Agenda item

To receive an update on the Covid-19 pandemic.

Chloe Morales Oyarce, CCG Head of Communications and Engagement, and Sarah Mansuralli, CCG Executive Director of Commissioning, introduced the report which provided an update on the Covid-19 pandemic.

Sarah Mansuralli explained that, since the unexpected first wave of Covid-19, a number of measures had been introduced to the system, which included monitoring and escalation and surge plans. It was noted that there was now provision to rapidly provide additional step down beds and that primary care hubs could be stepped up quickly. It was added that there were also options to have more care in the community and remote monitoring in care homes. It was explained that the governance structures, escalation procedures, and collaboration arrangements developed in the first wave had put the system in a strong position for the following surges and had created some strong foundations for the Integrated Care System.

Sarah Mansuralli noted that there had been some temporary changes to paediatrics but that these had now reverted back; evaluation of these changes was underway and could be shared with the Committee when available. It was noted that the system changes had been overseen by the System Recovery Executive which included local authorities.

It was explained that there was now a focus on system recovery from the Covid-19 pandemic. It was stated that North Central London had been selected as the accelerator hub for London which meant that it needed to recover its elective lists faster. Sarah Mansuralli noted that there was an aim to provide 120% activity which was a challenge but that North Central London would be working creatively and using clinical triage, out of hospital, and other support mechanisms. Work was underway to consider how to maintain capacity in the system, including working closely with social care; it was added that the Integrated Discharge Team had been very effective and was being maintained to retain capacity. It was also explained that the pandemic had acted as a catalyst for some culture changes, including recognising the interdependency of different health and care sectors, which had resulted in improved outcomes for patients and learning for the system.

The Chair asked about oxygen resilience and funding options within North Central London. Sarah Mansuralli acknowledged that there were some global issues with oxygen supply during heights of demand and noted that she would check what arrangements were in place.

The Chair noted that, following Brexit, a number of health and care staff had left the country which increased demands on the workforce. She stated that there were concerns that the aim to provide 120% capacity as part of the Covid-19 recovery programme would have a significant impact on the workforce. Sarah Mansuralli acknowledged that this was a concern and explained that work was ongoing as part of the Integrated Care System (ICS) People Strategy to work on workforce retention and resilience. It was noted that new models of care would include progression and professional development opportunities for staff. It was noted that it might be useful for the Committee to receive an update on workforce strategies.

Cllr Tomlinson enquired whether the use of North Central London as an accelerator hub would result in extended hours. Sarah Mansuralli explained that surgery would be extended to provide additional hours during the week and during the weekend. Paul Sinden, CCG Chief Operating Officer, stated that the system was looking to protect elective capacity and general capacity for winter pressures and/ or Covid-19 surges. It was explained that North Central London had been given accelerator status as it was organised in a way where it was able to provide additional capacity.

The Chair noted that there had been some changes to services, particularly services for children, during the Covid-19 pandemic. It was stated that there was some confusion amongst patients and that some children and parents were now attending A&E when it was not essential. It was enquired whether services were likely to change again and whether additional or improved communications were anticipated. Sarah Mansuralli explained that the paediatric units had now reverted to their previous service provisions and no immediate changes were planned, although it was acknowledged that it was not always possible to predict what would be required in the future, in the event of a further surge. She noted that a number of lessons relating to communications had been learned during the pandemic and that some good relationships had been developed, including with local authorities and schools. It was added that some communications in relation to common childhood conditions were being produced and this would be shared with the various communications networks soon.

RESOLVED

1.    To note the update on the Covid-19 pandemic.

2.    To request a future workforce update.