The Chair, Cllr Edward Smith welcomed everyone to the meeting. Apologies for absence were received from Cllr Huseyin Akpinar.

Members of the Council are invited to identify any disclosable pecuniary, other pecuniary or non-pecuniary interests relevant to the items on the agenda.

No declarations of interest were received.

To receive and agree the minutes of the meeting held on 3 November 2020.

The minutes of the meeting held on 3 November were agreed.

Matters Arising

There have been 17 deaths in care homes since November. Currently 34 care homes have recorded infections, totalling 63 residents and 49 staff. This figure is a reduction on previous weeks.

It was confirmed that all  the 82 care homes in the borough have PCR tests and Lateral Flow Tests.

No further data has been received from NHS England.

When leaving hospital, any covid positive resident will spend a period of time in one of 115 step-down beds provided in North Central London, before returning to their care home. 30 beds are provided at Chase Farm Hospital. No covid positive resident is returned to their care home before this period of isolation.

To receive a presentation from Andrew Wright (Director of Planning and Partnerships) and Dr Pardeep Grewal (Clinical Director of Mental Health Services-Enfield) from the Barnet, Enfield and Haringey Mental Health Trust

Andrew Wright and Pardeep Grewal provided an update on the Covid-19 response from the Barnet Enfield and Haringey Mental Health Trust (BEH MHT).

1)    The presentation highlighted the current position, the transformation of services through the pandemic and plans for future service provision.

2)    The Trust were well prepared for the current wave, following the initial outbreak last year.

3)    BEH MHT have supported acute trusts by providing a number of step-down beds for respiratory patients at Chase Farm Hospital.

4)    Approximately one third of staff have been vaccinated to date and the vaccination programme continues.

5)    The overall number of patients has not increased dramatically, however there is an increase in the number of patients presenting in crisis (compared to last year).

6)    There is a system in place for managing Covid-19 patients within distinct wards.

7)    The resilience of staff is being tested but the Trust management are supporting staff as appropriate. There is support for BAME staff and others at high risk through formal risk assessments and the launch of a new inclusion programme.

8)    The crisis team and community team have worked hard to keep people out of hospital, including young people and the very old.

9)     Although there have been many challenges, it is possible to identify a number of successes which will inform and improve future service provision; digital technology supporting more flexible working for staff; working in partnership to support other local hospital trusts.

10)Coming out of the National Long -Term Plan is some key investment for mental health services. There will be significant investment over the next 3 years which will result in a levelling up of resources across North Central London, which will benefit Enfield.

11)There are 2 aspects to the additional investment i) Community Mental Health Services will employ an additional 100 staff ii) The crisis offer will be strengthened. Both aspects will reduce the demand for in-patient beds by providing greater service provision in the community.

The Cllr Smith thanked Andrew Wright and Pardeep Grewal for a very clear and succinct presentation. The Chair asked Members for any comments or questions.

12)In response to a question concerning mental health issues resulting from social isolation and the strain on future service provision, it was noted that the impact is most likely to be felt within psychological/talking therapy areas.

13)Pockets of deprivation in the east of the borough are likely to see a negative impact of social isolation. The impact on vulnerable young people will not be evident for some years to come.

14)It was noted that there is a critical relationship between services such as the local authority schools service and the BEH MHT as part of an integrated provision.

15)Just over a third of the 3,700 staff have been vaccinated and issues around staff being reluctant to have a vaccine are being addressed. Absence rates for general sickness are no different but in Enfield, its below average but much higher in other  ...  view the full minutes text for item 21.

To receive a presentation from representatives of the North Central London Clinical Commissioning Group and the Enfield Council Public Health Team (The Integrated Care Partnership)

Enfield Officers and NHS Representatives gave a presentation which highlighted the learning gained from the flu vaccine immunisation programme which is being be applied to the covid vaccine roll-out.

1)    A summary of the flu vaccination eligibility criteria was provided, along with the level of take-up as at 14 January.

2)    A number of actions have been taken to increase the flu immunisation uptake, including engaging with the lowest performing GP surgeries and engaging with 4 mosques to support uptake in the Muslim community.

3)    The partnership working between the NHS, Enfield Council and the voluntary sector has helped to boost the uptake levels.

4)    A social media campaign was developed to educate and encourage residents to have the flu vaccination.

5)    The challenges and success were discussed, including providing vaccine hesitancy training to doctors and nurses and helping to challenge vaccine misconceptions.

6)    Education sessions with parents and children have been established via webinars.

7)    Targeting hard to reach groups has been a challenge, homeless, deprived community, Muslim community and Central and Eastern European communities.

8)    Lockdown has resulted in a reluctant of some residents to visit surgeries.

9)    ‘Healthy Intent’ softwear has identified where there is suspicion in certain communities, allowing a more targeted approach to encouraging immunisation.

10)In response to a question, it was confirmed that the approach to encouragement must be multifaceted as the reasons for not being immunised are varied. As an example of reluctance, the Eastern European community would only visit a doctor when unwell, rather than considering health prevention services, such as immunisation.

11)GP practices in Enfield are being used as vaccination centres for covid. All are performing well, with Carlton House having administered the highest number of vaccines to date. The Dugdale Centre will also become a vaccination centre in February.

12)Both the Pfizer and the Oxford/AstraZeneca vaccines are available in Enfield.

13)The order of supply to various cohorts was detailed, including the programme to cover care homes.

14)Community pharmacies are now beginning to provide a vaccination service. They must be able to provide 1,000 vaccines per week, opening 7 days per week, 8.00am-8.00pm.

15)It was noted that additional venues such as community pharmacies are welcome as long as they are properly regulated.

16)All care home residents and staff have been vaccinated, ahead of the deadline. The AstraZeneca vaccine has been more appropriate to use in care homes as it has no specific storage requirements.

17)The task has involved managing logistics of vaccine delivery, education of staff, coordination of teams on the ground and data collection.

18)BEH MHT have provided support to the vaccination process by utilising the CHAT Team and mental health nurses. In addition, MHT clinics have been made available for care home staff to obtain a vaccination. Supported living and housebound residents have also been vaccinated.

19)The collaborative work was emphasised, involving Medicus, one of the primary care networks in Enfield, the Council, Mental Health Trust and care  ...  view the full minutes text for item 22.

This is a pre-decision scrutiny item asking for comments on service provision at Alcazar Court and Skinners Court.

Cllr Cazimoglu, Cabinet Member for Health and Adult Social Care introduced this item, for noting.

1)    Extra care service provision provides independent, adapted accommodation with care and support available 24 hours per day, 7 days per week.  

2)    The service caters for a mixed community of need providing both low and high levels of support. This type of service often prevents or delays the need for people to enter residential care.

3)    The retendering process will be concluded by the end of January, with a lot of healthy interest in the contracts available. The final report will go to Cabinet for approval in April.

4)    It was confirmed that continuity of care would be provided, irrespective of the outcome of the retendering process.

To note the work programme for 2020/21

The work programme was noted. The agenda items for the next meeting in March will be considered further.

                                                                                    ACTION: Cllr Smith/Andy Ellis

To note the date of future meetings as follows –

Wednesday 24 March 2021

The date of the next meeting was noted as Wednesday 24 March 2021.