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 to enable patients to access urgent care without people queuing within waiting rooms in a similar way to how GPs have worked by putting a virtual service in place so people could access those services safely. Community services had been stepped down but were nearly back to pre-COVID levels, although the role had changed greatly.

Following the overview the Committee were given the opportunity to ask questions. The Chair thanked both the Accountable Officer for Trafford CCG and the Director of Commissioning for Trafford CCG for the way that the report was written as it was easy to read and understand.

Councillor Thompson asked about the mental health urgent care centres and what the plans were to open them. The Director of Commissioning for Trafford CCG responded that the service would not look very different to patients and would be co-located in A&E or urgent care departments. The centres would function by people who presented at those departments being triaged and then streamlined straight into those services rather than waiting while the mental health team made their way to see them. The centres were not really new but more of a different way of delivering the same service due to lessons learned from COVID 19.

Councillor Barclay asked what the likely hood was that the nightingale hospitals would be used. The Chair added to the question asking whether the hospitals had capacity to deal with the predicted increase in demand.  The Director of Commissioning for Trafford CCG responded that there were plans to reopen the nightingale hospital although it would be predominantly be used for patients who were COVID negative but needed step down services to provide more rehab therapy and support to free up hospital capacity. The hospitals would be able to cope with the increased demand but they would have to adapt their plans regularly. The peek was expected to come in the second week in November and was expected to be higher than the original modelling suggested. Changes had been made to hospitals plans to ensure that there were enough beds available to cope with COVID patients and ICU patients. There may be a need to look at triggers for when elective procedures would be cancelled but this was being coordinated at a GM level to avoid causing health inequalities across the region.  While the increased demand was going to be challenging there were clear plans in place for how the hospitals were going to cope through the second wave.

Following the questions the Chair of HealthWatch Trafford told the Board that their report on COVID 19 was due to be published soon and that there were a few elements that would be of interest to the Committee. HealthWatch Trafford had seen almost double the number of visits to their website in the six months since the outbreak of COVID 19 than had been seen in the previous year. The feedback that HealthWatch had received was that most people wanted to know about test and trace, the new119 number, and whether they could get a free test on the day. Youth watch Trafford wanted to know at what age they could visit a GP alone, about the mental health hubs, information on young parenting, and going back to school. HealthWatch had come up with 7 main findings and recommendations within the full report, which would be circulated shortly.

RESOLVED:

1)    That the report be noted.

2)    That the HealthWatch Trafford COVID 19 report be circulated to the Committee.