Agenda and minutes

There were no disclosable pecuniary interests.

The minutes of the meeting held on 17^th January 2024 were agreed and signed as a true record.

There were no Matters Arising.

Report of the Director of Public Health

The Board considered a briefing note, verbal report and presentation of the Director of Public Health which provided an update on the uptake of Measles, Mumps and Rubella (MMR) immunisation among children in Coventry and giving an overview of commissioning responsibilities and how partners were working together to build good immunisation rates and address areas of concern.

Measles was a preventable but highly contagious viral infection which, on rare occasions, could cause serious complications and could be fatal.  Young babies, the immunosuppressed and pregnant women were at higher risk of complications.  The MMR vaccine was the best way of protecting individuals, preventing outbreaks and protecting the most vulnerable individuals in the community.

As part of the childhood vaccination schedule, the MMR vaccination was routinely offered twice – at 1 year of age and as a pre-school booster.  Two doses of the vaccine provided the best protection.

The uptake of the MMR vaccine had declined over the years, including in Coventry and since 1^st October 2023, there had been an increase in measles cases country wide.

Responsibility for immunisation was fragmented with both NHS England (NHSE) and Coventry Warwickshire Integrated Care Board (ICB) holding lead roles on NHS immunisations delivery.

The main provider of MMR immunisations in Coventry were GP practices and the School Age Immunisation Services.  Uptake of the vaccine across all ages was lower in Coventry than the regional or national levels.  There was greatest success at achieving one dost of MMR by the age of 5 years however, the requirement for herd immunity was measured based on achieving two doses of MMR. 

Since summer 2023, an additional effort had been made to increase protection from measles and the levels of MMR vaccination.  This work began before the first cases of measles were seen in Coventry.  Work had been undertaken across all partners locally to ensure effective working to grow the rates of immunisation in all communities, including those less likely to routinely come forward.  Some key actions included:

·  Vaccinating Coventry Group – an established Coventry focused immunisation planning group whose aim was to bring all relevant parts of the system together to identify the best way of immunisations to the population of Coventry and reduce inequalities in accessibility.

·  Coventry and Warwickshire Schools Immunisation Service

·  Communications to increase public understanding

Councillor K Caan, Cabinet Member for Public Health and Wellbeing, congratulated the Public Health team for their report advising that the consequences of measles were very painful and the effects severe and he welcomed the work undertaken by the MMR immunisation teams across the city who were working proactively to roll out the vaccinations alongside schools.  The pop-up immunisation project had been very successful especially with the travelling, moving and new to the city communities.

Members of the Scrutiny Board, having considered the content of the briefing note, verbal update and presentation, asked questions and received information from the Director of Public Health on the following matters:

·  Single MMR vaccinations were not recommended.  Two vaccinations provided the best  ...  view the full minutes text for item 37.

Report of the Director of Adults

The Board considered a briefing note and presentation of the Director of Adults and Housing, on the progress made over the last 12 months to manage increasing demand in Adult Social Care and to advise how risk was monitored across all service areas.

Managing risk within a high volume and dynamic environment was part of the daily business of Adult Social Care.  Although the numbers of people waiting for an assessment across the services had reduced, additional risk management approaches were in place to support and enable people waiting for an update on their situation.

Some people waited longer than others for interventions and the average days waiting for assessment was not on target.  To mitigate risk and ensure those with the greatest need had an assessment completed in a timely manner, robust risk assessments and escalations were in place and a process had recently been introduced to monitor the risk which involved proactively contacting people to update on their situation and review risks.

Over the past year, improvements had been seen in many areas and a reduction seen in those waiting for further assessment as well as an increased number of positive change in a number of key Adult Social Care Outcomes Framework (ASCOF) indicators.

Increased casework complexity impacted on capacity and throughput of cases although cases deemed lower risk would wait longer for an assessment or review.

Overall levels of risk are monitored by Heads of Service.  Escalation processes were in place to monitor level of risks and response times to ensure cases were appropriately risk assessed and allocated accordingly.  Managers reviewed the priority cases on the list for allocation to a worker weekly.  Handover meetings were in place to support the handover between shifts for AMHP.  Heads of Service would also take action to mitigate risk by moving staffing resource to meet demand and reallocation of cases.

There were approximately 3600 people in receipt of ongoing care and support in Coventry, 2700 of which were in long term support for 12 months or more.  Overall referrals into intake Teams were 210 referrals per week (900 per month), 46% of which were Safeguarding referrals, significant numbers of which were resolved at source with only 40% requiring intervention from a Social Worker or Occupational Therapist.

The hospital social work team received an average of 700 referrals per month, all of which were allocated on the same day due to the timely nature of hospital discharges.

Increased demand on ASC meant waiting times are longer for some and were likely to be an issue of challenge in the forthcoming CQC Inspections.  Following the introduction of 2 new staff in January 2024, a positive impact was being seen.

Members of the Scrutiny Board, having considered the content of the briefing note, verbal update and presentation, asked questions and received information from the officers on the following matters:

·  Year on year increases were being seen in DoLS cases.

·  Referrals to ASC was a staged process.  A good proportion of patients did not  ...  view the full minutes text for item 38.

Report of the Scrutiny Co-ordinator

The Health and Social Care Scrutiny Board (5) noted the work programme.

RESOLVED that the Health and Social Care Scrutiny Board (5) notes the Work Programme.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no other items of public business.