Agenda item

Mr W Williams, Accountable Officer for Kent and Medway CCG, was in attendance for this item at the invitation of the committee.

Mr J Wright declared that he was a KCC–appointed Partner Governor of the Medway Hospital Trust.

1.            Mr Williams introduced the report and emphasised the importance of understanding the complexity of what the CCG was dealing with in terms of managing the impact of Covid-19, which had necessitated suspending many other services temporarily. Restarting these services was complex and involved overcoming ongoing challenges in terms of stringent infection control measures and physical distancing, which would inevitably have an impact on the throughput of cases. There were also some resources impacts in terms of revenue and capital funding.

2.            Mr Williams responded to comments and questions from the committee, including the following:-

a)    asked about inconsistencies in the information for the recommencement of various cancer screening services across the county, and what information about this was made available to patients, Mr Williams explained that statistics differed as they included different services.  He undertook to address the issue of patient information outside the meeting;

b)    asked to comment on the 9-10% of hospital deaths due to Covid-19 recorded in East Kent, Mr Williams advised that, although Thanet had recorded some of the highest Covid-19 death rates in the UK, rates in East Kent were now low, and he undertook to look into the pattern of most recent rates; 

c)    referring to infection control, he assured the committee that the Trust and nursing colleagues were closely involved in monitoring and that only one ward currently had any Covid-19 cases;

d)    referring to staff testing, he assured the committee that the rate of infection was very low and that all EKHUFT staff were being tested. He undertook to provide a written response to the committee on this issue;

e)    staff at QEQM had requested that Perspex screens be installed around A&E reception, and Mr Williams undertook to look into this at QEQM as well as the William Harvey and Kent and Canterbury hospitals and to provide a written response to the committee;

f)     Mr Williams advised that the risk of a second wave of infection in Kent depended on the extent to which the public adhered to public health advice to avoid transmission.  A Health Surveillance Board was looking in more detail at rates of testing and the number of calls made to the NHS 111 line.  He assured the committee that the latter had not risen, but he cautioned against complacency;

g)    asked how any resurgence in infection would be handled, Mr Williams advised that use of local lockdowns was an option and would help to manage any future spread of the virus. The first surge of the virus had been managed by taking over areas of hospitals, such as operating theatres, to accommodate Covid-19 patients, and this could be repeated if necessary as it helped manage capacity. It would also help to avoid the need to suspend other services while prioritising Covid-19 patients; 

h)    the importance of mental health issues was highlighted and a question asked about restarting support services in community.  Mr Williams acknowledged the increasing need for services for existing patients and those who had developed mental health issues as an effect of Covid-19.  He advised, however, that the level of increased need would be difficult to quantify;

i)     asked if small daily clinics would soon be able to re-start, Mr Williams advised that outpatient clinics and general practices were opening, offering face to face appointments wherever possible, so physical examinations could be undertaken. Optimum use would be made of non-face to face appointments to avoid travel wherever possible, for example, to and from care homes. He advised that 95% of patients in Kent and Medway were listed with GPs who had appropriate technology to offer non-face to face appointments; 

j)     a point was made that many people did not have access to online technology and would rely for information on the radio, so that medium should be included when considering how best to spread public information; and

k)    a view was expressed that many people did not seem to take the pandemic seriously and this was perhaps because the public health message had been toned down to avoid frightening the public. People needed to be told about the reality of dealing with the Covid-19 virus and to be encouraged to take it more seriously.  In the event of a second wave, it would be helpful also if the local authority response to it were quicker than for the initial wave.

3.            Mr Williams thanked the committee for the issues raised about communications and undertook to look into them.  He advised that it was not possible to give a date when all GP surgeries would be able to return to face to face appointments as each practice needed to assess the risk factors in their own premises, for example, in some practices it would be difficult to apply social distancing requirements fully.

4          The Chairman referred to a review of elective capacity in NHS trusts at the committee’s 5 May meeting, at which the committee had been advised that arrangements with the private sector to add to this capacity would continue until 31 August. He said it would be very helpful if this arrangement could be extended further and he offered to write to private sector providers on behalf of the committee to seek an extension and a review of tariffs. Mr Williams welcomed this as a helpful move.

5          It was RESOLVED that the update be noted, with thanks, and that the following action be taken:-

a)    Mr Williams provide written responses about the provision of protective screens at East Kent A&E departments, patient information, the rate of infection and testing; and

b) the Chairman write to the Secretary of State to seek an extension to the arrangement to provide additional capacity and a review of tariffs after consultation with Mr Williams.