To receive and, if so determined, to approve as a correct record the Minutes of the meeting held on 22 September 2020.

RESOLVED: That the minutes of the meeting held on the 22 September 2020 be agreed as an accurate record.

Members to give notice of any interest and the nature of that interest relating to any item on the agenda in accordance with the adopted Code of Conduct.

No additional declarations were made.

A maximum of 15 minutes will be allocated to public questions submitted in writing to Democratic Services (democratic.services@trafford.gov.uk) by 4 pm on the working day prior to the meeting. Questions must be relevant to items appearing on the agenda and will be submitted in the order in which they were received.

No questions were received.

To receive an update from the Director of Public Health

Councillor Slater gave a brief introduction to the item and informed the Committee that Trafford were due to go into tier 3 lockdown as of midnight and that new communications would be going out to the public informing them of what the new rules were.

Following the introduction the Director of Public Health updated the Committee on latest position within Trafford. The Committee were informed that Trafford had seen a slight reduction in the number of new cases but this was a reduction in cases among the younger population and there had actually been an increase in cases among the over 65 population, who were the people most vulnerable to COVID 19. The hospitalisation rates had started to increase and this was expected to continue in the next two to three weeks due to the increase in infections among the over 65 population.

There continued to be high rates of infection across the board with the two highest areas being Clifford ward and Hale Barns ward. Rates were over 400 per 100,000 in all four of the Trafford localities and there were only two wards with rates of less than 200 per 100,000. There was still a delay in receiving test results but there did not appear to be any issues in accessing tests within the area. The rate of people going for testing had dropped and it was thought to be due to publicity around sharing testing data with the police. The percentage of positive results remained high which suggested that the decline in people going for testing was not due to a reduction in the number of cases.  Contact tracing was working well locally but there were still issues with the national system. The team were doing a lot of work with schools and businesses when they had cases to determine who was likely to have been infected and whether the school or business needed to be closed.

The cases within schools had been community transmissions with a limited number of transmissions happening within schools. With regards to community engagement members of the team were due to go out in North Trafford the following day to talk to Mosque leaders and to go into shops and businesses to pass on information across the community.

Following the overview Committee Members were given the opportunity to ask questions. Councillor Barclay asked about fines and the involvement of the police and how the Council could counter the impact of that message. Councillor Barclay also asked whether there had been any further development of a local contract tracing system. The Director of Public Health responded that the legislation around the fines stated that it was up to local areas to implement and Greater Manchester would not be sharing data with the police due to the impact it had on people’s willingness to be tested. Fines may be issued but they would be for extreme cases such as businesses who continued to operate when they had been told to close. There were plans  ...  view the full minutes text for item 4a

To receive an update on the winter plan from the Executive Member for Adults Services.

The Executive Member for Adult Social Care informed the committee that they were keeping close contact with the Corporate Director of Adult Services around the infections within care homes. This was something that the Council had been working hard to prevent since the start of the pandemic. The Executive Member for Adult Social Care informed the Committee that she would be happy to come back to the Committee to provide updates on what the care home sector over the winter period. The restrictions around visits were continuing work was ongoing within the Council and with partner organisations to attempt to identify a safe way for visits to be conducted.

Following the introduction from the Executive Member for Adult social Care the Corporate Director of Adult services gave an overview of the presentation that had been circulated with the agenda. The Committee were asked to look at the modelling displayed on the third slide of the presentation which compared the first and second wave of the pandemic. In the first wave people were in hospital for around 10 weeks before discharge whereas in the second wave most of the people infected were younger and so were recovering quicker which required a different model of care.

Slide four set out the guidance and the requirements for a winter plan and a NHS wave three plan. Trafford had decided to create a single integrated plan which covered all of those aspects. Slide five set out the challenges over winter slide 6 addressed the NHS phase three work and surge planning. Slide 7 moved onto adult social care and the work that was ongoing to prevent spread throughout care home settings and those living at home. Slide 8 covered the local care organisations response who had been tracking their capacity across all of the support pathways.

The Director of Adult Services informed the Committee that a whole programme of work was in place, which had been developed with all partners, to deal with the demands of winter. The hospital discharge policies that had been in use since the start of COVID had been updated in line with changes to the legislation made in August and funding changes made from the 1^st September. A number of discharge to assess beds had been commissioned in care homes across Trafford and work had been done to ensure that any infection risks were minimised. Trafford were negotiating with Manchester about the use of a provider who would be able to look after patients who are COVID positive on discharge from hospital. The CQC had introduced an inspection requirement for homes used in this way and the Council had plans in place for these inspections to be carried out. Additional rapid discharge support was being commissioned to aid people to be discharged to their own homes and colleagues who provided therapy and nursing support were also increasing their capacity in line with the projected need. Work was also ongoing with health colleagues around support for the long term  ...  view the full minutes text for item 4b

To receive an update from the Accountable officer for Trafford CCG.

The Accountable Officer for Trafford CCG spoke about how well the Corporate Director of Adult Services and the Director of Public Health had worked with health services and that it had been a truly integrated approach taken throughout the Pandemic. Accountable Officer for Trafford CCG then handed over to the Director of Commissioning for Trafford CCG who gave an overview of the slides that had been provided as part of the agenda pack.

During the early phases of the Pandemic the CCG had worked with general practices to ensure that people were able to access services in a safe way. A total triage model where initial triage was provided remotely before an appointment was given had been introduced. IT support had been supplied to GPs to allow them to work from home to prevent infection among the workforce. Special provision was put in place to provide support to patients who may have had COVID 19. Supplies of PPE had been increased to ensure that there was an adequate amount to deal with the elevated demand. GPs had been given more flexibility in the hours of their contracts to allow them to work as best suited the demand. A suite of priority pathways were put in place including discharge to assess, virtual wards, end of life support, care home support, and urgent care pathways, which provided wrap around support for GPs and CCG staff had been redeployed to keep frontline services running within GPs. The next phase of work involved looking at GP networks and how GPs could work together to be more resilient. There was a CCG winter plan which linked directly with the Adult social Care winter plan and the flue vaccination plan.

The majority of mental health services had remained operational throughout the pandemic, although they changed how they delivered their services. The CCG were working with providers to prepare for the expected increase in demand. Providers across Greater Manchester were looking at ways they could work with and support each other to make the system more robust.

The elective programme had been stepped down at the start of the pandemic to allow hospitals to deal with the increased demand from COVID 19 and the focus had since been on recovery of the programme. The CCG had been working with MFT on how to get the services back up and running through the use of remote working, support from GPs and by working with patients to ensure that they needed the procedures that had been cancelled. The wait times were much longer with the number of people waiting over 52 weeks being expected to be over 6000 by March 2021 and the CCG were looking at possibilities of how they could manage this in different ways.

Urgent care activity had been greatly reduced during the original outbreak all the way through to the end of lockdown. Since the end of lockdown this had been increasing and was almost back to pre-pandemic levels. Lots of work was on going  ...  view the full minutes text for item 4c

To receive a report from the Executive Member for Children’s Services.

The Executive Member for Children’s Services stated that the report had been brought to the Committee as regular updates had been provided to the Children and Young Peoples Scrutiny Committee prior to the Pandemic. Since the last update a large amount of work had been done and progress had been made by the Council. Despite that progress there were still a many improvements to be made within Children’s services. The outbreak of COVID 19 had brought additional challenges to completing the Council’s improvement plan, such as keeping contact with vulnerable children and young people while sticking to the guidelines regarding contact.

Following the Executive Members opening remarks the Corporate Director for Children’s Services provided an overview of the report which had been circulated with the agenda. The report had provided a high level of detail for the Committee due to the amount of time that had passed and the amount of work that had to be covered. Broadly speaking the findings of the Ofsted report were based upon the leadership and management of Trafford’s Children’s services and what they understood about frontline services. In response to this Trafford had strengthened management arrangements, re-evaluated the role of what management was, and how it supported frontline staff. Issues around consistency of service provided to families across the borough had been identified and needed to be addressed. To tackle this Trafford had put new leadership arrangements in place from top to bottom of the service. An important element was making sure that all staff members had manageable caseloads and were receiving adequate support to fulfil their role.

Prior to the outbreak of COVID 19 the service had planned to hold of a number of workshops to maximise the levels of inclusion in the development of the improvement plan. Those planned workshops were not able to go ahead due to being in lockdown. Ofsted were due to conduct a visit but were also unable to because of the lockdown. A remote review was carried out instead and noted that significant progress had been made around governance, quality assurance, and leadership. Ofsted also noted significant improvements had been made to the front door service and the balance of caseloads for social workers.  Ofsted identified the need for Trafford to accelerate their improvement plans and the service addressed this by focusing on getting their approach right by going back to basics with the main focus of the service being to help children and families, to visit children and families, and to talk and listen to them. Multiagency arrangements had been kept in place throughout the pandemic and partners had been involved in refreshing the improvement plan.  

The Committee were informed that a new director for early help and children’s social care had been recruited in replacement of Cathy Rooney who had retired after many years of service. A strategic lead role for practice improvement and learning had been appointed whose role was to implement a model of coaching and support for front line practitioners.

Work had  ...  view the full minutes text for item 5.

To suggest and agree items, relating to the COVID 19 Pandemic, to be on the agenda for future meetings of the Committee.

The Chair asked Committee Members if they had any suggestions for items to be considered at their next meeting. Councillor Barclay suggested that the ongoing impact of COVID 19 on schools should be an item on the agenda. The Chair confirmed that the annual budget scrutiny sessions would be held on the 1^st and 3^rd of December 2020.

RESOLVED: That the suggested items be noted for consideration by the agenda setting panel.