Agenda and minutes

The Chair, Councillor K Caan, welcomed everyone to the meeting and indicated that the theme of the meeting was healthy adults and aging well.

In particular, the Chair welcomed Jacqueline Lucid (Carers Trust) and Gabriela Matouskova (Hope for Community) to their first meeting.

There were no declarations of interest.

The Minutes of the meeting held on 26 July, 2023 were agreed and signed as a true record.

There were no matters arising.

 The Chair, Councillor K Caan, provided an update on recent activities linked to the triggering of the heat weather warning and the launch of the Autumn flu jabs and COVID-19 booster campaign. All attendees were asked to encourage all those that are eligible to book their jabs as soon as possible.

The Board were informed that October marks a nationwide celebration of Black History Month, and also the start of the “Stoptober” annual campaign encouraging the nation’s smokers to make a quit attempt. As part of this year’s campaign, the Local Maternity Neonatal System (LMNS) for Coventry and Warwickshire are running a targeted stop campaign for pregnant women called “Love your bump”. Details of the campaign were outlined at the meeting.

The Chair reported on the Summer of Sports held in Coventry, including the hosting of the Westfield Health British Transplant Games, which saw over 2,700 transplant recipients, live donors, donor families and supporters gather for four days of sport and celebrations in the City, the second largest Transplant Games ever held. Sports Fest is in its 11^th year and over 15,000 residents took part in sport and physical activity during the festival. In addition, Coventry and Warwickshire were the host cities for the UK Corporate Games, which is the largest multi-sports festival for businesses and included Coventry City Council, which won a total of 21 medals.

The Board noted that another successful Wellbeing 4 Life festival had been held, organised in conjunction with the Council, Warwickshire County Council and the Coventry and Warwickshire NHS Partnership Trust. 

The Chair thanked everyone involved in hosting and supporting these events, and congratulated them on their success.

Report of P Johns, Coventry and Warwickshire Integrated Care Board.

The Board received a verbal update by Phil Johns, Coventry and Warwickshire ICB in relation to:-

·  The impact of recent industrial action and work being undertaken in this regard to meet the challenges, particularly in relation to the impact on waiting times

·  Performance figures for Ambulance handovers (which had improved since last year)

·  Budgetary issues and the need for all partners to work together in relation to financial pressures

·  Work being undertaken in relation to the vaccination rollout.

In response to questions, Andy Hardy, UHCW, outlined the significant impact of the industrial action being undertaken and the effect that this was having on services, patients and staff.

Verbal report of the Director of Public Health and Wellbeing

 Further to Minute 7/23, the Board noted that feedback received in relation to the Health and Wellbeing Strategy and the Joint Strategic needs Assessment (JSNA) had been received and reviewed. The final Strategy and the JSNA would be published shortly and shared with the Board.

The Chair thanked the Board for their valuable input in relation to this work.

RESOLVED that the Board notes and acknowledges progress of the design work on the Strategy refresh and the JSNA ahead of publication.

Report of the Director of Adults

The Board received a Briefing Note, together with a comprehensive presentation at the meeting, from the Director of Adults Services and Housing which outlined the CQC Assessment of Adult Social Care.

The Health and Care 2022 introduced a new legal duty for the CQC to review and assess the performance of local authorities in discharging their ‘regulated care functions’ under Part One of the Care Act 2014, specifically:

·  pursuit of wellbeing

·  preventing the need for care and support

·  promoting integration of care and support with health services

·  providing information and advice; promoting diversity and quality in provision of services (an efficient/effective market)

·  meeting the duty of co-operation

·  meeting needs; safeguarding adults

·  effective transition from children’s services

·  ensuring continuity of care and support

·  managing provider failure

·  providing independent advocacy support

The Care Act also links across to the Mental Health Act and the Mental Capacity Act meaning that CQC will also assess ASC’s performance in these areas. 

New powers for the Health and Social Care Secretary are in place to intervene where it is considered a local authority is failing to meet its duties.

The new single assessment framework focuses on the four key themes of:

Working with people: How Local Authorities work with people (this includes: assessing needs, care planning and review, direct payments, charging, supporting people to live healthier lives, prevention, wellbeing, information and advice)

Providing Support: How local authorities provide support (this includes: market shaping, commissioning, workforce capacity and capability, integration and partnership working)

Ensuring Safety. How local authorities ensure safety in the system (this includes: safeguarding enquiries, reviews, Safeguarding Adults Board, safe systems, pathways and continuity of care)

Leadership. Leadership capabilities within Local authorities (This includes: culture, strategic planning, learning, improvement, innovation, governance, management and sustainability)

In assessing Local Authorities performance against each of these themes CQC will focus on four key domains including: people’s experience, feedback from staff and leaders, feedback from partners, processes and outcomes. 

CQC have undertaken five local authority pilot assessments to refine their assurance process and prior to rolling out the assessment process later in 2023.  The pilot assessments are taking the form of off site information analysis, including care files, and on site interviews.

The Government have asked CQC to publish individual ratings of LA’s following the pilots and assessments.  These ratings will use either: Inadequate, Requires Improvement, Good or Outstanding.

To prepare for CQC Assurance, Adult Social Care are:

1.  Completing a self assessment of the ‘as is’ picture of the current level of assurance in relation to Part One of the 2014 Care Act. This assists in not only understanding self-identified areas of strength but also areas for improvement.

2.  Working with the Association of Directors Adult Social Services (ADASS) within the Midlands region and undertaken a one-day readiness review, with a further two day readiness review planned in October 2023. This has added to our insight and provided external scrutiny to the assurance process.

3.  Attending the series of webinars that ADASS have arranged to support local  ...  view the full minutes text for item 19.

Report of the Director of Adults and Chief Strategy Officer, UHCW

The Board considered a Briefing Note, together with a comprehensive presentation at the meeting, of the Director of Adult Services and Housing and the Chief Strategy and Transformation Officer, UHCW, which detailed the progress and next steps in respect of the Improving Lives work underway across health and care. The work is a joint programme of change and improvement across the City Council, UHCW, CWPT and the Coventry and Warwickshire ICB working with Newton Europe.

The work is led through the Coventry Care Collaborative which commenced in 2021 with a diagnostic to identify the scale of the opportunity for change and has since gone through stages of diagnostic, design, mobilisation and is now in the implementation stage. The programme aims to make a series of improvements across the urgent and emergency care system in Coventry expressed in activity terms in respect of the levels of acute attendances, emergency admissions and emergency readmission for adults over 65 in Coventry and the resulting demand on adult social care services as a result of hospital attendances.

The programme is aiming to deliver a minimum of £13.6m of value across the four organisations.  Some of this benefit is cash releasing, such as reductions in volumes of social care, and some of the benefit provides to opportunity to improve effectiveness, for example, changes in admission activity.  Alongside the financial benefits, the programme will support improving outcomes for people.  Simply put, reducing avoidable admissions to hospital is more likely to lead to people retaining a higher level of functioning and independence.

To deliver the programme three workstreams have been established as follows:

Hospital Processes:

This workstream focusses on Emergency Department, ward processes and the Integrated Discharge Team

Interfaces:

This workstream focusses on referral routes, community visibility of demand, how the Emergency Department connects to services and Discharge connection to services.

One Coventry Integrated Team:

This workstream focusses on the integrated care model, working with specialist teams, ability to intervene proactively in the community, community ownership of discharge from admission, community residential beds for discharge, and the appropriate use of Pathway 3 beds (Those with such complex needs that they are likely to require 24 hour bedded care on an ongoing basis following an assessment of their long-term care needs).

Under the programme, a number of trials have been operational across the three workstreams.  These trials have tested out new ways of working and brought colleagues together across UHCW, CWPT and CCC to work within a new model.  The core purpose of the trials has been to design, test, then review new models of operating with a view to establishing a model of support that can be rolled out city-wide. Some on the impacts realised from the trials are included in the presentation accompanying this report and include:

·  There have been early signs of the benefits to patients /residents reflected in the trials to date and feedback has been encouraging

·  Staff across the system have been largely positive about making the changes across organisations  ...  view the full minutes text for item 20.

Report of the Director of Adults

 The Board considered a Briefing Note, together with a comprehensive presentation at the meeting, of the Director of Adult Services and Housing and the Director of Business, Investment and Culture, which outlined the overall Commonwealth Active Communities “Coventry Moves” Programme with specific reference to the Adult Social Care area of work. A Year 1 Impact Report was appended to the Briefing Note.

Coventry City Council secured a grant award of £624,624 through the Commonwealth Active Communities funding that is part of Sport England’s wider investment into the Birmingham 2022 Commonwealth Games. The Coventry Moves programme is a two-year funded programme which runs to December 2023. The programme outcomes are to :-

·  Tackle and reduce isolation.

·  Understand and address how the effects of isolation across the city have

compounded inequalities, exacerbating pre-existing barriers to physical activity.

·  Decrease inactivity levels across the city. Increase activity levels with targeted groups.

The programme has three key focus areas:-

·   Go Parks – encouraging children and young people to get active in local parks and green spaces?.

·   Streets – providing ‘on your doorstep’ activation in targeted communities.

·  Coventry Moves – Adult Social Care – engaging the elderly population in care homes and over 50’s in the community?.

Coventry Sports Foundation (CV Life) were commissioned to lead on the Adult Social Care part of the programme working with residents in nine local care homes and assisted living settings as well as engaging with over 50’s in the community. CV Life have also commissioned four smaller organisations to deliver inclusive activities for the elderly population under the Coventry Moves banner.

The Board were informed of a wide range of activities provided by the programme and an indication of the positive impact on the physical, social and mental wellbeing those activities have had on a range of people, including people in care home and assisted living settings. The impact derived from this work can be evidenced through numerous case studies demonstrating significant impact on local people’s lives and examples of those were appended to the Briefing Note and include:-

·  Sporting Memories returning to Coventry & North Warwick Sports Club

·  Coventry Moves dance classes for residents at retired living scheme

·  Walking Netball with regular attendance of 20 people

·  Walking Rugby with regular attendance of 15 people

·  Slow Zumba classes improving participants ‘mind, body and soul’

·  Gardening club which aims to get more people active across older people housing schemes

The impact assessment of the overall Commonwealth Active Communities programme is being delivered through a national evaluation linked to the Birmingham 2022 Commonwealth Games in partnership with KPMG.

The Board noted thatthe Council will endeavour to build on the work of the Coventry Moves programme to continue the local impact. Alternative opportunities for further funding to continue the Coventry Moves programme beyond December 2023 are being explored with the potential to bid for further grants to continue the programme to March 2025. Programme sustainability is also being sought through the establishment of ‘social funds’ within care schemes and  ...  view the full minutes text for item 21.

Report of the Chief Strategy Officer, UHCW

The Board considered a Briefing Note, together with a comprehensive presentation at the meeting, which provided an update on the Coventry and Rugby Community Diagnostics Centre (CDC) development.

In August 2022 UHCW NHS Trust was awarded a significant capital investment of £18.4m to develop a CDC for the Coventry and Rugby area as a part of a national diagnostic improvement programme.  The planned development maximises the potential patient benefit by utilising a Hub and Spoke model, and plans have progressed to develop a CDC Hub in the centre of Coventry as well as spoke service at the hospital of St Cross site in Rugby specifically for Endoscopy services.

The new facility in the city centre will be located adjacent to the City of Coventry Health Centre in the Paybody building, which benefits from a clear history and identification as a healthcare campus and its location in the city centre, close to key public transport links and within an area of significant population deprivation makes a strong case for the improvement of accessibility and health outcomes for the local population. The new facility will offer a significant increase in diagnostic capacity for the Coventry population and when completed will welcome around 90,000 patients per annum.  This increase in capacity will aid healthcare services to see and diagnose patients in a timely manner. 

To support this, there is a significant workstream dedicated to patient pathway development, where it is aimed to expedite diagnosis through the development of one stop clinic pathways as well as direct access for primary care clinicians for some diagnostic tests. The programme team will be working with key stakeholders during the development phase to ensure the most efficient pathways and align diagnostic, treatment and community services to best meet the needs of patients locally. Details of key patient pathways were provided in the Briefing Note.

As a further development to the CDC, UHCW NHS Trust has been working with Coventry University (CU) with a view to co-locating teaching and learning facilities at the CDC to support the development of future staff to support diagnostic modalities.  Plans are progressing for CU to occupy part of the first floor of the Paybody building above the CDC.  This will support diagnostic teaching alongside the operational service with an increase in placement opportunities and a potential increase in course intake locally. 

The Trust is also seeking to align continual professional development opportunities for existing staff with the university team to aid in the retention of key staff to the local area.   Working in partnership with the University, the Trust is seeking to coordinate the activities of the Trust and University to develop a shared research portfolio.  Early focus for this research is based around health inequalities across the local population and the alignment of CDC services to CORE20plus5 priorities.  A proposed timeline of the development was provided.

The Board asked questions and made comments on a number of issues including:-

·  How the CDC will be critical to early detection

·  The anticipated benefits  ...  view the full minutes text for item 22.

The Board were informed that Chief Superintendent Pete Hendrick was attending his last meeting of the Board prior to his leaving his current position to take up a national policing role.

The Chair, on behalf of the Board and the City Council, paid tribute to the outstanding contribution Chief Superintendent Hendrick has made to the Board and the City as a whole during his time in Coventry and thanked him for all his hard work and commitment.

The Board wished him well for his new role.  

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

The Board noted that the Carers Trust would be holding a  Mind and Wellbeing Day at the Central Methodist Hall in October, to which the Board were all invited to attend. It was noted that further information in relation to the event would be circulated.