To approve as a correct record the minutes of the meeting held on 8 November 2023.

Decision

To approve the minutes of the meeting held on 8 November 2023.

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

This report provides the Committee with an overview of the work on health and homelessness in Manchester. 

The Committee considered the report of the Director of Public Health and the Executive Director of Adult Social Services that provided an overview of the work on health and homelessness in Manchester. 

Key points and themes in the report included:

·         Describing that work was co-ordinated through the Manchester Health and Homelessness Task Group which had been established in 2016 under the leadership of the Director of Public Health;

·         Reporting that the Health and Homelessness Task Group had been established as part of the Manchester Homelessness Partnership (MHP) and launched with the Manchester Homelessness Charter in 2016;

·         Many people with lived experience of homelessness were involved in co-writing the Manchester Homelessness Charter which was an integral part of the current MHP Homelessness Strategy 2018-2023; 

·         Reporting that to support and accelerate the successes of the MHP, and collaboration with the Greater Manchester Combined Authority, the Council had begun a refreshed transformation programme, A Place Called Home, in 2022;

·         An update on relevant local and national strategies;

·         Key statistics and epidemiological information;

·         Key health statistics from the National Health Needs Audit Report;

·         Describing the work of the various partners on the Task Group; and

·         Conclusion and next steps.

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

·         The Committee paid tribute to all partners working across the city to support homeless people;

·         Stating that the government had failed to respond to the issue of homelessness;

·         Noting that this failure placed a significant pressure on already depleted public services;

·         Did the Urban Village Medical Practice track homeless people to ensure they maintained contact with health services and attended health appointments;

·         Commenting that racism also needed to be considered as a health issue;

·         What was the criteria for an individual to access support from Mustard Tree;

·         Noting that when an asylum seeker was granted Leave to Remain they would often then present as homeless as they would lose any accommodation provided by the Home Office; and

·         What were the challenges to the Transformation Programme, A Place Called Home.

Dr Shaun Jackson, General Practitioner, Urban Village Medical Practice described that the Practice had been supporting homeless people for approximately 25 years, servicing 14,0000 patients with an integrated homelessness provision. He described that the approach to this work had evolved over the years by working in partnership with commissioners. He described that the pillars on which they approached this homeless work was delivering primary care; providing in-reach work for homeless people admitted to Manchester Royal Infirmary; providing out-reach services; and advocating on the issue of homelessness and health across the wider health system, both locally and nationally. He commented that the NHS needed to invest in homelessness health services reiterating the point that homelessness needed to be considered as a health problem and that early deaths amongst homeless people was as a result of unmet medical need. In terms of gaps in health provision for homeless people he stated that he would identify appropriate care and support for homeless people with complex needs, particularly  ...  view the full minutes text for item 58.

Report of the Director of Public Health and the Deputy Place Based Lead, NHS Greater Manchester (Manchester Locality)

This report provides an overview of health provision for Asylum Seeker Contingency (ASC) hotels in the city of Manchester.

The Committee considered the report of the Director of Public Health and the

Deputy Place Based Lead, NHS Greater Manchester (Manchester Locality)

that provided an overview of health provision for Asylum Seeker Contingency (ASC) hotels in the city of Manchester.

Key points and themes in the report included:

·         Providing an introduction and background, noting that in July 2020, Manchester Health and Care Commissioning (MHCC), the Clinical Commissioning Group for the city of Manchester at the time, was directed by NHS England (NHSE) to work with the Home Office, their provider Serco and other stakeholders such as Manchester City Council to commission primary care services for people placed in the ASC hotels.

·         Listing what primary care providers were expected to deliver as a minimum;

·         Discussion of the main issues and mitigating actions, including information on the NHS Greater Manchester Migrant Health Group that had been established;

·         Describing the approach to commissioning primary care services to meet the needs of people seeking asylum living in the hotels;

·         Highlighting some of the opportunities identified to build on the learning and expertise developed through this work, to better meet the needs of people seeking asylum, refugees and other migrants in the future; and

·         Noting that the work described supported Manchester City Council’s commitment to ensure that Manchester was a city of sanctuary for people seeking asylum.

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

·         Further information on the migrant health passport;

·         Information was sought on the NHS Greater Manchester Migrant Health Group, noting that issues experienced by asylum seekers were not confined to those accommodated in ASC hotels;

·         Did asylum seekers have a choice as to which GP they registered with; and

·         An update on Manchester becoming a City of Sanctuary.

Dr Fiona Watson, General Practitioner, Hawthorn Medical Centre described the work delivered to support asylum seekers housed in ASC hotels. She referred to a particular hotel that housed approximately 150 men. She described the integrated approach to help individuals access primary care services. She said that the team comprised of a multidisciplinary team, including GPs, Health Care Assistants and Nurses who would be present at the hotel once a week. She described that having a physical presence in the hotel helped foster positive relationships with both Serco, who had responsibility to provide properties for initial and dispersed accommodation requirements to support the welfare of asylum seekers, and the residents. She advised that the clinical priorities were infection screening, particularly for Tuberculosis; safeguarding; mental health and wellbeing work. 

Darren Parsonage, Head of Operations (Vaccination/Designated Clinical Officer) SEND, NHS Greater Manchester (Manchester) stated that the intention was to standardise the good work described by Dr Watson across all ASC hotels. He commented that, due to the nature of the asylum system and the fact that some hotel residents would move to different accommodation during their asylum-seeking journey, one of the providers had been developing a “migrant health passport” for residents who had longer term health needs to support continuity of  ...  view the full minutes text for item 59.

Report of the Director of Public Health

This report builds on previous health scrutiny reports “An Introduction to the Impact of Climate Change on Health and Healthcare in Manchester” (February 2022) and “Climate Change - The Impact of the Recent Heatwave” (December 2022). It provides a brief overview of how and why climate change impacts the health of Manchester residents and what activities are underway to monitor and mitigate these impacts.

The Committee considered the report of the Director of Public Health that built upon previous health scrutiny reports “An Introduction to the Impact of Climate Change on Health and Healthcare in Manchester” (February 2022) and “Climate Change - The Impact of the Recent Heatwave” (December 2022).

Key points and themes in the report included:

·         Providing a brief overview of how and why climate change impacted the health of Manchester residents and what activities were underway to monitor and mitigate these impacts;

·         Discussion of the impact of climate change on NHS Organisations in Manchester;

·         Discussion of the impact of climate change on the food system;

·         Discussion of the impact of climate change on migration;  

·         Mitigation, adaptation and emergency response;

·         Activities to reduce carbon emissions;

·         Activities to reduce air pollution;

·         Discussion of adaptation to climate change;

·         Adaptation to air pollution;

·         Heatwave Plan, noting the importance of having robust emergency response plans in case of severe adverse weather events;

·         Recognising the co-benefits to health from climate action, such as the increased provision of greenspace and/or the promotion of active travel;

·         Describing how work undertaken as part of the Making Manchester Fairer strategy helped to recognise and minimise health inequalities exacerbated by climate change; and

·         Next steps.

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

·         What was being done to communicate climate change activities with residents;

·         Paying tribute to the work undertaken by staff to support and assist residents in receipt of Adult Social Care in the Didsbury East Ward during the evacuation of homes as a result of flooding;

·         Did the introduction of the 30mph speed limit on Princess Road / Princess Parkway improve air quality;

·         Noting the cost of living crisis and the pressures experienced by residents and how this impacted on their ability to make informed choices, such as purchasing an electric car to reduce their carbon emissions; and

·         Noting the impact of housing and the ability to regulate temperature during extreme weather events and the impact this had on health.

The Committee heard from Councillor Shilton Godwin, Chair of Environment, Climate Change and Neighbourhoods Scrutiny Committee. She provided a testimony that had been provided by a medical practitioner that described the detrimental health impacts poor air quality had on young people. She concluded by emphasising the need to consider climate change as a health issue.

Dr Laura Parker, Specialist Trainee Registrar in Public Health stated that car idling was a particular issue that contributed to poor air quality. In regard to the specific question raised regarding the impact of reducing speed limits to 30mph and air quality, she advised that any analysis of this would be circulated.

Anna Bond, Deputy Director Manchester Climate Change Agency responded to the discussion regarding housing during extreme weather events. She said that the refreshed Climate Change Framework included a number of work streams that included retrofitting of domestic properties and net zero building standards. She also stated that the importance of access to green space was recognised and all the  ...  view the full minutes text for item 60.

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.