Agenda, decisions and draft minutes

Apologies for absence were received from Innes Richens and Helen Atkinson.

The Cabinet Member agreed to consider agenda item no.5 Public Health Response to Covid-19 first but for ease of reference, the minutes will be kept in the original order.

Councillor Smith declared an interest as she is in paid employment for the Hampshire branch of Unison.

Purpose

To inform the Cabinet Member for Health, Wellbeing & Social Care of the intention to extend arrangements for the Southsea Unit as part of the Portsmouth discharge to assess, (D2A) facility, providing reablement for Portsmouth citizens discharged from Hospital with care and support needs.

To inform the Cabinet Member for Health, Wellbeing & Social Care of the intention to assess future use of the Victory Unit, Wyllie Road site.

The Cabinet Member noted the report which is for information only and is not subject to call-in.

Andy Biddle, Director of Adult Care, introduced the report.

In response to questions from members, Mr Biddle explained that the Victory Unit had had the six-week rehabilitation model since it opened but it was not always very efficient as people sometimes stayed there longer than they needed to. The aim is to extend the rehabilitation period in people's own homes as they often do well in their own environment. They need help at first but then re-establish their own routines so rehabilitation can be as effective at home as in a bedded unit. Adult Social Care needs to examine the evidence to see if the six-week rehabilitation period is still the best model.

Councillor Winnington commended officers on the successful move from the Victory Unit to the Southsea Unit at Harry Sotnick House. It was very sensible to consider how to use resources on a city-wide basis. There is real expertise in the council's care sector and the work done over the last few years will show where there are gaps in care provision. Reviewing the future of the Victory Unit is part of this work.

The Cabinet Member noted the report which is for information only and is not subject to call-in.

Purpose

To update the Cabinet Member for Health, Wellbeing & Social Care on the Adult Social Care response to the Covid-19 pandemic that was presented to the Health, Wellbeing & Social Care Portfolio meeting in September 2020.

The Cabinet Member noted the report which is for information only and is not subject to call-in.

Andy Biddle, Director of Adult Care, introduced the report. Since it had been written testing has been made available for Personal Assistants. As of last week 77% care home staff have been vaccinated.

In response to questions from members, Mr Biddle said that Adult Social Care has tried to be flexible with supporting staff with stress and enabling them to get help, for example, ensuring the Employee Assistance Programme, is widely accessible. Support has been extended to care home staff. Mental health self-care will need to be made available after Covid-19, perhaps by exploiting digital resources. There is a practitioner with a particular interest in wellbeing who is helping staff.

There has been no provider failure during Covid thanks to local and national support. Before Covid there was over-supply amongst providers. The way forward is to manage the market so that there is the right provision but not over-provision. More people are staying in their own homes instead of going into residential care. Managing provision is complex and there is no perfect solution if providers want to withdraw. In the meantime the Victory Unit and a floor at Shearwater are a contingency measure in case of provider failure.

Councillor Smith thanked Mr Biddle personally for his hard work over the last year.

The supply of PPE after July is uncertain but could be a considerable burden for providers. Health measures such as "hands, face, space" are unlikely to be relaxed any time soon. Providers are not asking for help with PPE at the moment.

The number of Medically Fit For Discharge (MFFD) patients has fallen compared with March 2020 due to a number of factors. The NHS Scheme 2 funding means no assessments are carried out apart from a brief risk assessment so has reduced discharge delays. There is now a more seamless team approach with a single Senior Responsible Officer for discharge overarching NHS Solent and ASC. However, discharges are complex as patients' conditions can fluctuate rapidly, for example, someone could be MFFD in the morning but have deteriorated by the afternoon.

Councillor Winnington said the report is a good summary of what ASC is doing and demonstrates the importance of partnership working. He praised the work of the Portsmouth Mental Health Alliance which provides a wide-ranging support network. It is just as important to support staff as well as the people they look after. Engagement with care providers has enabled them to support vulnerable people at a time of enormous stress. They have coped magnificently. All care services in the city need to be recognised as key workers; this will help people see that care is a worthwhile career. He thanked ASC for all their work. In addition, cross-party support has enabled ASC and Children's Services teams to work together from a difficult time to a place of strength.

The Cabinet Member noted the report which is for information only and is not subject to call-in.

Purpose

To update the Health, Wellbeing and Social Care Decision Meeting on the Public Health Covid-19 Response including Test and Trace, Vaccination, Intelligence work and the work of the Health Protection Board and the Local Outbreak Engagement Board (sub-committee of the Health and Wellbeing Board).

The Cabinet Member noted the report which is for information only and is not subject to call-in.

Matthew Gummerson, Strategic Lead for Intelligence, introduced the Covid-19 Intelligence section of the report.

In response to questions from members, officers explained that although most care home residents have been vaccinated the slight increase in Covid cases in care homes may be because a single dose does not provide full efficacy; people can still test positive after vaccination. The cases were detected by asymptomatic testing. Mr Biddle mentioned that where two care homes had had recent outbreaks some residents had gone into hospital and it seems the vaccine reduces the impact of Covid.

Mr Gummerson said it was too early to give definite answers as to why the number of non-Covid deaths had been lower than average over recent weeks but it was probably due to the lower number of deaths from flu. The Covid restrictions have had a considerable effect on the number of deaths from flu and respiratory diseases. In a few months' time there will be enough data to analyse and interpret the figures.

Dominique Le Touze, Public Health Consultant, introduced the section on Test and Trace. Referrals to the local contact tracing service have fallen to about six cases per day. Community asymptomatic testing has not increased the demand on local contact tracing as much as thought. Approval has been received to continue community testing after 31 March and an options report has been written.

Councillor Smith said the role of the NHS, education and care homes in organising testing, and the support from volunteers, could not be underestimated. Their contribution should be placed on record. Councillor Winnington agreed that it was yet another affirmation of the local community working together.

Claire Currie, Public Health Consultant, introduced the section on vaccination. Surveillance of the effectiveness of the vaccination programme includes examining cases of Covid in care home residents who have been vaccinated.

In response to questions from members, officers said that about 66,000 people have had the first vaccine dose and as some first doses were given in December second doses are now being given; just under 6,000 second doses have been given. The supply of vaccine is expected to increase.

Councillor Winnington paid tribute to the NHS and the military working together for making the vaccination roll-out a smooth process.

Dominique Le Touze introduced the section on the Health Protection Board and Local Outbreak Engagement Board. Public Health has been asked to submit a refreshed local outbreak management plan at the request of the Department of Health & Social Care and will share it when approved.

Councillor Winnington thanked all organisations involved in the two Boards for their joint working and also the public for looking out for friends and neighbours. The end is in sight but there is still a long way to go.

The Cabinet Member noted the report which is for information only and is not subject to call-in.