Agenda and minutes

[To receive any apologies for absence]. 

Apologies for absence were received from Panel Members, Cllr Obaida Ahmed, Cllr Bhupinder Gakhal and Rose Urkovskis. 

Other apologies received were as follows :-

City of Wolverhampton Council’s, Director for Children’s and Adult Services, Emma Bennett. 

Deputy Chief Nurse at the Royal Wolverhampton NHS Trust, Vanessa Whatley. 

The Head of Engagement and Communication at the CCG, Jayne Salter-Scott. 

[To receive any declarations of interest]. 

There were no declarations of interest.

[To approve the minutes of the meeting held on Thursday, 19 November 2020 as a correct record].

The minutes of the meeting held on 19 November 2020 were confirmed as a correct record. 

[To consider any matters arising from the minutes].

There were no matters arising from the minutes.

[To receive a verbal update from the Chief Executive Officer of Black Country and West Birmingham CCGs - Mr Paul Maubach and the Managing Director of Wolverhampton CCG - Mr Paul Tulley on the CCGs merger]. 

The Chief Executive Officer of the Black Country and West Birmingham CCGs gave a verbal update on the CCGs merger.  In attendance for the item there was also the Managing Director of Wolverhampton CCG.

He stated that the CCG was a membership organisation, which was made up of the GP practices.  In October in the previous year, GP Members across the four CCGs across the Black Country and West Birmingham had voted in support of a merger of the four CCGs.  90% of practices across the four CCGs had supported the merger, which he considered to be an outstanding endorsement for the merger to proceed.

He commented that they were expecting the merger to be completed by 1 April 2021.  As part of the new arrangements there would be a local Commissioning Board, which would have Paul Tulley as a member and local GPs.  In addition invitations would be extended to the Director of Public Health and the Director of Adult Services to participate as and when they saw appropriate.  The trajectory which they were on, was to as much as possible, to transfer and devolve as much work into the new Integrated Care Partnership arrangements.  These arrangements were being developed by the Royal Wolverhampton NHS Trust.  They believed that the main emphasis in terms of the way they developed service delivery across Primary, Secondary Care and Community Services in Wolverhampton would be by supporting the partnership between the Royal Wolverhampton NHS Trust, the GP Practices and the Council. 

The Chairman had submitted the following questions in advance of the meeting to the Chief Executive Officer of the Black Country and West Birmingham CCGs :-   

1.     How will the Black Country CCGs Senior Management Team ensure that Wolverhampton does not suffer financially as a consequence of the merger? Will there be ring fenced budgets for the Wolverhampton area and will there be extra investment to help improve health inequalities, which have been even more marked by Covid-19? 

2.      Wolverhampton CCG has returned a surplus in recent years, in contrast to some neighbouring areas; can we be assured that surplus funds in the future will be re-allocated to improve health outcomes for Wolverhampton citizens?         

3.     Can you demonstrate how the merger will accelerate plans to ensure an improved and consistent quality of care in Primary Care across Wolverhampton.  Have you identified within Wolverhampton the areas which you will be looking at to improve Primary Care?    

The Chief Executive Officer of the Black Country and West Birmingham CCGs responded that when he was first appointed at Dudley CCG, they had actually given financial support to Wolverhampton CCG in his first two years.  More recently he rectified Walsall’s CCG deficit within a year as the turnaround Chief Executive.  He added that over the CCGs history across the Black Country all four CCGs had good financial stewardship including Wolverhampton.  It was his intention to maintain good financial stewardship and also to maintain investment in each of the places.  They would approach this by increasingly  ...  view the full minutes text for item 5.

[The Director of Public Health will give a verbal update on Covid-19 vaccinations and testing in the City of Wolverhampton]. 

The Director of Public Health gave a presentation on the subject of Covid-19 vaccinations and testing in the City.  Wolverhampton currently had a case rate of 854.4 per 100,000.  This was a very high rate in both a regional and national context.  The percentage case rate was down by a percentage of minus 17% from the previous week, which was a positive sign.  The average case rate in England was exceptionally high at a level of over 500 per 100,000.  The cases per day were extremely alarming and there had been one day when they hit 486 cases in one day.  The new Covid-19 variant, it was thought was driving the high rate of infection.  Working with Public Health England, it was thought that the new variant accounted for over 70% of new infections in the City. 

The Director of Public Health commented that the Wolverhampton Covid-19 case rate heat map was showing that the confirmed cases were increasing in the over 65’s and in people aged under 15.  They were targeting people most at risk to encourage them to keep themselves safe and to limit their movement within the population.  The messaging had resulted in a lower than expected death rate during the pandemic compared to the City’s health burden pre-Covid.  He wanted to be able to continue this going forward.  He was however concerned with the unprecedented rates of infection in people aged over 65.  This was worrying as the health risks of Covid-19 increased as you aged.  The impact of the high cases had not yet been seen within the hospital setting to the extent to which it would be in the future.

The Director of Public Health stated that testing within the City was the highest rate within the West Midlands and it was currently the eighth highest rate in the country.  17,479 tests had been undertaken in the seven days leading up to the 11 January 2021.  Testing was a core part of the strategy in fighting the pandemic in Wolverhampton.  He described the testing approach as a “Hub and Spoke” approach with a hub at the Civic Centre and spokes in the community, run by the community.  The first lateral flow test pilot had commenced in Sedgley Street Gurdwara.  At the end of the pilot 67% of those who had attended were from the BAME (Black, Asian and Minority Ethnic Community).  This had far outstripped other delivery modes previously in the City, which reinforced their approach to build on the model.  As a consequence, there was now a testing site at Bilal Mosque, St Joseph’s Church and Pendeford Library for key workers and in particular Teachers.  There were 4 additional community sites scheduled to open in the forthcoming weeks.  They would also be rolling out a Schools offer and a Workplace offer, for people that had to leave their home to go to work.  A regular testing programme for these people was the intention.   

The Director of Public Health presented a slide on Covid-19  ...  view the full minutes text for item 6.

[To receive a report on Mental Health Services and the Covid-19 response] 

Andrew Moody from Black Country STP Mental Health Commissioning introduced the presentation on Mental Health Services and the Covid-19 response.  When the pandemic started, they had setup twice weekly meetings of a group titled, the Black Country STP Mental Health Group.  These meetings brought all the partners together who were involved in providing Mental Health Services.  It was a forum which acted as an oversight and planning group which could make decisions.  It took financial decisions on where budgets provided from the Government, for the response to the pandemic, were allocated.  The appendix to the report provided with the agenda for the meeting detailed how the money had been used. 

Mr Moody commented that a number of wards and places of care had been closed during the pandemic due to a patient or staff member testing positive for Covid-19.  This had naturally had an impact on the capacity of Mental Health Services and the ability to provide access to inpatient facilities.  One of the ways they had responded to the challenge was by commissioning additional capacity.  He felt that they had responded quickly to the challenge and had sourced additional providers to meet the demand.  

Mr Moody remarked that communications during the pandemic were key.  Messages from Government and NHS England were being received regularly and it was important that these messages were sent to the appropriate people through the right channels as efficiently as possible.  The Black Country STP Mental Health Group had been a useful forum for problem solving and finding practical solutions.  PPE was one of the problem areas which they were able to effectively solve.  For all the challenges of Covid-19, they still had to continue their normal day to day work.  He cited the example of the improvements being made in perinatal health, for which there was currently a Community Transformation Programme.  It was therefore important to balance the response to the pandemic with ensuring that mental health services as a whole were continuing.  

Mr Moody commented that they had realised early on that Covid-19 was disproportionately effecting people in the Black, Asian, Minority, and Ethnic Community.  The Black Country Voluntary Services Group had been established, which met on a weekly basis and brought non-statutory partners together with other key partners such as the Police and Public Health.  The group helped to connect with people who ordinarily it would be a struggle to reach.  The pandemic had acted as a catalyst to make quick decisions that normally would have taken longer to have made.  The pandemic had helped to establish relationships which had proved beneficial to groups who had perhaps struggled to connect in the past.  At the end of the first lockdown it had been universally agreed to continue with the group.

Mr Moody remarked that the Black Country BAME Mental Health Steering Group had been established during the course of the pandemic.  Tackling inequalities across the system was one of its main aims.  It had been a very positive group. 

The Director of  ...  view the full minutes text for item 7.

[The next confirmed meeting of the Health Scrutiny Panel is scheduled to take place on Wednesday, 24 March 2021]. 

The Chair confirmed that the next scheduled meeting of the Panel was on Wednesday, 24 March 2021.  The Scrutiny Officer commented that after discussions with the Chair and Vice-Chair it had been proposed that the West Midlands Ambulance Service University NHS Trust would attend the March meeting to discuss their response to the Covid-19 pandemic.  A further item would be on Covid-19 cases, testing and vaccinations.  He added that the proposed agenda could potentially be revisited given the fast-changing nature of health at the present time.  

The Chair, on behalf of the Panel, thanked all the contributors to the meeting.

The meeting closed at 3:31pm.