The Director of Planning and Delivery, Birmingham and Solihull CCG, introduced the item and provided the following update on the Birmingham and Solihull service response to COVID-19:
· Since the last update, there had been significant changes in the previously reported position, as a result of the latest COVID-19 wave. The rate of COVID-19 had dropped a lot, however remained high. Similarly, hospital admissions remained high, and patients had been transferred out of Birmingham and Solihull Hospitals to manage demand.
· They were due to re-enter the restoration and recovery phase, and plans were being drawn up to prepare for this. Primarily this would focus on maximising capacity within the system for priority 2 and 3 patients. This would be a system wide approach, with a single waiting list across Birmingham and Solihull providers, which would mean that resources would be pooled.
· An elective coordination hub would be led by University Hospitals Birmingham (UHB). Decision making would take place at Chief Executive level in relation to the order that critical services would be restored. Where service changes would be made permanent, due process would be followed.
· The 2021/22 planning round had been deferred by NHS England and Improvement to Quarter 1 of 2021/22. They still awaited the national planning guidance and financial allocation for 2021/22. There was steps to identify the baseline financial position for the next financial year.
Members made comments and asked the following questions:
· A Member asked in what order services would be stood back up. The Director of Planning and Delivery explained that it would be decided on clinical priority, which was a process undertaken by clinicians.
· A Member queried how many staff were absent from work because of mental health problems and what support was available and accessed. Other Members flagged similar concerns. The Deputy Chief Executive, Birmingham and Solihull CCG, highlighted that there was a health and wellbeing programme of work and a “peoples” Board. Sickness and absence was monitored through this forum and information on this would be shared with the Board. The offer had been promoted to support staff mental health; it was recognised that this would need to be in place for a prolonged period of time.
· Members requested clarity about whether Solihull Hospital still had COVID-19 patients. The Director of Planning and Delivery confirmed that it no longer had COVID-19 patients, these were restricted to the Queen Elizabeth, Good Hope and Heartlands Hospitals. Strict measures to prevent cross infection remained in place.
· A Member questioned how people with degenerative diseases were prioritised. The Director of Planning and Delivery explained that all patients would be included and considered on the single waiting list.
· A Member sought clarification on the backlog of patients for the priority groups, how long it would take to work through this list and the process for this. The Director of Planning and Delivery noted that the figures for the priority lists shifted frequently, and information would be shared with the Board. There was detailed modelling work which would consider different scenarios of how capacity was managed to decide the priority list. The modelling would need to be completed before further information, such as time frames, could be shared.
· A Member requested further information on how junior doctors were used during the pandemic. The Deputy Chief Executive confirmed that this was a temporary measure at Solihull Hospital which provided additional support to a small amount of wards with patients were almost ready to be discharged. The learnings from this could be shared.
· A Member queried about the reduction of endoscopy services and whether this programme continued. The Director of Planning and Delivery explained that there was additional capacity for endoscopies put into the system at Solihull Hospital, and should be live in the near future.
· A Member stated that they had spoken to NHS staff who had given mixed reviews of the psychological support available. They asked whether anonymous feedback could be given on the support and what evaluation of the support had taken place to ensure it met their needs. A response would be provided on this.
· A Member noted that the there was a shortage of female mental health inpatient beds, and asked what the consequences of this were, what was done to manage this and had there been any adverse events. The Director of Planning and Delivery highlighted that there was a national shortage of mental health beds prior to COVID-19, which as a result led to out of area placements. They would then aim to repatriate these patients back into the area if an appropriate setting became available. The Deputy Chief Executive noted that these problems were high on their agenda, and would be worked through as quickly as possible.
· A Member asked whether the vaccine programme had started to take effect for care home residents and staff. The Deputy Chief Executive confirmed that the number and severity of infections was reduced; this was monitored on a weekly basis. It would still take time to see the full impact of the virus on these figures.
· A Member sought clarity on how the vaccination campaign could continue to be supported while other services were restarted. The Director of Planning and Delivery explained that a number of staff had been redeployed to support the vaccination campaign across a variety of sites and this would be factored into the modelling for restoration and recovery.
· A Member queried whether national guidelines were followed when services were paused and restarted, in particular referrals for some types of lymph node biopsies. In response the Director of Planning and Delivery highlighted that national guidance was followed and adhered to alongside the clinical advice. More information was be provided on lymph node biopsies.
· A Member requested further information on the current situation with the Nightingale Hospital in Solihull. The Director of Planning and Delivery noted that this was a nationally commissioned service, but that it had not been used to date.
· A Member asked how successful partner organisations had been to support vaccine delivery. It was confirmed that GP surgeries and other partners played a pivotal role in the vaccine delivery programme.
· A Member questioned how they would create shared services and policies as the restart and restoration work was undertaken. In response, the Director of Planning and Delivery explained that they had cemented and reinforced close partnership working as a result of COVID-19 and the ICS status. This would continue to be pursued in the future.
· A Member sought feedback on how different communities had accessed the vaccine. The Director of Planning and Delivery outlined that there had been considerable work with faith leaders and community representatives to reinforce the benefits of the vaccine with the communities who may be resistant. This work had received positive comments.
The Board NOTED the presentation.