Agenda and minutes

Apologies for absence are listed above.

Councillor Pilkington declared an interest in the Northern Care Alliance transaction update due to being employed by Manchester Foundation Trust.

The minutes from the meeting held on 22^nd July 2021 are attached for approval.

The minutes of the meeting held on 22^nd July 2021 were agreed as an accurate record.

There were no matters arising. 

There were no public questions.

A period of up to 15 minutes will be allocated for questions and

supplementary questions from members of the Council who are not

members of the committee. This period may be varied at the discretion of

the chair.

There were no members questions.

Will Blandamer, Executive Director provided an update on Covid-19.

Case rates continue to be around 300 in 100,000. It is too early to tell if children returning to school at the start of September have had an impact on case rates. Case rates in Bury are similar to the England average, which is considered as high.

There continues to be 25-30 patients with Covid-19 at Fairfield General Hospital and a number of Bury residents in other hospitals. Sadly, 3 more Bury residents died last week, from Covid-19.

Vaccination rates in Bury were explained:

·         There has been an 81.7% vaccination uptake for a first dose of the vaccine in cohorts 1-12, which is positive.

·         There is over an 85% first dose vaccination uptake in the over 50 year olds.

·         There has been a 62.6% first dose vaccination uptake within the 18-29 year olds.

·         The uptake from the younger cohorts in Bury is lower than expected, particularly within the 16-17 year olds. Insight work is being completed to understand the motivations and reasons for not taking the opportunity of the vaccines, with work being carried out with colleges to try to improve this.

·         95% of the people who should have received a second dose of the vaccine, have done, which is positive.

·         Plans are being made to deliver the booster programme and the delivery mechanisms are being considered for the 12-15 year olds vaccination programme.

Will Blandamer invited questions and comments from the committee members.

·         Councillor Grimshaw questioned what will happen to staff who work within care homes if they refuse the vaccination.

Will Blandamer explained that the vaccine is compulsory for staff within care homes. The uptake with the vaccination programme in care homes in Bury is the best in Greater Manchester. Staff who are reluctant to be vaccinated are not allowed to work in care homes.

·         Councillor Tegolo questioned if Covid-19 data can be broken down to the areas within Bury.

Will Blandamer explained that information is available at a neighbourhood and locality level, cases are reasonably consistent across the borough.

Pop up clinics are being provided in areas of low uptake of the vaccine. Six community pharmacists within Bury have agreed to support the delivery of the vaccination programme.

·         Councillor Tegolo questioned how the vaccination programme for 12-15 years will be delivered.

Will Blandamer explained that it will be primarily delivered through schools. It is hoped that all 12-15 year olds will be vaccinated before the October half term.

·         Councillor Birchmore questioned if younger age groups are being hospitalised with Covid-19.

Jon Hobday explained that there had been no specific information to suggest a shift in age range; those who are hospitalised, are predominately over 60 years old.

·         Councillor Tegolo questioned if the 3 people that had recently died of Covid-19, had been double vaccinated.

Will Blandamer explained that the Council and the CCG do not hold that information.

Simon Neville, Northern Care Alliance to provide a verbal update. Presentation attached.

Simon Neville, Transaction Director at the Northern Care Alliance provided an update on the transaction.

In 2016, the Salford Royal Trust was invited to advise and operate services for the Pennine Acute Trust. The Pennine Acute Trust was rated as an inadequate trust by the Care Quality Commission and the Salford Royal Trust was rated as an outstanding trust. In 2017, the Northern Care Alliance was established, which consisted of the Salford Royal Trust and the Pennine Acute Trust.

In 2019, the Pennine Acute Trust’s, Care Quality Commission rating had improved to ‘good’. The improvement suggested that the model was making a difference to patients and could help other struggling organisations in the future. It was decided that the model needed to be consolidated and integrated further.  It was decided that by operating across a larger footprint, the Northern Care Alliance would be able to invest more in digital innovations, that can further drive both quality and productivity gains.

As a part of the consultation, it was agreed that there should be a single hospital service for the city of Manchester, it was agreed that the North Manchester General Hospital component of the trust will be consolidated into the Manchester University Foundation Trust. The Pennie Acute Trust had developed some integrated services across its hospitals such as joint clinical services across Fairfield General Hospital and North Manchester Hospital. It was decided, to ensure the services remain sustainable and safe for patients, the transition would be completed in two phases.

On 1 April 2021, North Manchester General Hospital was separated from the rest of the Pennie Acute Trust. The second phase of the merger is planned to happen on 1 October 2021 where Oldham, Rochdale and Bury Care Organisations will join the Northern Care Alliance. During the interim period, Salford Royal Trust has continued to provide services from Bury, Oldham and Rochdale hospitals, pending the formal merger.

The transactions are being delivered in order to:

·         Help support and complement local integrated healthcare plans

·         To better meet the population health needs of local communities

·         Strengthen community support

·         Deliver more care closer to home

·         Maximise the use of estates on the Pennine Acute Trust footprint

·         Support acute hospital services

·         Strengthen the delivery of both acute and community-based services

To conclude the transaction, the NHS Improvement Oversight Committee agreed that the transaction should go ahead. A letter was received from the Secretary of State who was in agreement with the transaction and was prepared to dissolve the Pennine Acute Trust. Letters are due to be issued to staff to formally notify them of the change and the date of change. Staff members have been through a consultation process.

Beyond 1 October 2021, services will not change. There is a series of service level agreements between Manchester Foundation Trust and the Northern Care Alliance that underpins the separation of services but keeps them in the form that they already are. There will be changes going forward, those service agreements will gradually be unravelled over the  ...  view the full minutes text for item HSC.7

Jon Hobday, Public Health Consultant to provide a verbal update. Report and presentation attached.

Jon Hobday, Public Health Consultant provided information on how Bury is tackling obesity.

Obesity was described as a huge public health issue due to the financial costs and the years of life lost over the population. Poor physical health and mental health are linked to obesity. Over the last 6 decades the changes in how people live have contributed to obesity, due to changes with jobs being less physical, transport, food availability and food density that increases an obesogenic environment.

Obesity doesn’t affect groups equally and causes significant inequalities. People who are in the most deprived groups are significantly more likely to be overweight and obese and are twice as likely to go into hospital as a result of an obesity related condition.

Statistical information was shared on the percentage of adults and children who are classified as overweight or obese.

In Bury, 63% of adults are overweight or obese which equates to 84,000 adults. 34.9% of year 6 aged children and 23.6% of reception aged children are classed as overweight or obese; an obese child is more likely to grow into an obese adult.

A map was shared showing where the inequalities are within Bury, the most deprived areas show the highest levels of overweight and obesity.

Addressing the issues of obesity was described as complex. The vision is to create the healthy choice being the easiest choice by encouraging a positive food environment and a positive physical environment.

It was explained how Bury is supporting people who are overweight and obese and the activities that are available to reduce inequalities in physical activity.

The work that is being done to address food inequalities, as part of the food strategy was explained.

The next steps that are taking place to tackle obesity in Bury are:

•       To continue to create a whole systems approach to working collaboratively for the implementation of the physical activity and food strategies.

•       Build on existing successes and continue to strengthen delivery and engagement.

•       Utilise new funding streams and refocus existing resources and provision following the pandemic to build on innovation and reduce inequalities particularly targeting those most affected by Covid-19 and those with the highest levels of inactivity and the poorest diets.

Jon Hobday invited questions and comments from the committee members.

·         Councillor Walmsley raised concerns about the levels of obesity in the reception and year six cohorts. Concerns were raised in relation to the inequalities of obesity within the areas of Bury. Councillor Walmsley questioned what work had been done on the Bury’s food strategy to tackle the number of takeaways. Discussions took place around take away outlets and challenging planning decisions.

Jon Hobday explained that Francesca Vale who leads on the food strategy is liaising with the planning department to create a supplementary planning document.

·         Councillor Tegolo questioned what the exercise and referral programme does.

Jon Hobday explained that this is an adult service, aimed at people with a range of medical conditions, that will benefit from losing weight. A  ...  view the full minutes text for item HSC.8

Will Blandamer – Executive Director Strategic Commissioning Health and Care to provide a verbal update. Presentation attached.

Will Blandamer provided an update on the Greater Manchester Integrated Care System (GM ICS).

It was explained that an NHS England consultation took place in November 2020 and a White Paper was published in February 2021, proposing the disestablishment of Clinical Commissioning Groups (CCGs). The legislation was presented to the House of Commons in July 2021, subject to the legislation being approved, there will be no more CCGs in the country from 1 April 2022. There will be an aggregation of CCGs transferred into an Integrated Care System (ICS), in Greater Manchester all 10 CCGs will be a part of the GM ICS.

The Council has worked closely with the CCG, as the agency in the borough that is responsible for commissioning health and care services. There are joint appointments between the Council and the CCG to enable integration.

The ICS legislation focuses on removing barriers for integration, improving data sharing, removing competition and promoting collaboration. It has a focus on population health and health outcome values for taxpayers and refers to health inequalities. It contains new powers for the secretary of state to have direction over some hospital reconfiguration proposals.

Greater Manchester has been essentially working as an ICS for the last five years, with strong working partnerships between health and social care and the voluntary sector.  The legislation describes the balance of doing things once at a higher level such as at a Greater Manchester level and also operating locally and at neighbourhood levels.

There is a significant body of work taking place across Greater Manchester to plan for the closures of the CCGs and the creation of the GM ICS.

Key elements of the operation model were explained. At the moment, monies from the NHS services come through the CCG, in the future monies will come through the GM ICS. Bury remains committed to combine the money from the NHS and Council budget, which brings political leadership and clinical leadership together, to try and spend the health and care budget in the borough once. There is still lots to understand in terms of financial flows and what the partnership arrangements will look like in the borough. All CCG staff below board level will transfer to the GM ICS as a new organisation, most staff members will be deployed back into Bury to continue to work on transformation programmes. Bury is committed to maintain partnerships with other organisations to focus on population health and gain better service outcomes for residents.

Bury’s objectives from the locality plan was shared with the committee. The objectives outlined that the solution to making the health and care system sustainable, is to support residents to be well, independent, and connected.

A chart was shared that showed the health, care and wellbeing partnership system. A Locality Board is being created to set strategy and hold a budget for health and care.  Money will come into the Locality Board from the GM ICS and the Council. The Locality Board will feed into the Integrated Delivery  ...  view the full minutes text for item HSC.9

The Health Scrutiny work programme was discussed.

It was agreed:

1.         The next Health Scrutiny meeting should focus on mental health including addiction and treatment for addiction, elective care and an update on the Persona proposed savings.