Agenda and minutes

The Chairman welcomed everyone to the first meeting of the committee to be run as a Live event using Microsoft Teams.

1.    The Chairman reported that, following the recent passing of Mr Ian Thomas, the committee had a vacancy.

2.    Also, since publication of the agenda, formal notice had been given that the new Vice-Chairman of the County Council, Mr Michael Northey, had left the committee, leaving a second vacancy.

The Chairman paid tribute to Mr Thomas, saying what a valuable contribution he had made to the work of the committee and how much he would be missed by Members and officers.

To receive apologies for absence and notification of any substitutes present

Apologies for absence had been received from Mrs L Game and Mr K Pugh. 

There were no substitutes.

To receive any declarations of interest made by Members in relation to any matter on the agenda.  Members are reminded to specify the agenda item number to which their interest refers and the nature of the interest being declared

There were no declarations of interest.

To consider and approve the minutes as a correct record.

It was RESOLVED that the minutes of the meeting held on 6 March 2020 are correctly recorded and that a paper copy be signed by the Chairman as soon as safely practical. There were no matters arising.

1.    The Democratic Services Officer introduced the report and explained that all committees were being asked to agree to adopt and follow the protocols for all future meetings held virtually.

2.    It was RESOLVED that, in order to facilitate the smooth working of virtual meetings, the protocols be adopted.

1.         The Cabinet Member for Adult Social Care and Public Health, Mrs C Bell, gave a verbal update on the work of the Kent Resilience Forum (KRF).  The KRF had set up a multi-agency Recovery Coordinating Group, to comply with Government guidance, to co-ordinate with partners across Kent and Medway to produce an overall Recovery Strategy. The KRF consisted of several ‘cells’, of which Health and Social Care Recovery was one. Each cell had first to undertake an impact assessment identifying both the negative and positive impacts of the pandemic. A KRF report on 22 June, which was not yet publicly available, had identified strengths, weaknesses, opportunities and threats resulting from COVID-19.

2.         The main public health themes identified in the report were:

a)    Latent and generated demand, where services had not been available or people had chosen to wait before contacting services, as well as new demand arising from COVID-19. Activity in key services had dropped as some had been stood down during lockdown, but if activity in preventative services were to reduce, the demand for acute services could rise. Some problem areas, for example, domestic abuse and antisocial behaviour, had shown a rise during lockdown, and it was expected that, once the current hold on evictions ended on 23 August, there would be a sudden increase in those at risk of eviction seeking support, all of which was likely to increase the demand for services.

b)    Implications for mental health. Several groups appeared to be at risk of adverse mental health outcomes, including those with chronic physical and mental health conditions, those who had lost a family member, those with lower levels of education and those living in outbreak hotspots. Additional factors which appeared to influence mental health status were the duration of the quarantine period and associated financial losses incurred. Demand for mental health services had originally reduced but was already rising to pre-COVID-19 levels, and some cohorts, for example, young people, had already been identified as having extra risk factors.

c)    There had been an increase in attempted and actual suicide by young people as well as an increase in mental health concerns in new mothers. People with dementia had experienced some disruption to services, including access to assessments and Deprivation of Liberty Safeguards (DOLs) assessments. Family carers were known to have poorer physical and mental health than the general population and it was expected that the strain of caring during the pandemic would have worsened the situation for many carers. Local housing associations were reporting a significant percentage of the client group exhibiting mental health difficulties and/or substance and alcohol misuse. A lack of coordinated strategic approach to addressing these needs had resulted in varying degrees of response across Kent.

d)    Impact on communities - the full impact was not yet understood, and a further impact assessment needed to be undertaken. It was identified that COVID-19 would disproportionately affect different groups within society, including those already living in poverty, those most financially impacted by COVID-19,  ...  view the full minutes text for item 109.

1.            The Director of Public Health gave a verbal update on the following issues:

COVID-19 response – the average 7-day case numbers for all areas of the population and all areas of the county were now falling and there had been no spike increase in cases following the easing of lockdown. Data had been shared with all district council partners across the county, including Medway.

Outbreak Control plans - COVID-19 was a notifiable disease and any institution suspecting  a case was obliged to advise a local Public Health England team immediately so the latter could provide appropriate support and guidance on the steps which should be taken.  Most cases reported were only single cases rather than clusters, and clusters, where found, were small and were mostly in care settings. Data was monitored daily to identify how cases had arisen.

Media Campaign on COVID-19 – called ‘Protect Kent, Play Your Part’, this sought to remind the public that COVID-19 had not gone away and that they still needed to be vigilant and act responsibly to avoid a repeat surge of cases and second, localised lockdown, as experienced in Leicester. The public was reminded of the need to continue observing 2-metre social distancing, to stay at home as much as possible, to wash hands regularly and use hand sanitiser gel where provided. The campaign would seek to be as flexible as possible and identify and address local concerns.  The flu vaccine would be made available earlier than usual this autumn and had been launched on 2 July.  

Testing – an additional testing site had been established at Manston airport and launched on 6 July, and coverage of the Kent population with static, mobile and postal testing facilities was good.  If a cluster of cases were to be identified, a mobile testing unit could be deployed without delay.  The Department of Health was working to provide more walk-in and cycle-in testing sites and increase testing for vulnerable groups. 

Data analysis and modelling work – much data analysis was being done to identify patterns of infection and help to prepare for various scenarios in which rates might increase in any one sector of the population or area of the county. Looking ahead to winter, when national levels of respiratory illness always increased, work would seek to identify more of those in the population who would be eligible for a flu vaccine.  The vaccination programme would also start earlier than usual, in September rather than October.

Work with Partners – excellent partnership working had ensured that services could continue to be delivered. An Outbreak Control Plan had been published, to comply with Government requirements, and would be shared with all partners, and close joint working meant that all partners had an opportunity to learn from each other. With other local authorities, Kent had held outbreak control team meetings, in particular to address issues relating to the homeless.  This would also seek to avoid the situation experienced in Leicester and issues which had arisen in meat  ...  view the full minutes text for item 110.

1.       Mrs Tovey presented a series of slides which set out how service delivery had adapted to accommodate the working changes and social distancing enforced by COVID-19, including new ways for the public to contact and access services remotely, including digital access.  Some people wishing to access services chose to telephone rather than use the internet as they preferred to speak to someone, or else could not afford to use mobile data to use video access.  A multi-agency project group had been established to look at digital access and user preferences and understand how best to support those who wished to access services in this way. A survey had been launched to look at equity of online access to public health, mental health and wellbeing and children and young people’s services. The aim was to  identify the challenges involved and why someone may not access; for example, some people shared a computer at home and could not always use it privately, while others might not have broadband or might need training and support to use digital services effectively. An update on this work would be supplied to the committee at a later meeting. 

2.            A new wellbeing hub had been launched to give the public easy, localised access to trusted health information which could help keep them well.  This information continued to be updated and  tailored to optimise its relevance to key groups. A multi-agency group had been established to launch the hub at the start of April 2020, shortly after lockdown had started. In the first three months, there had been 4,801 page views, and initial feedback from use of the hub had identified anxieties around returning to work or school, families juggling childcare and work, those in the shielding community or with existing mental health and wellbeing issues  Local Members were asked to promote the wellbeing hub in their area and build public awareness of the information and guidance which was available there.

3.            The Cabinet Member, Mrs Bell, added that its development fitted well with the work of the Kent Resilience Forum recovery cell and emphasised the effectiveness of good local engagement and the importance of listening to residents. The aim was that as many people as possible should be able to benefit from digital inclusion, including people in care homes, for example, by a videocall with their GP, to save them the need to travel and to save both parties time. Staff in homes would be trained to help residents to use devices and there should be a device available in every home.

4.            It was RESOLVED that the update be noted, with thanks.

1.            Mrs Tovey introduced the report, which had been issued to the committee as a supplement to the main agenda pack, and highlighted the good performance of most services in the quarter leading up to the start of the COVID-19 pandemic and the start of lockdown. Data for four of the indicators had not been available at the time of writing the report due to the difficulties of collecting data during the pandemic.  

2.            The committee was being asked to support a change to key performance indicators (KPIs): to remove the existing indicator PHO2, which referred to the number and percentage of clients accessing GUM services offered an appointment to be seen within 48 hours, and replace it with a new indicator, to measure the proportion of all new first-time attendances taking up the offer and being screened for chlamydia, gonorrhoea, syphilis and HIV. This was something identified as a priority as part of the health needs assessment.

3.            Asked about home visiting services for parents of new babies, Mrs Tovey explained that responsibility for these services was shared by various bodies. If there was a health need or any concerns or vulnerabilities about the family, it was likely they would have had increased face to face contact. The maternity service would support leading up to the birth and continue to support women for the first ten days. They would carry out checks while in hospital, in addition to those undertaken in the home, and some visits in the antenatal period have been virtual during the pandemic.  The health visitor service was now conducting new birth visit in the home, however these were delivered virtually over the last few months, following national guidance. The service continued to offer face to face and virtual checks up to the age of two. The GP would make checks in the first 6 – 8 weeks, including immunisations. Communication between all agencies was critical to support effective care. Mrs Tovey undertook to provide more detailed information outside the meeting.

4. It was RESOLVED that:-

a)    the performance of Public Health commissioned services in Quarter 4 2019/20 be noted; and

b)    the suggested change to key performance indicators, to remove the existing indicator PHO2, which referred to the number and percentage of clients accessing GUM services offered an appointment to be seen within 48 hours, and replace it with a new indicator, to measure the proportion of all new first-time attendances taking up the offer and being screened for chlamydia, gonorrhoea, syphilis and HIV, be supported.

It was RESOLVED that, subject to future adjustments to reflect ongoing COVID-19 recovery work, the committee’s planned work programme be agreed.