The Locality Executive Director said during the COVID-19 Pandemic the NHS went into a command and control model working as part of NHS England. This resulted in a central control room in daily communication with health partners. Focus now is on recovery and return to normal levels of healthcare for non-covid patients, and preparing for winter and a possible second wave. COVID-19 has led to innovation in a number of areas and the NHS want to ensure that the learning is embedded across all services

A programme of work on planned care was paused and there has been a backlog of surgery. Hospitals are reviewing waiting lists and aiming to get patients into services as quickly as possible. There are now different standards on infection prevention and control to ensure it is COVID-19 compliant.

Work is taking place to prepare intensive care for a possible second wave. The aim is to maintain capacity for elective patients. The CCG are working with St George’s to create elective care capacity.

Cancer referrals dropped by 80% during the height of the Pandemic. Patients are presenting with more advanced symptoms and services are aiming to get diagnosis and treatment as quickly as possible. The CCG worked closely with the mental health Trust in July, as there has been increased mental health challenges due to COVID-19. There has been increased investment in psychological therapy services to support people.

Primary care faced huge challenges as well as great innovations during the pandemic. Workforce challenges are significant and the CCG are working with practices to support communities.  During COVID-19 this resulted in Practices working in collaboration.

A Panel member asked about the impact on children’s preventative health such as vaccines. The Locality Executive Director said they are working with Practices to ensure there are capture measures in place. There are other impacts on children such as those who are vulnerable and have complex needs. Some of those services have fallen away and the CCG working with schools and partners to ensure they are restored.

A panel member asked about the flu vaccination programme highlighting that the Boots Pharmacy  have begun advertising which is key to preparing for the winter.  It is was asked how community champions are contributing to sharing key messages around Covid-19. The Locality Executive Director said they are in discussion with Practices about flu vaccines, they will be arriving soon and there will be advertising campaigns. The CCG will use community champions as part of the community prescribing network.

A Panel member asked about the progress with the backlog of cancer patients and those with other treatments pending and what preparations are being put in place for a second wave. The Locality Executive Director said they aim to get to 90 percent of historical levels by the end of the year, will share information on trajectories when they are confirmed. There has been learning from the first wave, and a better understanding of how to use sites.

A panel member asked if we need a Centre for the rehabilitation for covid patients

The Locality Executive Director said this is unlikely because they will need a range of services as well as home services.  There is also lack of clarity about the evidence of re-infection risk. It will be important to see how the models of rehabilitation will evolve.

A panel member asked when the command and control unit would be disbanded and power handed back to local authorities. The Locality Executive Director said this will be a phased process, some has been handed back but there is some high level and regional co-ordination. Local control will be restored over a period of time.

A Panel member asked how much additional expenditure has been incurred and if CCG’s have been provided with extra money by central government. The Locality Executive Director said they been have been logging Merton spend and have been fully recompensed. Normal NHS financial Spend has been suspended

A Panel member asked how COVID has affected people from BAME communities and what plans are being put in place to address any issues. The Locality Executive Director said people from BAME communities were disproportionately affected in death and hospital admissions.  There are clinical, physiological issues, long term conditions and socio economic factors contributing to this. The CCG are working with general practice to identity risk and there is also a project to support people with diabetes. Statutory services can only go so far, the Health and Wellbeing Board Community sub-group will play an important role . The CCG are also working with mosques and temples to identify those at risk. The NHS has indicted it will ensure services do not marginalise those who face health inequalities.

The Chair asked the Deputy Leader and Cabinet Member for Finance to provide an update on costs of COVID-19 to the council. The Deputy Leader and Cabinet Member for Finance said the government has provided funding for health service deficits but not costs incurred by the local authorities. The Assistant Director for Adult Social Care said the council can claim COVID-19 related expenses from the CCG. The Locality Executive Director said the CCG has made all possible funding available as they are aware of the challenges.