Manchester City Council

Agenda and draft minutes

Agenda and draft minutes

Health Scrutiny Committee - Tuesday, 3rd November, 2020 2.00 pm

Venue: Virtual Meeting - Webcast at - https://manchester.public-i.tv/core/portal/webcast_interactive/485360

Contact: Lee Walker 

Media

Items
No. Item

40.

Minutes pdf icon PDF 297 KB

To approve as a correct record the minutes of the meeting held on 6 October 2020.

Additional documents:

Minutes:

Decision

 

To approve the minutes of the meeting held on 6 October 2020 as a correct record.

 

41.

COVID19 Update pdf icon PDF 151 KB

Report of the Director of Public Health

 

In October the Committee received the latest version of the Manchester 12 Point COVID-19 Action Plan. This report provides a brief update on some aspects of the Plan. In relation to Point 1 of the Plan (Data and Intelligence) the DPH will provide a presentation to the Committee on the latest available information.

 

Appended to this report is a copy of the presentation that will be delivered by the Director of Public Health at the meeting.

 

Additional documents:

Minutes:

The Committee considered a report of the Director of Public Health that described that in October the Committee had received the latest version of the Manchester 12 Point COVID-19 Action Plan. This report and accompanying presentation provided a brief update on some aspects of the Plan.

 

Some of the key points that arose from the Committee’s discussions were: -

 

·         What was the impact of Tier 3 in reducing rates of infection;

·         Did Manchester hospitals still have capacity to deliver non covid related services;

·         Every citizen needed to take personal responsibility to prevent infection by observing Public Health guidance;

·         Supporting the continued work of the Manchester Care Homes Board;

·         Continuing the Committee’s support for increased local control of a Test and Trace service;

·         Noting the introduction of mass testing in Liverpool, would this be introduced in Manchester;

·         Recognising the need to support NHS staff;

·         Recognising the importance for family contact for people living in care homes, particularly for those with dementia;

 

The Director of Public Health responded by stating that the impacts of any restrictions would not be realised for approximately 2-3 weeks later, and this would allow for comparisons to be made. He stated that it was important that all lessons learnt from interventions were understood to help inform and plan for future outbreaks. He supported the comment of the Member regarding personal responsibility for preventing the spread of COVID-19 and commented that the latest lockdown was an opportunity to reduce the rated of infection and strengthen the test and trace service.

 

In response to the question regarding hospital services, the Director of Public Health stated that sites were taking a pragmatic approach to the changing situation. He stated that currently Emergency Services continued to be provided.  Katy Calvin Thomas, Acting Chief Executive, Manchester Local Care Organisation added that there were approximately 300 COVID cases across Manchester hospitals and this was being managed, with additional capacity being created in intensive care settings. She described that work continued with partners to safely discharge patients to release bed capacity in hospitals, with the support of the Manchester Care Homes Board. She stated that the ambition was to maintain all hospital services safely for as long as possible, adding this situation was constantly monitored using the lessons learnt from the first wave experienced in March. 

 

In response to a specific question regarding the management of COVID cases on a general hospital ward, the Director of Public Health described the protocols that were in place to manage these. He further commented that the number of outbreaks in schools had been restricted to single cases or small clusters and he remained confident that schools were COVID secure.

 

The Acting Chief Executive, Manchester Local Care Organisation stated that NHS staff sickness was monitored to ensure staff were safe and a programme of staff testing had been developed.

 

The Executive Director of Adult Social Services acknowledged the importance of maintaining contact for people residing in care homes. She said that work was being developed to support  ...  view the full minutes text for item 41.

42.

Council's Medium Term Financial Plan and Strategy for 2021/22 pdf icon PDF 262 KB

Report of the Deputy Chief Executive and City Treasurer

 

The report will set out the impact of COVID-19 and other pressures and changes on the Council's budget for the period 2021-2025.  It will summarise the savings options under consideration from 2021/22 as well as set out the approach to Equality Impact Assessments and consultation as part of the budget setting process. It also sets out next steps in the budget process, including scrutiny of the draft budget options by this Committee.

 

Separately the report sets out the impact of COVID-19 on the capital programme and the implications for the budget.

 

Additional documents:

Minutes:

The Committee considered a report of the Deputy Chief Executive and City Treasurer that set out the impact of COVID19 and other pressures and changes on the Council's budget for the period 2021-2025.  The report also set out the impact of COVI19 on the capital programme and the implications for the budget.

 

The main points and themes within the report included: -

 

·         The Medium Term Financial Plan remained challenged by uncertainty, which included the outcome of the Spending Review and post 2021/22 the potential changes to how local government funding was distributed;

·         Prior to COVID19 there was an underlying budget gap of c£20m for 2021/22 rising to c£80m by 2024/25;

·         Dealing with the impact of COVID19 had resulted in major spending pressures, particularly in social care, but also across all Directorates;

·         The forecasted budget shortfall relating to COVID19 pressures and the Budget Position 2021/22 to 2024/25;

·         Initial proposals across all Directorates to start addressing the budget gap in advance of the Spending Review and Local Government Financial Settlement;

·         The need to undertake an Equality Impact Assessment on the options put forward, particularly those that involve impacts on services for residents and reductions in the Council’s workforce;

·         Proposed consultation on budget options and timescales; and  

·         Next Steps.

 

Decision

 

The Committee notes the report.

 

43.

Budget Options for 2021/22 pdf icon PDF 412 KB

Report of the Acting Chief Executive Manchester Local Care Organisation and Executive Director of Adult Social Services

 

As a result of additional demand for services and impact on the Council income as set out in the report to Budget Executive on the 14th October 2020 the Council is facing a significant funding gap for 2021/22 which is estimated to be £105m for 2021/22, £159m for 2022/23 and c£122m thereafter. The report of the Deputy Chief Executive and City Treasurer, elsewhere on the agenda provides an update on the financial context for 2021/22.

 

This report details the service and financial planning and associated budget strategy work that is taking place for adult social care with partners across the health and care system.

 

It details the identified and proposed opportunities to make savings in 2021/22 aligned to the remit of the Health Scrutiny Committee, to support the City Council to achieve a balanced budget in 2021/22.

 

As adult social care is both within the MHCC health and care pooled budget, works in partnership and is increasingly focused on integrating with community health services through the Manchester Local Care Organisation (MLCO); this report is jointly presented to the Scrutiny Committee by the key partners of MHCC, MCC and MLCO, noting the areas that will be led by MLCO.

 

It is important to note that the health contribution to the pooled budget is currently unknown as the NHS has not published the financial regime for 2021/22 yet.

 

Additional documents:

Minutes:

The Committee considered a report of the Acting Chief Executive Manchester Local Care Organisation and Executive Director of Adult Social Services that detailed the service and financial planning and associated budget strategy work that was taking place for adult social care with partners across the health and care system.

 

It detailed the identified and proposed opportunities to make savings in 2021/22 aligned to the remit of the Health Scrutiny Committee, to support the City Council to achieve a balanced budget in 2021/22.

 

As Adult Social Care was both within the MHCC health and care pooled budget, works in partnership and is increasingly focused on integrating with community health services through the Manchester Local Care Organisation (MLCO); this report was jointly presented to the Scrutiny Committee by the key partners of MHCC, the Council and MLCO, noting the areas that would be led by MLCO.

 

It was important to note that the health contribution to the pooled budget was currently unknown as the NHS had not published the financial regime for 2021/22 yet.

 

The Executive Director of Adult Social Services introduced the main points and themes within the report included: -

 

·         Providing and overview of ASC Statutory Responsibilities - Services, Eligibility, Care and Support;

·         Providing a context for the 2020/21 Budget ;

·         Covid-19 Pandemic and the ASC Improvement Programme - Context and Impact on Adult Social Care;

·         Planning to Support Council Budget 2021/22 Onwards;

·         Adult Social Care – Scope for Change and Supporting the Budget Challenge

·         Financial Planning Assumptions and Approach;

·         Improving Pathways and Focusing Support for Independence

·         MLCO Transformation Programmes Update

·         Health and Social Care System

·         Population Health

 

The Committee was invited to comment on the report prior to its submission to the Executive on 11 November 2020.

 

Some of the key points that arose from the Committee’s discussions were: -

 

·         Noting the importance of protecting services to support the most vulnerable residents in the city;

·         Noting that cuts had been imposed upon the city by the government since 2010 and demands on services had been exacerbated by the COVID-19 pandemic and it was therefore incumbent upon the government to adequately fund all local authorities and the NHS;

·         No cuts to services should be considered without a full analysis undertaken to understand the future impacts of these, noting the preference to the invest to save model of commissioning and designing services;

·         Recognising the importance of preventative services and initiatives to improve population health;  and

·         Recognising the need to protect mental health services, noting that the need for these services had increased as a result of the COVID-19 pandemic and would continue both in the short and long term.

 

The Executive Member for Adults, Health and Wellbeing stated that despite the imposition of austerity, Manchester had strived to protect services and support residents and staff working across services. She described that at the beginning of the COVID-19 pandemic the government had informed local authorities to spend what they needed to protect residents and the money would be reimbursed. She continued by  ...  view the full minutes text for item 43.

44.

Manchester Local Care Organisation, Winter Planning across Health and Adult Social Care pdf icon PDF 241 KB

Report of the Executive Director of Adult Social Services, Manchester City Council and Mark Edwards, Chief Operating Officer, MLCO

 

This report has been written to provide the Health Scrutiny Committee with an update to the Manchester Local Care Organisation’s (MLCO) response to winter and COVID-19 through the development of integrated planning across Health and Social Care.

 

Additional documents:

Minutes:

The Committee considered a report of the Executive Director of Adult Social Services, Manchester City Council and Mark Edwards, Chief Operating Officer, MLCO that report that provided Members with an update to the Manchester Local Care Organisation’s (MLCO) response to winter and COVID-19 through the development of integrated planning across Health and Social Care.

 

The points and themes within the report included: -

 

·         Providing a background and context for the report;

·         Details and scope of the MLCO winter planning – including Identification of leadership around the “Preparing for Winter Challenge Report”; Lessons learned during Covid-19 first wave pandemic, Activities to support demand management and Activities to support capacity management;

·         Adult Social Care Winter Planning and identified actions;

·         Describing the activities to support the care market, noting the four workstreams identified by The Strategic Care Homes Board;

·         Describing that the MLCO had developed its winter plan across the key domains; and

·         Immediate next steps.

 

Some of the key points that arose from the Committee’s discussions were: -

 

·         Would the recruitment of nurses to staff the NHS Nightingale North West impact on nurse capacity at other hospital sites;

·         Was there enough flu vaccine in Manchester;

·         Was the 36 beds identified at NHS Nightingale North West for Manchester and Trafford residents enough to meet demand; and

·         Further clarification on where the two 20 bed ‘discharge to assess’ facilities were to be located.

 

The Executive Director of Adult Social Services informed the Committee the two 20 bed ‘discharge to assess’ facilities had not yet been procured and further information would be shared with the Members when this was available. In response to the question relating to the flu vaccination she described that Manchester’s Flu Programme for 2020/21 had been reported to the October meeting and progress against this was monitored and reported. She further stated that there was no anticipated issues relating to the provision of PPE (Personal protective equipment)

 

The Chief Operating Officer, MLCO stated that the allocation of 36 bed spaces for Manchester and Trafford residents at the NHS Nightingale North West were governed and managed through the Manchester University NHS Foundation Trust. He described that capacity would continue to be monitored to ensure the facility remained safe and effective. He further stated that staffing of the site was managed through existing resources and local arrangements.

 

In concluding this item the Chair expressed his gratitude to all staff across all sectors who were working tirelessly to respond to the COVID pandemic and supporting the residents of Manchester.

 

Decision

 

To note the report.

 

45.

Overview Report pdf icon PDF 238 KB

Report of the Governance and Scrutiny Support Unit

 

This report includes details of the key decisions due to be taken that are relevant to the Committee’s remit as well as an update on actions resulting from the Committee’s recommendations. The report also includes the Committee’s work programme, which the Committee is asked to agree.

Additional documents:

Minutes:

A report of the Governance and Scrutiny Support Unit which contained key decisions within the Committee’s remit and responses to previous recommendations was submitted for comment. Members were also invited to agree the Committee’s future work programme. 

 

The Chair noted that a report on Mental Health Services and the response to COVID-19 would be requested for the December meeting.

 

The Chair advised the Members that he had received a written question from Macc that related to the impact of budget cuts on the VCSE Sector. He stated that the question would be referred to the Chair of the Communities and Equalities Scrutiny Committee and the relevant Executive Member for consideration.

 

Decision

 

To note the report and agree the work programme, subject to the above comments.