Agenda and minutes

Apologies for absence were received from Dr John Allingham (Kent Local Medical Committee), Louise Ashley (Dartford, Gravesham and Swanley ICP Senior Responsible Officer (SRO) Representative), Matt Dunkley CBE (Corporate Director, Children, Young People and Education, Kent County Council), Councillor Alan Jarrett (Leader, Medway Council), Navin Kumta (Clinical Chair, NHS Kent and Medway CCG), Andrew Scott-Clark (Director of Public Health, Kent County Council), Matthew Scott (Kent Police and Crime Commissioner), Miles Scott (West Kent ICP SRO Representative) and Wilf Williams (Accountable Officer, NHS Kent and Medway CCG).

On behalf of the Joint Board, the Chairman welcomed Jackie Brown and Pat Gulvin to the meeting. Jackie had recently taken up the role of Assistant Director, Adults’ Social Care at Medway Council and Pat Gulvin had been nominated to represent Medway Healthwatch.

He thanked their predecessors Suzanne Westhead and Eunice Lyons-Backhouse respectively for their work, support and advice to the Joint Board.

To approve the record of the meeting held on 17 September 2020.

Following further discussion and clarification which took place after agenda item 6 (COVID-19 Local Outbreak Control Plan) the record of the meeting of the Joint Board held on 17 September 2020 was agreed and signed by the Chairman as correct, subject to marking the following members as present:

·       Dr Bob Bowes, Governing Body Member, NHS Kent and Medway CCG

·       Councillor Angela Harrison, Cabinet Member for Health and Wellbeing, Swale Borough Council

·       Councillor John Rivers, Kent Association of Local Councils

·       Dr Robert Stewart, Clinical Designer, Design and Learning Centre for Clinical and Social Innovation.

Members are invited to declare the existence and nature of any interests in relation to any agenda item in accordance with the relevant Council’s Code of Conduct.

There were none.

The Chairman will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report.

There were none.

This report sets out the strategic framework for children and young people, based on the Case for Change and NHS Long Term Plan children and young people priorities for the NHS and partners and agreed recently through the Joint Committee of the Kent and Medway CCGs.

Discussion:

The Executive Director of Strategy and Population Health, Kent and Medway CCG, introduced the report which provided details of the strategic ‘system wide’ framework for children and young people. This was the first step in developing a Kent and Medway Children and Young People Strategy. The framework included 12 priority areas which were set out at paragraph 4.3 of the report.

The Executive Director of Strategy and Population Health drew the Joint Board’s attention to areas which had come to the fore because of the COVID-19 pandemic and where work continued to progress. She recognised that owing to the efforts to respond to the pandemic, some priority areas had not been progressed, however the Joint Board was assured that these areas would be picked up as soon as the system was able to. It was recognised that there was a need to reflect on the impact of COVID-19.

Generally, it was considered that the framework would facilitate joined up working between the Kent and Medway CCG and both Local Authorities to improve the life chances of children in Kent and Medway. Members raised several points and questions including:

·       ‘Ensuring a disproportionate response in the areas where outcomes for children and young people are the worst’ – amending an earlier iteration of the framework which had focussed on Thanet specifically but now had been broadened to incorporate this priority area was welcomed. It was acknowledged that this might not remain constant and aided a reactive approach.

·       Impact of the COVID-19 pandemic – recognising that the pandemic had had a significant impact on some areas of children’s lives, it was anticipated that the priorities might be reviewed or, at least, the order in which they would be progressed reviewed.

Indeed, a view was expressed that whilst the three overarching aims set out at paragraph 4.2 of the report were supported, it was considered that the priorities did not fully reflect the importance of child mental health and wellbeing which had, in many ways, worsened as a result of the pandemic. With reference to the final bullet of paragraph 6.1 of the report, the importance of improving child mental health was reiterated and further supported by Members. It was suggested that a report on mental ill-health prevention be presented to the Joint Board at a future date.

·       ‘Improving Services for looked after children (LAC)’ – reflecting on the challenges identified in the case for change, particularly the statistic that ‘around 10% of children and young people have a mental health issue and is a concern for LAC’, a concern was expressed that this underplayed the complexity of mental health difficulties that the cohort of children who were looked after had. It was noted that LAC were overrepresented in terms of usage of tier 4 mental health services, secure care, and youth justice provision. Given the recent regional initiatives to ensure LAC placed outside of their local area had good access to Child and Adolescent Mental Health Services (CAMHS), it was considered that  ...  view the full minutes text for item 523.

This report provides an update on steps taken to mitigate rising cases of COVID-19 across both Kent and Medway as it relates to the Local Outbreak Control Plan (LOCP). It also includes a summary of LOCP-related questions received from members of the public and answers provided by Public Health Officers (located in Appendix 1).

In view of the rapid evolution of COVID-19, the national and the Kent & Medway re-sponse, it was agreed at the Kent & Medway Joint Health and Wellbeing Board Agenda Planning Meeting that a PowerPoint presentation be delivered outlining; (1) the Kent & Medway experience over the course of the pandemic thus far and (2) our current response to COVID-19 since publication of this cover report. This will be pre-sented at the upcoming meeting. 

Discussion:

The Director of Public Health, Medway Council, introduced this report which provided an update on action undertaken to mitigate rising cases of COVID-19 across both Kent and Medway as it related to the Local Outbreak Control Plan (LOCP). He drew the Joint Board’s attention to recent stress testing, the ‘winterification’ programme and the targeted work which continued to be undertaken to support more vulnerable populations in Kent and Medway. He also gave a detailed presentation.

This presentation provided the most up to date data in relation to COVID-19 outbreaks in Kent and Medway and set out an analysis of trends and details of subsequent interventions within the following settings: Care Homes, Schools Colleges and Universities, Workplaces and Hospitals. The presentation also summarised the LOCP related questions received from members of the public fulfilling the engagement strategy of the Local Outbreak Engagement Board (set out in detail at Appendix 1 to the report). Finally, the presentation provided information about the launch of Asymptomatic Lateral Flow Device (LFD) Testing in Medway, the EU Exit Stress Test, preparation for vaccination and opportunities for the Joint Board to provide its support.

Members raised several points and questions including:

·       Asymptomatic LFD Testing in Medway – asked why a second test would be undertaken following a negative test result, it was explained that this was protocol and was important to create a ‘teachable moment’ to effect behavioural change. It was considered that repeat testing encouraged individuals to continue to follow the precautions, Hands, Face, Space. A view was expressed that it was important to establish Asymptomatic LFD Testing in Kent County Council (KCC) area. The importance of testing in the KCC area was echoed having considered the experience in Swale in relation to COVID-19 infection rates.

·       Increase trend in COVID-19 prevalence – in response to a request for further information in relation to the increasing prevalence of COVID-19 in Kent and Medway around October-November, it was suggested that this coincided with the government announcement about the second national lockdown. It was explained that across many of the then lower tiered regions there was a behavioural shift which influenced the rate of infection. This included changes to, for example, travel patterns and working arrangements which aided community transmission. More detailed analysis was being undertaken.

·       Education settings – a view was expressed that there was an excellent relationship between the Local Authority and Schools in Medway and it was explained that headteachers felt supported. With respect to school closures, it was appreciated that some schools had closed owing to difficulties around staff resourcing, nevertheless, decisions around school closures were complex and needed to consider relevant data.

·       Roving and mobile vaccination plan – asked about the vaccination plan within care homes, it was explained that hospital hubs would be established in the first instance. The initial hub was located at the William Harvey Hospital in Ashford. A roving model would aim to target more vulnerable communities such as care home residents and they would operate from  ...  view the full minutes text for item 524.

The report advises the Joint Board of the forward work programme for discussion in the light of latest priorities, issues and circumstances. It gives the Joint Board an opportunity to shape and direct the Joint Board’s activities.

Discussion:

The Democratic Services Officer advised the Joint Board that an agenda setting meeting took place on 4 November 2020. No amendments to the work programme were recommended at that stage.

Decision:

The Kent and Medway Joint Health and Wellbeing Board agreed the work programme set out at Appendix 1 to the report.