Agenda and minutes

No apologies were received.

To receive declarations of interest from Members.

There were no declarations of interest.

To answer any questions, if any asked by any resident of the Borough pursuant to Standing Orders.

There were no questions and deputations.

A statement was read out on behalf of Birmingham and Solihull Clinical Commissioning Group (BSol CCG) which provided information on the local roll out of the COVID-19 vaccine. Councillor Sexton read out a number of questions which she requested was passed to BSol CCG for a response.

The Board requested that the local vaccination campaign would be considered as a future item on the work programme.

To receive the minutes of the previous meeting held on 23^rd November 2020.

The minutes of the meeting held on 23^rd November 2020 were presented for approval.

A Member commented on Item 3 that Councillor Tim Hodgson had not been updated by Birmingham and Solihull Mental Health Foundation Trust. It was requested this was followed up.

RESOLVED

The minutes of the meeting held on 23^rd November 2020 were approved

As a result of the Covid-19 pandemic and introduction of the National Hospital Discharge Guidance, hospital discharge processes have changed significantly for people with care and support needs. This paper is intended to inform Scrutiny Board of these changes and the current position.

The Chief Officer, Out of Hospital Services, University Hospitals Birmingham (UHB) provided an overview of the changes to hospital discharges as a result of COVID-19. This included:

• The Trust currently had similar numbers of COVID-19 cases as during the first wave of the pandemic. Solihull Hospital had opened one ward for COVID-19 patients, while elective work continued. This position would be dependent on case numbers over the next 7-10 days.
• Although UHB were in a difficult position, they continued to pursue the positive work that was highlighted in the report. A number of discharges still took place outside of hospitals.

The Assistant Director for Adult Care and Health updated Members on the work that had taken place to enable safe and timely discharges to protect hospital capacity. Steps that had been taken in the COVID-19 pandemic included:

• The implementation of the national discharge guidance.
• Introduction of a home discharge service (care at home service with intensive support).
• Improvements to other discharge pathways.
• Development of an integrated hub which was a single team of health and social care professionals who would make multidisciplinary decisions to ensure individuals received holistic support and remained as independent as possible.

The following comments and questions were raised:

• A Member referenced a residents whose father had been discharged without prior notice and asked whether this type of incident would increase. The Chief Officer explained he would investigate the case.
• Members enquired whether residents who received a six week package would have it reviewed before it stopped, and if there were adequate sites to support these people. The Assistant Director for Adult Care and Support confirmed that they would reassess during the 6 weeks to identify if the care would need to be altered, or if further long term care was required. There were a number of sites which could support people on discharge which included a designated setting for COVID-19 positive residents.
• A Member enquired about what follow up visits which would take place after discharge, and the impact of COVID-19. The Assistant Director explained that they would contact residents who were discharged with a period of care to identify what support was required. During COVID-19, they aimed to do this primarily virtually to prevent an infection risk, however there remained the option of face-to-face appointments.
• A Member asked whether the reintroduction of the Care Act Easements had been considered as a result of staffing pressures. The Director for Adult Care and Support confirmed that staff absence rates were lower than the first wave, and additional services were in place. They would be kept under review.
• A Member commented on the importance of the option to work in the office to enable staff to have support with colleagues. The Director for Adult Care and Support stated that staff would still visit residents but it was very important to work as safely as possible. The Assistant Director added that a number of steps had been taken to engage with staff virtually.
• A Member asked if there was  ...  view the full minutes text for item 5.

To seek comments on the budget proposals identified for 2021/22 to 2023/24 within the Adult Social Care and Health cabinet portfolio, to go forward to the Resources and Delivering Value Scrutiny Board and the Full Cabinet in February 2021.

The Director for Adult Care and Support presented the report and outlined that the focus of the budget strategy as a result of the COVID-19 pandemic had been on reset and recovery, which meant that portfolios had not been asked to propose savings. They highlighted the following points in relation to the Adult Care and Support Directorate:

• The current net budget for adult social care and support was £57.143 million, which included a significant amount of one-off funding.
• The Directorate had been required to make £8 million of recurrent savings as part of the MTFS plans over recent years. The last reported financial year position for Period 6 was a £2.143m adverse variance as a result of COVID-19, which highlighted they would otherwise be in a balanced position.
• The two key areas of pressure that had been identified were the increase in wage inflation and younger adults demographic pressures. The mitigation proposals against these relate to grants, inflation assumptions and reserves to cover these pressures.
• There were some potential pressures which had not been incorporated into the MTFS proposals, as new information continued to become available on the longer term impact of COVID-19. This included the increased social care demand as a result of the increased support needed by older people and the rise of unpaid carers.

The Director for Public Health presented the Public Health Directorate MTFS update and highlighted the following points:

• Public Health was mainly grant funded through a ring fenced grant from the Department for Health and Social Care. They were unsure if the 2021-22 grant would have inflation applied to this.
• A substantial proportion of the grant would fund NHS services, and there were pressures in relation to salary uplifts within this organisation. This covered services such as drug and alcohol services, sexual health services, health visiting and school nurses.
• The significant issue for the Directorate was to understand the impact of COVID-19 on future demand for services, as this was not currently clear. There may be increased demand as some people have not accessed the service during the crisis.
• The Directorate was responsible for domestic violence services, and awaited confirmation on the continued funding allocation to support the requirements of the new domestic abuse bill.
• The Directorate also had to establish a longer term financial footing for the employment and skills service to support people back to work.
• There had been significant amounts of funding for the COVID-19 testing, contact tracing and wider measures, but there was uncertainty about whether there would be funding to enable the long term continuation of these measures. Conversations would continue to take place with central government and other partners.

The Head of Financial Operations provided a verbal update on the provisional settlement that had been received just before Christmas. This included that a further Social Care Grant had been announced for 2021/22 which provided £600,000 of additional funding and announced that the Council had the opportunity to raise a further 1% in terms of the Adult Social Care  ...  view the full minutes text for item 6.