Agenda and minutes

It was moved and seconded that Councillor Sam Corcoran be appointed the Chairman.

RESOLVED:

That Councillor Sam Corcoran be appointed as Chairman.

It was moved and seconded that Dr Andrew Wilson be appointed as the Vice Chairman.

RESOLVED:

That Dr Andrew Wilson be appointed as Vice Chairman.

Apologies were received from Chris Hart (Cheshire East Social Action Partnership), Dr Patrick Kearns (Cheshire East Integrated Care Partnership), Ged Rowney (Cheshire East Council), Clare Watson (NHS Cheshire CCG), Caroline Whitney (CVS Cheshire East).

To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.

There were no declarations of interest.

To approve the minutes of the meeting held on 23 March 2021 and note the minutes from the informal virtual meeting held on 26 July 2021.

RESOLVED:

That the minutes of the meeting held on 23 March 2021 be approved as a correct record.

That the minutes from the informal virtual meeting held on 26 July 2021 be noted.

In accordance with paragraph 2.32 of the Committee Procedural Rules and Appendix 7 to the Rules a period of 10 minutes is allocated for members of the public to address the meeting on any matter relevant to the work of the body in question.  Individual members of the public may speak for up to 5 minutes but the Chairman or person presiding will decide how the period of time allocated for public speaking will be apportioned where there are a number of speakers. Members of the public are not required to give notice to use this facility. However, as a matter of courtesy, a period of 24 hours’ notice is encouraged.

Members of the public wishing to ask a question at the meeting should provide at least three clear working days’ notice in writing and should include the question with that notice. This will enable an informed answer to be given.

There were no public speakers.

To agree the appointments of the Non-Voting Associate Members of the Board for the next 12 months.

RESOLVED

(1)That the current appointments for Non-Voting Associate Members be agreed for a further year, with the exception of Frank Jordan who left the local authority.

(2)That the newly appointed Executive Director of Place for Cheshire East Council be appointed as a Non-Voting Associate Member.

To receive an update on the development of Long Covid services.

Dr Andrew Wilson gave an update on the development of Long Covid Services which detailed the wide ranging variety of symptoms associated with long covid and the difficulty in dealing with these. Following the guidance published by NHSE/I in April 2021, national funding had helped support a proposal for a new pathway consisting of four tiers covering self care, primary care, community and specialist management services.

Comments and questions were made in respect of

-       Any indication of the impact on the primary, secondary and tertiary care services of those within Cheshire who have long covid;

-       The numbers who have had COVID who go on to develop long covid;

-       Why there were so few referrals to Cheshire and Merseyside ICS post covid assessment service;

-       Would tier 3 services be managed through Care Communities?

RESOLVED

That the update be noted.

To receive an update on the Urgent and Emergency Care Recovery and Winter Plan.

John Wilbraham (Cheshire East Integrated Care Partnership) and Councillor Carol Bulman joined the meeting during this item.

Dr Andrew Wilson and Jill Broomhall provided a verbal update on the expected winter pressures. These included an increase in flu levels, Respiratory Syncytial virus (RSV) in younger children, running alongside the current covid pressures.

The A&E Delivery Board had addressed a number of risks across the system which included

-       The insufficient community health and social care capacity to support discharges;

-       High numbers of those waiting in A&E;

-       Failure to meet ambulance handover timescales;

-       Staffing shortages across the whole system;

-       Increase in pressures on mental health services;

-       Increase in admissions due to RSV in those younger children.

Following identification of these risks the A&E Delivery Board had developed a number of actions which would be agreed at the A&E delivery board meeting on the 15^th September. These would then be reported back to the next Health & Wellbeing Board.

The A&E Delivery Board identified that local system awareness, development of hot hubs and media communication would be key to supporting the increase in winter pressures.

RESOLVED

(1)  That the update be noted;

(2)  That the actions agreed at the A&E Delivery Board be reported back to the next Health and Wellbeing Board.

To receive a verbal update on Test, Trace, Contain, Enable.

Matt Tyrer gave an update on the Test, Track, Contain and Enable system in Cheshire East.

There had been a slight increase in numbers within Cheshire which was now up to 344, per 100,000. There had been a general increase in numbers across the North West and North East. The South West had recently seen a spike in numbers associated with younger people mixing at a surfing event although these had now reduced significantly. There were concerns that there could be an increase in rates following the return of schools, but with the proactive approach to testing and high uptake of vaccinations it was hoped that any increase would be small in comparison to the increase that had been seen in Scotland.

The highest rate of numbers were in the 10-19 age year group but there had been an increase in numbers in the over 60s which was associated with greater mobility and testing over summer, alongside caring responsibilities for grandchildren.

There had been a good uptake in the vaccination programme which had seen Cheshire East identified as the highest performing of the nine authorities across Cheshire East and Merseyside. The uptake rate for those over 60s getting their second vaccination was over 95% and there had been a generally been a good uptake in the younger generation.

There had been a slight increase in hospital occupancy, but the number of deaths remained low.

Information on the development of the national strategy for the Test and Trace system is still awaited. In the meantime, lots of innovative work had been undertaken by the team to help support this and examples of good practice had been fed back to the Department of Health.

The Swab Squad had been proactive throughout the pandemic and recognition of their work had resulted in the team recently being shortlisted for an Association of Public Sector Excellence award.

RESOLVED

That the update be noted.

To receive a verbal update on the work of the Cheshire East Place Partnership.

This item and the Cheshire East Integrated Care Partnership update were considered together.

Steven Michael provided a verbal update on the Cheshire East Place Partnership and the Cheshire East Integrated Care Partnership.

A series of lock in sessions had been held with key accountable officers supported by him as the Independent Chair. The purpose of the sessions was to discuss the following:

1)    To seek agreement around the strategic vision for health and social care in Cheshire East;

2)    To identify the skills and capacity required to deliver the vision;

3)    To create the delivery plan for the coming years;

4)    To review the options in relation to the governance for it to work and agree a way forward.

There was a genuine shared ambition for service improvement and development within Cheshire East Place which was acknowledged as a significant step in the process.

The strategic vision for the population-based model for health delivery and service change, which had previously been presented to the Health and Wellbeing Board (HWBB) was agreed by all present.

Dr Lorraine O’Donnell explained that the work conducted in the lock-ins was focussed on those changes that would have the biggest impact on outcomes for its residents. This focus on ambition for change and shared understanding of the way forward was creating considerable momentum for change. She noted that each officer had taken away specific actions from the lock in sessions to help drive the agenda forward. As an example, on behalf of the Council she was leading the work to:

-          Complete a review of the governance arrangements that would be required, including consideration of the role of the ICP Board and the Health and Wellbeing Board in the future model.

-          Establish an Integrated Care Board.

-          Progress the appointment of a Place Lead.

The data requirements of a ‘population-health’ led approach were referenced and Dr Tyrer advised that Dr Susie Roberts had been appointed as a new Public Health Consultant with the lead for Health Intelligence. The Chair welcomed Dr Susie Roberts to the board and invited Dr Roberts to introduce herself to board members.

The Chair thanked the Board members for their comments. The Board endorsed the strategic vision and suggested that it would be helpful to have further discussion around the structure and governance at a subsequent Health and Wellbeing Board. He stressed the need for primacy of place within its ICS developments.

Dr Andrew Wilson gave an update on the work that would be required before and after April 2022 in relation to the disestablishment of Cheshire Clinical Commissioning Group. A Bill going through parliament was expected to dissolve CCGs on the 1 April 2022 and the Integrated Care Board would take on the CCG responsibilities. Cheshire CCG covered Cheshire East and Cheshire West and Chester and as a temporary measure pre-April 2022, the governing body would be considering the proposal to have two ‘Borough Place based’ committees at its October meeting. These would include additional local authority representatives. Discussions  ...  view the full minutes text for item 24.

To receive a verbal update on the Cheshire East Integrated Care Partnership.