[To receive any apologies for absence]. 

An apology for absence was received from Panel Member, Cllr Milkinderpal Jaspal. 

Cllr Jasbir Jaspal sent her apologies as the Cabinet Member for Public Health and Wellbeing.

Vanessa Whatley, Deputy Chief Nurse – The Royal Wolverhampton NHS Trust sent her apologies to the Panel.

Marsha Foster, Director of Partnerships, Black Country Healthcare NHS Foundation Trust sent her apologies to the Panel. 

[To receive any declarations of interest]. 

There were no declarations of interest.

[To approve the minutes of the previous Health Scrutiny Panel meeting as a correct record]. 

The minutes of the meeting held on 14 January 2021 were approved as a correct record. 

[To consider any matters arising from the minutes of the previous Health Scrutiny Panel]. 

The Vice-Chair asked the Managing Director of the CCG if he could give an update on the work ongoing on structures for the CCGs merger.  The Managing Director of the CCG responded that the merger had been approved.  The appointments had been made to the new Governing Body and also to the Wolverhampton Commissioning Board.  The Governing Body would be meeting for the first time formally after the 1 April 2021.  In addition, during April there would be the first meeting of the Wolverhampton Commissioning Board.  There was an ongoing management change process in relation to the management structure to support the single CCG.  They were partly through the process; the first phase had been completed earlier in the year.  They were currently out to consultation with effected staff on the second phase of the management of change process.    

[To receive a short report on the Diabetic Eye Screening Procurement Programme in Birmingham, Solihull and the Black Country]. 

[Karen Davis, Interim Head of Public Health Commissioning NHS England and NHS Improvement will be in attendance]. 

The Interim Head of Public Health Commissioning NHS England and NHS Improvement presented a report on the Diabetic Eye Screening Programme in Birmingham, Solihull and the Black Country.  The current programme contract expired on the 30 June 2021.  They therefore needed to undertake a procurement exercise for the programme.  It was possible that the way the services were currently provided could change.  This was because the new provider could provide services in a different way or because the existing provider had a reduced amount of venues to use because of the Covid-19 restrictions.  There were two types of venues where diabetic eye screening could be provided.  One was GP practices or Health Centres and the other one was High Street opticians.  Mobile vehicles were an alternative option for diabetic eye screening providers to use as long as they delivered the services in line with the national specification.     

The Interim Head of Public Health Commissioning NHS England and NHS Improvement stated that as part of the patient engagement exercise they would use existing users’ feedback as part of the annual contract review from the existing provider.  There had been other procurements locally within the Midlands and so they could use this feedback as well but recognising that the population would not be reflective of the Birmingham and Black Country area.   They would be conducting some work with Diabetes UK, who had completed similar exercises to support patient engagement.  In addition, following discussions with the Chair and Vice-Chair of the Panel earlier in the day, she had agreed to form a set of questions which they would like responses to from users of the service.  They were particularly keen to receive responses from hard to reach groups. 

The Chair asked if he could have some more information on the patient engagement exercise.  The Interim Head of Public Health Commissioning NHS England and Improvement responded that they had some existing information from users of the service from the current provider.  They had previously completed a procurement in the area of South Staffordshire and so they had all of this information on file.  They were meeting Diabetes UK on the forthcoming Friday to discuss how they could help access the views of patients and users.  They recognised that people from hard to reach and deprived communities did not traditionally come forward to give their views.  They were happy to develop a set of questions which could illicit responses from patients in terms of priorities and issues they may have when accessing the service.  Members of the Panel could then distribute these questions to their contacts.  They were also open to suggestions on how they could obtain the views of patients in deprived Inner-City settings. 

The Chair asked if there were any plans to introduce new digital solutions to improve the eye screening programme.  The Interim Head of Public Health Commissioning NHS England and NHS Improvement responded that there were no plans currently that would impact on the current procurement.  The Diabetic Eye Screening Programme  ...  view the full minutes text for item 5.

[To receive an information pack and presentation from the West Midlands Ambulance Service University NHS Foundation Trust on their response to the Covid-19 pandemic].

[Mark Docherty (Director of Nursing and Clinical Commissioning) and Pippa Wall (Head of Strategic Planning) will be in attendance]. 

The Panel agreed to take the West Midlands Ambulance University NHS Foundation Trust item before the item on Covid-19 cases, testing and vaccinations due to the Director of Public Health experiencing IT issues.

The Director of Nursing and Clinical Commissioning, and the Head of Strategic Planning of the West Midlands Ambulance University NHS Foundation Trust gave a presentation on their Trust’s response to Covid-19 and on some other matters that had been requested.  Members complimented the representatives from the Ambulance Service on their thorough presentation, the slides of which were despatched with the agenda.  They also thanked the Ambulance Service for their vital courageous work in the health system.  They noted the outstanding rating of the service.

The Chief Executive of the Royal Wolverhampton NHS Trust remarked that the Royal Wolverhampton NHS Trust’s performance of ambulance turn around times in the last few months of 2020 had been appalling.  This was because normally to release ambulances they would put patients in corridors in the Accident and Emergency Department and provide nurses.  Due to Covid-19 they were not able to continue with this practice.  He therefore considered it remarkable the performance of the West Midlands Ambulance Service, in terms of response times, in Wolverhampton had not suffered.  They had provided a brilliant service.  He was pleased that the performance at New Cross Hospital had improved substantially, in terms of releasing ambulances. 

The Chair asked for the results of the Covid-19 antibody testing carried out on West Midlands Ambulance Service staff.  The Head of Strategic Planning responded that 22% of the staff tested for Covid-19 antibodies had them.  It had been sometime though since the tests had been conducted.  

The Vice-Chair stated that the NHS 111 Service was a vital service to help prevent A&E attendance and unnecessary ambulance call-outs.  He asked what steps were being taken to improve the service further.  The Director of Nursing and Clinical Commissioning responded that the 111 Service had been provided by West Midlands Ambulance service for approximately the last 18 months.  They had already carried out a number of improvements including ensuring that calls were answered promptly.  They had ensured that the training of the call handlers was robust and that they were appropriately supervised.  Every single call was recorded.  There was now a much larger clinical support into the 111 Service.  This included pharmacists, mental health nurses and Doctors.  People working for the 111 Service would also be trained to answer 999 calls and so the service was becoming more integrated.  He hoped this would encourage people to stay with the Ambulance Service.  He saw no reason why a call handler or paramedic could not one day work their way up the organisation to the role of Chief Executive.

A Panel Member complimented the Ambulance Service on their performance during the last year.  She asked how reflective the West Midlands Ambulance staff profile was of the general population in terms of equalities.  She also asked about the service’s Whistleblowing Policy for in  ...  view the full minutes text for item 6.

[The Director of Public Health will give a presentation on the latest information regarding Covid-19 cases, testing and vaccinations]. 

The Director of Public Health gave a presentation on Covid-19 cases, testing and vaccinations.  For the seven days up to the 21 March, Wolverhampton had a Covid-19 case rate of 60 cases per 100,000 people.  This was a marked difference from the earlier stages of the second wave, which had been a real challenge.  Six weeks before Wolverhampton had a case rate of 1000 per 100,000.  The average case rate per 100,000 for the region was 65.4, meaning Wolverhampton did not have a dissimilar rate.  In some areas in the West Midlands the rates were increasing again.  This emphasised that at a certain rate, probably around 100 cases per 100,000, any outbreaks would amplify the percentage increase rate at a local level.  The levels of Covid-19 cases in Wolverhampton were now at a similar level to those in early September 2020.  Due to an increase in lateral flow testing, they were now finding more cases which were largely asymptomatic. 

The Director of Public Health presented a slide on Public Health’s strategic approach which was based on three key principles.  These were the vaccination roll out, compliance and testing, and contract tracing.  Protecting the most vulnerable was a key aim.  The most vulnerable were those most likely to be hospitalised and had a greater chance of death.  The strategic approach was outlined in the Outbreak Control Plan which was currently being refreshed and was due to be published on the forthcoming Friday.  He commented that he would welcome the opportunity to present the Outbreak Control Plan at the next scheduled Health Scrutiny Panel. 

The Director of Public Health presented a slide on Covid-19 testing within the City.  The lateral flow sites for asymptomatic testing continued along with PCR sites for people exhibiting symptoms.  There was a total of 11 testing sites within the City.  Schools children and staff were now conducting tests in the home environment.  In Social Care, routine testing was taking place and also with NHS partners.  A local offer had just been launched to compliment the national offer to businesses, whereby they were incentivising organisations to embrace Covid-19 testing.  The more testing which took place, the earlier they could identify cases and prevent the virus spreading.  95% of the cases in Wolverhampton were now the UK variant, a very transmissible strain of the virus.  There was also a mobile testing unit in the City which was used in areas of high prevalence and also areas with low uptake for testing.  It had proven to be exceptionally useful.  In the past 7 days up to the 21 March, there had been 42,363 tests conducted in Wolverhampton.  He regarded this as a phenomenal effort.  They were averaging 42,000 tests a week within the City and this would be built on moving forward.  This was a good position to be in as the country came out of lockdown.  He stated that the National Test and Trace system picked up 78% of cases within Wolverhampton.  Through the local tracing function, they picked  ...  view the full minutes text for item 7.