Agenda and minutes

To note any apologies for absence.

Apologies were received from Cllrs Stephen Hirst and Susan Williams.

To report any declarations of interest.

No declarations of interest were made at the meeting.

To confirm the minutes of the meeting held on 5 March 2024.

The minutes of the meeting held on 5 March 2024 were noted and agreed as a confirmed record of that meeting.

A presentation on the Trading Standards Animal Health Plan and Public Health Communicable Disease Plan. A joint presentation from the Trading Standards and Public Health Teams on Zoonotic Disease Enforcement, including actions to respond in the event of an outbreak. 

Please refer to the report to be considered under item 7 of the agenda (Chief Fire Officer Report) for information on this item.

5.1 Members received a comprehensive presentation on the Trading Standards Animal Health Plan and Public Health Communicable Disease Plan. The presentation was a joint presentation from the Trading Standards and Public Health Teams on Zoonotic Disease Enforcement, including planned actions to respond in the event of an outbreak of a disease.

5.2 To view the report and presentation published with the agenda, please refer to the link here.

5.3 In addition to the slide show presentation for this item, members were asked to note pages 38 to 43 of the agenda pack and the Trading Standards update included in the Chief Fire Officer Report.

5.4 Disease Control Plans are updated locally in conjunction with the local resilience forum and Gloucestershire County Council’s emergency planning team. Plans are tested on a regular basis via multi-agency table-top exercises. The exercises allow for “worst case” scenarios, virtually responded to by all relevant agencies, identifying any requirements to improve or edit the plan and to ensure that all partners are aware of their roles and responsibilities.

5.5 The Gloucestershire ‘Communicable Disease Plan’ (CDP) provides a pre-determined multi-agency response to communicable disease incidents and outbreaks that occur across Gloucestershire. The plan outlines logistical arrangements and options for accessing and mobilising health protection resources as required to implement effective health protection control measures.

5.6 The plan does not, however, seek to replicate or supersede existing arrangements to respond to major incidents, neither does it cover the management of common communicable disease control activities routinely undertaken by health protection teams associated with the UK Health Security Agency as part of their normal working practice. It was explained that it was important to note that not all exposures to zoonotic disease required activation of the Communicable Disease Plan.

5.7 The decision to establish an Incident Management Team (IMT) meeting is taken based on an assessment of risk by the UK Health Security Agency and the Local Authority Director of Public Health (or nominated deputies).

5.8 The Gloucestershire Local Resilience Forum Plan was tested in October 2023, with participation from a large number of stakeholders across health, care, local authorities and regional experts. An example of Avian Influenza exposure in humans was one of the scenarios tested at this time.

5.9 Members enquired how prepared the county was to respond to a disease outbreak. Officers informed members that those teams involved in responding to an outbreak were in constant discussions with the UK Health Agency and with Defra on the issue.

5.10 In addition, key data and information relating to the potential risk of an outbreak was under constant review. One factor associated with an increased risk of an outbreak is reflected by population increase. As the county becomes more densely populated, so does the risk of disease. Members were assured that the county had very good surveillance and was hyper-sensitive to potential risks and visible signs of an outbreak.

5.11 It was confirmed that the restrictions imposed in 2023 in response to a potential avian flu outbreak  ...  view the full minutes text for item 4.

To note the Adult Social Care and Communities Performance Report 2023/24 (Quarter 3) detailing performance for the period October to December 2023 (report attached). The report to be taken as read and noted at the meeting.

5.1 The committee noted the Adult Social Care and Communities Performance Report 2023/24 (Quarter 3) detailing the performance of Adult Social Care Services for the period October to December 2023. The report was taken as read at the meeting.

5.2 To view the report and presentation published with the agenda, please refer to the link here.

5.3 Noting comments about some of the performance data reported at the meeting, it was suggested that it might be useful to review current ‘Key Performance Targets and Indicators’ on which the performance of the council’s adult social care services is measured for relevance and usefulness, and this was agreed.

5.4 Areas of specific focus identified at the meeting as requiring further scrutiny/monitoring included ‘NHS care related targets’ for which data provided by the Gloucestershire Health and Care NHS Foundation Trust was pivotal. Other areas of focus included domiciliary care, provision and availability of care homes in the county, vaping in older people and child obesity.

5.5 Members were asked to consider and make notes on the Market Position Statement published with the agenda for the Cabinet meeting on 15 May 2024, (for consideration the following day). A detailed presentation on the Market Position Statement would be considered at the ASCC meeting on 23 July 2024. Action by - ASCC

5.6 Noting questions about integrated brokerage arrangements and the decision to centralise the brokerage of respite/bed-based care taken in September 2023, it was suggested that a more detailed update be included in the Adult Social Care update report for consideration by the committee at the 23 July meeting. Action by – Adult Social Care Team

The report was noted.

An overview of information on matters relating to the portfolio of services delivered by the Chief Fire Officer of the Gloucestershire Fire and Rescue Service and within the remit of the Gloucestershire County Council’s Adult Social Care and Communities Scrutiny Committee, (Trading Standards and Coroner Services). The report will be taken as read and any highlighted information noted at the meeting.

Members will have an opportunity to ask questions on the contents of the report.

6.1 The committee received an overview of information on matters relating to the portfolio of services delivered by the Chief Fire Officer of the Gloucestershire Fire and Rescue Service and within the remit of the Gloucestershire County Council’s Adult Social Care and Communities Scrutiny Committee, (Trading Standards and Coroner Services). The report was taken as read at the meeting.

6.2 To view the report and presentation published with the agenda, please refer to the link here.

6.3 It was reported that the Gloucestershire Coroner’s Service would be submitting funding bids for consideration as part of the Medium-Term Financial Statement process 2024/25. The funding would be allocated towards seeking additional urgent staffing resources from which to ease current and ongoing pressures. In addition, it was hoped the bid would secure additional funding to add to the baseline budget to cover inflationary, price-inelastic cost increases affecting the service.

6.4 Current service delivery risks included: -

       i.       Lack of duty pathologists available to undertake Coronial post-mortem work remains the highest current risk to the service.

      ii.      Coroner’s officers working to full capacity and at levels not seen before.

      iii.      Specific incidents leading to the suspension of service, reputational damage, closure of complex authority to conduct post-mortems removed.

      iv.      Injuries to mortuary staff and reduced ability to move deceased around complex.

      v.      Ongoing risks to Gloucestershire County Council from incurring significant legal costs, if, or when the HM Senior or Area Coroner’s judicial decisions are challenged. (To date no successful challenge made)

      vi.      Risk of a mass fatalities incident occurring in the County. (Whilst all costs would fall outside the Coronial budget, there would inevitably be a significant knock-on effect on Coronial resourcing and business as usual).

6.5 At the full council meeting on 26 June 2024, a review of the committee terms of refence would be considered. Members to consider proposed changes to the terms of reference as agreed by the County Council’s Constitution Committee on 10 June 2024.

In addition to the proposed changes to the ASCC, (set out below), one member at the Constitution Committee meeting queried the Trading Standards, Libraries and Registration Service and Coroners topics falling within the remit of Adult Social Care and Communities Scrutiny Committee. It was felt the topics might be best placed for discussion at Fire Scrutiny Committee meetings and that the Chairs of both committees have a conversation on the proposal.

The report was noted.

An overview of information on matters relating to the delivery of Adult Social Care in Gloucestershire. The information will be taken as read at the meeting. Members will have an opportunity to ask questions on the contents of the report.

Please refer to Appendix 1 of the report for an update on the Working as One Programme.

7.1 Members received an overview of information on matters relating to the delivery of Adult Social Care in Gloucestershire. The information was taken as read at the meeting. For more details, please refer to the report published with the agenda for the meeting at the link here.

7.2 Members attention was drawn to Appendix 1 of the report and an update on the NHS Gloucestershire ‘Working as One’ Programme. It was explained that the aim of the programme was to co-ordinate health and care for people and to provide support to enable people to stay healthy, recover quickly following an illness, and to ensure that care and treatment was received in the most appropriate place. The comprehensive programme was launched at a system-wide event in September 2023. For more information, please refer to the link here.

7.3 Incorporated within the report was an update on the Care Quality Commission (CQC) assessment of Gloucestershire County Council Adult Social Care Services. Members were informed that on 18 March 2024, as a requirement of the Health and Care Act of 2022, the council had received notification from the Care Quality Commission (CQC) of its intention to assess Gloucestershire’s adult care services.

7.4 Gloucestershire is the first local authority in the South-West Region to be notified of the assessment. At the time of the meeting, it was anticipated the CQC would be on site from mid-May to October 2024, with six weeks’ notice in advance of any onsite visit.

7.5 For more details of the self-assessment process and the councils preparations for inspection, please visit https://www.gloucestershire.gov.uk/health-and-social-care/cqc-assessment-of-gloucestershire-adult-social-care/

7.6 The Executive Director of Adult Social Care, Wellbeing and Communities gave an in-depth update on the development and publication of the Market Position Statement (MPS) for Gloucestershire. Following an intensive period of consultation, the MPS was now complete and would be considered at the Cabinet meeting on 15 May 2024. Once approved, the MPS would be published on the County Council website in early June.

7.7 Members were asked to study the document in detail and to submit any questions to jo.moore@gloucestershire.gov.uk before the next meeting. A full presentation on the statement would be made at the ASCC meeting on 23 July 2024.

The report was noted.

An overview of information on matters relating to the delivery of Public Health Services in Gloucestershire. The information to be taken as read at the meeting. Members will have an opportunity to ask questions on the contents of the report.

8.1 Members received an update on matters relating to the delivery of Public Health Services in Gloucestershire. The report was taken as read at the meeting. To view the information report circulated with the agenda, please refer to the link here.

8.2 The Director of Public Health introduced the item with an outline of county-based information and key statistics provided by the Office of National Statistics.

8.3 As reported at previous meetings, members were advised of a drop in the number of people receiving their Measles, Mumps and Rubella (MMR) Vaccination, combined with an increasing number of measles outbreaks in most parts of England, including a small number of cases in the South-West Region and in Gloucestershire.

8.4 The World Health Organisation recommendation is that 95% of the population should receive two doses of the MMR vaccine in order to prevent measles spreading.

8.5 In 2022-23, the average number of children in England (age under 5) reported as having received the vaccine had been 84.5%. The uptake of the vaccine in Gloucestershire had been slightly higher and was now over 90%. There were, however, still pockets of lower uptake, predominantly in central urban areas.

8.6 During the 4 weeks from 25 March 2024, 220 new cases of measles had been reported. This represented an increase on the 191 newly confirmed cases reported for the equivalent period in UKHSA data published on 18 April 2024. The highest number of cases reported had been in the London area, representing 94 of 220 cases, (42.7%), West Midlands, 47 of 220, (21.4%), and the North-East, 23 of 220, (10.5%).

8.7 Between 1 October 2023 and 22 April 2024, there have been 13 confirmed cases of measles in the South-West region. Whilst this represented less than 1.1% of the nationally confirmed cases, and reflected a successful uptake of MMR vaccinations in the county, UKHSA was continuing to work with the ICB, Gloucestershire County Council and with local partners to ensure adequate pathways were in place to respond to cases and potential outbreaks, as required.

8.8 In addition to an increased number of measles outbreaks, there was also a larger than expected number of cases of pertussis, (whooping cough), that had been notified to UKHSA in England. In 2023, there had been 858 new lab confirmed cases of pertussis reported to the UKHSA, whereas in 2024, 555 cases had been laboratory-confirmed in January and 913 cases in February alone.

8.9 It was suggested that intervention measures implemented to help control the spread of COVID-19 between March 2020 and July 2021 might have had an impact on other infectious diseases, including pertussis. Consequently, pertussis activity has been exceptionally low across England since April 2020. The current rise in the number of pertussis cases had just become a national exceedance, with cases now slightly higher than pre-pandemic levels. 

8.10 Pertussis is most likely to cause severe illness in young babies. It is therefore critically important to promote vaccination in pregnancy as key to passively protecting babies before  ...  view the full minutes text for item 8.

To suggest items for consideration at future meetings.

Members will have an opportunity to review the work of the committee during the past council year, 2023-24, and to make any recommendations for items the committee may wish to consider in 2024-25. Officers to advise of matters that may be of interest to the committee or require members views. Please refer to the attached summary work plan.

9.1 As the final meeting of the committee under the current membership, members were asked to reflect on items considered at meetings during 2023-24 and to put forward items for consideration by the new committee at its first meeting in July.

9.2 The committee was advised of a dementia awareness training session for all members scheduled to follow on after the Adult Social Care and Communities Scrutiny Committee meeting on 10 September 2024.

23 July 2024

10 September 2024

12 November 2024