To consider any items which the Chair has agreed to have submitted as urgent.

The Chair introduced an item of urgent business by inviting Councillor Wills, LGBT Men's Lead to address the Committee on the subject of World Aids Day.

Councillor Wills stated that the George House Trust had organised a World AIDS Day online vigil to remember people lost to HIV, show solidarity with people living with HIV around the world and commit to challenging HIV stigma and discrimination. 

Councillor Wills encouraged all Members to attend the vigil at 7pm on Tuesday 1st December and stated he would recirculate the information and link. He further encouraged Members to donate to Passionate about Sexual Health (PaSH) Partnership, a collaboration between BHA for Equality, George House Trust and the LGBT Foundation. The PaSH Partnership worked to deliver a comprehensive programme of interventions to meet the changing needs of people newly diagnosed with HIV, living longer term with HIV or at greatest risk of acquiring HIV.

Members were reminded that Manchester was a Fast Track City that was working to ending new cases of HIV within a generation.

The Executive Member for Adults, Health and Wellbeing paid tribute to all clinicians and the Voluntary Community and Social Enterprise (VCSE) sector for their work in this important area and stated that she fully supported the virtual vigil.

Decision

To note the update and support the virtual vigil.

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

Decision

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

Report of the Director of Public Health

In July the Committee received the Manchester Local Prevention and Response (Outbreak) Plan and has received regular updates on the 10 Point Plan and more recently the 12 Point Plan which relate to the overarching document. 

The attached Plan now incorporates two major additional programmes of work relating to Targeted Testing at Scale and the Mass Vaccination Programme.

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, including Targeted Testing at Scale and the Manchester Mass Vaccination Programme,

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

·         Welcoming the reported improvements in infection rates, however the need to be mindful that infection rates were still high and COVID-19  remained a threat;

·         The public needed to continue to observe Public Health advice and guidance to reduce the risk of infection;

·         How many critical care hospital beds were occupied by COVID-19 patients;

·         Were there concerns regarding the potential impact on infection rates in the New Year following the relaxation of restrictions over the Christmas period;

·         What work was being done with the student population to avoid a spike in cases when students return to Manchester in January;

·         Welcoming the introduction of mass testing and what was the anticipated timescales; and

·         Noting that communities often crossed borders within Greater Manchester as assurance was sought that all residents would be offered a vaccine. 

The Director of Public Health reiterated the message that all residents needed to consider their personal risk when considering their options during the Christmas period. He said it reminded essential that everyone continued to observe the Public Health messages to mitigate the risk of further infections.

In response to the specific question regarding students, the Director of Public Health stated that the local Public Health team continued to work closely with the local Universities and they continued to make representations to Government to ensure students were tested prior to their return to Manchester to prevent another outbreak, similar to that what was experienced in October. He said that this was important as the focus and priority in the new year should be to focus resources on the roll out of the vaccination. He said that despite this the testing sites at the Universities would be retained and Universities would continue to be supported to digest national guidance and formulate plans and strategies that could be clearly communicated.

The Director of Public Health stated that at the time of reporting the number of critical care hospital beds occupied by COVID-19 patients was 46 and that he would circulate further data on this following the meeting.

Regarding vaccination, the Director of Public Health stated that priority groups would be vaccinated by Easter 2021, with the remaining adult population vaccinated by summer 2021. He described that all of the Greater Manchester authorities would work together to progress this programme in line with national guidance to ensure a consistent delivery.

The Executive Member for Adults, Health and Wellbeing stated that the decline in the infection rate was as a result of the determination and sacrifice of the residents of Manchester. She expressed that caution was required over Christmas to avoid a  ...  view the full minutes text for item 48.

Report of the Director of Commissioning NHS Trafford Clinical Commissioning Group

This report provides the Health Scrutiny Committee with an update on the urgent care changes happening in Manchester in line with Greater Manchester and national strategy.

The Committee considered a report of the Director of Commissioning NHS Trafford Clinical Commissioning Group that updated Members on the urgent care changes happening in Manchester in line with Greater Manchester (GM) and national strategy.

The main points and themes within the report included: -

·         In response to Covid-19, there was a refresh of the GM Urgent Emergency Care (UEC) priorities, which included a 'UEC by Appointment’ model to reduce the risk of crowding within Emergency Departments (ED) with the principal aim of reducing the number of self-presenter attends by 25%;

·         Proving a description of the various elements of the programme that comprised of:

·         NHS 111 First

·         Streaming at the Front Door

·         Clinical Assessment Service

·         Virtual Clinical Hub

·         Urgent bookable appointments

·         Describing progress to date; and

·         Next steps.

Dr Manisha Kumar, Executive Clinical Director MHCC provided the Committee with an oral update on the Walk In Centre located in the city centre. She described that this facility was co-located in Boots and due to the available space and the numbers of people attending changes were required to ensure it remained COVID safe. She described that a Talk Before You Walk model would be introduced to manage patient flow at the site and minimise the risk of COVID infection. She described that a facility would still be provided for the most vulnerable patients to present and wait for treatment. The Chair thanked Dr Kumar for the update and commented that the Committee would consider scheduling an update on this issue for a future meeting.

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

·         The Committee had always advocated for the provision of Walk In Centres across the city and had vigorously opposed the closure of these, noting that the consequence of this would be an increase in presentations at Emergency Departments;

·         Would Emergency Departments still have to comply with national waiting time targets;

·         The model was predicated on an effective  NHS111 service and what had been done to support and adequately resource this service;

·         What consideration had been given to ensure the service was inclusive and accessible to all, including those for whom English was not their first language;

·         Noting the difficulties some patients experienced accessing Primary Care it was understandable that many patients resorted to attending Emergency Departments in the knowledge that they knew they would receive treatment; 

·         Whilst recognising the need to introduce measures to ensure patient safety during COVID-19 was it anticipated that this model would continue post COVID;

·         Noting the importance of assessments being undertaken by clinicians to ensure the most appropriate patient care pathway was identified;

·         To ensure the safe and appropriate transfer of care it was important that patient records were accessible across the various health services;

·         What was the initial feedback on the Clinical Assessment Service that went live on the 4 November 2020; and

·         How was this change being communicated to the general public.

The Director of Commissioning, NHS Trafford CCG responded to questions and comments by advising the  ...  view the full minutes text for item 49.

Report of the Greater Manchester Mental Health NHS Foundation Trust

This paper presents the GMMH organisational response to the COVID-19 pandemic and the steps take to sustain services throughout the initial lockdown period and then develop a sustainable model of provision. Steps taken to forward plan the changing demand and impact on services as a consequence of the pandemic are also presented with a surge predicted to coincide with the autumn and winter months.

The Committee considered a report of the Greater Manchester Mental Health NHS Foundation Trust (GMMH) that described the organisational response to the COVID-19 pandemic and the steps take to sustain services throughout the initial lockdown period and then develop a sustainable model of provision. Steps taken to forward plan the changing demand and impact on services as a consequence of the pandemic were also presented with a surge predicted to coincide with the autumn and winter months.

The main points and themes within the report included: -

·         Providing an introduction and an overview of national guidance;

·         Describing the GMMH COVID-19 Governance Arrangements;

·         Information on the Recovery Planning Group;

·         Information on the work of the Physical Healthcare and Infection Prevention and Control workstream;

·         A summary of the work of the Service Users and Carers workstream;

·         A summary of the work of the Workforce workstream;

·         Information on Demand and Capacity Planning;

·         Information on Community Activity;

·         Information on Crisis Response;

·         The response to Student Mental Health;

·         Winter Planning;

·         Infection Prevention and Control;

·         Vaccination; and

·         Lateral Flow Testing.

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

·         What work had been undertaken with local universities to support the local student population;

·         How was this specific work with students communicated;

·         Welcoming the extended 24/7 crisis helpline and did this link in with other services such as Child and Adolescent Mental Health Services (CAMHS);

·         Noting the IAPT (Improving Access to Psychological Therapies) service reported as providing increasingly efficient access and as a result the service had reduced secondary waits throughout Manchester by over a 1000 clients, what percentage of clients did this represent;

·         What work was being done to improve the transition from Children’s Services to Adult Services;

·         Noting the anticipated long-term impact of COVID-19 on mental health what comparisons could be made with other periods of economic downturn;

·         Has there been an increase of people with mental health issues presenting at Accident and Emergency Departments; and

·         Noting the increase in digital access to services, could people still access face to face services and support.

The Executive Director of Operations, GMMH informed the Members that the service for students had been established pre COVID-19 and had been established using the GM Transformation fund. She described that teams were established at each University and the number of referrals to this service had increased and staff had been deployed to support this service.  The Deputy Director of Strategy MHCC further added that COVID-19 had highlighted the need to improve access to this service and Commissioners across Greater Manchester were looking at this using the lessons learned.

The Associate Director of Operations, GMMH stated that the 24/7 crisis helpline was open to all age groups and not restricted to mental health. He advised that the helpline could sign post to other services and offer advice on other issues such as substance misuse, NHS 111 and CAMHS.

The Associate Director of Operations, GMMH stated that he would circulate the details of the percentage of clients  ...  view the full minutes text for item 50.

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.

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. 

Decision

To note the report and agree the work programme.