Agenda and minutes

To consider and approve the minutes of the previous meeting held on 9 July 2020, as a true and correct record of the proceedings.

Resolved:-

That the minutes of the meeting held on 9 July 2020, be approved as a true and correct record of the proceedings.

To receive declarations of interest from Members in respect of items listed on the agenda.

There were no declarations of interest.

To receive questions relating to items of business on the agenda from members of the public or press who are present at the meeting.

The Chair confirmed that no questions from the press or public had been submitted.

To consider whether the press and public should be excluded from the meeting during consideration of any part of the agenda.

The Chair confirmed that there was no reason to exclude members of the press or public from any items for consideration at the meeting.

To consider a report exploring the progress made 10 years on from the Marmot review in respect of addressing health inequalities.

Consideration was given to a report providing an overview of progress over the last 10 years related to the Marmot Report, which revealed significant health inequalities throughout the country. The report illustrated that very little positive progress, if any, had been made over the last 10 years in respect of the six objectives outlined by Marmot. These were: giving every child the best start in life; enabling all children, young people and adults to maximize their capabilities and have control over their lives; creating fair employment and good work for all; ensuring a healthy standard of living for all; creating and developing sustainable places and communities; and finally, strengthening the role and impact of ill-health prevention. With respect to these goals, findings had shown even greater decline and deprivation in people’s health broadly in the last 10 years. The report averred that initiatives from central government emphasising changes to behaviour of individuals and to the health care system had not been hugely effective, indicating the serious need to identify and shape the social determinants of health. The challenge, then, was to find ways to improve the social determinants of health without the benefit of extra local government funding following a decade of austerity. It was noted that the purpose of bringing this report today was to garner input that would feed directly into the consideration and decision on this topic by the Health and Wellbeing Board at its 16of September meeting. Data illustrating how deprivation has affected Rotherham, specifically, was also considered. The data included Rotherham’s measure on the indices of deprivation, covid-19, and other areas related to health inequality and social determinants of health. It was noted that on some measures Rotherham has not followed national trends—with worse outcomes for women than for men.

In discussion, Members requested more information to explain why this area had declined so much in the last 10 years, and if anything could be learned from other areas that have not declined as much as Rotherham. In response, officers emphasised the difference in baseline status of the various areas and authorities. A further response in writing was offered in order to provide more detail from a Public Health perspective as to lessons learned comparatively with other areas.

Clarification was also requested regarding the provision of testing to people with disabilities. In response, officers provided reassurances that people with disabilities had been involved in testing, and it was agreed that one of the officers would come and talk to a meeting of Speak Up to answer more questions about this topic.

Members asked if more funding would be provided to help refresh efforts in early intervention and education. The answer asserted that no extra funding from central government could be expected. It was noted that places where there were lots of tests and positive cases were not the only areas of concern because places where there have been none or very few could hide another issue. Currently, there was a recruitment campaign for a  ...  view the full minutes text for item 100.

To consider a report providing a progress update in respect of the Carers Programme.

Consideration was given to a report providing information about a developing strategy and offer for Carers in Rotherham, including unpaid Carers and young Carers. Recent efforts to redefine pathways had necessitated a subsequent redefinition of the Carers Strategy. Carers had been included as part of the Place Plan. The report illustrated the framework to refresh the Carers Strategy based on feedback from Carers themselves, in which Carers contributed potential improvements that would help them most. Carers stated they hoped to see four key recommendations: a smoother transition from children’s to adults’ services, consistency in approach – such as dedicated case workers, strengthening information and advice that is available to Carers, and making sure that the target operating model had enough advice and support for Carers to help them avoid hitting the crisis trigger point. Incorporating this feedback from Carers as well as feedback from partners, the implementation plan was created to last through this year and from 2021-25.

Tasks for this year were divided into four quarters, and a number of these were completed, including a survey feedback process and a peer review feedback process in February. In March, resources were reallocated to meet the COVID crisis. In the months that followed, activities still continued but did not follow the timeline. Through May, June and July, unpaid Carers’ meetings were held because it was clear that information and good advice was needed. A Carers information pack was also put together for comment and review by partners before publishing among the partners’ networks. The Carers Grant programme offered £50k to support Carers, with 31 applications that have come through so far against that grant and Crossroads Carers facilitating this applications process.

It was emphasised that, while the timeline was interrupted due to redistribution of resources during COVID, the team have still made progress against the original programme. Some tasks that were still ongoing had been able to begin on time and had been able to make positive progress. The next steps were to build on the assistive technology interest people have, since people were all working in different ways now. Technology also had allowed Carers to communicate with each other and providers to get the best information in the fastest way possible. Calls for IT support and equipment had been the most prevalent requests in recent days. To meet the demand, work was currently in progress with the Digital Solutions Group in Adult Social Care.

As Council buildings remained closed for now, and eventually reopened, the implications for the Carers Centre would be considered. The important thing was understanding the developing changes and their implications. Creating a new timeline was also important now, and the new strategy was expected to be ready for introduction in quarter one of 2021. The current strategy would run until 2021. The key objectives underway were: that the Carer experience would be mapped, examining any gaps and embedding new knowledge of these gaps into the Carers programme; building on the information offer by looking at traditional  ...  view the full minutes text for item 101.

To receive an update briefing for information from Healthwatch.

Consideration was given to a briefing presented by Healthwatch providing information into recent activities and future plans. Among Healthwatch’s news was the selection of a new Steering Group comprising five members from the local area who have agreed the new Work Programme, with three priorities for the remainder of the year:

1.      Mental Health Issues that have arisen as a result of COVID 19.

2.      Changes to Health Care Services: examining what works and what does not work, especially virtual consultations.

3.      Adult Social Care

It was noted that for each of these priorities, impacts on the BAME communities would be duly considered and prioritised.

It was further noted that Healthwatch had just concluded recruitment and appointment of a new Engagement Officer and an Information and Campaigns Officer. The recruitment was described to have been timely, as engagement activities had considerably increased. During Quarter One, 70 phone calls were taken; during August alone 72 were taken. It was noted that this increase was likely a result of publicity on social media and other digital platforms throughout the pandemic.

Healthwatch were also participating in a joint campaign with the Care Quality Commission, #becauseweallcare. The first part of this campaign had examined hospital discharge during the pandemic. Currently, case studies were being collected, and the report on this work, tailored for a Rotherham context, was expected to go out during late September. Further collaborative efforts were summarised including PCM discussions, working with the Coordinator of Diversity and Inclusion at Rotherham Hospital; setting up a quarterly newsletter and developing two placements once again this year for year-three medical students focusing on loneliness and obesity.

Following the update, the Chair thanked Lesley Cooper for keeping the Commission informed and congratulated Healthwatch on accomplishing so much in such a short time.

To receive a verbal update from The Rotherham NHS Foundation Trust with respect to post Covid-19 activities.

Consideration was given to a verbal update from The Rotherham NHS Foundation Trust. The update provided information as to the activities of Rotherham Hospital during COVID to date as well as preparations for the future, especially the next few months.

It was emphasised that covid and non-covid pathways had had to be developed, and areas and staff had been divided into covid and non covid. These ways of working paired with PPE and social distancing measures had reduced efficiency. Whilst there were exceptions, most patients who presented with covid were treated using the covid hospital approach. Those needing inpatient care were sent to the infectious disease unit at Royal Hallamshire because expertise was concentrated there, and it helped the hospital contribute to national research by concentrating covid treatments there for study. It was noted that there were some exceptions. For example, as of the current date, there had been one patient at Rotherham hospital being treated for covid. In total, 652 patients with covid had been treated, 19 of these as inpatients, and 204 of these had died. Staff had been off with covid or in isolation because of contact, but these numbers had improved such that currently only 25 staff were currently off for covid-related reasons--either because they had covid or because they were in quarantine.

The main thrusts associated with the National Phase 3 Letter were in three areas: getting back to near normal activities, preparing for winter whilst staying able to switch back on covid response if needed, locking in learning that has come from innovative pathways that have been developed. 

Regionally, a plan was in development regarding what could be achieved by working differently. The draft plan targets were similar to those of other trusts across the area, as many similar problems had been faced by all. Preparations for winter respiratory viruses and vomiting viruses were underway. The Trust had struggled over recent years with emergency pathways and bed base, etc. These issues had begun to be addressed, which had been accelerated by covid. Staff were currently working on being able to organise the bed base to support frailty, short-stay patients, etc., in ways that are most effective. A goal of 100% staff compliance with flu vaccination, beginning in late September, was underway. As for locking in learning, digital methods of delivering care had been undertaken. Many of the innovations could have been implemented years ago, but people have found it natural to continue to provide care in traditional ways.  It was expected that in future a mix of face to face and virtual consultations would take place. It was also noted that South Yorkshire would be participating in an upcoming pilot programme for a treatment for type two diabetes.

Following the update, Members asked for more information about how the initiative about type two diabetes would work. The response noted that the initiate had been designed for rapid weight loss paired with life coaching and education. The programme had been tested extensively in research, and  ...  view the full minutes text for item 103.

To consider a briefing report providing an overview of the recent scrutiny workshop on Covid-19 Response and Recovery that was held on 16 July 2020.

The Governance Advisor presented outcomes from the discussion held at the workshop on COVID-19 recovery and response, a workshop which examined the local picture during COVID, including such topics as GP’s, Care Homes and Hospitals. The purpose of the Workshop was twofold: to gain assurances that the right activities were taking place to respond to COVID and prepare for any second wave, and to gain assurances that plans were in motion to recover and reset any activities which had been altered or paused due to COVID.

Resolved:-

1.       That gratitude and thanks to colleagues working at Rotherham Hospital and in primary care be formally recorded and fed back, commending them on their commitment and bravery in responding to the pandemic and caring for patients. 

2.       That the gratitude and thanks of health partners to colleagues working in care homes be formally recorded and fed back, in recognition of their hard work and care for residents during the pandemic.

3.       That Members support the Council and partners through their communication with residents to reiterate key messages, to help people understand the measures being taken, and to encourage people with health needs to go to primary care in the first instance to ensure early presentation for diagnosis.

4.       That residents be encouraged to download and use the Rotherham Health App as they are able.

To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.

There were no urgent items of business.

The next virtual meeting of the Health Select Commission will be held on Thursday, 22 October 2020, commencing at 2 pm.

The Chair announced that the next virtual meeting of the Health Select Commission would be held on 22 October 2020, commencing at 2.00 pm.