Agenda item - Presentation from Brighton & Hove Clinical Commissioning Group (CCG) and BHCC Health & Adult Social Care (HASC) on the Covid 19 Crisis

(verbal presentation)

7.1       This item was presented by Rob Persey, BHCC Executive Director, Health & Adult Social Care; Ash Scarff, Deputy Managing Director, CCGs; and Alistair Hill, Brighton & Hove Director of Public Health.

7.2       In response to a complaint from Cllr Powell that links on the BHCC website Covid pages were not working properly, officers agreed to investigate. (It appeared that, although all the appropriate information was on the website, some faulty links meant that not all pages were linked correctly to other pages. The issue was subsequently resolved.)

7.3       In response to a question from Cllr Grimshaw on how the NHS planned to manage a possible second wave of Covid, Mr Scarff told members that the CCG was working with NHS Trusts to optimise workforce planning and flexibility. Moving some services to digital interfaces may also increase productivity, particularly where social distancing or PPE issues have made face-to-face interactions less productive. Mr Persey added that partners were working on the Mental Health Collaborative: developing new pathways around wellbeing and community mental health to ensure that there is additional capacity to meet demand spikes.

7.4       In answer to a query from Cllr McNair on messaging around face masks, Mr Hill confirmed that there is a role for local Public Health teams to promote the appropriate use of face coverings.

7.5       In response to concerns raised by Cllr McNair about tourists and/or protestors congregating in large numbers in the city, Mr Hill agreed that this was a worry. It is important that everyone continues to practice social distancing.

7.6       In answer to a question from Cllr Hills on transport and air pollution worsening the impact of Covid, Mr Hill agreed that this is a real issue. The city Joint Health & Wellbeing Strategy already recognises the connections between air quality and health and wellbeing and Public Health works closely with transport planners to improve air quality and to encourage active travel. This has led to the recent successful active travel funding bid.

7.7       In response to a query from Cllr Osborne on whether Covid mortality data can be broken down into demographic groups, Mr Hill agreed to look into this, but noted that there is a lack of mortality data relating to certain demographics (e.g. ethnicity). It is still too early to know how many more deaths there will be this year than against the five-year average.

7.8       In answer to a question from Cllr Osborne on the timing of lockdown, Mr Hill told members that it was difficult to say whether lockdown came at the right time, in part because public behaviour was already changing before lockdown – e.g. the week prior to lockdown saw significant drops in transport activity.

7.9       In response to points raised by Cllr Osborne regarding care homes data and test & trace, Mr Hill responded that he would look at how data on care homes is represented as this may appear confusing.

7.10    In answer to a question from Cllr Osborne on test & trace, Mr Hill explained that if people develop Covid 19 symptoms then they should self-isolate (as should their household members) and seek a test. If the test is positive, then they will be put in touch with the national test & trace service which will follow-up any contacts they have made. Contacts will be instructed to self-isolate for 14 days and to seek for a test if they show any symptoms. Local Public Health teams do not directly deliver this test and trace service however  where a case is associated with  a ‘complex setting’ (e.g. a school or care home etc.), the local Public Health England Health Protection Team will lead contact tracing and the local BHCC Public Health team are likely to be involved.

7.11    Fran McCabe noted that she was concerned about staff burn-out given the long and intense hours that staff across NHS and care services had been working during the crisis. She was also eager to know whether the successful Integrated Discharge and Responsive Services teams would be retained following the crisis. Mr Persey agreed that staff burn-out is a critical issue affecting back-office as well as front-line staff. There are no guarantees that funding will continue for any specific service, but there is definitely a case to be made to protect successful interventions as much as possible. Mr Scarff added that CCGs are currently evaluating the success of Covid measures. There is a particular concern about waiting times, especially for cancer services. This is something that should be scrutinised by the HOSC. Although cancer services continued throughout the crisis, there have been issues with diagnostics and robust recovery planning is needed here.

7.12    Ms McCabe added that there has been an understandable focus on the success of digital during the crisis; but whilst it certainly has an important role to play, it needs to be recognised that digital has its limitations, and it is questionable whether it is really what patients want. Mr Persey agreed that this was a valid point and is something that services are aware of.

7.13    In response to a question from Cllr Appich on data for local health and care worker deaths, and whether any of these came from BAME communities, Mr Hill said he did not have data on this but would investigate.

7.14    In response to a query from Cllr Appich on test & trace communications to the deaf community and to BAME and other potentially hard to reach groups, Mr Hill told members that communications would build on current good practice on engaging with various communities. Community Works and the BHCC Communities team are actively involved in this work, and a guiding principle is that this will be done with communities rather than top-down. The Public Health team is also happy to engage directly with communities, and translated resources are being developed.

7.15    Cllr McNair commented that he was worried about any wholesale move to digital for mental health services, given the therapeutic value of developing face-to-face relationships. Mr Persey agreed, and told members that thought needed to be given to mental health workforce planning given the likely future demand for services.