Agenda item - Covid: Local Health & Care System Responses and Planning

Report of the Executive Lead, Strategy, Governance & Law on health and care systems actions and planning regarding the Covid emergency (copy attached)

13.1    This item was introduced by Lola Bankoko, CCG Managing Director. Grace Hanley, BHCC Assistant Director, Health & Adult Social Care, was also present to answer questions.

13.2    Members were told that there were a number of learning points from the first wave of Covid 19. These included:

·         Systems were used to responding to localised, short-term incidents rather than sustained, global ones.

·         There was sometimes an overload of information and guidance from Government.

·         Having different digital platforms hampered co-working.

·         There were significant issues with PPE supply.

This learning has been incorporated into system planning for service restoration & recovery and into planning for winter 20/21. Particular points include:

·         The need to support staff at risk of burnout.

·         Actions to address health inequalities.

·         Recovery of services is complicated by the need to maintain social distancing and infection control requirements. This means that many services will be running at lower than normal productivity levels.

·         Workforce shielding and self-isolation will also impact productivity.

·         Primary care is resuming more face to face consultations.

·         Elective procedures have resumed.

·         Dementia services have resumed.

·         Urgent and cancer care were never paused. However, there has been reduced demand in these areas, with people reluctant to present for treatment. Work is under way (including projects with Healthwatch) to encourage people to present for treatment if they need to.

·         Mental health demand has increased, and additional capacity has been added for psychological therapies, the crisis café etc.

·         Communities with worse Covid outcomes will be targeted. These include BAME communities, people with disabilities and men.

13.3    Grace Hanley added that services have learnt a lot during the pandemic, particularly around partnership working and the challenges and opportunities offered by remote working. It is important that organisations adapt quickly to remote working as staff require different types of support.

13.4    In response to a question from Cllr Williams on engaging with digitally excluded people, Ms Bankoko told members that face to face consultations will always be offered where clinically appropriate, although this may involve longer waiting times. The switch to digital was much more rapid than had been planned for and the system is still learning the best ways to operate digitally. For example, staffing is finite which means that phonelines may not always be answered promptly. However, using call-back means that callers do not have to wait for long periods for their call to be answered.

13.5    Fran McCabe commented that the move to digital had changed the relationship between service users and providers. The recent Healthwatch survey of experiences with digital found that younger people were generally comfortable with digital contact, but that older people were less so. Face to face appointments are better for many people and it is important that services do not over-rely on digital. Ms Banjoko noted that ‘digital by default’ was really just an interim position to deal with an urgent situation and that future services would include a mix of digital and face to face.