We need health and social care scrutiny in time of Covid19

Because of the Covid 19 pandemic, all Calderdale Council, committee and panel meetings have been suspended until 15th May.

In the light of ongoing controversies and confusion over the government’s strategy for dealing with the pandemic, Calderdale and Kirklees 999 Call for the NHS think it is vital that the health scrutiny committees continue to scrutinise NHS, social care and children’s services.

Our reasons are spelled out in a statement (below) that we sent to the Chairs of Calderdale and Kirklees Joint Health Scrutiny Committee AND to the Scrutiny Officer for the West Yorkshire and Harrogate Joint Health Scrutiny Committee.

It is perfectly possible to hold virtual meetings that are open to the public using platforms like Zoom, which can accommodate up to 100 people. If the authorities are worried about the public getting stroppy, they have a mute button for microphones.

However, the Scrutiny Officer for the West Yorkshire and Harrogate Joint Health Scrutiny Committee has sent us a statement that Leeds City Council, which provides the Chair for the Committee, has decided to cancel all Scrutiny Board meetings for the foreseeable future. Including the West Yorkshire Joint Health Overview and Scrutiny Committee.

The Council’s Statement does include the caveat:

“As Scrutiny Board Chairs we are actively engaged in the review and clearance of key decisions that are necessarily taken under our Urgency provisions. It is also worth confirming that Call-in arrangements continue and, if such a meeting were to be necessary, this would be facilitated as a remote meeting of the appropriate Board.”

The Chairs of Calderdale and Kirklees Joint Health Scrutiny Committee have not replied to our request.

Since sending the email, we have become even more convinced of the need for effective scrutiny of measures to deal with the Covid19 pandemic, and the effects of this on “normal” NHS and social care services. [link coming soon]

Our Statement to Health Scrutiny Chairs and Scrutiny Officer, 22.3.2020

We need health and social care scrutiny in time of Covid19.

In our view it is vital that all usual health meetings should continue as virtual and involve the public as per usual.

It is particularly important to continue (virtual) meetings of the Calderdale and Kirklees Joint Health Scrutiny Committee AND the West Yorkshire and Harrogate Joint Health Scrutiny Committee, that scrutinises the plans and actions of the West Yorks and Harrogate Integrated Care System aka Health and Care Partnership.

Item 7 in Calderdale Council’s 10 point plan in response to Covid19 is “Support governance, decision making and community leadership”:

Rationale

We need openness and transparency about the actions of the Department of Health and Social Care, NHS England and NHS managers in Calderdale and Kirklees AND across West Yorkshire and Harrogate, and how these actions affect both the public, patients and NHS and social care staff.

We need to know accurate facts about:

  • The supply and provision of personal protection equipment for ALL frontline NHS staff in and out of hospital AND for ALL social care staff in care homes AND doing home visits.
  • The supply and provision of widespread Covid19 testing in the community AND for all frontline staff in the NHS
  • The issue of whether all NHS hospital staff and those employed in the Wholly Owned Subsidiary are being paid occupational sick pay if they are sick or have to self-isolate – Calderdale and Huddersfield hospital trust staff apparently told Indie reporter Shaun Lintern that staff in the Wholly Owned Subsidiary are not, but the hospital trust tweeted this isn’t true.
  • Whether the centralisation and digitisation of pathology services ,in line with the Carter “efficiency” recommendations has affected the ability of the NHS in our area to provide Covid19 testing.
  • Whether Calderdale and Huddersfield hospitals microbiology lab is able to carry out Covid19 testing and if not, why not. (The microbiology lab in a Hampshire hospital is already doing this.)
  • What Calderdale and Kirklees Councils (and other Councils in West Yorkshire and Harrogate) are doing to deliver their statutory Health and Social Care responsibilities.
  • Whether local authorities are effectively communicating and enforcing social distancing, in line with Calderdale Council’s Covid19 10 point plan, number 8.

What are the implications for statutory health and social care responsibilities of these bits of the Coronavirus Act?

Calderdale Council’s Covid19 10 point plan only includes Delivering Statutory Health responsibilities – it makes no mention of social care.

Part I of Schedule 11 of the Coronovirus Bill (as introduced to Parliament) essentially suspends the Care Act 2014 duties in England to assess and arrange services to meet the needs of disabled adults. The only exception is where a failure to provide services would result in a breach of the European Convention on Human Rights. The Bill risks leaving many disabled adults with no entitlement to care (at a time when their need for care may be considerable).

The Bill would apparently also allow NHS providers to delay undertaking the assessment process for NHS continuing healthcare for individuals being discharged from hospital until after the emergency period has ended – so how are they supposed to cope? What are our Councils planning to do about this?

The Bill would make changes to the Care Act 2014 in England to enable local authorities to prioritise the services they offer in order to ensure the most urgent and serious care needs are met, even if this means not meeting everyone’s assessed needs in full or delaying some assessments. This basically looks like repealing the requirement for Councils to meet their statutory social care requirements.

“Routine” healthcare

How are our hospitals, GP and community health services going to continue to provide “routine” healthcare to patients who don’t have Covid19?

Palliative care at home for covid19 patients

How are NHS end of life and social care services going to provide effective palliative care at home to Covid 19 patients and their family members, if not all Covid19 patients are admitted to hospital? Given the NICE guidance about which patients are to get critical care in hospitals, and the use of the Clinical Frailty Index as a key part of the clinical decision tree, what proportion of Covid19 patients are estimated to die at home?

ICU and radiology capacity

How many ICU beds are there in Calderdale and Huddersfield hospitals and across West Yorkshire and Harrogate as a whole. Are there enough ICU staff?

Are there enough scanners and radiology staff? We understand that radiologists are now keeping one scanner for patients with suspected or confirmed Covid19 and another for the other patients, because of the obvious risk of infection.

Effects of speedy discharge of hospital patients

What are the effects of NHS England’s requirement for speedy discharge of hospital patients in order for hospitals to provide extra space for covid19 patients?

These are only some of the vital questions that need public scrutiny.

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