provided to Covid patients in community hospitals across the county.

Trust colleagues were involved in lateral flow testing twice weekly and running the Polymerase chain reaction (PCR) Testing Centre at Edward Jenner for staff and families of GHC, GHT and social care and for people requiring a pre-procedure test.

The provision of Personal Protective Equipment (PPE) to Trust staff remained a key element of the Trust response, as was providing Covid-secure buildings for both staff and patients. Many Trust colleagues continued to work remotely, where possible, to help reduce the risk of spread among teams and services.

The Trust was also involved in leading the development of clinics for people who continued to suffer with Covid symptoms 3 months after diagnosis. The Trust was currently testing a multi-disciplinary approach with colleagues from Gloucester Hospitals and Primary Care with the aim of developing this as a key programme of support in line with national guidance.

The Trust was heavily involved in the roll out of the Covid Vaccination Programme, working alongside the Primary Care Networks and Gloucestershire Hospitals NHS Foundation Trust. In line with the national guidance on the priority groups for vaccination, some Trust colleagues had started to receive the vaccine and had commenced a programme to support the immunisation of its own inpatients, particularly those who are vulnerable due to their complex health needs. A Housebound vaccination programme was being offered.

The Trust continued to focus on the Home First approach and the need to increase the number of discharges from both acute and community hospitals who returned directly to home rather than to a nursing or residential home

Vaccinating Trust colleagues against the flu had been an important consideration this year due to the increased risk of contracting flu and Covid. More than 90% of frontline colleagues had received the flu vaccine. The  Childhood Immunisation Team had worked throughout the winter months in delivering the flu vaccine to all primary school children (Reception to Year 6) and all Year 7 children in secondary school. The majority of immunisations were delivered within schools. At the time of the report, more than 40,016 school children had been vaccinated.

The briefing note was noted.

An update from the Executive Director of Adult Social Care and Public Health on matters relating to Public Health

Sarah Scott, Executive Director of Adult Social Care and Public Health, introduced the Public Health Report.

A member noted the work involved in trialling treatments to prevent individuals from contracting HIV and asked if this work could be coordinated alongside work by Gloucestershire Health Care’s sexual health and advisory service. The request was noted and the Executive Director agreed to make enquires with the current provider. Action by – Sarah Scott

Another member requested an update on sexual health services at the next meeting and this was agreed. An update to be included in the next Public Health report to the committee.

The report was noted.

An update from the Executive Director of Adult Social Care and Public Health on matters relating to Adult Social Care

Sarah Scott, Executive Director of Adult Social Care and Public Health, introduced the Adult Social Care Report.

A member enquired about the impact of increased pressures at work from Covid-19 and the challenges of working in a crisis on the public health team. The Executive Director confirmed that the team was working in extremely difficult conditions. Staff were exceptionally busy and continuing to maintain appropriate standards in spite of the challenges. There were no issues to report at this time.

The report was noted

An update on matters relating to the delivery of services within the Chief Fire Officer (Gloucestershire) portfolio of services, (comprising; Gloucestershire Fire and Rescue Service, Trading Standards, Civil Protection and Coroners Services).

Wayne Bowcock, Chief Fire Officer (CFO) for Gloucestershire Fire and Rescue Service (GFRS), gave a detailed update on current issues/key areas of work within the CFO portfolio of services, including: Fire and Rescue Service, Trading Standards, Civil Protection and Coroners Services.

Updating members on the response to the Covid-19 emergency, the Chief Fire Officer stated that, throughout the national emergency, GFRS had collaborated with GCC colleagues and with regional and national emergency services to support the local community. The actions of GFRS in response to the pandemic had been recognised in a letter from the Fire Minister, Lord Greenhalgh, received in November 2020, following an application to the Fire Covid-19 Contingency Fund.

It was reported that GFRS had been the subject in the ‘first round’ HMICFRS Covid-19 Inspection in November 2020.  During the inspection the following factors had been considered (a) What was working well and what had been learned; (b) How the fire sector had responded to the Covid -19 emergency; (c) How fire services were dealing with the problems they faced; (d) What changes were likely as a result of the pandemic. Although the inspection report was not yet publicly available, it was believed GFRS had performed well and that the report was favourable.

A summary of activities performed by GFRS in response to the pandemic is summarised below:

Community Covid-19 Testing – the recent government announcement that people unable to work from home could access LFD (Lateral Flow Device) testing had created some issues. GCC and GFRS were looking at how this might be implemented. The Operational Resilience Cell, together with colleagues from GCC, Public Health and DHSC were looking to establish a Local Testing Site (LTS) at various locations around the County. This would be a walk-in model to allow people to access a full PCR (Polymerase Chain Reaction) test without the need for an appointment. The first LTS will be located in Gloucester City. A Mass Testing Site at the Royal Agricultural University, Cirencester went live on 3 December 2020, with training and induction taking place in conjunction with colleagues from GCC. GFRS continued to supply staff to deliver this project. In response to rising infection rates, a testing site in Gloucester City had been set up. It was expected that GFRS staff will be involved in the work at this site.

In addition, fire crews were carrying out test & trace welfare checks on residents who had not responded to contact by national or local test & trace services. GFRS was working with Public Health to review the impact of this activity. At least 1000 of these visits had been carried out by GFRS staff.

Covid-19 Vaccinations: Clinical staff inductions had taken place at the Primary Care Networks Vaccination Site at Cheltenham East Fire Station on 2 December 2020. The first Covid Vaccination Clinic had been delivered on 16 December 2020. The site had delivered 330 vaccines each day prior to the Christmas holiday. Capacity was expected to rise to 1000 plus per  ...  view the full minutes text for item 9.

In response to Motion 843: Enabling Road Safety Measures, (considered by full council in September 2029) and the establishment of a Cabinet Panel by the Adult Social Care and Communities Scrutiny Committee in October 2019, Cllr Dave Norman MBE: Cabinet Member for Public Protection, Parking and Libraries, to present the outcome report, (including recommendations), from the Road Safety Cabinet Panel Review.

The report to be noted and any comments to form part of the Cabinet discussion at the Cabinet meeting on 24 March 2021.

The report will be taken as read at the meeting.

Members noted the final report of the Road Safety Cabinet Panel, (introduced by Cabinet Member: Public Protection, Parking and Libraries, Cllr Dave Norman). The report will be presented to Cabinet at its meeting on 24 March 2021. The report can be viewed at the link here

Comments made at the meeting, (in response to the Panel’s recommendations), included i) concerns about the complexities of the Traffic Regulation Order (TRO) process; ii) lack of enforcement in relation to speeding issues; iii) safety concerns about the use of electronic scooters in public places; and iv) the need for increased investment in the council’s road safety budget.

The committee endorsed the report, subject to the comments made at the meeting.

To suggest items for consideration at future meetings, (Adult Social Care and Communities Scrutiny Committee and Health Overview and Scrutiny Committee).