Agenda and minutes

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

The minutes of the TVJHSC meeting held on 24 September 2021 were deferred for consideration at the next meeting.

NOTED

Representatives from 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 Advanced Public Health Practitioner (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 135^th position and Stockton in 96^th position in terms of prevalence. The point was made that in effect all of the prevalence rates in the Tees Valley were quite low, with sustained community transmission at around 300-400 cases per 100,000 population. This compared to the highest Local Authority rates of 860 cases per 100,000 population. However, the rates in the Tees Valley were increasing slightly. 

· In respect of cases by specimen date there had been a spike around October, which the data had shown reflected a return by schools after the half term break. Over the last couple of weeks there had been a slight fluctuation but rates seemed to be levelling while the England rate was rising.

· In terms of testing rates it was highlighted that the Tees Valley did have lower testing rates than the England average, as a proportion of the population.

· The cases by age band were highlighted and it was noted that for all of the local authorities within the Tees Valley the 5-9 and 10-14 age band up to 3 December 2021 had been significantly higher than the other age bands. In the most recent week Redcar and Cleveland had the highest rate in the 5-9 age band. There had also been a slight increase in the 30-40 age band, which was potentially caused by household transmission to parents and public health teams were continuing to work closely with schools and families. Cases were being monitored and support to schools provided.

· Reference was made to the hospital data, the number of hospital COVID patients in County Durham and Darlington was 59, South Tees 54 and North Tees and Hartlepool 33. The figures had decreased in recent weeks but the hospitals were still experiencing new cases. 

· Mortality rates across the Tees Valley were significant and the rates ranged from 284 per 100,000 in Stockton for those with COVID mentioned on the death certificate to 328 per 100,000 for Hartlepool, with excess deaths above the average figures for the period 2015 – 2019 being significant. All of the Tees Valley rates were higher than the national average.

· In terms of vaccination uptake, the figures showed the top 20 performing Local Authorities nationally, with Northumberland topping the charts for both first and second doses, with a coverage of 89.1 per cent and 82.9 per cent respectively. All of the Tees Valley Local Authorities had coverage rates above the national average of 78.2 per cent for first dose and 71.6 per cent for second dose, with the exception of Middlesbrough where coverage was 74.7 per cent and 67.1 per cent respectively. A real positive was that the booster uptake across all five local authorities was above the national average. Sustained efforts were being made  ...  view the full minutes text for item 16.

Representatives from TVCCG will be in attendance to provide an update to the Committee in respect of the following:-

-       Learning Disabilities Respite Review

-       Breast Diagnostic Services

The Director of Commissioning and Strategy at TV CCG gave a presentation entitled Breast Diagnostic Services Current Position. The presentation highlighted background information, the work undertaken over the last year, how the public, service users and stakeholders had been involved in the engagement exercises, the themes that had emerged and the next steps in this journey.

It was noted that although the Covid-19 pandemic had halted some of the progress following the patient engagement exercise. Both North and South Tees Trusts had continued to collaborate to maintain the service for patients through very difficult times. Some themes identified from the engagement included;

•       The Breast Diagnostic Service was evaluated well by survey respondents with 95% rating the service either good or very good.

•       Positive comments had been made about the high standard of care received, the professionalism of staff, the excellent communication as well as the efficiency of the service.

•       A number of respondents had expressed their frustration with the closure of the James Cook service

•       Linked to the above it had been noted that some patients were unaware of the ‘one-stop-shop’ approach at North Tees and better communication of this would have supported reduced patient frustrations and uncertainty.

In terms of next steps the Tees Valley system partners had agreed to implement and expand the use of innovative ‘Free-Flap Surgery’ (where appropriate), as part of the Breast Cancer pathway to improve outcomes for patients. This surgery would be performed at James Cook Hospital and had commenced in October 2021.

In addition the Northern Cancer Alliance had established a Managed Clinical Network for Breast Cancer Services. The vision of the managed clinical network was to enhance the quality of breast cancer services including breast cancer screening, diagnostics and treatment services, thus enhancing care across organisations; jointly reducing inequality, improving outcomes and patient experience in alignment with the recommendations in the NHS Long Term Plan. Future plans for the service model would be progressed through this approach, with an initial focus on building capacity and resilience in the breast imaging workforce.

In the meantime the service would continue to be delivered from North Tees as it was the safest and most effective way of ensuring that those presenting with symptomatic breast conditions were able to access the treatment they required. It was advised that in terms of the national standard the target was currently that 93 per cent of patients presenting on this pathway should be seen within a clinic within two weeks. In the Tees Valley 94 per cent of patients were currently being seen within two weeks, which was significantly higher than the England average of around 84 to 85 per cent. The current pathway was effective and there were mitigations in place to assist with any transport issues.    

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

· Reference was made to the breast care facility available at the Friarage Hospital at Northallerton and whether further information could be provided on the type of  ...  view the full minutes text for item 17.

A Member from each of the Tees Valley local authorities has been invited to visit the Lotus Ward on 9 December 2021 following the reopening of the ward earlier this year. An update on the visit will be provided at the meeting and a link to the video, produced by CNTW in respect of the Lotus Ward can be accessed via the following link:- https://youtu.be/ilLLNbAeYBc

The Chair advised that further to the offer for a visit to be undertaken by the Committee to the Lotus Ward at Acklam Road Hospital, as provided by the Associate Director of Specialist Children and Young People Services at Cumberland, Northumberland, Tyne & Wear NHS Foundation Trust at the last meeting, a visit was held on 9 December 2021.

Feedback from the visit by those Members in attendance was requested and the following views were provided:-

·         The visit was extremely impressive and the facilities were superb. The learning facilities available were excellent and the equipment that they had ensured the staff could keep in touch with the schools the children attended. The children had access to their own computer and the work the children had produced was particularly moving. Walking through the various wards it was understandably secure but the children had access to a basketball court and outdoor space where they could sit, play and even have a barbeque. It was such a clean and beautiful place. It was well resourced and well managed and all of the questions asked were really well answered. The rooms were also equipped with specialist technology to ensure that the young people could be easily monitored to reduce any risk of self-harm.

·         Unobtrusive technology was present throughout the ward and the young people had access to a kitchen to cook meals for each other. A laundry room was also available, as was a music room and chill out spaces. The compassion and dedication of the staff was also noticeable.

During discussion the following points were raised:-

·         It was queried as to the age of the children on the ward and it was advised that the children were aged 13 to 18. In terms of staffing the unit the Lotus Ward was extremely well staffed in terms of both the number and the level of qualified staff available. It was, however, recognised that nationally there was a shortage of specialist Children’s Mental Health Nurses.   

·         In terms of demand there was currently no waiting list for young people to access the Lotus Ward. The unit was currently staffed to accommodate 6 young people, however, if an additional young person needed to be admitted the Trust would make the necessary arrangements.   

AGREED that a letter of thanks be sent to the staff and young people at the Lotus Ward for hosting the visit.

Unfortunately representatives from NEAS were unable to attend the meeting but would be in attendance at the next meeting of the Committee.

The Chair highlighted a number of the key points contained within the ‘Review of Our Year’ document, as submitted to the Committee by NEAS and these would be discussed at the next meeting.

AGREED that the item be deferred to the next meeting of the Committee.