Agenda and minutes

Councillor Levy (Chair) welcomed all attendees to the meeting. It would be the last meeting he would chair, and he thanked the Members present for their support to the scrutiny panel and commitment to the scrutiny process.

Apologies for absence were received from Councillor Dey, who was substituted by Councillor Neville.

Apologies for slight lateness were received from Councillors Demirel and Neville.

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

There were no declarations of interest.

To agree the minutes of the previous meeting held on 17^th February 2022.

The minutes of the meeting held on 17 February 2022 were agreed with the following amendment:

•  Post meeting action point to be added to Minute 4 : additional information to be provided as requested by Councillor Hamilton; the response to the concerns raised by the JHOSC; and the outcome of the judicial review.

The information to be added to the 16 March minutes as a follow-up note.

ACTION:  NCL CCG / Governance Secretary

To receive an update on the rollout of the vaccination programme in Enfield.

RECEIVED the report of the Director of Public Health.

•  Introduction by Dudu Sher-Arami (Director of Public Health) and Dr Fahim Chowdhury (GP and CCG Board Member).

•  The vaccination programme was not finished: there would be a roll out of the booster dose for vulnerable adults in the Spring, and roll out of vaccination to 5 – 11 year-olds via primary care. Planning had already begun for Winter 2022/3.

•  Tackling health inequality was a major focus. The Borough Partnership Immunisation and Screening Workstream Group would continue to work on vaccine inequality. Closer work would continue with local communities.

•  The high level of collaboration between organisations across Enfield, including the NHS, voluntary sector and the Council, was highlighted. A lot had been learned from the vaccination work so far.

In response the following comments and questions were received and responded to.

1.    In response to the Chair’s queries about potential concerns further to recent relaxation of restrictions, it was confirmed that nationally there had been a slight rise in the number of Covid cases and the pandemic was not over. No-one could accurately predict the future, but the vaccination was very effective at preventing death and hospitalisation, and vaccinated people who did become infected experienced much lower severity of disease. Concerns focused on groups with lower vaccine uptake as the unvaccinated would experience higher rates of hospitalisation and death. This was still work in progress. Vaccine manufacture would respond to future Covid variants in a speedy manner and the vaccination programme would continue, along with work to raise vaccine confidence and respond to community needs. Assurance was given that relaxation of restrictions was now appropriate. There were multiple lines of treatment even for the very vulnerable. North Middlesex University Hospital ITU had returned to normal patient numbers.

2.    In response to the Chair’s query about the scaling down of vaccine infrastructure locally, assurance was given that the borough had greater vaccine provision and slots than there was currently demand for. There was extra provision in the borough via additional pharmacies and an additional primary care location, and provision was 7 days a week.

3.    In response to Councillor Georgiou’s queries about difference in vaccine uptake rate by gender, it was advised that women were generally more likely than men to present for health care and to follow health seeking behaviours.

4.    In response to Councillor Georgiou’s further queries, it was confirmed that low vaccine uptake was seen in various geographical, socio-economic, ethnic, and cultural groups. Risks had been highlighted early to Black communities which were known to be more badly affected by Covid. It was confirmed that all patients had continued to be contacted to receive vaccinations. Vaccine uptake inequality did not seem to be related to availability or accessibility but rather to misinformation. An appointment system had been necessary early on to prevent overwhelming the system and to prioritise the most vulnerable. After that point, a walk-in system was better. Pop-up vaccination facilities were provided in support  ...  view the full minutes text for item 4.

To receive a report detailing what the council is doing to become inspection ready.

RECEIVED the report of the Head of Safeguarding Adults.

•  Introduction by Doug Wilson, Head of Strategy and Service Development, Health, Housing and Adult Social Care.

•  The legislation changes and the new duty for the Care Quality Commission (CQC) to assess how Local Authorities are meeting their adult social care duties were highlighted.

•  Much of the detail was awaited at this point, but officers anticipated what the new regulatory framework may look like and the primary principles had been used to plan a programme of work to prepare. Extra members of staff had also been recruited to increase senior capacity and work towards a longer term strategy.

In response the following comments and questions were received and responded to:

1.    In response to the Chair’s queries in respect of the CQC assessments, it was advised that officers’ experience was of fair mindedness from the CQC, and importance of evidence. The pressures on the NHS were a driver for integrated care systems; social care and local services were important as part of the solution.

2.    In response to Councillor Demirel’s queries, the key importance of partnerships was highlighted and working together for a common cause as had been successfully done during the Covid pandemic.

3.    In response to Councillor Hamilton’s query about funding, it was confirmed that over the last 10 years difficult decisions had to be made about spending, but it seemed that the corner was now being turned and that the importance of social care was now being better understood.

4.    In response to Councillor Hamilton’s further query about passage of the legislation through Parliament, it was advised that it was now well progressed and a lot more was known recently about the proposals.

5.    In response to Councillor Anolue’s queries regarding working together, the duty to be clear with the public was stressed, and partnership with Healthwatch. Intervention at an earlier stage was important, and not just responding to crises. There was openness to new ideas and a collaborative approach, giving people power to shape services and delivery. The CQC would be interested in people’s experiences in getting what they need and being supported.

6.    Councillor Neville commented on the Council’s good record in adult social care, and asked about Council care home provision. It was confirmed that Enfield had a significant care market in services and care homes. As opposed to pre-pandemic there were more empty beds, but the government had supported providers, and vacancy rates were improving. There was a need for short specialist care. Bonds with the NHS had been cemented over the last two years and discharge arrangements were working well. The pandemic had also made the Council’s relationship with providers much stronger.

7.    In response to Councillor Georgiou’s queries, it was confirmed that the Council had a good relationship with the CQC and that the key lines of enquiry would be developed with local authorities, though officers were aware of what good and best practice looked like, and Enfield was considered  ...  view the full minutes text for item 5.

The Chair expressed his thanks to Members and Officers for their participation and Governance team for their support. The Chair was thanked for his role and fairness shown to Members from all sides.

Meeting dates for 2022/23 would be approved by Annual Council Meeting following the election.