Agenda item

This report provides an initial response from mental health commissioners and from AWP’s Bath and North East Somerset Locality Team, to key recommendations in the report of the joint scrutiny.

The Director for Adult Care and Health Commissioning introduced this item. She explained that the cover report had a focus for B&NES whilst the Joint Scrutiny Report was attached at Annex A. She drew their attention to the eight recommendations within the cover report.

Councillor Eleanor Jackson stated that it had been nine months since Councillors had met with AWP and that they needed to make sure they were carrying out their recommendations. She proposed that if local work was still required a Task & Finish Group could be put in place.

The Director for Adult Care and Health Commissioning said that a new inspection by the CQC was due in May 2016 which is likely to result in a further action plan.

Councillor Vic Pritchard, Cabinet Member for Adult Social Care & Health said that as a member of the cross party working group that met as a result of the previous CQC report it was a good opportunity to meet the AWP management team. He added that the process was led by Wiltshire as they had the majority of concerns.

William Bruce-Jones, AWP stated that services locally have improved considerably. He said that the next inspection would report on services across AWP, not on services within each locality and it would therefore be potentially difficult to extract relevant local information.

Councillor Eleanor Jackson wished to thank Emma Bagley for her work on the joint scrutiny for B&NES and Henry Powell in Wiltshire. She said that the other Local Authorities will have to form a view on future joint working proposals.

The Director for Adult Care and Health Commissioning said that the Select Committee would still receive regular reports and briefings relating to all mental health services in B&NES including those provided by AWP and, of course, information on specific issues as and when it requests it.

Councillor Paul May thanked Councillor Pritchard & Councillor Jackson for their participation in the Working Group.

Councillor Lin Patterson asked for an explanation of a Section 136 Protocol.

William Bruce-Jones replied that this related to Police powers under the Mental Health Act to detain a person for up to 72 hours for further investigation and assessment within a designated place of safety. He added that this was currently located within Southmead in Bristol and occasionally the custody suite in Keynsham was used.

Following a brief debate the Select Committee RESOLVED to approve the following recommendations from the Joint Scrutiny Panel report;

(i)  Recognises and appreciates AWP’s positive and open engagement in the process.

(ii)  Recognise that improvement measures were underway prior to the CQC inspection report being published and these appear to being followed through.

(iii)  Notes the changes in leadership at both executive and board level, shortly before and after publication of the CQC report.

(iv)  That Cabinet Members and Health and Wellbeing Boards respond to

a)  The concerns reported that Delayed Transfers of Care (DToCs) equate to a significant percentage of out-of-Trust placement bed days for older people and of out-of-Trust bed days for adults requiring acute inpatient care,

b)  Provides information of what is being done to address this.

(v)  Recommends that CCGs assess with AWP the requirement for a common Section 136 Protocol in line with the Mental Health Act Code of Practice.  At the same time, that consideration is given to realigning those places of safety with the appropriate constabularies as custody suite sites are reviewed.

(vi)  That the Cabinet Member and the Health and Wellbeing Board investigate the concerns reported by AWP regarding housing or step-down accommodation for patients with no fixed abode and the impact on Delayed Transfers of Care (DToCs) so that appropriate action can be taken if necessary.

(vii)  That CCGs and Health and Wellbeing Boards respond to concerns highlighted by the CQC report and echoed by AWP regarding:

·  Limited availability of beds being a Trust-wide issue, with intensive, acute and older people’s beds always being in demand;

·  Bed pressures meaning that care has sometimes been provided away from patients’ home area, making it difficult to maintain the support of loved ones.

The Select Committee decided to defer the recommendation set out below until the next inspection by the CQC had taken place.

(viii)  Invites participating health scrutiny committees to hold discussions regarding the merits of a longer term cross-authority scrutiny group to monitor the AWP improvement programme and the Trust’s performance in the future.