Agenda and minutes

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

Apologies for absence were received from Councillors Will Sandry and Lynda Hedges.  Councillor Simon Allen was a substitute for Councillor Sandry.

Members who have an interest to declare are asked to:

a)  State the Item Number in which they have the interest

b)  The nature of the interest

c)  Whether the interest is personal, or personal and prejudicial

Any Member who is unsure about the above should seek advice from the Monitoring Officer prior to the meeting in order to expedite matters at the meeting itself.

There were none.

There was none.

At the time of publication no notifications had been received.

There were none.

To confirm the minutes of the above meetings as correct records.

RESOLVED that minutes of the above meetings be confirmed as a correct record and signed by the Chair.

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

The Chairman invited Councillor Vic Pritchard (Cabinet Member for Adult Social Services and Housing) to update the Panel on current issues within his portfolio (attached as Appendix 1 to these minutes).

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

Councillor Willcox asked about the prospects of getting houses for people who were on the housing waiting list (9,200 people) and the impact that the Localism Bill would have on the way people are housed in future.

Councillor Pritchard responded that annually 500 people had been housed in the area.

Jane Shayler added that the Localism Bill proposed that Councils would have greater power to restrict entry to the housing waiting list but the Bill could be changed before it becomes an Act.  Nevertheless, it was fair to say that quite a significant proportion of people would not make at the current housing waiting list and the Council would make waiting list process as efficient as possible.

Councillor Whittock expressed his concern that the Older People’s Independent Living Service would only be available for people in the Somer Housing.

Jane Shayler responded that Somer had been awarded the service after open tender and that this new service would be open to all residents of B&NES who meet the criteria, regardless of whether they are resident within Somer Housing.

Councillor Jackson asked how many homeless people had been homed outside of bath and North East Somerset.

Councillor Pritchard responded that the ‘Out of area placement’ arrangement with the West of England area was that each Council would contribute with 5% of their housing stock.  For comparison 5% of the housing stock in Bath and North East Somerset was much lower than 5% of the housing stock in Bristol in actual number terms.  Councillor Pritchard added that the Council would be able to identify who would have greater need for the housing.

The Chairman asked that the presentation given by Ian Savigar to the Corporate Performance and Resources O&S Panel on the Housing Benefit be circulated to the Panel.

The Chairman thanked Councillor Vic Pritchard for the update.

The Panel will receive an update from the BANES NHS on current issues.

The Chairman invited Janet Rowse to update the Panel on current issues in the NHS BANES (attached as Appendix 2 to these minutes).

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

The Chairman asked about the clustering arrangements for PCTs announced in the NHS Operating Framework.

Janet Rowse replied that the Strategic Health Authority are responsible for ensuring the establishment of PCT clusters: the most significant influence on NHS spend is the patient flow to hospital services; RUH provides care to B&NES and Wiltshire residents and it is therefore possible that NHS B&NES would cluster accordingly. More information will be known shortly.

The Chairman congratulated that stroke services within NHS B&NES were assessed as being in the ‘best performing’ category for care and support.

The Chairman said that the ambulance response dropped dramatically during the severe weather conditions. 

Councillor Brinkhurst said that in November-December last year some of the ambulance service was brought from Wiltshire, and that the Panel should see a report on ambulance performance.

The Chairman agreed with this suggestion and suggested that, if possible, the Panel could have a report on ambulance performance at the March meeting.

 The Chairman thanked Janet Rowse for the update.

The Panel are asked to consider an update from the BANES Local Involvement Network.

The Chairman invited Diana Hall Hall to update the Panel on current issues involving BANES LINk as per the report.

The Chairman said that the future of the LINks and are yet to be confirmed but that it is most likely that LINks would form the basis of the new Health Watch. 

The Chairman thanked Diana Hall Hall for the update.

The Healthier Communities & Older People Overview & Scrutiny Panel is recommended to:

·  Comment on the Service Action Plans, taking into account the matters referred to above.

·  Identify any issues requiring further consideration at the special meeting of the CPR Overview and Scrutiny Panel in January and subsequently by Cabinet as part of the annual Service Action Planning and Budget process, in February.

• Identify any issues arising from the draft Service Action Plans it wishes to refer to the relevant portfolio holder for further consideration in advance of the Cabinet meeting in February.

The Chairman invited Janet Rowse and Jane Shayler to introduce the report.

Janet Rowse went through the report and highlighted for the Panel the areas of consistency and the areas of change since the medium term financial and service plan was presented in November 2010. It was confirmed that the headline finances remain constant, but that the subsidy for Community Meals was not longer included as a proposal within the Service Plan.

Jane Shayler said that the funding for the services from the third/voluntary sector supported 160 contracts (but not necessary 160 providers).  So far the savings had been identified and agreed with the providers without the impact on delivered services.

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

Councillor Brinkhurst asked if the was any Member input into the third/voluntary sector grant.

Jane Shayler responded that the Council delegated to officers decisions on voluntary grant programme.  Councillor Pritchard does sit on the commissioning body, which is multi agency group, but he had no input in the decision.

Councillor Brinkhurst commented that Members of the Council should be informed on the decision making process for contracts with the third/voluntary sector.  The Panel agreed with that comment.

Jane Shayler informed the Panel that the spending on the Community Learning Service had been reduced to the level of specific grant funding.  The capacity of the Community Development workers would be reduced as an outcome of the reduced funding.  Jane Shayler explained that Community Development workers supported community groups by giving them advice finances and similar issues and act as a link between different community groups.

Councillor Allen said that the reduced capacity of the Community Development workers would not fit within Big Society idea.

Jane Shayler said that 3 individuals would be affected but that there was ongoing discussion with the Policy and Partnerships on that issue.

The Chairman said that the service didn’t seem to be particularly placed well within the Council structure and that they seemed more to be within Policy and Partnerships service.  He felt that it would be wrong to lose very valuable service as they would fit within the Big Society idea.

Councillor Pritchard said that there would not be the end of the service.  £370k of the grant could be put into the Bath College who would take on community learning, but some jobs would be lost.

It was RESOLVED to:

1)  Note the Service Action Plan; and

2)  Send the following comments to the Corporate Performance and Resources O&S Panel:

a.  Members of the Council should be informed on the decision making process for contracts with the third/voluntary sector;

b.  The Healthier Communities and Older people O&S Panel felt that it would be wrong to lose Community Learning as a valuable service that fit well within the Big Society idea and that although there was not request to amend the service action plans for Adult Services, the Council should look into other ways to keep that service running.

The purpose of this paper is to provide BaNES’ Healthier Communities and Older People Overview & Scrutiny Panel with sufficient information about the Head and Neck Cancers, Ear, Nose and Throat (ENT) and Oral and Maxillofacial (OMF) Services Review to allow the Panel to decide whether or not to support the proposals to implement the new clinical service model at University Hospitals Bristol NHS Foundation Trust (UH Bristol) in line with the service specification.

The Chairman invited Tracy Cox, Liz Eley (Patients’ representative) and John Waldron (RUH Medical Director) to introduce the report.

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

Councillor Clarke said that this was excellent example on how the review should be conducted and that he supported the outcome and recommendations.

Councillor Brinkhurst agreed with Councillor Clarke and added that the consultation had been fantastic.

Councillor Jackson also supported the outcome and recommendations and added that she was particularly pleased how issues related to ethnic minorities had been tackled.

It was RESOLVED that the panel supported the decision of the Professional Executive Committees and Board of NHS BaNES:

1)  To implement a clinical service model for a centralised hub for all inpatient and day case Head and Neck Cancers, Ear, Nose and Throat (ENT) and Oral and Maxillofacial (OMF)services with satellite and spokes providing diagnostic, follow up and less complex procedures.

2)  For the centralised hub to be located at the BRI and hub services to be provided and managed by University Hospitals Bristol NHS Foundation Trust (UH Bristol)and for UH Bristol to proceed with implementation planning for May 2012 (in line with the opening of South Bristol Community Hospital). 

3)  For UH Bristol to work with local commissioners and providers from across the network to ensure there is good access to spokes across the network area.

Obesity is a major health problem for people in Bath and North East Somerset.  It is a major contributing factor for type II diabetes, cardiovascular disease, a contributory factor in hip and knee replacements as well as many other health problems.  The rates are rising for both children and adults.  There are a range of contributing factors in the rise in obesity and this strategy aims to address these where we can locally through preventing more people becoming overweight and obese and through the provision of treatment to those who are an unhealthy weight.

The Healthier Communities & Older People Overview & Scrutiny Panel is asked to agree that the strategy is approved for publication and implementation.

The Chairman invited Helen Erswell to introduce the report.

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

Councillor Jackson commented that people using modern cancer treatments and therapies gain weight and that could be considered in the strategy.

Councillor Willcox said that a lot of people, in particular women, smoke cigarettes because of they feel it would reduce their weight.

Helen Erswell replied that  NHS B&NES has a very proactive ‘Stop Smoking’ service which does address this issue within the programme, however she did acknowledge that some younger women do associate weigh loss with smoking.

Councillor Ball asked if the obesity was hereditary. 

Helen Erswell replied that it was not genetic but more to do with the lifestyle in the family which do tend to be passed on from parents to children.

Councillor Allen asked if the service also looked at underweight issues.

Helen Erswell replied that although the strategy was set to tackle overweight issues it also gives information about healthy weight.

The Chairman said that the outcomes and benefits on this matter would not be seen until 5 to 10 years down the line.

Councillor Brinkhurst said that this would be ideal for press campaign, especially with magazines read by young people.

Councillor Jackson asked if this report could go to the Parish and Town Councils as they were responsible for allotments.

It was RESOLVED that the Panel recommended that the ‘Shaping Up’ Strategy be approved for publication and implementation.

The latest publication in 2010 of the Local Authority Health Profiles identified B&NES as an outlier with a high proportion of the total number of deaths taking place during the winter months. This paper updates the Committee on the actions being taken to tackle this and bring about improvement.

The Healthier Communities and Older People Overview & Scrutiny Panel is asked to agree that the Action Plan of the B&NES Affordable Warmth Action Group is proportionate and comprehensive.

The Chairman invited Dr Pamela Akerman and Philip Milner (NHS BANES) to introduce the report.

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

Councillor Jackson asked how many winter deaths were related to people who were not taking flu vaccination.

Philip Milner responded that the NHS needs to work with the GPs to get information related to that matter.

The Chairman said that the only thing missing from the action plan was engagement with the communities by knocking on the door and asking people if they need something.  That sort of community engagement would also cover a number of other relevant issues.

Councillor Allen agreed with the Chairman’s comment and added that Community Development workers would be ideal for community engagement.

It was RESOLVED that the Action Plan of the Bath and North East Somerset Affordable Warmth Action Group was proportionate and the plan should also include engagement with the communities.

A comprehensive review of gynaecological cancer services commenced in September 2008 and came to a close in September 2009.  At the conclusion of the review the 6 Primary Care Trusts (PCTs) in the Avon & Wiltshire & Somerset Cancer Network made a recommendation that complex gynaecology cancers from the RUH should be transferred to UHB in the future in order to deliver a service that was compliant with the NICE Improving Outcome Guidance (IOG).

A  Joint Overview and Scrutiny Committee was due to be held in June 2010 but following the general election these plans were postponed as the Secretary of State for Health set out new policy commitments on service reconfiguration. These are a set of 4 measures against which proposed service re-configurations should be tested and referred to as the “the four tests”.

The attached paper informs the Healthier Communities & Older People Overview & Scrutiny Panel Committee of the outcome of a local assessment of the gynaecological cancer services review against the “four tests”.  It also informs the panel based on this assessment of the proposed next steps for a revised local solution to providing gynaecology cancer services.

The Chairman invited Tracy Cox and John Waldron to introduce this report.

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

Councillor Clarke said that the Panel was never convinced that the proposed new service could match the service provided by the RUH.

Janet Rowse responded that working environment had changed and that she was very pleased with the outcome.  She also thanked all people who worked on this matter.

Councillor Brinkhurst said that this was the example of working together and listening to each other. 

John Waldron emphasised the key role of the patients and users for this review.

The Chairman concluded the debate by saying that one issue related to the Gynaecological Cancer review was the lack of clinical evidence.  This was the biggest challenge for this Panel in terms of its work with the PCT.  This was what the Health Scrutiny was all about.

It was RESOLVED to note the local assessment against “the four tests” and the proposed set of conditions to work towards delivering local services that are IOG compliant.

This is a briefing on young people’s substance misuse issues in Bath and North East Somerset, including ketamine use.

The Healthier Communities and Older People Overview & Scrutiny Panel is asked to note the report.

The Chairman invited Rosie Dill to introduce the report.

Rosie Dill went through the report and also introduced Liz Ball from Project 28.

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

Councillor Jackson asked what effect closure of the Radstock Youth Centre would have on the work in terms of preventing drug misuse amongst young people and why so many young people take Ketamine.

Rosie Dill replied that she was aware of restructuring within the Youth Services but that she was working quite close with that service on preventing drug misuse amongst young people.  Liz Ball said that one of the reasons why so many young people take Ketamine was because it was cheap to buy.

Councillor Brinkhurst asked if Project 28 works with the affected families and why there was an increase in number of young people using drugs and alcohol.

Rosie Dill responded that Council staff and Project 28 deliver a lot of support to parents and families affected by the alcohol and drugs misuse.  She couldn’t give the exact reasons why there was an increase in number of young people using drugs and alcohol.  Rosie Dill also said that there were no particular hotspots in the area on this matter.

Councillor Jackson said that Ketamine abuse was one of the causes for youth homelessness back in 2008-09. 

Liz Ball said that in 2008-09 there were quite a few squats in Norton Radstock which were associated with young people and Ketamine abuse.

It was RESOLVED to note the report.

This sets out the Panels future workplan for Panel members to discuss.

The Panel noted their workplan for the next meeting with the following additions (all to be confirmed):

• Report/briefing on swine flu
• Ambulance performance report
• Somer Housing update to include information on how they plan to deliver Older People’s Independent Living Service.