Agenda and minutes

The Democratic Services Officer drew attention to the emergency evacuation procedure.

Janet Rowse (Sirona Chief Executive) had sent her apology to the Panel.

Councillor Eleanor Jackson declared personal and non-prejudicial interest at this point of the meeting as she is Council’s representative on Sirona Care & Health Community Interest Company.

Councillor Vic Pritchard declared personal and non-prejudicial interest at this point of the meeting as he is Council’s representative on Sirona Care & Health Community Interest Company.

Councillor Anthony Clarke declared personal and non-prejudicial interest on the agenda item ‘NHS and Clinical Commissioning Group update’ as he is Council’s representative on the Council of Governors of the Mineral Water Hospital (RNHRD).

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There was none.  The Chairman informed the meeting that he agreed to bring forward the agenda item ‘Healthwatch position update’ which will be presented to the Panel straight after confirmation of the minutes from last meeting.

Mr Greg Hartley-Brewer will address the Panel with his statement under item 15 on the agenda (How the PCT monitors quality of NHS Dentistry in BANES).

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To confirm the minutes of the above meeting as a correct record.

Policy developments outlined within the Health and Social care Act currently before parliament outline a new duty on local authorities to ensure the provision of Healthwatch. Healthwatch is a development in public involvement and will be the body that replaces the existing Local Involvement Networks (LINK). In Bath and North East Somerset activity has been taking place since spring 2011 to prepare for the commissioning of Healthwatch working towards an implementation date of April 2013. The panel received a report at its meeting in July 2011 at which point the ideas for Healthwatch were being finalised. Additional position updates have been included within the LINK committee reports. A formal update is being presented to ensure the Panel has comprehensive and current information on the firm plans for Healthwatch and the development taking place towards its pending implementation.

Members are asked to consider the information presented within the report and to note the key issues described.

Derek Thorne (Consultant) introduced the report.

The Panel made the following points:

The Panel noted that the Council has decided not to make an award under the current procurement process for Local Healthwatch and asked about the implications on that decision.

Derek Thorne responded that the Council decided to restart the process in October 2012 in order to meet the deadline of April 2013.  The Council has also been working to ensure continuity for the work of Local Involvement Network host service, which is Scout Enterprises.

The Panel asked about the Healthwatch governance and whether there was an opportunity to have Council representative on Local Healthwatch.

Derek Thorne welcomed the idea of having Council representative on Local Healthwatch.

The Panel commented that the engagement of the public must be via traditional communication (leaflets, newsletters, etc.) and also by using the latest communication technology (internet, social media, etc.) in order to inform people of all ages on the latest developments.

Derek Thorne took this comment on board.

It was RESOLVED to note the report and that comments made by the Panel in terms of the governance and communication be forwarded to the appropriate officers via Derek Thorne.

The Panel will have an opportunity to ask questions to the Cabinet Member and to receive an update on any current issues.

The Chairman informed the meeting that Jane Shayler (Programme Director for Non-Acute Health, Social Care and Housing)  would introduce the Cabinet Member update (attached as Appendix 1 to these minutes) in the absence of Councillor Simon Allen (Cabinet Member for Wellbeing).

Councillor Bryan Organ said that older people are mainly interested in the quality and cost of care.  Councillor Organ also said that Social Care and Funding is quite difficult issue to deal with considering increasing number of older people in the country and increasing cost of care.

Councillor Vic Pritchard commented that the White Paper on Social Care and Funding (summary briefing and commentary by the Local Government Association is attached as Appendix 2 to these minutes) has some quite significant changes and asked if those will be implemented or they are there to stimulate the debate.

Jane Shayler responded that her understanding is that we are not expecting proposals in the White Paper to be implemented until 2014, which is part of the usual legislative process.  This is the next stage in quite lengthy process.

Councillor Katie Hall agreed with Councillor Organ on this matter and asked about whether the White Paper includes clarification of social care eligibility criteria and what should be considered a “substantial” level of need and what should be considered a “critical” level of need within national framework.

Jane Shayler replied that she was not aware that proposals rule out on Local Authorities’ view on what was considered critical/urgent only although there are proposals on tighter national guidance on what critical looks like, what substantial looks like and what moderate looks like.  There are quite a lot of variations as in some areas what might appear to be “moderate” level of need might be in other local authority seen as either “substantial” or even “critical”.

Councillor Hall asked how we, as authority, compare with other authorities on this matter.

Jane Shayler responded that our criteria are not as detailed as some areas’ criteria so it is more open to the practitioners’ judgement.  Jane Shayler also said that she does not have more detail on what the national picture is likely to look like.

Councillor Eleanor Jackson said that it was regrettable not to have Cabinet Member for Wellbeing to hear his views on this matter.  Councillor Jackson also regretted that White Paper is far too over-cautious and there is need for a radical thinking on this matter.

Councillor Lisa Brett asked if this authority will be feeding their views in the Care and Support Bill consultation and how the panel could be engaged on this matter.

Jane Shayler responded that it would be expected from Bath and North East Somerset to provide a response.  Jane Shayler also said that she would be happy to work with the Panel and the relevant Cabinet Member and agree a response via email.

The Panel unanimously AGREED to be involved in consultation on the Care and Support Bill via email.

Councillor Pritchard felt that Cabinet Member for  ...  view the full minutes text for item 27.

The Panel will receive an update from the NHS and Clinical Commissioning Group (CCG) on current issues.

The Chairman invited Dr Ian Orpen (Clinical Commissioning Group – CCG) to give an update to the Panel.

Dr Ian Orpen updated the Panel with the current key issues with BANES CCG (attached as Appendix 3 to these minutes).  Dr Orpen also updated the panel on the current situation with the Royal National Hospital for Rheumatic Diseases in Bath (also known as ‘The Min’).  Transition Board has been established and the meeting of that Board and representatives from the CCG, NHS and the RUH Bath will take place in the week commencing Monday 30^th July.  The subject of the meeting is to discuss how to go forward.  Dr Orpen said that the RUH needs to become a foundation trust in order to join The Min with the RUH.

Councillor Katie Hall commented that her parents had quite bad experience with the new NHS 111 service in County Durham and Darlington.  Councillor Hall asked what will be put in place to provide good service in BANES.  Councillor Hall also asked what qualification/s 111 operator will be required to have.

Dr Orpen replied that the CCG is aware that nationally there are mixed views on 111 services.  The CCG is also very concerned about the impact so, for that reason, one of the CCG leads, on behalf of BANES and Wiltshire CCG, will be involved in the process and give some clinical input into the way this is rolled out.  Dr Open also said that Wiltshire Medial Services (WMS) currently provide services for out of hours.  They are not medically qualified but they are competent.  Staff that work at the moment in the WMS are likely to be TUPE-transferred across to provide 111 operator services. 

The Chairman said that he participated in the selection and Harmoni were clearly the best providers, which should give people confidence.

Councillor Tony Clarke said that all issues surrounding ‘The Min’ should have an element of transparency with the public.  Dr Orpen agreed with this comment and said that the RUH Bath is the only hospital in the country that doesn’t have rheumatology services.

The Chairman thanked Dr Ian Orpen for the update.

The Panel are asked to consider an update and report on visits to Care Homes in B&NES from the BANES Local Involvement Network.

The Chairman invited Mike Vousden to take the Panel through the update as printed in the agenda papers.

The Chairman also invited Jill Tompkins to take the Panel through their reports on visits to four Care Homes in BANES.

Following the updates from Jill Tompkins and Mike Vousden the Chairman congratulated the Local Involvement Network Team on quite comprehensive reports for each of four Care Homes.  The Chairman said that he was pleased that there was no profound criticism in any of the report.  The Chairman concluded by saying that he will be support the LINk if they have intention to continue with visits.

The Panel unanimously AGREED with Chairman’s comments.

This report will provide an opportunity for the Panel to discuss the proposals for future joint working arrangements with health, as described to the Cabinet on 11 July and to receive any verbal updates as appropriate.

Mike Bowden (Divisional Director for Service Development) introduced the update to the Panel.

The Panel welcomed the update and expressed their hope that partnership between the Council and future health bodies, such as the Clinical Commissioning Group, is as good as it was between the Council and the PCT in the past few years.

It was RESOLVED to note the update.

The Panel will receive verbal update on housing allocations.

The Chairman invited Mike Chedzoy (Housing Services Manager) to give a verbal update on Housing Allocations.

Mike Chedzoy highlighted the following points in his update:

Housing Services are currently reviewing the housing allocation scheme.  The housing allocation scheme is called Homesearch at the moment.  Homesearch aims to give more choice in deciding where people want to live. Properties that are available for rent will be advertised each week in a weekly advertising cycle. At present there are more than 12,000 applications waiting on the Homesearch register. The service is only able to advertise approximately 750 properties per year.  Private rented properties are now advertised on the Homesearch website so that local accredited private landlords and lettings agents can advertise their available accommodation. These landlords will consider people who are receiving Local Housing Allowance (Housing benefit).  Consultation, with the general public, on the future of housing allocation has been going on for a year and people are asked if they support the following criteria:

1.  Priority to people who want to downsize

2.  Priority to people who are overcrowded in their units

3.  The housing register be restricted to people who work and live in BANES; and

4.  Priority to people/household who provided contribution to the community.

The first three criteria received strong support from those who participated in the consultation whilst the fourth criterion did not get strong support and it is unlikely that it will be used in the new policy.

Following the new guidance on social housing, the Housing Services are also proposing are proposing to give extra help to members of the armed forces, people who care for others or who foster children by giving them additional priority and more flexible housing need assessment.

New policy will be released in April 2013.

The Panel made the following points:

Councillor Lisa Brett gave her support to criteria 4 - priority to people/household who provided contribution to the community.

The Panel asked about the strong public support for downsizing and about the additional priorities for people who foster children.

Mike Chedzoy replied that downsizing will be very much a choice and not enforcement, which should not affect older people.  The service will be asking for the evidence that the applicants are existing foster-carers or have been approved to be foster carers and this will be closely monitored.

The Panel asked how the service would ensure the quality of the private housing.  The Panel also asked what will happen to fathers who are separated from wife/partner and children – will they have any chance for separate rooms when visiting.

Mike Chedzoy replied that Council will receive guidance from the Government about the use of private sector in housing.  Mike Chedzoy also said that there will be no change in the policy related to separate households but that the service can always make allowances for joint custody.

The Panel asked how people without the PC and access to internet can submit their housing applications.

Mike Chedzoy replied that the service  ...  view the full minutes text for item 31.

Further to the report to Panel of the 18th May 2012 which set out the Quality Assurance Framework for social care services generally, this report is the first in a series of quarterly reports which focuses specifically on the quality of care and performance of residential and nursing homes under contract in Bath & North East Somerset.

The Wellbeing Policy Development & Scrutiny Panel is asked to note the contents of the report and contribute relevant feedback and articulate clearly the role of the panel in relation to the QAF.

The Chairman invited Jane Shayler to introduce the report.

The Panel made the following points:

The Chairman said that the Panel had an extremely good report from the Local Involvement Network who looked in depth in four of our care homes.  However, in the latest edition of the ‘Midsomer Norton, Radstock & District Journal’ (known as Journal) it says that “25% of care homes in BANES are not compliant”.  This is in conflict with the report that the Panel had before them.  The Chairman asked how the press got hold of this information that is adverse.

Jane Shayler said that the article is unfortunate and potentially misleading as it misinterpreted the information put in the report.  The use of the word ‘not compliant’ relates to the framework within which the Care Quality Commission (CQC) regulates providers.  In the table on page 69 of the report there is a summary of the 44 homes in BANES that have been inspected by the CQC.  28 homes met all standards but it is not unusual for care providers not to be completely compliant with all standards.  It is partly because the standards are quite challenging but also because that full compliance represents the level of excellence that not all providers can achieve consistently.

The Chairman said that the professional evaluation from Jane Shayler does not translate through to this article.  The public will read this article and not the document that is in the report, which they probably may not understand.  What the public might understand is the dramatic headline that 25% of care homes are un-safe or of a poor quality, which may not be the case.  This will cause unnecessary apprehension for someone who is scheduled to go to a care facility that is not fully compliant.  We need to somehow counter this article with immediate effect and say that the information has been misconstrued.

Mike Vousden from LINk said that they have regular meetings with the CQC about these issues.  Although the standards are extremely important to be followed there are some small minor technicalities that are less significant within those standards.  So, non-compliance might be on trivial issues.

The Chairman said that these issues may not be translated correctly in the article and that he would want this to be rectified so the public understand the picture.

Jane Shayler said care homes that are not compliant with all of the CQC standards were taken seriously by the Council.  However, the Council also have to use the judgement around that in terms of the risk associated.  If the Council used only those homes that are fully compliant with the CQC standards then we would stop using a number of much loved and much valued care services in this and other areas.

The Panel RESOLVED that immediate reply from the Council should come from the Communications and Marketing Team in order to rectify this issue hopefully in the next edition of Journal.

The Wellbeing PDS Panel is asked to note the PCT monitors quality of NHS Dentistry in B&NES.

The Chairman invited Greg Hartley-Brewer to read out his statement.

Mr Hartley-Brewer highlighted the following points in his statement:

• Dental Reference Officer’s report for a visit undertaken to Oldfield Park on 27^th May 2010
• ADP Oldfield Park not recording clinical data accurately
• Provision, or non-provision, of scale & polish in BANES
• Residents of Radstock and Chew Valley have to travel to access an NHS Dentist
• Use of the Dental Contract Management Handbook by the PCT
• The residents of BANES have had to put up with poor treatment in some practices for far too long and had to pay privately for treatments that should be available on the NHS

A full copy of the statement from Mr Hartley-Brewer is available on the minute book in Democratic Services.

The Panel thanked Mr Hartley-Brewer for his statement and for his contribution on tis matter.

The Chairman invited Julia Griffith (BANES NHS) and Nathan Brown (Dentist from the Parks Dental Practice in Keynsham) to introduce the report.

The Panel made the following points:

The Panel asked about the PCT’s dependency on self-assessments.

Julia Griffith explained that the self-assessment process depends on dentists reporting accurately.  The PCT would compare all of the self-assessments to see if there are any areas of weakness and where the support is needed.  The dentists were meant to be honest as they could be.  If the PCT identified areas of weaknesses then they would write to dentists and ask them to report back on actions they have taken to improve.  If there was a concern that the action plan was not carried out then the PCT would investigate further.  Every practice was visited by the Dental Reference Service.

The Panel asked about an issue that some people were denied access to the NHS dental treatment.

Julia Griffith said that there are number of areas in dental contract that were always grey areas.  For example scale and polishing – it is the role of the dentist to ensure that the patient is dentally fit and if the patient needs scale and polish for health reasons then it will be covered by the NHS.  If not then it will be private treatment.

The Panel asked about root canal treatment.

Julia Griffith responded that this is also an area that is challenging.  The NHS would provide the fee for that service and there are some procedures that will be covered with that.  The PCT realises that within the pay band some treatments are more costly or cheaper to carry out than others.  Overall this should balance out.

The Panel said that patient has little or no knowledge on what is wrong and what to expect so they heavily depend on the dentist to tell them.

Nathan Brown said that dentists have ethical responsibility and that they have to give patients options and choices. 

The Panel asked what percentage of BANES population has regular dental treatment and if there is dental plan for gypsies and travellers.

Julia Griffith responded that the PCT target of  ...  view the full minutes text for item 33.

There is a new statutory requirement for the local authority to conduct research activity. This is called the Joint Strategic Needs Assessment (JSNA). The JSNA and aims to provide the big picture about current and future needs of the Bath and North East Somerset population. Our JSNA has been produced in partnership between the Public Health Team and Policy and Partnerships. This report and accompanying presentation outlines the process undertaken and highlights key findings.

The Health and Wellbeing Policy Development & Scrutiny Committee is asked to:

·  Note the process and findings of the JSNA.

·  Consider how the JSNA can be used as an evidence to effectively support future scrutiny activity.

·  Consider who else needs to be told about the JSNA and sources of information which should be included in future updates.

The Chairman invited Paul Scott (Acting Director of Public Health) and Jon Poole (Research and Intelligence Manager) to give a presentation on Joint Strategic Needs Assessment (JSNA) in Bath and North East Somerset.

Paul Scott and Jon Poole highlighted the following points in their presentation:

• Objectives
• What is JSNA and what does it say?
• Needs Assessment – Local Approach
• Framework for an ‘Enabling’ Needs Assessment
• Who is it for?
• Website address – www.bathnes.gov.uk/jsna
• Introduction
• Aging population
• Long Term Conditions (Physical & Mental)
• Lifestyle risk
• Social & Environmental factors
• How are we using JSNA?
• Locally
• How can you use it?

A full copy of the presentation is available on the minute book in Democratic services.

The Panel made the following points:

Members of the Panel debated with officers some of the topic areas of the main document and came to the conclusion that each topic would require considerable debate at the meeting.

For that reason the Chairman suggested that the JSNA be a regular item on the agenda with intention to break down the main document into areas which will be presented at the future meeting (i.e. aging population at September meeting, complex families for November, etc.) 

The Panel AGREED with Chairman’s suggestion.

It was RESOLVED to note the presentation and for the officers to take on board Panel’s wishes.

The Department of Health has launched a consultation on whether standardised (plain) packaging of cigarettes and other tobacco products should be introduced in the UK. The consultation is open until 10th August 2012.

Due to increasing restrictions on tobacco advertising in recent years, tobacco packaging has become one of the tobacco industry’s leading promotional tools. Research suggests that plain packaging would increase the impact of health warnings, reduce false and misleading messages that one type of cigarette is less harmful than another, and reduce the attractiveness of products to young people.

Australia will become the first country in the world to require all tobacco products to be sold in plain packaging, from December 2012. The UK government has committed to consulting on options to reduce the promotional impact of tobacco packaging, including plain packaging.

The Wellbeing Policy, Development and Scrutiny Panel is asked to inform the Government that it supports the introduction of standardised (plain) packaging for all tobacco products in the UK through a collective response to the consultation.

The Chairman invited Paul Scott to introduce the report.

On a motion from Councillor Eleanor Jackson, and seconded by Councillor Douglas Nicol, it was unanimously RESOLVED to inform the Government that the Wellbeing Policy Development and Scrutiny Panel supports the introduction of standardised (plain) packaging for all tobacco products in the UK.

It was also unanimously RESOLVED that Panel’s resolution be communicated to The Right Honourable Don Foster (Member of the Parliament for Bath) and to Mr Jacob Rees-Mogg (Member of the Parliament for North East Somerset).

This report presents the latest workplan for the Panel.

It was RESOLVED to note the workplan with the following additions/amendments:

• Draft Homesearch Policy (date to be confirmed)
• Joint Strategic Needs Assessment – standing agenda item with different theme each meeting.

Some Panel Members felt that agendas are too crowded and because of that Wellbeing PDS meetings are too long.  The Chairman said that he might call an extra meeting of the Panel in October (if required).