Today the county’s Health Overview & Scrutiny Committee (HOSC) met in private for a joint Q&A session with the parallel scrutiny committee on adult social care and with senior local health and social care managers. I was part of this meeting as Cheltenham Borough Council’s representative but I don’t think it should have been held in private – and I said so. The county’s planning committee managed to hold a public virtual meeting last month yet the HOSC – which hasn’t met properly since January – isn’t even going to try to meet formally and in public until July. And this at a time of obviously heightened concern about public health, the NHS, care homes and the reconfiguration of local services like Cheltenham’s A&E during the crisis.
So here’s my public report back on some of the key questions raised and points made:
- We did take time to thank the NHS, public health and social care teams and all their staff. And I added thanks to managers for innovations like mobile chemotherapy and online GP appointments that we should stick with even after the virus is defeated!
- I questioned hospital chief executive Deborah Lee and Mary Hutton from the Gloucestershire clinical commissioning group (the NHS body that pays for local NHS services) about the planned reconfiguration of local services during the coronavirus crisis and whether or not these were genuinely temporary. The changes are aimed at separating Covid19 and non-Covid19 patients as far as possible, limiting the risk of transmission and enabling other services to return to something like normality. But they do involve temporarily downgrading Cheltenham A&E to a minor injuries unit (and possibly only a daytime one) while Gloucestershire Royal becomes the ‘front door’ for emergency admissions where Covid (‘red’) and non-Covid (‘green’) patients are separated, as well as centralising general surgery and possibly other surgical specialities in Gloucester while Cheltenham is kept clear of Covid for other intensive care cases, oncology, acute stroke care and some ‘elective’ or planned surgery.
What’s worrying local campaigners like REACH is that this doesn’t obviously reflect a neat red/green split and looks suspiciously like the rejected plan to downgrade Cheltenham General emergency and general surgical care that we all thought had been ditched. I was assured that the detailed changes were genuinely aimed at separating red and green patient pathways and that, yes, a full ‘Type 1’ A&E would be restored at Cheltenham in the end. I hope so.
- Local Director of Public Health Sarah Scott reported the latest county statistics on the coronavirus. Following the national trend, they show fewer cases and deaths from Covid19 in Gloucestershire. Our total of 1369 confirmed cases (national data) and 533 deaths remains higher than more rural areas further south west but comparable to neighbouring counties and to statistically similar ones across the country. The urban areas of Gloucester (402 cases) and Cheltenham (320) are highest, again reflecting the pattern elsewhere. Questioned by Lib Dem representative from the Costwolds Paul Hodgkinson, she said there was no evidence that the Cheltenham Festival had caused extra deaths, not least because no attendees were traced or tested. The racecourse itself took the decision to carry on, following government guidance at the time.
- Leckhampton & Warden Hill county councillor Iain Dobie raised the sharp drop in cancer treatment reported by the hospitals trust. He was told that referrals in from GPs and elsewhere were still running at only 55% of the normal rate suggesting many people with worrying symptoms are still staying away, even from their GPs. If that’s you, don’t delay.
- I asked about the government’s test & trace strategy announced as ‘live’ on 28 May. It clearly isn’t up and running at full tilt locally with some data already coming through from national level but not yet in a format that allowed local public health teams to act on it effectively. We were told that could still be weeks away. Which makes the ongoing government lifting of lockdown measures look risky in the extreme.
- The county council reported on the situation in care homes which is still concerning but at least testing and personal protective equipment (PPE) provision are now much better. Still, we were told some care homes had refused training in the proper use of PPE and that this training has only just started for domiciliary care workers who visit vulnerable people at home. Another alarming statistic was that there had been no great rise in hospital admissions fom care homes despite Covid. While some very frail residents wouldn’t have wanted admission regardless of illness, that still suggests to me that elderly people who should have gone to hospital didn’t. Perhaps part of the emerging national picture that government simply wasn’t on top of the lethal crisis in our care homes.
Several of the senior public health and NHS staff agreed we are not out of the woods yet. In the absence of widespread vaccination or more effective treatment, Covid19 may be a real threat for at least a year more. A second surge in infection is quite posssible. So please abide by the measures still in force including keeping your distance, regular handwashing and limiting contact with those from outside your household. More details here.