Verbal Update.
Minutes:
Councillor Sarah James, the Cabinet Member for Adults and Health, gave a short overview of key developments within her portfolio and, in particular, the response to the Covid-19 crisis and next steps arising from it. The following key points were noted:
a. She gave her condolences to those within the local community who had lost loved ones during the pandemic. A virtual book of condolences would be opened. She acknowledged the contribution of the local voluntary and community sector in responding to the crisis. Large numbers of people within the borough were coping with loss and, in addition, there had also been a severe economic impact, with a 550% increase in Universal Credit claims;
b. People from Black and Minority Ethnic (BAME) communities had been severely affected by the crisis, with disproportionately high death rates. Going forward, further consideration would need to be given to the wider determinants of health;
c. The response to the pandemic had been undertaken with a range of partners. There were now new discharge hubs at the North Middlesex and Whittington hospitals and this was enabling discharges to take place far quicker. The Community Reablement Service had significantly increased its capacity. The “Proud to Care” initiative had facilitated the successful recruitment of care workers and other boroughs were now emulating this campaign. A new model of Intermediate Care had also been developed. In addition, supplies of emergency Personal Protection Equipment (PPE) had also been provided where required;
d. Public Health had played a key part in responding to the crisis and were instrumental in developing a local outbreak plan. There were more than 9,000 people in Haringey who were shielding and over half had registered on the government’s website. Many residents had needed essential supplies and Connected Communities had responded to this, including the provision of food parcels. Around 9,000 people had contacted the Connected Communities helpline, which could provide a wide range of support including information, advice and guidance. All calls were triaged for any safeguarding issues;
e. Food had been the top issue and there were now two food hubs within the borough. Some direct purchasing of food had taken place and the food available included hot meals for those who needed them. 30% of those receiving food parcels needed them due to financial issues. The remainder had been unable to access food;
f. Lack of digital access was a particular issue and the voluntary and community sector were helping to address this;
g. Responding to the crisis had been a partnership effort and much stronger links had been developed, especially with the voluntary and community sector. 700 volunteers had assisted with the response. A grant of £600,000 had been made available to voluntary and community sector organisations in order to assist with the further development of the sector;
h. A Community Impact Assessment was being undertaken. In particular, the effect on the BAME community was being considered and a number of recommendations had been made to the Health and Well Being Board. Further data would be collected and work undertaken to develop greater resilience. In addition, the protection of BAME staff would be considered including the undertaking of risk assessments. Equitable access to services was also a factor and, in addition, the wider determinants of health needed to be considered; and
i. There were still many challenges to be faced, including responding to any second wave of infections. In addition, there was a clear need to address inequalities.
In answer to a question regarding the payment of sick pack to care workers, Councillor James reported that standard Statutory Sick Pay was provided for within contracts. There were regular provider forums and they key messages that had been given was that care agencies should allow staff who were shielding to be furloughed and continue to pay staff who were self-isolating but not ill themselves.
In respect of Connected Communities, she reported that its work had been widely praised. The service had provided a more agile way of working, with a “light touch” approach. It also involved working co-operatively across the voluntary and community sector. She hoped that the model could be maintained going forward. Connected Communities had pre-dated the pandemic and was continuing to be rolled out. Learning from its experience in dealing with the pandemic would be taken on board.
In response to another question regarding the disproportionate impact of the pandemic on BAME communities, she stated that a report from Public Health England report had covered this issue. In addition, a report from the borough’s BAME Forum had been made to the Health and Well Being Board. Both of these had highlighted the need for more information and robust and reliable research. The North Middlesex Hospital was, amongst others, undertaking research into the issue. The voice of local communities had been built into the Community Impact Assessment. It was important that the right questions were being asked and that there was a need for more equitable access to services. Some groups within the community were not coming forward and the reasons for this needed to be established.
She reported that the Community Impact Assessment included provision for research within the community and consideration of the wider determinants of health. In addition, the community framework had been co-produced with the community and voluntary sector. There was still much work to do though. The policies of Community Wealth Building and Health in all Policies were key and were now embedded across the whole of the Council.
She reported that the first draft of the Community Impact Assessment was circulating for comment. It was to be an iterative process. Joint work also needed to be undertaken by the Health and Well Being Board and it was important that recommendations were agreed. The George Floyd case had also raised a number of issues that needed to covered. The Community Impact Assessment had been led by officers and the community so far. There would nevertheless be opportunities for elected Members to feed into the process in due course.
In response to a question regarding care homes and exposure to Covid-19, she reported that close contact was being maintained with care providers. Advice and PPE were provided. Action was also included in the local outbreak management plan. Will Maimaris, Director of Public Health, reported that the best way of protecting care homes was to prevent virus outbreaks in the community as it was very difficult to stop leakage. Hospital discharge protocols were being looked at and this had also been done earlier on. Care home testing was being increased and consideration was also being given to the use of the antibody test. The testing of staff was of particular importance.
In answer to a question, Mr Maimaris reported that there was an up to 20% chance of false negative results of swab tests. If there were nevertheless clear symptoms, people could be re-tested. Basic infection control measures needed to be effective. Lessons learnt from were being shared with care homes.
In respect of domestic violence, the Cabinet Member reported that the lockdown had been difficult for families. Although reports had dropped initially, they had since risen by between 30 and 35%. Refuges were all now open and four new ones were being made available. However, services normally relied on face-to-face interaction and, although clients could be contacted virtually, they may not necessarily be in a private space. There was likely to be a surge in demand once lockdown ended. There were also the issues of girls gangs and honour based violence. The new few months were likely to be challenging.
Mr Maimaris reported that listening and engagement events had taken place, including some with BAME communities. The commissioning of services for Violence Against Women and Girls was also being reviewed, which was a key part of the Community Safety Strategy for the borough. Issues were also reported to the Health and Well Being Board. The Committee requested further information of the listening and engagement that had taken place. (Action: Director of Public Health).
In respect of the Autism Hub, the Cabinet Member reported that the aim was that this would open in September. Advertisements had gone out, contractors lined up and the capital spend agreed. There would be a need for re-provisioning Learning Disability and Autism. Although the intention was that housing would also be provided on the site, this was likely to be upstairs from where the service would be located.
Committee Members requested that a Members’ briefing be arranged on the Recovery and Renewal Plan for the borough. The Cabinet Member felt that this was a good idea and agreed to speak to the Leader of the Council regarding it (Action – Cabinet Member for Adults and Health). The Plan was a large piece of work and very much a work in progress. It would be updated regularly. It included an analysis of lessons learnt and how services would resume.
Beverley Tarka, Director of Adults and Health, that engagement with residents
had been initiated and would be continuing. This had been facilitated by the greater use of IT, which had enabled more regular contact with residents. The enhanced contact with residents had included welfare and benefit checks and feedback had been very positive. The response to the pandemic had been integrated and through partnership, including sharing of data. There was much that could be built on. Improved discharge pathways had enabled a figure of zero delayed transfers of care to be achieved. Capacity for reablement had also been doubled and current arrangements would be made permanent. The Recovery and Renewal Plan had so far involvement with a range of partners, staff and Healthwatch. More engagement was planned, particularly with health partners. There was potential for additional surges in infection and planning to address this needed to be developed further.
In answer to a question, it was agreed that information would be provided to the Committee on how voluntary sector organisations could apply for the £600,000 of grant funding that had been allocated by the Council (Action – Director of Adult and Health Services).
RESOLVED:
1. That further information be provided to the Committee by the Director of Public Health on the listening and engagement exercises that had taken place in respect of Violence Against Women and Girls;
2. That a Member Briefing session be arranged on the borough’s Recovery and Renewal Plan; and
3. That information be provided to the Committee by the Director of Adults and Health on how voluntary sector organisations can apply for the £600,000 of grant funding that has been allocated by the Council for voluntary and community sector organisations.