Agenda and minutes

Apologies for absence were received from Councillor Cosgrove.

There were no declarations of interest received.

There were no items of urgent business received.

There were no public questions received.

The Minutes of the meeting of the Health Scrutiny Committee held on 7^th July 2020 are attached for approval.

RESOLVED that the minutes of the meeting of the Health Scrutiny Committee held on 7^th July 2020 be approved as a correct record.

The Committee received a report providing assurance that the provision of urgent health care in the community has been maintained through the Covid-19 pandemic period and that the offer to Oldham residents has been improved.  A number of national mandates which created the need to redesign some services were highlighted and the intention of Oldham CCG to engage with residents when possible to ensure that the structures were responsive to Oldham’s needs was advised.

A national mandate had required the CCG to prevent all walk-in’s to primary healthcare settings and to open a Covid Assessment Centre (CAC).  Previously, a consultation had been held in October 2017 to better understand what the community would want to see if the Walk in Service at the Oldham Integrated Care Centre (ICC) was to close, following which the CCG Governing Body had agreed to move towards closure of the Walk In Centre and to a new system offering bookable appointments for urgent primary care closer to home.  Development work was still ongoing at the onset of the pandemic and a review of services going forward was now underway.

The Covid-19 pandemic had required all health and social care organisations to quickly develop services to enable residents to access and receive the right care whilst also learning to manage in a new and changing environment. As well as setting up the CAC and stopping walk-in primary care facilities at the ICC to allow the CAC to deal with Covid-related cases, there was a need for the hospital to have as much space in the emergency department (ED) as possible. At the hospital’s request, the Out of Hours service moved from the hospital into the ICC and the GP working in the ED relocated into the CAC.  As the CCG was required to cease walk-in appointments at the ICC, the same workforce plus extra from IGP Cares was used in the CAC.

The CCG’s commissioning intentions had been to provide a digital service which could offer clinical assessment and treatment to residents easily, quickly and link into other services in order to prevent the resident going into hospital or having to leave their home, and this had been in early stages of planning when Covid-19 arrived.  In light of the changes to services, this digital aspect had been accelerated to support the community and was introduced quickly alongside the CAC using the same workforce, estates and IT systems.  The CAC now sees any patient face to face and the centre in the ICC has been renamed as the “Oldham Clinical Digital Hub” for the time being.  The Hub offers a multidisciplinary workforce, including GP’s, nurses and allied health professionals, and has direct links with community health and social care services, End of Life services and the ED. Examples of digital patient pathways were described to the Committee and examples appended to a submitted report.

A Member noted that the pandemic had shown a need for change, and that the reported changes were good for working  ...  view the full minutes text for item 6.

The Committee received an update on the development of the early help offer for children and families in Oldham and on the connections to other areas of activity, including place-based working and linkages to a range of other work relating to prevention and early intervention in the Borough.

‘Working together to safeguard children’ (2018) is the statutory guidance for inter-agency working to safeguard and promote the welfare of children which recognises that providing early help is more effective than reacting later in promoting the welfare of children. Early help is defined as “providing support as soon as a problem emerges, at any point in a child’s life, from the foundation years through to the teenage years” and which includes addressing parental issues such as poor mental health, drug and alcohol misuse and domestic abuse which impact upon the lives of children in the family.  The guidance highlights the need for local organisations and agencies to work together to identify children and families who would benefit from early help, to undertake an assessment of their need for early help, and to provide targeted early help services to address the assessed needs of a child and their family which focuses on activity to promote outcomes for the child.  The safeguarding partners needed to publish a threshold document which sets out the local criteria for accessing help and services and the Oldham document, available on the Safeguarding Partnership website, sets out four levels of early help offer that would be made according to the need.

Earlier work on ‘Oldham Family Connect’ arose from an identified need to strengthen the support offer for children and families with multiple or high level needs in order to prevent the need for social care intervention and to reduce the likelihood of needs re-escalating. The Early Help service part of the offer, established in April 2015, had resulted from the recommissioning of a range of services to deliver a better integrated offer based on an approach of multi-skilled key workers supporting a whole family. During 2020 there had been a rethink of the approach to Oldham Family Connect, considering the multi-agency early help offer to children and families at all levels of need rather than focusing on support at the intensive level. Work was therefore being undertaken to refresh the Partnership’s Early Help strategy for supporting children and families, including reviewing and developing the offer and providing clarity about how this operates across the whole range of needs.  It was intended that the refreshed strategy will be agreed by the Partnership in late 2020.

The project was no longer being described as Oldham Family Connect given the wider multi-agency offer.  As part of the wider development, it was intended to reorganise the targeted early help services within the Council, requiring a governance structure that would enable partners to agree priority outcomes for children and families and to plan how they will work together.  Other work included the recommissioning of the commissioned early help offer, inputting  ...  view the full minutes text for item 7.

Further to Minute 13 of the meeting of the Committee held on 7^th July 2020, the Committee received a report inviting consideration of a Council Motion “Ban on Fast Food and Energy Drinks Advertising” that had been referred to the Committee for consideration.  The consideration was based upon two appendices to a submitted report.  Firstly, a report submitted in the first instance to the Committee at the meeting held on 7^th July 2020 (the ‘July report’), and secondly a draft ‘Health Weight and Physical Activity Strategy’ document, the submission of which had been requested by the Committee at the July 2020 meeting.  The Committee was advised that the draft Strategy had been compiled in the pre-Covid-19 period and would require redrafting to reflect changed circumstances and national direction before it could be resubmitted for formal consultation.

The July report had given a consideration to the Council Motion and had included a briefing on the evidence around fast food and energy drinks (or High Fat Sugar and Salt (HFSS) Foods) and which recommended that

·         any restriction or ban on such advertising should be accompanied by measures to promote healthier options; and

·         in support of a ban, any breach of the Committee on Advertising Practice Guidelines around advertising of HFSS foods should be referred to the Advertising Standards Agency.

The July report had further presented information in respect of the various action points of the Motion and the following issues were highlighted –

·         With regard to asking Transport for Greater Manchester (TfGM) to consider an advertising ban similar to that introduced by the Mayor of London, details of the London ban, including the Transport for London (TfL) policy, and an initial view from TfGM which included noting the coverage of the London ban, the use to which TfGM’s advertising revenues were put, and some possible support for the promotion of healthier options;

·         With regard to the advertising or sale of fast food and energy drinks on Council property, a distinction was drawn between the Council’s immediate estate where such matters were considered as being addressed, and the Council’s managed or leased estate, it being noted that the equivalent TfL estate sat outside the London policy and that if the policy was extended to Council’s managed or leased estate this would lead to financial implications;

·         With regard to asking partners to make similar undertakings with regard to bans on sales and advertising, while this might be undertaken in isolation, the briefing paper within the July report noted that work to promote healthier options should sit alongside this.  The draft Strategy had proposed a multi-agency approach, to be led by the Health and Wellbeing Board, which would provide the base from which to share the Council’s experience and encourage others.

In discussion, it was suggested that the issue was one which would be very difficult to progress in isolation and that Oldham alone could make only small changes.  While the intent of the Motion was good, it was suggested that it would  ...  view the full minutes text for item 8.

The Committee was advised that the Council, at a meeting held on 17^th June 2020, had referred an action arising from a Council Motion ‘Chatty Checkouts and Cafés’ to this Committee.  The Committee was asked, in consultation with Age UK Oldham and District Teams, to examine the practicalities of introducing Chatter and Natter Tables in Council premises, to identify where they could be established, and to identify how referrals to such provision might form part of social prescribing.

The action had, in the first instance been referred to the Thriving Communities Programme Manager for initial consideration, it being noted that social prescribing forms part of the Thriving Communities programme.  The action was to be considered alongside other activities and priorities which Covid-19 is presenting and it was proposed that a report to a future meeting be programmed into the Committee Work Programme. 

RESOLVED that the referral of the action arising from the Council Motion ‘Chatty Checkouts and Cafés’ and the initial actions taken be noted.

The Committee gave consideration to the proposed Health Scrutiny Committee Work Programme for 2020/21, outlining those issues which would be considered by the Committee during the municipal year. 

Members’ attention was drawn to the update with regard to the Public Health team’s work programme and the intended submission of an item related to immunisations at the October meeting; to a request to determine how to receive the agreed consideration of anonymised safeguarding cases as individuals might still be recognisable if this was held in a public meeting; and the need to reschedule the Children and Young Persons Alliance item against the planned agenda for the October meeting.

RESOLVED that –

1.            the Health Scrutiny Committee Work Programme 2020/21, as presented, be noted;

2.            the consideration of anonymised safeguarding cases be considered in a workshop session, provided that the nature of the consideration does not duplicate training in safeguarding already provided to elected Members.

The next meeting of the Health Scrutiny Committee is scheduled to take place on Tuesday, 13^th October 2020 at 6.00 p.m. 

It was noted that the next meeting of the Health Scrutiny Committee was scheduled to be held on Tuesday 13^th October 2020 at 6.00 pm.