The Health and Wellbeing Board met on Monday 20 July 2020 to discuss the ongoing response to the COVID-19 pandemic, focusing on recovery, restoration, and local outbreak management. Key decisions included noting the progress on NHS recovery and restoration plans, supporting immediate actions to engage with local BAME communities regarding COVID-19, and approving the draft Local Outbreak Management Plan.

Local NHS Recovery and Restoration Update

The Board received an update on the recovery and restoration efforts across health and social care services following the significant pressures of the COVID-19 pandemic. Representatives from Barking, Havering and Redbridge University Hospitals Trust (BHRUT), Barts Health, and North East London Foundation Trust (NELFT) shared their experiences and strategies. Magda Smith of BHRUT highlighted the ongoing challenges of managing COVID-19 risks while reorganising services to accommodate patients who could not be seen earlier in the year. Bob Edwards from NELFT praised the dedication of health and social care staff, noting the establishment of a 24-hour mental health support line and improved access to psychological services, with virtual appointments becoming a standard offering alongside face-to-face services. Dr Anil Mehta, Vice-Chair of the Redbridge Clinical Commissioning Group (CCG), emphasised the importance of primary care teams providing comprehensive care and acknowledged the diverse backgrounds of clinicians. Gladys Xavier noted the formation of a working group to engage with communities on short and long-term interventions, particularly in anticipation of a potential second wave of the virus. Claire Burden provided an update on Barts Health, specifically Whipps Cross Hospital, detailing efforts to double critical care capacity and manage ward patients, and highlighted that by 20 July, only nine patients were being treated for COVID-19. The Board resolved to note the presentation and comments on the recovery and restoration plans, and that feedback on the impact of changes would be presented at a future meeting.

Impact of COVID-19 and Local Actions

The Board discussed the disproportionate impact of COVID-19 on various ethnic groups, citing evidence from Public Health England (PHE) that indicated higher risks of death for people of Bangladeshi ethnicity and other ethnic minorities compared to White British individuals. It was clarified that these disparities were not directly due to ethnicity but were exacerbated by long-standing inequalities driven by socio-economic disadvantage. Immediate actions to address these inequalities were outlined, focusing on preventing virus acquisition, empowering communities to navigate risks, understanding community concerns, and co-producing culturally competent communication messages. Louise Dibsdall informed the Board about an upcoming meeting on 23 July to prepare these messages, thanking the Council's communications team for their assistance. Further engagement events were planned, including sessions for faith leaders and individual communities. The Board resolved to note and support the proposed immediate actions to engage and communicate with local BAME communities.

COVID-19 Responses from a Local Healthwatch Perspective

Cathy Turland presented a report on Healthwatch Redbridge's response to the COVID-19 pandemic. Healthwatch had adapted its working practices to address patient, carer, and service user concerns and information needs, ensuring the user voice remained heard. Two main projects were highlighted: a care home survey, which indicated positive outcomes with no COVID-19 cases and good testing levels, and a public survey that was ongoing until the end of September, aiming for a diverse range of responses. Healthwatch was also exploring piloting online virtual meetings for those who preferred them over written surveys. The report on the first phase of the care home survey had been well-received by the London Care Home Oversight Committee. The Board resolved to note the report and the responses contained within it.

Local Outbreak Management Plan

The Board reviewed the draft Local Outbreak Plan, a requirement for all local authorities by the end of June 2020. This plan outlines a partnership approach to managing local outbreaks, community clusters, and potential localised social restrictions, working in conjunction with a London-wide outbreak plan framework. Ian Diley presented the plan, explaining it as a living document that would be updated as needed. A local testing site was to be established in Mildmay Car Park, operating seven days a week. Discussions covered provisions for people with disabilities, local access to testing sites for those with language difficulties, and data protection (GDPR) concerns. Scenario testing was scheduled to begin the following week, with the plan to be amended and presented again at the next Board meeting. It was noted that the meeting was inquorate for this item due to the absence of a BHR CCG representative. The Health and Wellbeing Board approved the Outbreak Management Plan, with the understanding that an updated version would be presented for formal approval at the next meeting.

Public Participation

Mr D S Datta raised concerns about the proposed virtual appointments system for primary care, fearing it would limit access for the elderly, particularly for systems like cancer referrals and secondary care. He argued that virtual appointments could not replace face-to-face care post-COVID-19 and expressed concern about GP surgeries potentially closing. Dr Anil Mehta assured attendees that while virtual appointments would be offered, face-to-face services would remain available.

Other Business

The Board also noted the requirements of Standing Order 68 regarding electronic media and the Remote Meetings Protocol. Apologies for absence were received from Tracy Welsh of Redbridge CCG. The minutes of the previous meeting on 2 March 2020 were approved. The date of the next meeting was confirmed as 7 September 2020.