Agenda and minutes

AGREED that Councillor Alma Hellaoui be elected as Chair.

AGREED that Councillor Layton be elected as Vice Chair.

There were no declarations of interest at this point in the meeting.

The minutes of the Tees Valley Joint Health Scrutiny Committee held on 22 June 2021 were approved as a correct record.

Representatives from Cumbria, Northumberland and Tyne & Wear NHS Foundation Trust (CNTW) and Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) will be in attendance to provide an update in respect of the following:-

• CAMHS at Acklam Road Hospital / Lotus Ward Admissions 2021/2022
• Respite and Short Break provision
• TEWV Performance 2021/2022 – Q1
• Community Mental Health Transformation Programme

Lotus Ward – Acklam Road Hospital

Representatives from Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust (CNTW) gave a presentation in respect of the recently opened Lotus Ward at Acklam Road Hospital.

In terms of background it was advised that CAMHS services at West Lane Hospital had been closed in 2019 following CQC regulatory action. A formal request was then submitted by NHS England/NHS Improvement (NHSE/I) to establish a CAMHS inpatient service in Teesside and following Board approval CNTW had agreed to provide a 10 bedded General Adolescent Inpatient Unit for young people aged 13-18 years.  

‘Lotus’ had been selected as the name of the ward (a symbol of regeneration) following research and engagement with young people residing within Ferndene and Alnwood Wards and Lotus Ward was to be managed by the Trusts’ Specialist CAMHS Clinical Business Unit within the North Cumbria Locality Care Group. It was advised that Lotus had opened on 5 April 2021 following NHSE/I approval and CQC registration and patient occupancy had commenced on 10 May 2021.

With regard to admissions there had been 15 admissions to date 13 transfers, 2 direct admissions and information was provided in respect of the localities from which young people had been referred into the service, as follows:-

Localities: Co Durham (6), Tees (4), Sunderland (2), North Yorkshire (1), Gateshead (1), North Cumbria (1) and the average length of stay was 34 days.

As part of the ensuing discussions the following points/questions were raised:

· In response to a query as to how confident CNTW were that the measures taken this time would work and the issues experienced in the past would not be repeated. It was emphasised that CNTW was confident in the approach it had taken to establishing the unit and the whole team around getting the environment right and ensuring value based recruitment. In terms of staffing ratio it would be one of the better established wards, the clinical leadership and number of Band 6 staff appointed would ensure staff at the unit had considerable experience. This was further strengthened by the presence of Medical Directors.

· Reference was made to the need to at times use restraint to safeguard individuals, other patients and staff but there would be no use of mechanical restraint at Lotus.

AGREED that the information in the presentation be noted and a visit to Lotus Ward for members of the Committee be arranged in advance of the next meeting.  

Working collectively to review the mental health system - Update

Representatives from Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) gave a presentation entitled working collectively to review the Mental Health System. The presentation highlighted the vision and outcomes envisaged for Community Mental Health Transformation, the action that had been taken over the last 6 months, how staff and service users had been involved, the PCN pilot and developments including the introduction of PCN Mental Health Practitioners, Patient Feedback and the Design Event. 

It was advised that the aim of NHS England’s Community Mental Health  ...  view the full minutes text for item 12.

The Chief Officer at Tees Valley Clinical Commissioning Group (TV CCG) and Director of Public Health for South Tees will be in attendance to provide an update in respect of the local NHS / Public Health response to COVID-19.

The Director of Public Health (South Tees) provided an update on the ongoing Covid-19 situation and made the following points:

·  In terms of the national summary, it was shown where the Tees Valley was sat in the national rankings, with Middlesbrough in 36^th and Stockton in 65^th. The point was made that in effect all the rates in the Tees Valley were very similar, with sustained community transmission at around 300 cases per 100,000. The rate had fallen from around 400 per 100,000 in the previous week or two and whilst rates were high they did appear to be falling at the moment. 

· In respect of cases by specimen date there was no real discernible fall, although the rates did show that rates were beginning to fall following an increase from when the schools had returned after the half term break. All of the local authorities in the Tees Valley were following the same patterns in terms of case rates.

· The cases by age band were highlighted and it was noted that for all of the local authorities within the Tees Valley the 10-14 and 15-19 age band up to 19 September 2021 had been significantly higher than the other age bands. There was also a slight increase in the older age group, which was potentially caused by waning immunity but further details would be provided to the Committee in respect of the booster

· Reference was made to the hospital data, the number of hospital COVID patients in County Durham and Darlington was 195, South Tees 75 and North Tees and Hartlepool 43. The figures for County Durham and Darlington appeared to be increasing and the Director of Public Health at Darlington had advised that the increase had largely been driven by an increase in Durham. It was unclear why the figures for North Tees were slightly lower than South Tees but potentially this could be owing to the overall numbers in the respective catchment areas.

· In terms of the hospital bed occupancy levels, theses were currently around 80 per cent in North Tees, South Tees and Durham and Darlington, with Hartlepool moving into 90 per cent occupancy rates. The point was made that there was the potential that once winter emergency activity started to increase COVID patients adding to overall activity would become significant if the numbers did not start to fall. 

· Mortality rates across the Tees Valley were significant and the rates were 260 per 100,000 for those with COVID mentioned on the death certificate to 307 per 100,000 for Hartlepool, with excess deaths above the average figures for the period 2015 – 2019 being significant.

· In terms of vaccination uptake, a phenomenal effort had been undertaken by the NHS supported by the local authorities, public health teams and broader teams in terms of supplementing the national programme with pop-ups in an effort to target communities that had lower vaccination uptake rates.

· In effect the percentage coverage reflected the deprivation demographics across the Tees Valley,  ...  view the full minutes text for item 13.