To approve as a correct record the minutes of the meeting held on 12 January 2022.

Decision

To approve the minutes of the meeting held on 12 January 2022 as a correct record.

The Director of Public Health and Medical Director, Manchester Health and Care Commissioning, will circulate a presentation on the latest available data relating to Manchester COVID-19 rates and the Manchester Vaccination Programme. 

The Committee considered the joint presentation of the Director of Public Health and the Executive Clinical Director, Manchester Health and Care Commissioning, that had been circulated to all Members in advance of the meeting. The presentations provided an update on COVID-19 activity that included the latest available information on data and intelligence.

Key points and themes in the presentation included:

·         The latest headline figures for the 7 days ending 2 February 2022;

·         An update on the vaccination programme with particular reference to the vaccine coverage, vaccine equity, the 12–17 year old programme and the Overseas Pilot;

·         Information on the Communications and Engagement Plans; and

·         Pregnancy and COVID-19 and the related targeted engagement work.

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

·         Welcoming the report and acknowledging the information that had been provided surrounding pregnancy following the discussion at the previous meeting;

·         What was the approach to ensuring those vulnerable residents who required a fourth vaccination were being contacted;

·         What advice was being given to enable care homes to safely manage any outbreaks of COVID-19;

·         Noting that the vaccination rates in Manchester were low compared to the national data;

·         The need to promote and emphasise the message of the wider social responsibility of receiving the vaccination;

·         The need to publicise people’s experience of suffering with COVID who had not taken up the offer of a vaccination;

·         Were Further Education settings included in the communications strategy, adding that work needed to be done to challenge the myths surrounding pregnancy and the vaccination amongst young people;

·         Thanking the officers within the Neighbourhood Teams for their continued good work and support they continued to provide to local communities; and

·         The need to use trusted voices on social media to disrupt myths surrounding COVID-19 and the vaccination.

The Director of Public Health advised that if an outbreak of COVID occurred in a care home setting each home would be supported to manage the outbreak appropriately, using all of the national guidance.

The Executive Clinical Director, Manchester Health and Care Commissioning acknowledged the comments raised regarding the promotion of the vaccination both in terms of social responsibility and using lived experiences as a lever to encourage people to come forward. She added that any promotional and educational campaign would require sensitivity when using an individual’s personal experience to articulate the impact of COVID-19 on both families and individuals.

The Executive Clinical Director further advised that there was an audit underway of GP records to identify those vulnerable patients who would be eligible for a fourth jab, adding that if Members had concerns about an individual, they should encourage them to contact their GP surgery. She further commented that this exercise also assisted with ensuring that all Learning Disabled citizens were supported to obtain their vaccination in an appropriate setting for them.

The Director of Public Health advised that following this exercise of auditing GP records a bench marking exercise could be undertaken to more accurately report on how Manchester compared to  ...  view the full minutes text for item 62.

Report of the Executive Director Adult Social Services and Director of Public Health

Following the Spending Review announcements and provisional local government finance settlement 2022/23 the Council is forecasting a balanced budget for 2022/23, a gap of £37m in 2023/24 and £58m by 2024/25. This report sets out the high-level position.  

Further to minute (HSC/21/45) the Committee considered the report of the Executive Director Adult Social Services and Director of Public Health which provided a further update on the saving proposals being proposed as part of the 2022/23 budget process.

Key points and themes in the report included:

·         Following the Spending Review announcements and provisional local government finance settlement 2022/23 the Council was forecasting a balanced budget for 2022/23, a gap of £37m in 2023/24 and £58m by 2024/25;

·         The finance settlement was towards the positive end of forecasts and no actions beyond those outlined in November were required to balance next year's budget;

·         The settlement was for one year only and considerable uncertainty remained from 2023/24;

·         A longer-term strategy to close the budget gap was being prepared with an estimated requirement to find budget cuts and savings in the region of £60m over the next three years;

·         £30m of risk-based reserves had been identified as available to manage risk and timing differences;

·         A description of the Adult Social Care Priorities;

·         An overview of the Manchester City Council Adult Social Care Budget and Manchester Local Care Organisation aligned budget; and 

·         The capital budget and pipeline priorities.

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

·         The need to explicitly articulate the demand on the Adult Social Care budget and the services that the Council is statutory responsible to deliver, in the context of continued austerity and budget cuts;

·         The need for a fair, long term financial settlement for the city;

·         The budget should be used to address the recognised health inequalities within the city;

·         The Government was in denial of challenges faced by the NHS;

·         Paying tribute to the Deputy Leader and officers and NHS partners for their continued commitment to protecting the most vulnerable residents within the city; and

·         Was there any possibility of further additional one off funding sources.

In response to comments the Director of Finance (MLCO) stated that there were no further additional one off sources of funding, adding that the integrated approach to the budget ensured that there was an appropriate use of the budget and resources available.

The Deputy Leader commented that whist the overall settlement announcement was towards the positive end of expectations, this did not constitute being a good settlement and the Council had lost over £400m from its budget since 2010.  If the Council had received the average level of cuts in funding, this year it would have at least £85m in its budget. The Council was also still dealing with the legacy of the COVID pandemic and the promise from government that it would compensate local authorities with whatever they needed. She added that it was not possible to undo a decade of cuts with a settlement in one year that was not as severe as anticipated and looking beyond next financial year there was significant worries which meant that the Council needed to continue its call for fair and sustainable funding.

The Deputy Leader  ...  view the full minutes text for item 63.

Report of the Executive Director of Strategy / Deputy Chief Accountable Officer, Manchester Health and Care Commissioning

Part one of the report provides an update on the establishment of a Greater Manchester Integrated Care System/Integrated Care Board (ICB) and Manchester Locality Board. The Chair Designate for the ICB will attend the Scrutiny meeting.

Part two of the report provides an update on the refreshed Manchester Locality Plan which will ensure that local priorities continue to be delivered during the transition to the new arrangements in 2022/23.

The Committee considered the report of the Executive Director of Strategy & Deputy Chief Accountable Officer, MHCCthat provided an update on the establishment of a Greater Manchester Integrated Care System / Integrated Care Board (ICB) and Manchester Locality Board.

Key points and themes in the report included:

·         Subject to legislation passing through parliament, Integrated Care Systems (ICS) would be established in England from 1 July 2022;

·         The report described the four aims of the ICS and the national core building blocks of an ICS;

·         Greater Manchester would witness a shift from the Greater Manchester Health & Social Care Partnership (GMHSCP) arrangements to a new Greater Manchester ICS and Integrated Care Board (ICB);

·         Integrated Care Board would take on the functions of Clinical Commissioning Groups (CCGs) which would be disestablished on the 30th June 2022;

·         Manchester City Council and NHS leaders had both contributed to the developing GM ICS and ICB arrangements and worked to develop locality arrangements for the City of Manchester;

·         Describing the arrangements and function of the Manchester Partnership Board, noting that it would comprise of political, clinical and managerial leadership;

·         Sir Richard Leese had been appointed Chair designate of the Greater Manchester ICB along with two non-executive directors; and

·         An update on the refreshed Manchester Locality Plan which would ensure that local priorities continued to be delivered during the transition to the new arrangements in 2022/23.

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

·         Recognising the sound foundations that had been established within Manchester to continue to support the continued integration of health and social care to deliver the best health outcomes for Manchester residents;

·         Did the Chair Designate of the Integrated Care Board recognise the concerns expressed that the model would present an opportunity for privatisation of the NHS;

·         Who would be responsible for the commissioning of dental services, noting the importance of commissioning preventative dental services;

·         Would the new model be more transparent and accountable in its decision making process;

·         The need to address the issue of staff recruitment and retention, recognising that this was a local and national issue;

·         The need to improve the physical infrastructure of the health service estate, noting that this also related to the climate change report that was on the meeting’s agenda;

·         The Board needed to reflect the diversity of the city; and

·         The need to recognise the significant impact the previous two years had had on staff working in the NHS to respond to the pandemic and any reorganisation needed to be managed sensitively with support offered to all staff impacted by change.

The Chair Designate of the Integrated Care Board stated that the proposed Manchester Locality Plan model and governance arrangements were a positive development to deliver improved health and care. He stated that this built upon the established and trusted relationships across partners in the city. He advised that he recognised the comments raised regarding the privatisation of services, however commented that he did not share these concerns. He further addressed the  ...  view the full minutes text for item 64.

Report of the Director of Public Health

The purpose of this report is to provide an introduction to climate change in Manchester and the city’s ambitions and activities to date. The report provides an overview of the impact that climate change is having, and is predicted to have in the future, on the health of Manchester’s residents and the potential impacts on healthcare services and facilities in Manchester.

The Committee considered the report of the Director of Public Healththat provided an introduction to climate change in Manchester and the city’s ambitions and activities to date. The report provided an overview of the impact that climate change was having, and was predicted to have in the future, on the health of Manchester’s residents and the potential impacts on healthcare services and facilities in Manchester.

Key points and themes in the report included:

·         Providing an introduction and background, noting that in July 2019, Manchester City Council declared a Climate Emergency which recognised the need for the Council, and the city as a whole, to do more to reduce carbon dioxide (CO₂) emissions and mitigate the negative impacts of climate change;

·         Noting that the Our Manchester Strategy set out the commitment that ‘Manchester will play its full part in limiting the impacts of climate change’ and the subsequent Manchester Climate Change Framework 2020-25 and its four headline objectives;

·         Providing an overview of the reports published recently that had emphasised the link between climate change and its impact on health;

·         Recognising the need to consider vulnerability as well as hazard and exposure to climate change if we were able to gain a full appreciation of the risk;

·         Discussing the implications of extreme weather events and the activities in Manchester to mitigate against these;

·         Noting that air pollution presented a significant public health problem and describing the activities in Manchester to mitigate against this, including an update on the introduction of the Clean Air Zone;

·         Providing a discussion on the relationship between food and climate and providing an overview of the work of the Manchester Food Board;

·         The relationship between mental health and climate change; and

·         Health Care System and Services and the steps taken to reduce emissions.

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

·         Welcoming the establishment of the Health and Wellbeing Climate Change Advisory Group, and noting the partners involved in this group;

·         Recognising the impact that poor air quality had on health outcomes, particularly for young people and elderly residents;

·         The need to acknowledge the harmful effects of particulate matter when considering air quality;

·         The need for air quality data to be easily accessible; and

·         That a report on the climate change action plans of the local NHS Trusts be considered at an appropriate time, noting that this should include the consideration given to improving the existing estate.

Dr Raja Murugesan, Manchester Health and Care Commissioning advised that he was a member of the Manchester Climate Change Agency and Partnership. He advised that the priority for the NHS currently was post COVID recovery, and this included a green and sustainable recovery with climate change as a consideration of all decision making. He further commented that the harmful effects of particulates and poor air quality was recognised and understood.

The Head of Environment, Planning and Infrastructure advised that the issue of poor air quality was being addressed at a Greater  ...  view the full minutes text for item 65.

Report of the Governance and Scrutiny Support Unit

The monthly report includes the recommendations monitor, relevant key decisions, the Committee’s work programme and items for information. The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission.

The 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.

Decision

The Committee notes the report and agrees the work programme.