Agenda and minutes

Health Scrutiny Panel - Thursday, 19th November, 2020 1.30 pm

Venue: Via Microsoft Teams

Contact: Martin Stevens  Tel: 01902 550947 or Email:


No. Item



[To receive any apologies for absence]. 


Apologies for absence were received from Cllr Bhupinder Gakhal and Tracy Cresswell.


Vanessa Whatley, Deputy Chief Nurse at the Royal Wolverhampton NHS Trust and Marsha Foster, Director of Partnerships at the Black Country Healthcare NHS Foundation Trust also sent their apologies to the meeting.


Declarations of Interest

[To receive any declarations of interest]. 


There were no declarations  of interest. 


Minutes of the meeting held on 17 September 2020 pdf icon PDF 520 KB

[To approve the minutes of the meeting held on 17 September 2020 as a correct record.]



The minutes of the meeting held on 17 September 2020 were agreed as a correct record, subject to the reduction in the CCG Management Costs target figure for the current year reading 20% rather than 25%. 


Minutes of the meeting held on 22 October 2020 pdf icon PDF 460 KB

[To approve the minutes of the meeting held on 22 October 2020 as a correct record]. 


The minutes of the meeting held on 22 October 2020 were approved as a correct record. 


Matters Arising

[To consider any matters arising from the minutes.]



Cllr Lynne Moran asked for it to be put on the official record, the Haven Refuge Centre being particularly grateful for the time invested by Public Health to help the refuge to operate safely throughout the Covid-19 pandemic.  She also wished for her personal appreciation to Public Health, in helping the Third Sector to be written into the official record. 


Draft Budget and Medium Term Financial Strategy 2021-2022 to 2023-2024 pdf icon PDF 417 KB

[To receive a report on the draft Budget and Medium Term Financial Strategy 2021-2022 to 2023-2024]. 

Additional documents:


The Finance Business Partner introduced the report on the draft Budget and Medium Term Financial Strategy 2021-2022 to 2023-2024.  Appended to the report to the Scrutiny Panel was the Draft Budget and Medium Term Financial Strategy 2021-2022 to 2023-2024, this had been received by Cabinet in the previous week.  They were seeking feedback on how the budget relevant to the remit of the Panel aligned with the priorities of the Council.  The report recommended that the response from the Panel to Scrutiny Board be finalised by the Chair and Vice Chair of the Health Scrutiny Panel.  Scrutiny Board would then submit a final response to Cabinet.


The Finance Business Partner stated that there was a legal requirement for the Council to set a balanced budget each year.  This had last been done when Council approved a balanced budget for 2020-2021 on 4 March 2020.  At that time, it had been projected that the Council would be faced with finding further estimated budget reductions totalling £15.5 million in 2021-2022, rising to around £20 million over the medium term to 2023-2024.  Work had been ongoing to close the budget gap since March with budget reductions or income generation ideas.  However, Covid-19 had become much more of an issue than at that point, meaning there had been significant financial implications on both the finances and operating environment of the Council.


The Finance Business Partner referred to section 6 in the main report which summarised the Draft Budget and Medium Term Financial Strategy report.  The report included details about the financial implications of Covid-19 and it agreed the core principles of how the Council would deal with any budget pressures going forward.  The Council had a proven record of financial planning, being able to set a balanced budget and responding to any shortfalls in future budgets.  The report included a table showing the one off grants the Council had received from Government for responding to the short-term financial pressures of Covid-19.  The table showed a shortfall of about £324,000 between the grants the Council had received and the financial cost pressures that were being forecast.  This did not include any costs of a second lockdown or the “Relighting Our City Programme.”  Grants were changing on a weekly basis and so the financial situation was constantly evolving.


The Finance Business Partner stated that the main assumption for setting next year’s budget was that in response to previous Government announcements, the Council assumed the Government would fund any financial pressures relating to Covid-19 in full.  If this was the case, they were forecasting a gap to set a balanced budget next year of approximately £4.5 million.  This was achievable and Directors had been given targets to work out budget reduction measures to try and close the gap.  If the costs relating to Covid-19 were not met by the Government, the financial pressure could rise up to £23.2 million for next year.  This would have a significant impact and would result in a fundamental review of all  ...  view the full minutes text for item 6.


Dentistry during Covid-19 pdf icon PDF 1 MB

[To receive the attached information pack.  A presentation will be given at the meeting on Dentistry during Covid-19.  A represensative from Public Health England and NHS England and NHS Improvement will be present]. 


The Deputy Head of Primary Care Commissioning from NHS England and NHS Improvement and the Consultant in Dental Public Health from Public Health England gave a presentation on Dentistry during Covid-19.  A briefing report had also been circulated with the agenda.  The briefing note had contained a summary of pre-Covid Dental Services including maps.  Detailed information on Dental fees had been provided in the note.  NHS Dental fees had not changed due to Covid.  Some private Dentists had increased their charges.  You did not need to be registered with a Dentist like you did with a GP.  In theory patients were able to attend any Dentist, it was however true that many Dentists did maintain a list of regular patients.  Patients were able to find details of Dental practices on the NHS website,


A range of specialist care was available through Hospital or Community Dental Services on referral.  In the Wolverhampton area this was provided by the Royal Wolverhampton NHS Trust. 


The Deputy Head of Primary Care Commissioning stated that services, due to the pandemic, at present were severely constrained due to limited capacity.  This was because of the nature of the work of Dentistry, the need for social distancing and infection control and downtime required between treatments, to change the air.  Certain Dentistry procedures were aerosol generating, such as when using drills.  It was now normal to have remote telephone triage prior to or instead of being seen face to face.  During Covid-19 there was currently no walk-in services available.  Dentists had been told to prioritise urgent care and vulnerable patients rather than routine check-ups.  Some patients were required to be seen at other centres due to Covid-19.  There were some established urgent Dental centres, which could also be used for people in the vulnerable category.  They were aware that obtaining care was difficult at present for those without a usual Dentist, but urgent care could be accessed via NHS 111.  They were looking to try and improve this pathway as it was often the most vulnerable patients in this position. 


The Deputy Head of Primary Care Commissioning remarked that local Dentists and services were working together to try and maintain and recover services.  Guidance and support were being provided to Dentists and other services to help them adapt the way they worked.  It was however a reality that patients were having to wait longer for the care they needed both at a high street or in a Hospital service and the range of options for treatment may have been more limited than was previously the case.


The Deputy Head of Primary Care Commissioning commented that since the report had been published with the agenda for the meeting, the team had contacted six practices previously identified as not providing a full range of services including aerosol generated procedures and had established that all of these were now offering these procedures and had been since September / early October.  She provided the local information on levels of patients exempt  ...  view the full minutes text for item 7.


Update from Director of Public Health - Covid-19

[To receive a verbal update from the Director of Public Health on the latest information regarding Covid-19 in the City of Wolverhampton].


The Director for Public Health gave an update on Covid-19 in the City.  The weekly case rate per 100,000 in the West Midlands was currently at 319.2.  In Wolverhampton it was at 330.0.  He expected that figure to rise to somewhere between 360.0 to 365.0 the following day.  He showed a graph showing the rise in cases from the 30 August 2020 across England, the Black Country and Wolverhampton.  Towards September and October 2020 there was a significant rise in the curve in Wolverhampton.  The dip on the graph from 13 November 2020 could probably be explained by the lag in lab results coming through.  The case rate in Wolverhampton had not accelerated at the rate of its Black Country neighbours, it was doing comparably better, although cases per 100,000 still remained high and it was still accelerating.  Wolverhampton’s case rate was higher than the average for the Country.  The average for England for the 7 days up to 16 November was approximately 250 Covid-19 cases per 100,000.  Dudley and Sandwell had the highest rates in the Black Country. 


The Director for Public Health presented a slide on Covid-19 case rates by ward area in Wolverhampton in the 14 days up to 16 November 2020.  The key point from the slide was that if there was a ward which was showing a low number of Covid-19 cases, this didn’t mean the infection wasn’t within the ward area.  It was often a sign that more testing was required.  As an example, Heath Town ward had been showing a low rate a few weeks ago.  When targeted testing was undertaken, a higher amount of cases was found within the ward area.  The Covid-19 infection had spread across the City, it was not contained to any particular wards.  It was key to encourage people to undertake a PCR test if they had symptoms and when they did not have symptoms they could receive a lateral flow test at one of the pilot areas.


The Director for Public Health displayed a heat map showing the Covid-19 age specific confirmed case rate per 100,000 in Wolverhampton in the 7 days up to 12 November 2020.  Where there was a darker shade it indicated a higher rate for each of the five different age groups differentiated.  The 60 plus age group was starting to show a darker bracket, which was the group which needed to be the most protected.  This was because this age group were more likely to have to receive hospital treatment and to have poorer outcomes if they caught the virus.  Protecting the most vulnerable was key. 


The Director for Public Health presented a slide on responding to the second wave.  The fact that the vaccine was in development was positive news but it was important that this did not distract from the immediate issues of the importance of compliance with guidance, testing, contract tracing and ensuring systems were in place as a bridging strategy before a vaccine was rolled out.  There were  ...  view the full minutes text for item 8.


Local Outbreak Engagement Board Draft Minutes pdf icon PDF 237 KB

[To consider the contents of the Local Outbreak Engagement Board draft Minutes from the meeting of 29 September 2020 and 12 November 2020 ]. 


[The Local Outbreak Engagement Board draft Minutes from the meeting of 12 November 2020 are marked – To Follow]. 


The Scrutiny Officer reported that the minutes from the September meeting of the Local Outbreak Engagement Board had been circulated with the agenda.  The minutes from the 12 November 2020, Local Outbreak Engagement Board had unfortunately not been approved in time for the meeting.  Members of the Panel had however been sent a link to the recording of the November meeting.


The Chairman referred to the Communications Toolkit to Councillors and Community Champions recently mentioned at the Local Outbreak Engagement Board meetings.  He asked for some more information on the initiative and asked who the Community Champions were.  The Development Manager gave some context to the Local Outbreak Engagement Board.  The Government had required the establishment of Local Outbreak Engagement Boards as part of the Local Outbreak Plan development work.  Wolverhampton’s Local Outbreak Engagement Board was Chaired by the Leader of the Council and was a Sub-Board of the Health and Wellbeing Together Board.  The public meetings were currently taking place every two months, with the option for additional meetings as appropriate.  The meetings were live streamed.  The purpose of the Board was to have oversight of plans and actions to prevent and manage Covid-19 outbreaks in the City, as well as providing leadership around communications and public engagement. 


The Development Manager commented that three Councillors had put themselves forward as Champions.  These were Cllr Rupinderjit Kaur, Cllr Zee Russell and Cllr Simon Bennett.  They had been working with these Councillors on what resources they felt would be beneficial to Councillors.  In development was a key numbers / key messaging document which would be able to be shared with colleagues.  They were also looking at the role of social media and how Councillors could create videos to spread the key messages wide in the community.  They were also looking at how they could work with the community and voluntary groups.  They had been working in partnership with the Learning Communities Partnership which had a wide membership.  The Learning Communities Partnership had established a Task and Finish group which were considering which resources would be beneficial to the community.  The toolkit was an ongoing process, messages changed and so a clear network which was dynamic was important.   


A Member of the Panel commented that in his view he thought key messages needed to be delivered from one body rather than multiple champions.  He suggested the Cabinet Member or Director needed to take the lead in relaying messages rather than individuals as he was concerned the messages could be diluted and cause confusion.     


The Chair asked the following question, “A recent BBC Article - identified that people with learning disabilities were up to six times more likely to die from Covid-19 during the first wave of the pandemic.  A report from Public Health England found the death rate for those with a learning disability was 30 times higher in the 18-34 age group.  What action is Wolverhampton taking as a health and care system to help safeguard this vulnerable group within the  ...  view the full minutes text for item 9.


Future Meetings

The future confirmed meeting dates of the Health Scrutiny Panel are as follows:-


14 January 2021 at 1:30pm


24 March 2021 at 1:30pm


The future confirmed meeting dates of the Health Scrutiny Panel were confirmed as follows:-


14 January 2021 at 1:30pm


24 March 2021 at 1:30pm


The Scrutiny Officer commented that the Chair and Vice-Chair of the Panel had indicated that they had requested Mental Health during Covid-19 to be an item at the January meeting in the New Year.  They wanted the item to be in two parts, adult’s mental health and young people’s in schools mental health.  The other item suggested had been an update on the progress of the CCGs merger.


The Chair wished all Members and Health Partners a happy and safe Christmas.