To approve as a correct record the minutes of the meeting held on 3 March 2020.

Decision

To approve the minutes of the meeting held on 3 March 2020 as a correct record.

Report of Deputy Chief Executive and City Treasurer

In light of the current national and international public health emergency situation, Manchester and Greater Manchester (GM) declared a major incident on Friday 20 March 2020.  This activated the multi agency response arrangements in line with the GM generic response plan and the pandemic flu plan.  The Prime Minister’s unprecedented announcement at 8.30pm on Monday 23 March set out the seriousness of the situation and the expectations of all residents, businesses and public services.  Reports to the Executive on 6 May and 3 June 2020 set out in detail the Council’s response to this crisis.  Over recent days and weeks, the lockdown guidance has eased and a number of further specific guidance notes have been received which are informing our actions and response. 

This note is intended to provide Scrutiny with a brief summary of the current situation in the city in relation to COVID-19 and an update on the work progressing in Manchester in relation to areas within the remit of this committee.  Further detail on specific issues will be available as required.

The Committee considered a report of the Deputy Chief Executive and City Treasurer that provided a brief summary of the current situation in the city in relation to COVID-19 and an update on the work progressing in Manchester in relation to areas within the remit of this committee. 

The main points and themes within the report included: -

·         Detailing the Public Health response, both at a Manchester and Greater Manchester level;

·         Describing the financial implications and funding arrangements for the City Council and the implications of this;

·         Recovery planning, including a reset of the Our Manchester Strategy and workforce considerations; and

·         An update on Adult Social Care.

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

·         Welcoming the regular updates Members had received outside of the formal scrutiny meeting structure;

·         Noting the significant impact COVID-19 had on the Council’s budget, in addition to a decade of austerity;

·         Staff should be supported and encouraged to continue working from home as this would support social distancing and reduce exposure to COVID-19;

·         The reduction in funding for Adult Social Care was significantly higher in those areas with high levels of deprivation;

·         The financial support for Local Authorities recently announced by Government was not weighted to support those areas with high levels of deprivation;

·         Lobbying of Government needed to continue to ensure appropriate funding was awarded to Local Authorities; and

·         Concern that the budget savings identified included an option not to recruit vacant reablement posts.

Further to the information provided in the published report, the Director of Public Health informed Members that the updated mortality figures (up to 12 June 2020) for Manchester were 383, with 76 of these within a Care Home setting.

The Executive Director of Adult Social Services addressed the Committee and acknowledged the comment regarding staff safety by stating the Council remained committed to safe working practices. She further commented that with regard to budget savings, the report described proposals only and work was still ongoing to understand the budgetary implications.

The Executive Member for Adults, Health and Wellbeing stated that announcements regarding future funding were still awaited from Government, however initial indications were that they would not compensate for loss of income incurred by Local Authorities during this period. She described that the Council continued to plan and work towards delivering a balanced budget. 

Decision

To note the report.

Report of Director and Deputy Director Adult Social Services

This note is intended to provide Scrutiny with a brief summary of the current situation in the city in relation to COVID-19 and an update on the work progressing in Manchester in relation to areas within the remit of this committee.  Further detail on specific issues will be available as required.

The Committee considered a report of the Director and Deputy Director Adult Social Services that provided information and data on the measures introduced to support and maintain care home provision in Manchester during the COVID-19 outbreak.

Officers referred to the main points and themes within the report which included: -

·         Describing the landscape of Care Homes across Manchester;

·         The strategy adopted in response to the pandemic to support this sector to ensure that Manchester residents were supported;

·         Describing the work undertaken with partners to deliver this, building on established strong relationships to deliver a co-ordinated system wide response, both at a local level and across Greater Manchester;

·         Information on the work of the Community Infection Control Team;

·         Describing a range of initiatives enacted to support this sector, including the operation of the Mutual Aid Hub to oversee personal protective equipment (PPE) provision and the adaptation of Moston Grange Care Home;

·         Information on testing arrangements for Care Homes;

·         Detail on the financial measures to support providers;

·         Data on the outbreaks, infections and deaths (involving COVID-19 in care homes; and

·         Next steps and planning ahead.

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

·         What was the approach taken to those Care Homes who had not applied for testing;

·         Noting the benefits realised of the integration of Health and Social Care to respond quickly and effectively to the pandemic, with particular reference to the ability to test patients prior to discharge from hospital into a care setting;

·         Analysis was required to understand excess deaths in the region;

·         Was the Care Home sector financially resilient enough to withstand the pandemic and what support was being offered;

·         What impact had improved air quality experienced during the pandemic period had on mortality figures;

·         What financial support was offered to those residents in Care Homes who were self-funding; and

·         What was the rationale for the block booking of beds in Care Homes.

The Director of Public Health said that the introduction and control of testing at a local level would provide greater management and oversight of this activity across a range of settings and he advised that follow up work was ongoing with those settings that had not applied for testing. The Executive Director of Adult Social Services added that a pilot scheme was being delivered across Greater Manchester that would deliver testing in supported accommodation settings.

In regard to the comments surrounding analysis and understating of the mortality rates, the Director of Public Health informed the Members that a recent report published by the Office of National Statistics had presented a number of explanations, however work would be undertaken at a local level to understand the Manchester context. He described that issues such as air quality would inform this analysis and information on the outcomes of this would be reported to the Committee at an appropriate time. 

The Executive Director of Adult Social Services stated that a report on the support offered to Care Home providers could be provided for consideration  ...  view the full minutes text for item 22.

Report of the Director of Public Health

This report provides more detailed information on the national, Greater Manchester and Manchester approach to Test and Trace and the development of the Manchester COVID-19 Management Plan, referred to in the overarching COVID-19 Update Report.  The Manchester Test and Trace Team went “live” on Monday 8th June and the Director of Public Health is the Senior Responsible Officer (SRO) for the development of the COVID-19 Management Plan.

The Committee considered a report of the Director of Public Health that provided detailed information on the national, Greater Manchester and Manchester approach to Test and Trace and the development of the Manchester COVID-19 Management Plan, referred to in the overarching COVID-19 Update Report.  The Manchester Test and Trace Team went “live” on Monday 8 June 2020 and the Director of Public Health was the Senior Responsible Officer for the development of the COVID-19 Management Plan.

Officers referred to the main points and themes within the report which included: -

·         Providing a summary of the national NHS Test and Trace service launched by the UK Government on 28th May 2020;

·         Describing the approach to test and trace in Greater Manchester and Manchester Test, Trace, Contain and Enable (TTCE), noting that the GM TTCE approach would involve the creation of 10 bespoke Local Outbreak Control Plans;

·         The Manchester Public Health Team were currently collating the production of the Manchester Local Outbreak Control Plan (COVID-19 Management Plan) across a range of settings;

·         Locality roles and responsibilities and GM Roles and Responsibilities and identified priorities; and

·         Noting that the Director of Public Health at the City Council would lead the development of the Manchester COVID-19 Management Plan with local partners.

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

·         Recent reports in the media suggested that meat and food processing plants were susceptible to outbreaks of COVID-19 and what was being done to monitor these locally;

·         Following the announcement that lockdown rules were to be relaxed what were the concerns regarding further outbreaks and how would this be managed;

·         What reassurance could be offered to residents concerned about leaving their contact details with premises; and

·         What guidance and support was being offered to the many different businesses across the city.

The Consultant in Public Health addressed the comments regarding meat and food processing plants by reporting that colleagues from Environmental Health were supporting this activity and all such sites had been identified and a Greater Manchester plan was developed to manage and support such sites. In regard to any concerns residents may have when requested to leaving personal contact details with premises, such as pubs or restaurants it was important to emphasise that this information would only ever be used to contact them to alert them in the event of another patron who then subsequently reported symptoms. She stated that it was then vital if contacted to follow the advice and guidance given to prevent a further outbreak.

The Director of Public Health stated that whilst he acknowledged the messages and instructions from Government were changing it was important that the advice and messages given to the public were clear to minimise the risk of further infections. He said that this information would continue to be reviewed following any Government announcements.

The Director of Public Health reiterated the statement regarding personal information only ever being used for tracing purposes and that if contact was required, a telephone call would  ...  view the full minutes text for item 23.

Report of Manchester Health and Care Commissioning

This report provides an overview of how the NHS has responded to, and is recovering from, the impact of Covid19.

The Committee considered a report of Manchester Health and Care Commissioning that provided an overview of how the NHS has responded to, and is recovering from, the impact of Covid19.

Dr Kumar referred to the main points and themes within the report which included: -

·         Providing a description of both national and regional requirements;

·         An update on Local Arrangements noting that in Manchester, and across Greater Manchester, Community Cells had been established. These worked with Hospital Cells and linked in with the wider response and recovery work being led by local authorities;

·         Current financial arrangements;

·         An update on Health service provision during the pandemic;

·         Monitoring the impact of COVID-19; and

·         Understanding the impact of COVID-19 on Black, Asian and Minority Ethnic (BAME) communities.

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

·         Acknowledging that COVID-19 impacted BAME communities and commenting that recognition needed to be given to the impact on specific religious communities due to their ethnic heritage;

·         Consideration needed to be given to density within households and the rates of COVID-19;

·         Supporting the ‘Welcome Back Manchester’ campaign and who was this being used to encourage people to access health services;

·         What measures were in place to follow up patients who missed a routine hospital appointment, especially vulnerable residents. 

Dr Kumar responded to the discussion by informing the Committee that COVID-19 was a new disease and the understanding of this was evolving. She described that it was now understood to be a vascular rather than a respiratory condition. She stated that work continued to develop an understanding of this disease, especially in relation to its impact and prevalence across BAME and particular religious communities and citizens, and this understanding would then inform the response and guidance. She stated that this work was continuing at pace, with the involvement of all partners and acknowledged the importance of this understanding in the context of an imminent relaxation of the lockdown rules and the potential for a second wave of infections

Dr Kumar stated that currently the NHS was operating at a Level 4 COVID -19 warning (a COVID-19 epidemic was in general circulation; transmission was high or rising exponentially), with Primary Care operating on a telephone consultations and triage model. She stated that those patients who were due regular health checks were being contacted and ‘Safe and Well’ checks were also being undertaken with vulnerable patients by telephone. She further informed the Committee that if a patient was to miss an appointment with a hospital, the GP Practice would be notified and follow up calls would be made, and if necessary the patient would be triaged again and re-prioritised as appropriate. She further gave an assurance that if a patient failed to attend a hospital appointment they would not be removed from the waiting list and every attempt would be made to contact the patient.

The Director of Corporate Affairs, MHCC informed the Members that Health and Social Care messages would be included in the ‘Welcome Back Manchester’  ...  view the full minutes text for item 24.

Report of the Governance and Scrutiny Support Unit

This report includes a summary of key decisions that are within the Committee’s remit as well as an update on actions resulting from the Committee’s recommendations.

The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission (CQC) within Manchester since the Health Scrutiny Committee last met.

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.

Decision

To note the report.