Agenda and minutes

The Chair expressed his shock at the recently announced criminal activity by David Fuller in hospitals provided by the Maidstone and Tunbridge Wells NHS Trust. An independent inquiry had been announced and was due to report in 2022. The Chair asked for “Maidstone & Tunbridge Wells Trust - Mortuary security” to be added to the work programme, for scheduling once the investigation had concluded.

Mr Chard declared that he was a Director of Engaging Kent.

RESOLVED that the minutes from the meeting held on 16 September 2021 were a correct record and they be signed by the Chairman.

Paula Wilkins, Chief Nurse and executive lead of the vaccination programme, K&M CCG was in attendance for this item.

1.    Ms Wilkins introduced the report and provided a verbal update on developments since the report was published. She confirmed that: a total of 2.8m vaccines had been given in Kent and Medway; that 58% of people eligible for a booster had received one; that the case rate per 100,000 had reduced, with a higher rate among the 0-59 age group; that 177 Covid-19 positive patients were in Kent and Medway hospitals, 20 of which were in intensive care; and that elective care had continued.

2.    Members were invited by the Chair to ask questions. Discussion included:

a)    A Member asked for clarification on the difference between the third vaccine dose and booster, including eligibility. Ms Wilkins confirmed that the third dose and booster were distinct and had begun their rollout at the same time. The third dose was intended for the immunosuppressed only, who were identified by coding. Members were informed that recipients of a third dose would be eligible for a booster after 6 months.

b)    Ms Wilkins was asked what guidance Members could share with their constituents to highlight the continued risk of Covid-19. She encouraged Members to share the health advantages of the vaccine, which included the reduced risk of death. She noted that it was important to stress in communications with residents, that the vaccine did not prevent people from contracting Covid-19. The committee were reminded that mask wearing remained a personal choice, though were encouraged in NHS buildings.

c)    A Member asked what had been done to engage hard to reach communities regarding the vaccine programme. Ms Wilkins verified that an inequalities group had engaged with minority groups and worked to consider culturally sensitive information. She noted that the work of the group was long-term and extended beyond the vaccine programme.

d)    Asked what steps had been put in place to mitigate the impact of protests on the vaccination of 12-15 year olds in schools, Ms Wilkins explained that initially vaccination of the age group could only be delivered through the Public Health run school vaccination programme, but that had since been relaxed, allowing the use of designated walk-in vaccine centres.

RESOLVED that the report be noted and the item return at the next meeting.

Bill Millar, Director of Primary Care, K&M CCG and Dr Caroline Rickard, Kent Local Medical Committee were in attendance for this item.

1. The Chair welcomed the attendees and invited them to introduce the report.

2. Dr Rickard explained the role of the Kent Local Medical Committee. This included independently representing and advocating for the interests of general practice; representing the majority view of GPs to NHS England, K&M CCG and other national and local organisations; and providing advice and support to GPs on all professional matters.

3. Mr Millar outlined developments since the report was published. He confirmed that NHS England had published “Our plan for improving access for patients and supporting general practice” on 14 October 2021, and that the CCG had been in contact with practices following this.

4. The Chair confirmed that some Members had shared questions in advance of the meeting, which were addressed in the report. He also told the Committee about concerns he had received from the Health Reform and Public Health Cabinet Committee about access to primary care services.

5. Members recognised the benefits of virtual appointments but did not think they were effective in all cases. Mr Millar noted that 70% of feedback from virtual consultation patient surveys had been positive. It was acknowledged that patients without internet access did not have access to the survey. Dr Rickard reminded the Committee that virtual triage originated from an NHS England directive during the early stages of the pandemic. She added that the proportion of virtual and face-to-face consultations varied between practices and was influenced by their size and capacity. The wider responsibilities of GPs beyond patient consultations were highlighted, such as writing prescriptions and managing recruitment.

6. A Member asked whether a salaried employment arrangement, as opposed to the existing GP contractor model, could better meet the demands of communities. Dr Rickard said this had been debated by GPs but was not favoured because there would be a loss of historical community knowledge with a salaried model.

7. Concerns were raised by a Member relating to staffing levels and GP-patient ratios. Members wanted to see a GP-patient ratio breakdown by district. Dr Rickard and Mr Millar stressed that the challenges faced in primary care were not limited to staff shortages. It was also highlighted that primary care was not just delivered by GPs but a wider group of professionals including paramedics, physiotherapists and social prescribers, therefore the GP-patient ratio had limited use. Mr Millar confirmed that work with partners nationally had been undertaken to help to address staffing levels, in particular in Swale and Thanet. He added that the Kent Medical School would provide part of a long-term solution. Dr Rickard detailed the additional challenges faced in primary care, which included increased overall demand, partly caused by suppression during lockdown and increased elective care waiting times, requiring additional support. She noted that staffing issues had been exacerbated during the pandemic, the link between the abuse of staff, increased vacancies and  ...  view the full minutes text for item 42.

RESOLVED that the report be noted.

1.    Members asked that an update on winter pressures and flu in relation to Covid-19 be included in the standing Covid-19 update at the next meeting.

2.    The Chair confirmed that Members would be given the opportunity to question SECAmb on their capacity, as part of the future update on HASU implementation item.

RESOLVED that the Work Programme for be noted, subject to the inclusion of the following items:

·         Mortuary security at Maidstone and Tunbridge Wells NHS Trust.

·         Update on HASU implementation. Update on GP provision in Kent. To include how government issue GMS contracts; access, including lunchtime closures; quantification of unmet need; PCN rollout and how it will impact services; facilities strategy, including the use of Section 106 contributions; eConsult; and Patient Participation Group (PPG) engagement.

·         Deal Hospital phlebotomy.

·         Impact of Covid-19 vaccine mandate on NHS staff levels.