Issue - meetings

To receive a report from the Hampshire Clinical Commissioning Groups providing an update regarding the NHS response to the Covid-19 pandemic locally, including the progress of the vaccination programme and service recovery. Also included for information are written updates from the following Trusts:

·         University Hospital Southampton NHS Foundation Trust

·         Southern Health NHS Foundation Trust

·         Frimley Health NHS Foundation Trust

The Committee received an update from the Hampshire and Isle of Wight Clinical Commissioning Group, and written only updates from Frimley Health NHS Foundation Trust, University Hospitals Southampton NHS Foundation Trust and Southern Health NHS Foundation Trust, on the ongoing NHS response to the pandemic and the progress of the vaccination programme in Hampshire.

It was highlighted that it was now recommended to offer the covid vaccine to children over the age of 12. It was noted that immunity wanes, therefore a booster programme was planned for the winter to give priority groups a third dose. It was confirmed that being fully vaccinated did not mean people wouldn’t catch covid, but reduced the chance an individual would need hospital care if they did catch it. Members commented that there was a need to communicate to remind people that there remains a risk and safe practices should be continued once vaccinated.

RESOLVED:

The Committee note the update.

To receive an update from the NHS commissioners in Hampshire, providing an update on developments in the Covid-19 NHS response in Hampshire since the last meeting on 11 January.  Including written updates from the following Trusts:

·         Hampshire Hospitals NHS Foundation Trust

·         University Hospital Southampton NHS Foundation Trust

·         Portsmouth Hospitals University NHS Trust

·         Frimley Health NHS Foundation Trust

·         Southern Health NHS Foundation Trust

The Committee received a report from the Clinical Commissioning Groups providing an update on the impact to date of the pandemic and third wave of COVID-19 on the NHS in Hampshire and Isle of Wight and the COVID 19 vaccination programme (see Item 8 in the Minute Book). The Committee also noted that written updates had been provided by the following Trusts:

·         Hampshire Hospitals NHS Foundation Trust

·         University Hospital Southampton NHS Foundation Trust

·         Portsmouth Hospitals University NHS Trust

·         Frimley Health NHS Foundation Trust

·         Southern Health NHS Foundation Trust

The Hampshire and Isle of Wight COVID-19 Deputy Incident Commander gave a verbal update on the progress locally of the covid vaccination programme. It was reported that 93% of residents in the priority 1 category had been vaccinated. The current focus was the over 65s and those over 16 with long term conditions. Those with learning disabilities had been risk assessed as a priority group and specific clinics had been designed for this cohort along with the offer of home visits.

Members asked questions for clarification and learned that:

·         It was hoped a vaccination site local to the population in Alton would be confirmed soon

·         All those shielding due to being clinically vulnerable were due to be offered the vaccine by the end of March

Members expressed their thanks to the NHS and the volunteers involved for the success of the vaccination programme so far.

The Hampshire and Isle of Wight Covid-19 Clinical Medical Acute Lead and Interim Clinical Transformation Director gave a verbal update on the position, reporting that hospitals were now caring for around 400 covid patients compared to around 1,000 at the peak. More than 10% of those waiting for an operation had now been waiting over a year. It would be the priority for the next six months to address waiting times.

RESOLVED:

The Committee note the update.

To receive an update on the HIOW NHS system approach to COVID.  

The Committee received a report from the Clinical Commissioning Groups

covering Hampshire and the Isle of Wight providing an update on the response of the NHS in Hampshire to the Covid-19 pandemic (see Item 6 in the Minute Book).

The Hampshire and Isle of Wight NHS Covid-19 Clinical Medical Acute Lead (and Interim HIOW Clinical Transformation Director) gave a verbal update on the latest position. It was reported that hospitals in the county were coming under pressure due to the numbers of Covid patients and elective services had been suspended unless life saving. Capacity was being utilised in the independent sector and mutual aid arrangements were in place to enable hospitals to work together to manage bed demand.

A verbal update on the vaccination programme was also provided by a representative of the Clinical Commissioning Groups. Members heard that the focus of the vaccination programme was to avoid hospital admissions resulting from Covid and therefore was initially targeting vulnerable groups in four categories. This included care home residents and staff, the over 80s and frontline health and social care staff, then the over 75s, followed by the over 70s and the clinically extremely vulnerable over 18.

Primary Care Networks were working together to form vaccination hubs, of which there were 39 sites across Hampshire and Isle of Wight for administering the vaccines. Larger Vaccination Centres were also being established of which there would be 4 in Hampshire; one on the Isle of Wight, one in Portsmouth, one in Southampton and one in Basingstoke. 39,000 doses had been given out locally to date, out of a total population of around 1.7 million. 

The Chief Operating Officer of Frimley Health NHS Foundation Trust provided an update on the position of the Trust, as part of the population in the north of Hampshire used their services. It was reported that cases had increased in the area covered by Frimley Health more quickly than in the rest of Hampshire in the weeks leading up to the meeting, including as a result of the new more infectious strain.

Members asked questions of all the speakers for clarification and further information.

RESOLVED:

To note the updates received.

To receive an update on the NHS Hampshire and Isle of Wight system approach to COVID including second wave/winter planning and recovery.

Including updates from the following Trusts:

a.    Hampshire Hospitals NHS Foundation Trust

b.    University Hospitals Southampton NHS Foundation Trust

c.    Portsmouth Hospitals University NHS Trust

The Committee received an update from the Clinical Commissioning Groups covering Hampshire and the Isle of Wight providing an update on the response of the NHS in Hampshire to the Covid-19 pandemic (see Item 8 in the Minute Book). A written report and accompanying presentation provided an overview of the health element of the Hampshire and Isle of Wight Local Resilience Forum response to Covid-19; the NHS restoration and recovery work; and planning work being undertaken across Hampshire and the Isle of Wight (HIOW) for winter and a potential second wave of Covid-19. A written update had also been received on the position for Hampshire Hospitals NHS Foundation Trust, University Hospitals Southampton NHS Foundation Trust and Portsmouth Hospitals University NHS Trust.

Members heard that planned care was ceased during the peak of the pandemic. These services were re-starting but there was a backlog that had resulted in long waiting times. Effort was being put in to ways to see additional patients to help reduce this. It was noted that over time different treatment methods for covid-19 had been developed, some of which did not require anaesthetist supervision, therefore if hospitalisations from the virus increase in a second wave the impact would hopefully be less than in the first wave. There had been learning from the first wave that it was hoped would mean the system would be better prepared to respond to a second wave.

RESOLVED:

That the Health and Adult Social Care Select Committee:

1.    Note the system wide update

2.    Note the Trust specific updates provided

3.    Request that updates continue to be provided at each meeting of the HASC.

To receive an overview on the HIOW system approach to COVID and work completed as part of the Local Resilience Forum response.

To receive Trust specific written updates from:

a.    Hampshire Hospitals Foundation Trust

b.    Southern Health Foundation Trust

c.    Portsmouth Hospitals Trust

Representatives from Hampshire and Isle of Wight (HIOW) organizations provided an overview of service changes and highlighted developments during the pandemic.  

Members heard that healthcare organizations and staff appreciated the “thanks” they had received and have been working hard with colleagues in Social Care, Police, and Fire.  All have been grateful for the public’s help in adjusting how they accessed services.  Residents adapting quickly and following the guidance has been key.  

The pandemic has been a major incident and one that has been ongoing for a long period of time.  The aim has been to prepare and plan for the reasonable worst case scenario whilst hoping for the best.  Capacity has been provided where needed and managed in new ways.  Changes that have been on the list for years, took place in 2-3 weeks.  It was imperative to maintain critical services and restore them, e.g. carefully rescheduling operations, considering PPE and social distancing needs.  Patients were quite anxious initially to come into the hospital, but the hope is that there has been a shift in thinking and they now feel safer returning.  

In order to exit the lockdown safely and prevent a second outbreak, the guidance and safety measures need to be followed.  While numbers have dropped, Covid is still active.

Different agencies have been working well together in unifying understanding and action.  Covid outbreaks have been less clear and building urgency in communities has been critical.  Maintaining critical services in the priority areas of support have been key, including protecting the vulnerable and keeping them safe and maintain public order. 

Work must continue in that perspective and with effective precautions.  Careful plans are now being put into place for a new normal while watching out for the next wave.  The reasonable worst case is still on everyone’s minds and they are ready for quick and critical fact-based decisions even with scant information but in the right context.  

The real thing is often never quite like the exercise and Covid has had a life changing impact.  However, it has been a privilege to come together with colleagues and organizations focused on issues as one team while maintaining the sovereignty of each team.  

Upon clinical reflection, there have been about 2 million people affected including those who have been tested and those whom providers suspect may have been infected.  There are high numbers of patients in some areas, fewer in others. There has been a fairly uniform experience overall with anxieties about outbreaks and hotspots.  Approximately 5-10k residents have died naturally and 1400 of those of Covid in Hampshire and Isle of Wight.  Many were elderly and frail so there has been some crossover in those areas.  

Hospital resiliency was maintained, and capacity was always available against anticipated numbers.  This is a tribute to the integrated work that goes on with partners and the community response.  

While there has been some alarm about care homes, work with social care and care home colleagues continues alongside the restoration of critical and then  ...  view the full minutes text for item 206