Agenda and minutes

Online Meeting, Health Overview and Scrutiny Panel
Tuesday 6 July 2021 7:30 pm

You can view the individual reports for this meeting by selecting the headings from the numbered list of items at the bottom of this page. Alternatively you can view the entire agenda by selecting 'Agenda Reports Pack' below.

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Contact: Fiona Cotter  Tel: 020 8547 4607/email:  democratic.services@kingston. gov.uk

Items
No. Item

71.

Questions

A 20 minute period for public questions on items which are not on the agenda.

Minutes:

There were no public questions formally submitted.

72.

Apologies for absence and attendance of substitute members

Minutes:

Apologies for absence were received from Councillors Heap, Ravalia, Ryder-Mills, Stuart and Councillor Yoganathan. Councillors Dunstone and Green attended as subsitutes.

73.

Declarations of Interest

Minutes:

There were no declarations of interest

74.

Minutes

To approve as a correct record the minutes of the last Panel meeting on 21 April 2021.

Minutes:

Resolved, that the minutes of the meeting held on 21 April 2021 be confirmed and signed as correct.

75.

Report of the Chair pdf icon PDF 59 KB

Minutes:

Received as information.

76.

Eating Disorders pdf icon PDF 176 KB

Report by SW London CCG.

Minutes:

The Panel considered the report of the Executive Locality Director – Kingston and Richmond updating members on the work of South West London & St Georges NHS Mental Health Trust (SWLSTG) in providing a specialist Community Eating Disorder Service (CEDS) for Children and Young People (CYP) from 5 South West London Boroughs including Kingston.

 

The report detailed the service developments pre-pandemic, the surge in demand since the middle of 2020 and the investment and transformation work taken forward to manage demands in service.

 

In response to the increase in demand, the threshold for accepting referrals had increased. The change in threshold enabled the service to prioritise referrals, offer eating disorder treatments and were more focussed on family therapy.

 

The Panel heard that meeting the increase in Children and Young People (CYP) eating disorders was one of the top priorities for mental health in South West London, and this related to both the surge in demand pre-Covid as well as during the pandemic.

 

The demand pressures had resulted in an unprecedented backlog in waiting lists, increased complexity of presentations, increased anxiety and stress in the team managing the referrals, and an increase in complaints and recruitment challenges.

 

To address these challenges investment had been secured in 2020 and 2021/22 and would focus on increasing the referrals accepted by the Trust, the range of interventions and to re-establish the intensive treatment offer to CYP, and to stabilise the team and add to the skill mix.

 

It was clarified to the Panel that some measures had been identified to make improvements in the short term –

 

·         Increasing the activity and complexity of the presentations being managed

 

·         Improvements in the current pathway and additional support such as BEAT, links with primary care colleagues and increasing health checks

 

·         workforce and recruitment strategy and skill mix

 

·         A review of the in-patient facilities

 

The Panel was informed there had been work undertaken to strengthen the in-patient provision and reduce presentation in Emergency Departments (ED). Pre-pandemic the number of beds in SWL was 12 and these were closed over the pandemic and then reopened with 5 beds. This was to enable a look at the model to reduce the length of stay to a 12 week in-patient model. It had been agreed to increase the number of beds to 7 and by March 2022 the capacity would be back to 12 beds.

 

In response to a question from the Panel on the number of beds and the model, it was confirmed there were currently 7 wisteria beds open and there would be a move back to 12 beds in the early part of 2022. The 12 week length of stay had been achieved by having more intensive input with CYP when they were on the ward, in order to maximise their recovery and minimise their length of stay. On return to 12 beds that more intensive model of care would continue enabling more young people to be seen during the course of a year. An initial evaluation on  ...  view the full minutes text for item 76.

77.

CAMHS Update pdf icon PDF 157 KB

Report by SW London CCG.

Minutes:

The Panel considered the report of the Executive Locality Director – Kingston and Richmond, updating members on Children and Adolescent Mental Health Services (CAMHS) within Kingston.

 

Referrals to CAMHS services initially dropped at the start of the pandemic but had begun to rise sharply. During the pandemic additional services were provided working with Education and Social Care to support those identified as at risk, investment continued into CAMHS services and the development of a model moving from a tier structure to an iThrive model, which would enable those currently working in tiers to work in a more collaborative way, was in progress.

 

The Panel heard there was a range of mental health support in schools, with Achieving for Children (AFC) providing emotional health services and complex and specialist presentations managed by South West London & St Georges Mental Health Trust (SWLSTG), and access to tiers 2 and 3 via the CAMHS single point of access staffed by both AFC and SWLSTG.

 

In relation to the impact of Covid 19, it was explained that children and young people had reported concerns around their emotional wellbeing and mental health, particularly around school and college closures and a lack of social contact. All services continued to be open throughout the pandemic, but there had been an increase in demand including urgent cases which meant waiting times for referrals did increase, and the service model had to be reviewed to deliver digital assessments.

 

The Panel asked for clarification in regard to iThrive and what it involved and if there were any recruitment challenges. It was explained the iThrive model had an inclusive and collaborative approach to the individual between the tiers. Recruitment was generally a challenge, with challenges in the area of qualified practitioners and other skill mixes.

 

The Panel highlighted that a significant number of referrals were coming in as neuro-developmental presentations to do with Autism, specifically in relation to post diagnostic support. A request was also made for an update on the protocols in place for moving between children’s and adult’s services.  It was noted by the Panel that work was in progress on these issues and an update would be provided later in the year.

 

In response to a question from the Panel on which tiers would need focused resources, it was confirmed that it was essential that tier 3 and tier 4 was adequately resourced but also having a focus on early intervention prevention as much as possible.

 

The report was received as information with a request that an update be provided at a future meeting of the Health and Overview Panel in 9 or 12 month’s time

 

78.

Kingston Stronger Together Hub Presentation pdf icon PDF 101 KB

Report by Director of Public Health and AD Healthy and Safe Communities.

Minutes:

The Panel received an update and presentation from the Director of Public Health and AD Healthy and Safe Communities on the Kingston Stronger Together Partnership and Hub (KST).

 

The services provided had been of benefit to the community particularly for people who had been self-isolating and those who were clinically extremely vulnerable. Support had been available to access food, medicine, emotional support and access to vaccines, and also early intervention, health, social care and safeguarding services.

 

Over 3,500 households had been supported to date, and the Borough had been in an increased response status due to the rise in cases with those self- isolating continuing to receive support.

 

The services employs 9 core council staff as well as 130 volunteers who support the delivery of the essential response service. Those involved in setting up the support services included Kingston Food Bank, Voices of Hope, Goodgym, Kingston Churches Action on Homelessness and Citizens Advice

Kingston. Your Healthcare also received direct referrals from the KST Hub for people with long term conditions who have COVID-19.

 

Anyone impacted by Covid-19 could access the Hub either by going online to the Council’s website or by phoning the contact centre, and the Hub was open 6 days a week, Monday – Saturday.

 

In addition to those unable to leave their homes due to Covid, the Hub was also supporting homeless individuals, with 180 homeless people a week engaged with. Additionally, over 65,000 homes and business had received information on the support available from KST.

 

The Panel was provided with some examples of case studies which detailed the support given to individuals in different circumstances, and acknowledged the work that had been carried out and how it was an example of bringing the community together.

 

It was explained to the Panel that although there had been a great deal of support from voluntary sector partners, due to high demand, there had not been enough capacity to refer some cases on. The more complex and time consuming the cases, the more capacity was required, and the partnering services did not have that capacity to deal with those cases. The Voluntary Community Sector Review would be helpful both in mapping the services available and identifying where gaps continued to be.

 

It was noted by the Panel that a large proportion of the homeless cohort had mobile phones, as this was their primary source of communication. It was also noted that Staywell had provided a great number of services during the pandemic, and KST refers to Staywell for social prescribing support services.

 

The Panel noted that KST had found the way of working over the past 12 months to be very effective, in terms of the ability to mobilise multiple resources across their partners in order to deliver services. It would be preferable to continue with collaborative working permanently in order to tackle food and financial insecurity and the inequalities experienced by some local people.

 

The report was received as information with a request that an update be provided  ...  view the full minutes text for item 78.

79.

Verbal Update on Covid-19 and Vaccination

Verbal update on Covid-19 and vaccination by Director of Public Health and AD Healthy and Safe Communities and the SW London CCG.

Minutes:

The Panel received a verbal presentation from The Director of Public Health and AD Healthy and Safe Communities, which included slides providing an update on Kingston’s Covid-19 response.

 

From mid-May Kingston’s infection rate had started to increase very quickly, and had gone from a case rate of 13 to over 80, with the case rate dropping during half term. This was due to the case rate being driven by young people aged 20-24 who weren’t at that time eligible for vaccination, and in Kingston’s older teenage population. There had been some success in an increased response to the surge and cases plateaued, but the London and South West London rate had continued to accelerate with Kingston following a similar acceleration pattern.

 

Despite the increase in case rate the benefit of vaccination could be seen with the weakening of cases in the community translating into cases in older age groups and to hospital admissions. There had not been a dramatic increase in hospital admissions even 2 or 3 weeks on. The case rates in different age groups was explained with an emphasis that vaccination roll out was still the main drive.

 

In terms of hotspots in the Borough, Chessington South & Malden Rushett had fairly high rates at 202, a 157% increase on the week before. Hook had seen a big increase with a doubling of the case rate to 269, and Berrylands South had had a small increase but a high case rate of 187.

 

The Panel was provided details of the increased response to the rise in case rates that was implemented between 9 – 29 June 2021, which involved 4 key areas of action;

 

1.    Identify currently unidentified COVID-19 cases in the borough by increasing testing using PCR (and, secondary aim, encourage regular testing with LFT) (and then support to self isolate)

 

2.    Protect vulnerable residents and reduce transmission as a whole: increase uptake of vaccination amongst unvaccinated in key national target groups through ‘Surge Vaccination’.

 

 

3.    Encourage full isolation when required and support uptake of testing by improving awareness of support available and access to self isolation payments.

 

4.    Identify contacts, encourage PCR testing in contacts and support self isolation through continued VOC tracing and implementation of new ‘self isolation support check ins’.

 

The Panel was provided details on testing during the surge period of 9 – 29 June 2021, which included the distribution of PCR tests to all of Kingston’s schools and which was a ‘whole school’ approach that included the pupils and staff and their households. A large number of tests were completed through this route.

 

Over 5000 tests were carried out at mobile testing units, and Local Contact Tracing success rates remained high being the highest / second highest in London.

 

The Panel was also informed of the range of communications used in regard to surge testing, including the use of local and national media interviews as well as the use of social and digital media.

 

In response to questions from the Panel  ...  view the full minutes text for item 79.

80.

Regular Updates pdf icon PDF 273 KB

For the information of Members, to receive update from Health and Social Care Partners.

 

This report was compiled for the Health and Wellbeing Board which was due to meet on 22 June 2021 but which has been postponed to 22 July 2021 and any further updates will be provided orally.

Minutes:

The Panel received the report as information

81.

Urgent Items authorised by the Chair

Minutes:

The were no urgent items

82.

Exclusion of the Press and Public

This item is included as a standard agenda item which will only be relevant if any exempt matter is to be considered at the meeting:

 

To exclude the public from the meeting under Section 100(A)(4) of the Local Government Act 1972 on the grounds that it is likely that exempt information, as defined in Part I of Schedule 12A to the Act *, would be disclosed.

(*relevant regulatory paragraph to be indicated eg paragraph 1 for information relating to any individual)

 

Minutes:

The motion to exclude press and public was not required.