Agenda and minutes

Venue: Council Chamber - Guildhall, Bath. View directions

Contact: Mark Durnford  01225 394458

Items
No. Item

18.

WELCOME AND INTRODUCTIONS

Minutes:

The Chair welcomed everyone to the meeting.

19.

EMERGENCY EVACUATION PROCEDURE

The Chair will draw attention to the emergency evacuation procedure as set out under Note 6.

 

Minutes:

The Chair drew attention to the emergency evacuation procedure.

20.

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

Minutes:

Councillor Geoff Ward had sent his apologies to the Panel.

21.

DECLARATIONS OF INTEREST

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting. Members are asked to indicate:

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest,  (as defined in Part 2, A and B of the Code of Conduct and Rules for Registration of Interests)

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officeror a member of his staff before the meeting to expedite dealing with the item during the meeting.

Minutes:

Councillor Paul May declared an other interest as he is Sirona board member.

22.

TO ANNOUNCE ANY URGENT BUSINESS AGREED BY THE CHAIRMAN

Minutes:

There was none.

23.

ITEMS FROM THE PUBLIC OR COUNCILLORS - TO RECEIVE DEPUTATIONS, STATEMENTS, PETITIONS OR QUESTIONS RELATING TO THE BUSINESS OF THIS MEETING

At the time of publication no notifications had been received.

 

Minutes:

There were none.

24.

MINUTES - 29th July 2015 pdf icon PDF 127 KB

Minutes:

The Democratic Services Officer reminded the Select Committee that at the last meeting they were asked to make nominations to the South Western Ambulance Service (North Area) Joint Health Overview and Scrutiny Committee and that at the meeting Councillor Geoff Ward was nominated to take up one of the three nominations available.

 

Following the meeting the Democratic Services Officer said that he had received communication from Councillor Tim Ball that he would like to take up one of the nominations and therefore the Democratic Services Officer asked that this be confirmed by the Select Committee.

 

The Panel duly agreed to his nomination.

 

The Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chair.

25.

Clinical Commissioning Group Update

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

Minutes:

Dr Ian Orpen gave the Select Committee an update on behalf of the Clinical Commissioning Group (CCG), a summary is set out below.

 

He informed them that Bath and North East Somerset ranks top for preventing people from dying prematurely. He said that the latest data released on 23rd September that measures the number of years of life lost (per 100,000 registered patients) from conditions that are usually treatable shows we are the best performing CCG in England. 

 

Councillor Eleanor Jackson said that she was concerned about an inequality within some areas of the Council.

 

Dr Ian Orpen replied that it would be a challenge to maintain these current figures and that they would seek to tackle inequality.

 

Councillor Lin Patterson asked how B&NES currently performs on winter deaths.

 

Dr Bruce Laurence replied that he felt that we perform well on this matter these days.

 

The Director of Adult Care and Health Commissioning added that a great deal of energy efficiency work had been carried out on older properties and the homes of elderly people.

 

Councillor Tim Ball asked if within a future report that some of those inequality factors could be addressed and thought given to as to how those concerned can seek to elongate their lives.

 

Dr Ian Orpen said that 85% of health outcomes are down to the individual, their lifestyle and employment, but acknowledged the role that they have to play.

 

He explained to the Select Committee that there is ongoing poor performance in terms of delivering against the national target for A&E waiting times. He said that the position for August 2015 was 86% compared to the national target of 95% of patients in A&E to be seen within four hours. He added that not many areas reach the 95% target.

 

Councillor Tim Ball asked if the four hour period was broken down into categories at all as he had always felt that any children or those with serious injuries had been seen swiftly.

 

Dr Ian Orpen replied that he felt that the figures relating to patients arriving at A&E were quite stable, but that the complexity of conditions had increased. He added that on average patients were staying around half a day to a day longer in hospital. He stated that there was never a handover delay between ambulances arriving at the RUH.

 

Councillor Paul May asked if there was an issue with patients being discharged from A&E.

 

Dr Ian Orpen replied that the RUH had low numbers in terms of delayed transfer of care.

 

He informed the Select Committee that the CCG supported the roll out of the new Meningitis B vaccine to protect babies from the disease. He stated that GPs now offer the vaccine alongside other routine infant vaccines at two months, four months and 12 months of age. He added that in August the CCG also promoted availability of the new Meningitis W vaccine for teenagers.

 

He said that two CCG employees had  ...  view the full minutes text for item 25.

Additional documents:

26.

Cabinet Member Update

The Cabinet Member will update the Panel on any relevant issues. Panel members may ask questions.

Minutes:

The Cabinet Member for Adult Social Care & Health, Councillor Vic Pritchard addressed the Select Committee.

 

He wished to add his congratulations to Curo for the work they did with regard to the case of Legionnaires’ disease.

 

He said that he would try to make progress on the publication of the AWP - Joint Health Scrutiny Working Group report.

 

He said that he wished to expand on his response at the previous meeting on how the Health & Wellbeing Board differed from the Health & Wellbeing Select Committee. He said that the Select Committee would scrutinise the role of the NHS and that they have the power to refer matters direct to the Secretary of State.

 

Councillor Tim Ball asked if the cuts to Public Health budgets are deeper than expected how this impact would be mitigated.

 

Councillor Pritchard replied that measures are in hand for the expected level of cuts and that he would be addressing the LGA on the matter of removing ring fenced funding to attempt to protect it.

 

Councillor Eleanor Jackson agreed that it was important to protect the ring fenced funding and welcomed his attempts to progress the AWP report.

 

The Director of Adult Care and Health Commissioning assured the Select Committee that the specific actions identified by the CQC, including those relating to potential ligature points were addressed as a matter of urgency.

 

Councillor Paul May commented that he hoped the Council would look to minimise cuts to frontline services within the Health & Social Care budget.

 

The Chair thanked Councillor Pritchard for his update on behalf of the Select Committee.

27.

Public Health Update

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

Minutes:

Dr Bruce Laurence addressed the Select Committee, a summary is set out below.

 

Improving fitness and health in older people

 

He explained that Retirement in ACTion (REACT) is funded by the National Institute for Health Research. REACT is a UK study based on a successful US programme called LIFE. It is designed to support older adults to become more active. It is being run by the University of Bath in conjunction with others and Bath will be one of the pilot sites.

 

He said that a 12 month programme would be delivered in leisure centres and health clubs. Participants will be offered group sessions (15-20 per group) targeting cardiovascular, strength, co-ordination and flexibility. It includes a focus on socialising opportunities and enjoyment and promotes local activities to sustain long term impact.

 

He added that a pilot REACT study would start in Spring 2016 to test the recruitment and measurement strategies. 180 people (60 in Bristol/Bath) will take part across the three centres. The main trial would begin in Autumn 2016.

 

Sexual Health Needs Assessment

 

He shared some of the findings with the Select Committee.

 

B&NES is a low prevalence area for gonorrhoea with 27 infections per 100,000 population in B&NES in 2013, compared to 55 per 100,000 in England), genital herpes (38 per 100,000 in 2013, compared to 60 per 100,000 in England) and genital warts (123 per 100,000 compared to 137 per 100,000 in England); In 2013, B&NES had a very low incidence of syphilis (5 per 100,000 compared to 6 per 100,000 in England)

 

Chlamydia detection rates in B&NES are below the recommended rate of 2,300 chlamydia diagnoses per 100,000 15 to 24 year olds

 

B&NES has a low level of under 18 conceptions, and low level of teenage conceptions when compared to statistical neighbours (18 per 1,000 females aged 15-17 in B&NES in 2013, 21.7 per 1,000 females in statistical neighbours and 28 per 1,000 females in England)

 

B&NES has a lower rate of abortions than both the regional and national comparators (12.7 per 1,000 women aged 15-44 in 2013, compared to 14 per 1,000 women aged 15-44 in the South of England, and 16.1 per 1,000 women aged 15-44 in England)

 

He said that five key themes for improvement, with associated actions had been identified as detailed below:

 

1.  Strengthening intelligence and research: including investigating in greater depth the sexual health needs of and service provision for vulnerable and at risk cohorts; and improving the content of sexual health data;

 

2.  Strengthening sexual health service provision: including examining ways to increase the numbers of young people attending GUM and CaSH services; increasing the level of chlamydia testing amongst under 25s; increasing the level of LARC provision amongst women; and improving understanding of the strengths and areas for development in school-based relationships and sex education provision

 

3.  Strengthening prevention and promotion: including developing the SAFE branding scheme; improving website access to information about services; and ensuring all sexual health media  ...  view the full minutes text for item 27.

Additional documents:

28.

Healthwatch Update

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

 

Minutes:

Alex Francis, Healthwatch B&NES Project Coordinator addressed the Select Committee, a summary is set out below.

 

Preventing ill health by helping people to stay healthy

 

She said that work was progressing with Julian House to understand the experiences of local homeless people and how we can help them to improve their health. She explained that a survey has been drafted by Healthwatch and is now being agreed with Julian House staff. The survey includes questions about a range of health and social care services in addition to the commissioned in-house medical service provided at Manvers Street Hostel and Julian House’s own services, namely the hostel and homeless discharge work at the Royal United Hospital Bath. She said that they hope to run the survey during the autumn.

 

Improving the quality of people’s lives

 

She informed them that Healthwatch regularly receives feedback regarding primary care and that this feedback varies greatly, but often includes:

 

·  Concerns about waiting times for appointments;

·  The need for more information and signposting to voluntary and community-based services to help people manage their health independently; and more recently,

·  Concerns about new housing developments and the provision of primary care services in areas where there is already a perceived strain on resources, for example, Foxhill and the Mulberry Park development

 

She said that Healthwatch also hears positive comments regarding primary care services, for example:

 

·  The group said that Newbridge Surgery has a really easy telephone appointment system for practice nurses and GPs. The GPs aren't always able to call back on the same day but you get allocated a day and time slot.

·  Commentator said that St. Chads is a great surgery. They provide staggered GP surgery start times to cover 7am - 8pm. The surgery also has a Friends group that raises funds for the surgery.

 

She explained since April 2015, people have been able to rate and review health and social care services via the online Healthwatch B&NES feedback centre. She added that Healthwatch is seeing a steady increase in use of this feedback centre by members of the public, patients and their families/ carers and that a new feature has now been added to the website which enables providers to respond to feedback about their services.

 

She said that Healthwatch has also heard feedback from members of the public regarding the relocation of services from the RNHRD to the RUH. All feedback regarding the relocation of services to the RUH will be shared with the Trust and NHS BaNES Clinical Commissioning Group Quality Group.

 

Tackling health inequality by creating fairer life chances

 

She stated that Healthwatch is working with B&NES Council, St Mungos Broadway and the B&NES Health and Wellbeing Network amongst others, to develop a Mental Wellbeing Charter. The charter is linked to ‘Think Local, Act Personal’, a national initiative which helps organisations to make personalised services truly person-centred.

 

She said that the Mental Wellbeing Charter has been drafted and will be discussed with service users, carers and their families  ...  view the full minutes text for item 28.

Additional documents:

29.

Transfer of commissioning of Health Visiting and Family Nurse Partnership Services to the Council pdf icon PDF 73 KB

From 1st October local authorities will take over responsibility for commissioning 0-5 services (Health Visiting and Family Nurse Partnership) from NHS England. This report provides the Select Committee with details of the transition plan.

Additional documents:

Minutes:

The Assistant Director of Health Improvement and the Public Health Development and Commissioning Manager gave a presentation to the Select Committee regarding this item. A copy of the presentation will be available online as an appendix to these minutes and a summary is set out below.

 

·  From 1st October local authorities will take over responsibility for commissioning 0-5 services (Health Visiting and Family Nurse Partnership) from NHS England.

 

·  A 0-5 Transition Board has been planning for and overseeing the  handover to ensure a smooth transition and has in place  a risk assessment to identify and mitigate any risks associated with this transfer. The provider (Sirona Care and Health) have an agreed transition plan in place and are ready to safely manage the shift from “registered” to “resident” population.

 

·  The contract and the novation agreement have been signed and the Public Health commissioning team are fully prepared to take on their contractual responsibilities and report on the mandatory elements within the core Health Visiting service and aspire towards continuous service improvement, in partnership with other Children’s Services commissioners.

 

Transition Issues

 

·  Contractual status / Your Care Your Way

 

·  18 Month Stability Period

 

·  Ring fenced public health budget

    £7.183 million plus additional estimated

£2.774 million per year for HV and FNP (including commissioning costs)

 

·  Savings review

 

National Health Visiting Core Specification

 

·  Delivery of the Healthy Child Programme;

 

·  Assessment and intervention when a need is identified; and

 

·  On-going work with children and families with multiple, complex or safeguarding needs in partnership with other key services including early years, children’s social care and primary care. 

 

·  5 mandated touch points

 

·  6 high impact areas

 

 

Transforming the service

 

The transformed service is described as the 4-5-6 model. Health Visitors and family nurses deliver this service and are a vital link between primary care and early years.

 

4 Levels of Service

 

Your community

Universal

Universal plus

Universal partnership plus

 

5 Universal Health Reviews

 

Antenatal health promoting visits;

New baby review;

6-8 week assessment.

3-4 month visit (local additional offer)

1 year assessment (9-12mths)

2-2½ review

 

6 High Impact Areas

 

Transition to parenthood

Maternal mental health

Breastfeeding

Healthy weight / nutrition and physical activity

Minor illness and accidents

Health and wellbeing / development

 

Family Nurse Partnership

 

This service is provided to 69 young families and will give support to them until the child is 2 ½ years old.

 

0-5 Sector Led Improvement

 

Aims to: 

·  Share learning and develop practice for 0-5 year old services both within and outside of the council including developing leadership to:

·  Embed family-centred approaches to improve outcomes

·  Implement evidence based practice to improve 0-5 and family outcomes

·  Transform and integrate 0-5 and 5-19 services

·  Evaluate early years’ service improvement

 

Councillor Bryan Organ said that he was pleased that transition arrangements were now a priority.

 

The Director of Adult Care and Health Commissioning replied that transition planning had hugely improved under the Joint Commissioning Manager for Learning Disabilities.

 

Councillor Paul May asked if the staff involved saw the transfer as an advantage.

 

The Public Health  ...  view the full minutes text for item 29.

Additional documents:

30.

Your Care, Your Way: Consultation Briefing pdf icon PDF 98 KB

This report provides the Select Committee with a briefing on the progress of the Your Care, Your Way review.

Additional documents:

Minutes:

The Your Care, Your Way Programme Manager and the Senior Commissioning Manager gave a presentation to the Select Committee, a summary is set out below.

 

The Making Plans document has been circulated detailing the four models and fourteen priorities with a view to developing a top five priorities.

 

Currently in phase 2 of 4 – Design & Specify. Provide an outline of the business case in November / December 2015.

 

The need for change is because of an ageing population, an increased demand, public expectation and a lack of money.

 

The current provision is £69.24m to over 60 providers for 400 services.

 

Vision – We will have health and care services in the community that empower children, young people and adults to live happier and healthier lives. Supporting people to access services when they are needed in as seamless a way as possible, navigators will assist individuals to access pathways of care and support.

 

There are attributes and challenges with all four possible models and whichever one is chosen we will look to providers to work more collaboratively.

 

Model 1 – Focus on conditions

 

Model 2 – Focus on circumstances

 

Model 3 – GP led Wellbeing Hubs

 

Model 4 – Community led Neighbourhood Teams

 

 

We will try to address loneliness and isolation through this review.

 

New technology is to be embraced and apps may be used in future work.

 

Councillor Paul May asked if GP’s and providers used any common IT systems as he felt that a fully integrated system was required.

 

The Your Care, Your Way Programme Manager replied that there were two in use in the main.

 

Councillor Tim Ball said that in terms of budgets we must make sure that we have the ability to deliver what we are consulting on.

 

The Your Care, Your Way Programme Manager replied that we have been clear to providers on the financial challenges of the future.

 

The Senior Commissioning Manager added that money was not the main driver behind this review and that a significant budget exists. He said that the review was a challenge to think about the best model that we can provide.

 

Dr Ian Orpen stated that doing nothing was not an option and that this was a real opportunity for change. He said that he had heard a lot of positive feedback so far.

 

Councillor Paul May said that it was very welcome to see such a customer focus to the review.

 

The Your Care, Your Way Programme Manager reminded those present that the consultation was open until 30th October.

 

The Select Committee RESOLVED to:

 

i)  Note the content and approach, for consultation, the document attached as Appendix 1 : Making Plans - Consultation Document Phase Two and;

 

ii)  Acknowledge the proposals for market engagement as set out in Section 5 of this report.

31.

Select Committee Workplan pdf icon PDF 110 KB

This report presents the latest workplan for the Select Committee. Any suggestions for further items or amendments to the current programme will be logged and scheduled in consultation with the Chair of the Select Committee and supporting officers.

 

Minutes:

The Director of Adult Care and Health Commissioning reminded the Select Committee that during the course of the meeting they had requested an update on information relating to Alcohol and Substance Misuse.

 

Councillor Paul May asked if specialist services could have an input into the RUH items in November.

 

Councillor Eleanor Jackson reiterated her previous request to have involvement from the Governors of the RUH. She also asked for the AWP - Joint Health Scrutiny Working Group report to be added to the workplan.