Agenda and minutes

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

There were no apologies for this meeting.

Councillor Loraine Brinkhurst declared personal and non-prejudicial interest as the Council’s representative on Sirona Care and Health.

The Chairman invited Mr Philip Gait to address the Panel.  Mr Gait already asked the question which was printed in the agenda.

Mr Gait said that he had asked this question because he was keen to secure the best outcome for service users, the tax payers and this Council.

He felt that the tender proposal to create one large sub-regional Home Improvement Agency covering the West of England would not be in the interest of the local tax payers and vulnerable residents for those reasons:

1: There are no economies of scale in the provision of these services. But there are additional management overheads like the previous provider Hanover Housing.

2: There are no duplication savings. The four authorities all have different funding priorities, grant criteria and loan procedures etc. These are different because the authorities are different.

3: It would not give value for money. See the additional costs for the Somerset HIA that is only providing a basic service and the problems being experienced by Devon. Talk to the Chairman of Scrutiny at Somerset County Council for his views – learn from their experience.

4: It is not in line with this Council’s view of the Localism Bill and what it means for commissioning and the associated Best Value Guidance.

5: It is not in line with the formation of the proposed Health and Wellbeing Boards and GP Consortia.

Mr Gait asked Council Members to look in detail before making any decision.

A full statement from Mr Philip Gait is available on the minute book in Democratic Services.

The Chairman thanked Mr Gait for his statement and his question and informed the meeting that this issue will be debated under Cabinet Member Update agenda item.

The Chairman invited Councillor Simon Allen (Cabinet Member for Wellbeing) to give an update to the Panel (attached as Appendix 1 to these minutes).

The Panel asked the following questions and made the following points:

Councillor Clarke asked about the Home Improvement Agency (HIA) Commissioning and for how long the contract is likely to be for.  Councillor Clarke expressed his concern that flexibility would be lost if we have single provider for the area.

Jane Shayler replied that the contract will be awarded for 3 years.  At the moment we are having a single provider for the area and their services are not subject of the Any Qualified Provider model.

Councillor Brinkhurst commented that the HIA consultation is ready to go out and it could be that various recommendations come out of it.

Jane Shayler said that the outcome might well be status quo in that the existing provider could win the new contract.  However, the Council needs to go through the procurement process and the outcome of the procurement process is not yet determined at this stage.  It could be that the existing provider might put in a bid in a partnership with a provider from another area.  Jane Shayler suggested that the Panel should, as part of the consultation process, receive a report on the Home Improvement Agency Commissioning for November meeting.

The Panel welcomed the suggestion from Jane Shayler.

Councillor Organ said that he was not sure that bigger is better (in terms of the provision of housing related support to vulnerable people to help them live independently).

Councillor Jackson said that in her Ward (Radstock) current housing related support was impressive.  Councillor Jackson, like Councillor Clarke, was also concerned about the flexibility.  She also felt that the consultation on the HIA commission should include paper-based as well as an on-line survey considering that there are many people who still don’t have broadband at their homes (mainly over 60 population).

Councillor Allen commented that the current service is well respected service in the area.  The Council would consult with the local residents to find out what they want.  The Panel will be also included in the consultation.  Councillor Allen welcomed the suggestion from Councillor Jackson and said that survey will be also in paper form.

Councillor Hall asked if the Home Energy Efficiency scheme would run every year.  Councillor Allen replied that the scheme is generally available throughout the whole year. 

The Chairman said that BANES Care & Repair were particularly successful in providing housing related support service.  He also question the aspiration of the West of England to cover the whole ex-Avon area with one provider although with the main benefit to Bristol.  The Chairman said that there has to be a viability of that business and he felt that some projects provided by the Care & Repair, like Potting Shed project in Radstock, will stop after the HIA is commissioned.

It was RESOLVED that the Panel will receive a Home Improvement Agency Commissioning report for November meeting.  ...  view the full minutes text for item 23.

The Chairman invited Tracey Cox (the NHS BANES Programme Director for Commissioning) to give an update to the Panel (attached as Appendix 2 to these minutes).

The Panel noted the update.

The Chairman invited Diana Hall-Hall and Mike Vousden to take the Panel through the update.

Diana Hall Hall and Mike Vousden expressed their concerns about the lack of the consultation on the future of the High Dependency Unit in Hillview Lodge.

The Chairman informed the meeting that the future of the High Dependency Unit will be debated later in the meeting (under agenda item ‘Specialist Mental Health Service re-design’).

The Chairman thanked LINks representatives for an update.

The Chairman invited Paul Birkett-Wendes (GWAS General Manager for Wiltshire locality) and John Oliver (GWAS External Communications Manager) to introduce the report.

The Panel asked the following questions and made the following points:

Member of the Panel asked if the response time is based on the paramedic who goes ahead of the ambulance.  The member felt that last year, on couple of instances, the response time was more than 19 minutes.

Paul Birkett-Wendes responded that the time is calculated when basic life support is given to the patient.  Winter time is always a challenge and it could be at this time of the year when the response time is slightly higher than average.  Paul Birkett-Wendes also said that the ambulance want to accept the increase in demand during winter months and not overburden the RUH by treating patients at site and keep the beds in the RUH free.

Member of the Panel asked what the distinction between the first and full response is and who make the call on sending air ambulance or motor vehicle.

Paul Birkett-Wendes responded that the first response is from community responders (who live in that community).  Dispatcher would make a call for air or motor vehicle ambulance after they receive a call.  Vehicles are always sent to the site anyway.

John Oliver added that as a service GWAS has access to several helicopters in the area, all based in Filton with clinical paramedic and doctor.

The Chairman thanked GWAS representatives for the report and their attendance.

It was RESOLVED to note the report.

The Chairman informed the meeting that he would move this item forward in respect of the presenting officer who had to attend another meeting.

Tracey Cox introduced the report.

The Panel asked the following questions and made the following points:

Members of the Panel asked about the rationale on prioritising the services and what criteria were used to choose these services.  The Panel also asked why some of the other services, such as adult hearing services, were not considered.

Tracey Cox replied that the rationales for choosing what local services would be prioritised are the following:  the service with not so good local provision, the service that is practical and something that will be sustainable.  Tracey Cox also added that this was phase 1 in the process which requires 3 areas to be identified by September 2012.  On second question Tracey Cox responded that the list to consider service had national categories plus 2 local ones.  In terms of the adult hearing service the PCT went through the procurement process to base services locally.

It was RESOLVED to note the report.

The Chairman invited Andrea Morland (Associate Director for Mental Health and Substance Misuse Commissioning) and Hazel Watson (Director of Nursing for AWP) to introduce the report.

Andrea Morland took the Panel through the report and explained that there is an on-going conversation with the AWP about the High Dependency model of care.  The beds in the High Dependency Unit (HDU) had not been used for 9 months now.

Hazel Watson added that previously two types of beds were provided in Hillview Lodge – acute and HDU.  Hazel Watson said that she is convinced that the better model is the provision of mental health acute assessment and treatment services in acute in-patient wards and Psychiatric Intensive Care Units rather than High Dependency Units.

Diana Hall Hall said that Bath and North East Somerset Local Involvement Network is satisfied with the clinical view on the proposed change but dissatisfied that the procedure (consultation) had not been followed.

The Panel asked the following question and made the following points:

Members of the Panel expressed their concerns that the lack of the consultation with the partners/organisations, such as Bath and North East Somerset Local Involvement Network, could backfire and create difficulties in implementing the proposed service redesign.  The Panel also queried what the other authorities do with their HDU beds.

Andrea Morland replied that in this particular instance, services could not be considered under Any Qualified Provider mechanism as they are funded on a different basis.  The beds are not sold to others under current contract arrangements.  Andrea Morland also said that some areas have less well developed community service and, as a consequence, are not using their in-patient beds efficiently.

The Panel asked who mostly uses beds in Hillview Lodge – men or women.  Hazel Watson replied that it is mostly men who use beds in Hillview Lodge and that the service might be considering single sex units in terms of the equalities.

It was RESOLVED:

1.  To agree with the implementation of a Care Home and Community Hospital Liaison service can progress, reinvesting resource currently attached to Ward 4, St Martin’s Hospital.

2.  That the plans for the implementation of the Adult of Working Age services redesign are in line with local and national strategic intentions.

3.  That the Panel instructed officers to enter into further consultation with partners/organisations (including BANES LINks) and pending Members’ visit to the Hillview Lodge defer Panel’s resolution on provision of mental health acute assessment and treatment services takes place in acute in-patient wards and Psychiatric Intensive Care Units rather than High Dependency Units until the next meeting.

The Chair invited Sarah Shatwell (Associate Director for Non-Acute & Social Care) to introduce the report.

The Panel asked the following questions and made the following points:

The Panel asked how TUPE transfer would work for individual staff members.  The Panel also stressed that the service users want to see, and get the service, from the same people/staff.

Sarah Shatwell replied that the analysis of the delivered hours to individual users will be done and according to results it is likely that TUPE would apply to particular staff members.  This would be in the interest of continuity of care.

It was RESOLVED to note the report.

The Chairman invited Sarah Shatwell to introduce the report.

Sarah Shatwell informed the Panel that the Extended Research Pilots were awarded to the following services:

•  Integrated Health & Social Care Re-ablement - Sirona/Way Ahead

•  Intensive Home From Hospital Support - Age UK/Care & Repair

•  Handyperson & Minor Adaptations - Care & Repair/Bath Monday Somer/Sirona

•  Telehealth – Sirona

It was RESOLVED to note the report.

The Chairman invited Dr Pamela Akerman (Joint Director of Public Health) to introduce the report.

The Panel asked the following questions and made the following points:

The Panel felt that this should come to the Panel in near future as some issues were not yet defined (such as the budget for 2012-13).  The Panel felt that they should monitor the transition progress with the information on partnership work between the Public Health team and other services/departments in the Council, HR transition and the arrangements upon which the Council will be expected to take over public health responsibilities from the NHS BANES.

It was RESOLVED that the Panel will receive a further update on transition of public health responsibilities from NHS BANES to the Council at one of the future meetings.

The Chair invited Jane Shayler to introduce the report.

The Panel asked the following questions and made the following points:

Member of the Panel expressed her concern that there was no adequate provision for women in homeless hostels and asked why there was such imbalance present.

Jane Shayler agreed with the Panel Member that the provision for women in Julian House was not adequate.  The reason for it was that women tend use other options available (family, friend, etc) and they are also more likely to get statutory accommodation with the Council.  Julian House is really the last resort for them.

Member of the Panel commented that £400k allocated to the ‘tarmac’ in Radstock could be used for social care and homelessness.

The Panel also discussed the £230k revenue funding allocated for the support of the hostel facility.

It was RESOLVED that the Panel asked the Cabinet Member for Resources what is the intention of £230k allocated for the revenue support of hostel facility for homeless.

The Panel noted the current workplan with the following additions:

·  Home Improvement Agency report for November 2011

·  Verbal update on consultation on the High Dependency Units beds in Hillview Lodge for November 2011 (tbc)

·  Dental Access Services update for May 2012

·  Transition of Public Health responsibilities from NHS BANES to the Council (update) – date to be confirmed.