The Committee received and noted a joint presentation on the increased pressure on the health and social care system due the significant additional challenges given the ongoing COVID-19 pandemic.  A summary of the discussions may be summarised as follows:

The Sub-Committee noted that:

·         The Tower Hamlets Adult Social Care Winter Plan 2020-21 sets out their preparedness for the upcoming winter period and reflects the requirements set out in the national Adult Social Care Winter Plan. The plan is aligned to the Outbreak Control Plan and to Winter Plans held by health partners.

·         It is a requirement for each Local Authority to have in place an Adult Social Care Winter Plan by 31 October as described in the national Adult Social Care Winter Plan.

·         This plan was presented to Cabinet on 28 October and together with Tower Hamlets System Winter Plan 2020-21 and is now being presented to Health and Adults Scrutiny sub-committee for information.

• Covid presents specific risks to people experiencing homelessness; people rough sleeping or living in temporary accommodation are in a high-risk group, many with long term conditions, that mean becoming infected with the virus could have severe consequences.  However, some homeless patients had apparently been discharged straight back to the streets; often without their housing or underlying health problems having been addressed.
• It was understood that hospitals, local authority housing teams and voluntary sector organisations had a clear process from admission through to discharge to ensure homeless patients are discharged with somewhere to go and with support in place for their on-going care.
• Whilst NHS hospitals across the capital can treat the acute illnesses and injuries of patients who are homeless, they do not have the resources to give them time to recuperate before safely discharging them back into the community.  To address this, since April to help ease the burden on NHS hospitals and provide the care that these patients need the Mildmay is utilising the expertise of its doctors, nurses, and therapists to ease the burden on NHS hospitals by providing rehabilitative healthcare for people who are homeless or rough-sleeping and recuperating from illness or injury. 
• This frees up NHS beds and provides respite for this vulnerable cohort, with a far better chance of a safe and full recovery.  Once discharged from, the aim is that people will be supported by specialist homelessness provision.  In addition, within Tower Hamlets the relevant teams have been working together to purchase additional accommodation and during the first wave of Covid additional accommodation was purchased for the homeless persons so that was part of the availability for people being discharged from the Royal London in addition to the existing hostels pathway.  However, it was noted that if there are examples of where there have been discharges onto the streets these should be drawn to the attention of the relevant officers.
• Regarding people leaving hospital who have tested positive for COVID-19 and are transferring to a care home (and elsewhere) the priority is to ensure that everyone receives the right care, in the right place, at the right time, and the prevention of infection. Also, to ensure that the wellbeing of residents and their relationships with friends and family is considered and supported.
• The Integrated Hub came into being in April 2020 with the aim of facilitating rapid discharge for adult patients declared medically fit to return to their place of residence or a new care placement.  This involved establishing immediate health and social care support.  
• In terms of mental health support North East London NHS Foundation Trust (NELFT) have re-provisioned their acute services so that they can treat people with Covid effectively through ensuring they can be discharged swiftly through to the right place; with any ongoing care they need.  However, if there have been any difficulties with this service then officers are happy to look at that separately.
• NELFT have re-provisioned their services predominantly by looking at online and telephone-based support to patients and carers.  Accordingly, officers would welcome any feedback about how that is going, and if carers have experienced difficulties or indeed if people have found it problematic to get their mental health support.  In addition, NELFT is extremely interested in looking at that because as with all the providers they are keen to keep adapting their services so that they can continue to offer them in the in the most sensible way during the during the pandemic.
• The coronavirus has had a severe impact on the Boroughs poorest and most vulnerable especially those who are without access to the internet and therefore at risk of being left behind as services move online unless there are offline alternatives.
• They would be provided with details on the flu vaccines in relation to the Borough (Subsequent to the meeting the following was provided):

a)    The number / % of residents in the borough who qualify for a flu vaccine who have received it?

Note: the data provided by CCG was up to 13/12/2020, covering those registered with a Tower Hamlets GP, excluding eligible school-aged children as it is administered by Vaccination UK based on the following eligible cohorts:

Total eligible population 77,598

Total vaccinated 38,920

Total uptake 50.2%

b)    What age children are eligible for the flu vaccine?

Children from 6 months up to 18 years of age at clinical risk

All children aged 2 or 3 as of 31st August 2020

School-aged children (all children in primary school and all Year 7 secondary school-aged children)

c)    What is the data on the number/percentage of those eligible who have received it?  

Reception: 38.2%

Year 1: 37.1%

Year 2: 37.9%

Year 3: 38.9%

Year 4: 36.1%

Year 5: 35.3%

Year 6: 31%

Year 7: 24%

d)    The number/percentage of the council workforce who have had the flu vaccine?

As of 30 November, 12% of the council workforce have been recorded as taken the flu vaccination. 

This equals 697 staff members based on workforce figures of 5806 as of Jul 2020.

The Councils target for this year was to vaccinate 60% of the workforce, which is a total of 3513 (based on workforce figures above).

The data does capture those who had their vaccination at their GP/Local Pharmacy providing staff record this on HR Self Service (HRSS).

HRSS is the main data source hence the Councils comms asking all staff irrespective of their vaccination route to update HRSS – this is to enable future benchmarking of take up. The number of staff that have got vaccinated via the workplace scheme as of November 2020 are 363 with 334 being vaccinated via their GP/Local Pharmacies.

• The NHS will offer the COVID-19 vaccine to people most at risk from coronavirus. In London, the vaccine will be offered in some hospitals and pharmacies and local vaccination centres.
• The order in which people will be offered the vaccine is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI).it will be given to:

• The vaccine will be offered more widely as soon as possible.