Agenda and minutes

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

Councillor Sharon Ball sent her apology for this meeting.  Councillor Caroline Roberts was a substitute for Councillor Sharon Ball.

Councillor Bryan Organ sent his apology for this meeting.

Councillor Simon Allen sent his apology for this meeting.

Jane Shayler (Programme Director for Non-Acute Health, Social Care and Housing) sent her apology for this meeting.

Diana Hall Hall and Jayne Pye (B&NES Local Involvement Network) sent their apologies.

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 Officer before the meeting to expedite dealing with the item during the meeting.

Councillor Eleanor Jackson declared an ‘other’ interest as a Council representative on Sirona Care and Health Community Interest Company.

Councillor Vic Pritchard declared an ‘other’ interest as a Council representative on Sirona Care and Health Community Interest Company.

Councillor Anthony Clarke declared a ‘disclosable pecuniary interest’ in item 13 on the agenda ‘Provision of Neuro-Rehabilitation at the Royal National Hospital for Rheumatic Diseases’. Councillor Clarke withdrew from the meeting for the duration of this item.

Councillor Caroline Roberts declared an ‘other’ interest in item 13 on the agenda ‘Provision of Neuro-Rehabilitation at the Royal National Hospital for Rheumatic Diseases as she is married to an employee of the Royal United Hospital.

The Chairman invited Councillor Tony Clarke to address the Panel in his capacity as the Chairman of the Great Western Ambulance Service Joint Scrutiny Committee.

Councillor Clarke informed the Panel that the future of the Great Western Ambulance Service Joint Scrutiny Committee is in some doubt due to disappearance of the Great Western Ambulance Service last month (February).  Councillor Clarke will meet with the Chief Executive Officer and Chief Medical Officer of the South West Ambulance Foundation Trust early next month to discuss future arrangements.  Councillor Clarke suggested to the Panel to have a further update on this matter on the agenda for the next meeting of the Panel.

The Panel AGREED to have an update on future of the Great Western Ambulance Service Joint Scrutiny Committee from Councillor Clarke at the next meeting of the Panel.

Councillor Eleanor Jackson, who was Member of the Great Western Ambulance Service Joint Scrutiny Committee, paid a tribute to Councillor Clarke as the Chairman.

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

Following some corrections, the Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chairman.

The Chairman informed the meeting that the Panel still didn’t receive a response from Jane Shayler on how successful was the usage of the social media and the press by Sirona during the recent cold snap.  The Panel asked the Democratic Services Officer to send a reminder to Jane Shayler.

Councillor Lisa Brett informed the meeting that she is yet to meet with the officers in order to get answers to her written questions made just before the meeting on 28^th January (minute 82, 1^st paragraph). The Panel asked the Democratic Services Officer to send a reminder to relevant officers.

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 Councillor Simon Allen (Wellbeing Cabinet Member) and Jane Shayler (Programme Director for Non-Acute Health, Social Care and Housing) sent their apologies for this meeting and asked the Democratic Services Officer to read through the Cabinet Member update (attached as Appendix 1 to these minutes).

Councillor Eleanor Jackson said that it was extremely unfortunate that either Councillor Simon Allen or Jane Shayler could not be at the meeting today to answer the questions from the Panel.  Councillor Jackson expressed her concerns that this update didn’t cover that 94 elderly people were left without knowing what their future homecare would be.  Councillor Jackson also thought that Councillor Allen might have some thoughts about the Neuro-Rehab issue that is on Panel’s agenda.

Councillor Tony Clarke commented that meetings of the Panel are scheduled long time ahead and he felt that it was inappropriate for Cabinet Member or senior officer not to be at the meeting.

The Chairman agreed with the comments above and expressed his disappointment that Councillor Simon Allen and/or Jane Shayler are not here to answer directly questions and queries from the Panel. 

The Chairman asked to be minuted that the Panel should expressed their dissatisfaction with the lack of presence from Cabinet Member and Programme Director for Non-Acute Health, Social Care and Housing and asked for a more responsible approach from these two positions.

The Council has a duty to provide temporary accommodation for people who are homeless, have a local connection, are in priority need for accommodation and who did not become homeless intentionally.  At the request of panel this report aims to provide an update on the current demands around homelessness and specifically temporary accommodation.

The Wellbeing Policy Development & Scrutiny Panel is asked to note the report.

The Chairman invited Councillor Tim Ball (Cabinet Member for Cabinet Member for Homes and Planning) and Mike Chedzoy (Housing Services Manager) to introduce the report.

Councillor Ball and Mike Chedzoy took the Panel through the report.

The Panel made the following points:

The Chairman said that personally he wanted a lot more information about ‘rough sleepers’ in the report.  The national press reported that there was 25% increase in ‘rough sleepers’.  The Chairman said that the answer to his question to Councillor Tim Ball about ‘rough sleepers’ was a little vague.  It stated that different approach was now in place – instead of counting physically the number of people sleeping rough, the approach was to make estimated guess on how many people are sleeping rough.  The Chairman also said that some data in the report was not concise.

Councillor Tim Ball said that issue about ‘rough sleepers’ is very important issue.  Councillor Ball explained that there are rules on how the count is done.  To get the actual estimate properly the Council worked with the relevant agencies.  The number is high but still well below the national average.  This option also excludes those people who live on boats and in caravans. 

Mike Chedzoy added that Local Authority should carry out the count every year.  This year the Council went to estimate on how many people sleep rough and we established we have 22 ‘rough sleepers’.  Last year there were 4 people.  Mike Chedzoy said that he led on the estimate.  Mike Chedzoy explained that it is very hard to do the count in the night.  Rules are that we have to know the name of the individual and not only as ‘man by the river’.  Those information need to be checked with Julian House as well.

The Chairman asked if we can provide adequate support now that we have more realistic figures on number of rough sleepers.

Mike Chedzoy responded that Julian House will offer the overflow for emergency accommodation.  They also have link with the YMCA.  On the first night they will have to sleep on the mattress but the next day they will be accommodated.

Councillor Tim Ball added that some people chose not to go to the hostel for their own reasons.

Councillor Jackson said that she was on one of the previous counts and understands how difficult is to count people.  Councillor Jackson expressed her concern that three people from Radstock Ward are sleeping rough and in order to get some support they will have to travel to Bath via bus.

Mike Chedzoy responded that we have dedicated phone line for support services and people would get the immediate response wherever they are. 

Councillor Tim Ball added that there is local number for Julian House and that there is also a national number released by the Government recently to assist people reporting any homeless issue.

Councillor Katie Hall asked if there are any known hotspots where 'rough sleepers' congregate over night.

Mike Chedzoy responded that  ...  view the full minutes text for item 96.

The Panel will receive an update from the 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 Orpen updated the Panel with current key issues within BANES CCG (attached as Appendix 2 to these minutes).

Members of the Panel expressed quite a few concerns about the NHS 111 service and its ‘soft’ launch on 19^th February this year.  Due to the recent problems the full launch of the service has been delayed until 16^th April 2013 to enable some of the service issues to be resolved.

Members of the Panel requested a report from the CCG on the NHS 111 for the next meeting of the Panel.  The report should include contractual arrangements with Harmoni (111 provider for the area), handling of the increase in calls to ambulance services, 111 out of hours services (quality, staff background, staff experience), link between 111 and 999 numbers, performance data, whether referrals made to GP and the RUH are appropriate referrals (what mechanism is used to capture those data, how it is shared and Harmoni’s part in sharing/controlling the data).

It was RESOLVED to receive a report/update on the NHS 111 at the next meeting of the Panel.

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

Item withdrawn from the agenda as there were no Local Involvement Network members present at the meeting.

This report describes the outcome of the process for procuring a provider for Healthwatch B&NES (Local Healthwatch), and the provision of an NHS complaints advocacy service (ICAS), both from 1st April 2013. The provision of a Local Healthwatch service and an NHS complaints advocacy service are statutory requirements of the Health and Social Care Act 2012.

Members are ask to note the information presented.

The Chairman invited Susan Bowen (Funding and Programme Manager) to introduce the report.

Susan Bowen took the Panel through the report.

The Chairman commented that in the ‘Specification for the delivery of Healthwatch in B&NES’, under first paragraph of 3.4 (Contract Monitoring Requirements) it says the following: ‘Healthwatch B&NES will report on its activities and finances to the Council on at least a three-monthly basis throughout the term of the agreement and more frequently and as reasonably specified as part of a performance management review process’.  The Chairman felt that this would be best achieved through the Wellbeing PDS Panel by having the regular updates from the Healthwatch at every meeting of the Panel. 

It was RESOLVED to ask Healthwatch to provide regular updates to the Panel.

Purpose of the Report -
 

To report to the Bath and North East Somerset (B&NES) Wellbeing Policy Development and Scrutiny Panel:

·  the proposed re-provision of specialised neuro-rehabilitation services ( inpatient and outpatient)  provided at the Royal National Hospital for Rheumatic Diseases (RNHRD’s) from April 1st 2013; 

·  that additional capacity for the provision of level 1/2A neuro-rehabilitation has been identified and agreed in principle with two alternative providers at Level 1 and a wider range of providers at Level 2A to ensure continuous provision from 1st April should scrutiny vote to support this interim re-provision proposal;

·  that a programme of stakeholder (patients, carers, public, RNHRD staff and providers) engagement  on the short- and long-term provision of neuro-rehabilitation in the South West has been carried out, with due regard given to two extensive reviews of local services recently carried out by Somerset and Devon Local Involvement Networks.

(This paper should be read in conjunction with the Bath & North East Somerset Primary Care Trust’s briefing on the re-provision of the non-specialised Outpatient Neuro-rehabilitation service – marked as part 2).

The B&NES Wellbeing Policy Development and Scrutiny Panel is asked to:

·  note that patients from the South West have and will continue to receive the best quality neuro-rehabilitation services that the NHS is able to provide;

·  note there have been no issues regarding quality or safety in the RNHRD’s decision to cease providing neuro-rehabilitation after the 31st March 2013;

·  note the continued high level of quality care and family experience that the recommendations are able to support;

·  note commissioners’ collaboration with key stakeholders, including patients and the public as well as potential providers, in developing the recommended re-provision option;

·  note that proposals should maintain the existing high quality of care without any adverse effect on current in-patients or future access to the service;

·  support the proposal for service re-provision in the proposed centres.

The Panel also requested from the Royal National Hospital for Rheumatic Diseases to provide their view on the part they played in the process for the future of the Neuro Rehabilitation Services (attached as ‘Update from the RNHRD’).

The Chairman invited Sue Davies (Acting Director, South of England Specialised Commissioning Group, South West Team), Tracey Cox (B&NES Clinical Commissioning Group Chief Operating Officer - Designate) and Kirsty Matthews (Chief Executive of the Royal National Hospital for Rheumatic Diseases) to address the Panel.

The Chairman informed the meeting that the Panel will first get presentations from Sue Davies and Tracey Cox and also a summary from Kirsty Matthews.  The Panel will ask the questions afterwards and make their recommendations.

Sue Davies gave a presentation where she highlighted the following points:

• Overview
  • Outline of the proposal for re-provision
  • Outline of the Patient and Public Engagement process undertaken by the Specialised Commissioning Team
  • Feedback from engagement process
• Specialised Neuro-rehab services
• Where do people come from? (chart)
• Proposals for re-provision – Level 1 & out-patients
• Proposals for re-provision – Level 2A & out-patients
• Arrangements for current patients
• Public engagement process
• Average travel times
• Feedback from PPE events
• Summary

A full copy of the presentation from Sue Davies is available on the Minute Book in Democratic Services.

Tracey Cox gave a presentation where she highlighted the following points:

• Out-Patient Neuro-rehabilitation Services
  • Spasticity clinic
  • Physiotherapy (including Functional Electrical Stimulation)
  • Psychology
  • Counselling
  • Splinting
• Current Patient Activity
• How will patients’ needs be met after April?
• What patients told us….
• Communications with patients
• Current team (picture)

A full copy of the presentation from Tracey Cox is available on the Minute Book in Democratic Services.

Kirsty Matthews explained the background for the decision to close the Neuro-rehab services at the RNHRD.  It was very difficult and sad decision for the RNHRD Board to decide to close this exemplary service but the decision was made purely for financial reasons.  The Board took into consideration that over the past three years there was a significant change in referral patterns, as explained in the report.  This change has led to a 50% reduction in income for this service over the last two years which had critical impact on the ability of the service to continue.  The service was making a loss of on average £430k per year.  This means that the service was not covering its direct cost or making a contribution towards the costs of the estate and infrastructure that supports it.  These immediate service losses contributed to the RNHRD’s overall financial challenge where the organisation was currently losing £10k a day.

Kirsty Matthews explained that, in taking its decision to close the service, the Board took account of all financial pressures and the necessity of responding to a financial position that has resulted in the organisation being found by Monitor to be in significant breach of one of its terms of authorisation.

The RNHRD undertook an engagement exercise during November and December 2012 and comments were received from clinician’s professional bodies, MPs and public.  An equalities impact assessment was also completed and taken into account.

Kirsty Matthews concluded that the RNHRD worked very hard that there is minimum disruption to their patients.  The RNHRD were very  ...  view the full minutes text for item 100.

This report presents the latest workplan for the Panel.

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

• An update from Councillor Anthony Clarke on Great Western Ambulance Service Joint Scrutiny Committee future arrangements – May 2013
• Report on Rough Sleepers – May 2013
• NHS 111 Service – May 2013
• Neuro-rehab re-provision update – September 2013