Agenda and minutes

The Chairman welcomed everyone to the meeting, particularly Councillor Neil Butters for whom this was his first meeting and Councillor Eleanor Jackson who had rejoined the Panel.

Councillor Lisa Brett had sent her apologies to the Panel.

Councillor Simon Allen also sent apologies that he was unable to attend but he had submitted his Cabinet member report.

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.

Councillor Vic Pritchard declared an “other” interest as a representative of the Council on Sirona Care & Health Community Interest Company.

Councillor Eleanor Jackson declared an “other” interest as a representative of the Council on Sirona Care & Health Community Interest Company.

Priscilla Elton made a statement on the subject of transport to appointments at Bath RUH.  Although the delays getting patients to their appointments had been improved, there were still exceptionally long delays getting people back home. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Pamela Galloway on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Alexander Jones-Grech, a young person, on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Simeon Wakely, a young person, on the subject of warm water swimming.

Jacqui Dodd read a statement on behalf of Susan Smith on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Sheila Hawken on the subject of warm water swimming.

Sue Jones made a statement on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Iain Pring on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Jenny Shrubsall on the subject of warm water swimming. A copy of the statement can be found on the Panel’s Minute Book.

Susan Charles read a statement by Eamon McClelland on the subject of warm water swimming.

The Chair thanked all the speakers.  He felt that collectively the statements were persuasive.  He read a prepared statement a copy of which can be found on the Panel’s Minute Book.

Councillor Sarah Bevan asked Susan Charles if she was aware that the current provider had responded that warm water swimming at 32^oC is a danger to those with heart and blood pressure problems.  Susan Charles replied that it was possible to provide swimming at 28^oC in the large pool and 32^oC in a pool for gentler swimming.

Councillor Bryan Organ asked Susan Charles whether she had been speaking to the Council’s Planning department about plans in the pipeline for new leisure provision.  Susan replied that she had been in conversation with Matthew Smith and Marc Higgins.

Councillor Sharon Ball observed that when she had swum in the RUH pool, it had been quite cold. She asked Susan Charles if she knew how often the temperature was monitored.  Susan replied that she did not know how often it was monitored – but she was aware that there were long queues for use of that facility and the one at Bath Mineral Hospital.

Councillor Neil Butters asked Susan Charles if she was aware of warm water provision made by neighbouring authorities.  Susan replied that a facility at Swindon provided hydrotherapy facilities 7 days a week  ...  view the full minutes text for item 23.

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

Councillor Simon Allen had sent his apologies to the Panel that he had not been able to attend.  His update report, a copy of which can be found on the Panel’s Minute Book, was read by Jane Shayler (Deputy Director - Adult Care, Health and Housing Strategy and Commissioning).  Jane led the Panel through the report and drew out relevant points.  She apologised that there was no update on rough sleepers but said that this would be included in Councillor Allen’s next report to the Panel.

Councillor Eleanor Jackson disagreed with the description of Writhlington pool as “outdoor because it had a roof and was indoor.  She was concerned that the estimated cost of repair was £500K – staff at the pool felt that the cost would be no more than £150K.  Jane Shayler said that the figure of £500K had been provided by professionals in Property Services who were qualified to estimate the costs of turning the pool into a fit for purpose hydrotherapy pool.

Councillor Vic Pritchard was pleased that Carer Support Services were working well but he was apprehensive that the Care Act was about to increase the number of clients by lowering the threshold.  He asked Jane Shayler whether there were any implications.  Jane said that the Council welcomed the extension of the right for carers to have an assessment of their needs and confirmed that the Council does already commission carers assessments and fund Personal Budgets for carers.  However, there might well be funding implications for the Council associated with an increased number of carers assessment and Personal Budgets.

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

Dr Ian Orpen (Chair of the CCG) introduced the report by explaining some of the terms used.  He was delighted to report that the Urgent Care Centre was operational since 1^st April and was enabling prompt treatment while taking the strain off the emergency department.  He pointed out that the latest GP Patient Survey showed that Bath & NE Somerset had the best access to GP services in the country.  He promised the Panel a more detailed response in September to the transport issues raised by Priscilla Elton but in the meantime he introduced Derek Laird, National Director of Operations, Arriva, and asked the Chair if Derek could address the Panel.

Derek Laird explained that the transport contract had only been operating for 6 months and the demand for transport had been much greater than had been specified in the tender invitation.  The contract had replaced 34 separate contracts, so the data had been difficult to Significant progress had been made but there was still much to do and this would have his full attention.  An added complication was the need for different types of transport tailored to each patient’s needs.  He was working closely with the commissioners to resolve this.  Dr Ian Orpen agreed that the resolution of this was also a priority for the RUH.

Councillor Eleanor Jackson reported that when she and Councillor Clarke had met with care providers, they had complained that their own appointments were being disrupted because they were not being advised when patients would be late home from hospital.  She asked whether some communication could be arranged to prevent this.  Derek Laird agreed that this was important and he would report on it in September.

Councillor Sarah Bevan asked if parking at RUH was a problem for drivers and if they had been getting parking tickets.  She was assured that this was not a problem because Arriva drivers worked well with the RUH on this.

Councillor Kate Simmons referred to the need to get the right balance of car and ambulance provision in the service.  She asked whether information had been made available to Arriva about this.  Derek Laird said that Arriva would not have had any advance information on this because the data was previously spread across 34 separate contracts and in fact the contract was started with all new vehicles.

Councillor Anthony Clarke asked Dr Ian Orpen whether the CCG had started preparations for the provision of GP services in Fox Hill following the new development.  Dr Orpen reported that there had already been some discussions; although the CCG did not deliver primary care, it might have a view on some issues.

Councillor Eleanor Jackson observed that the Panel had in the past been critical of the failings of the 111 service, which she felt was now working much better.  She was concerned however that when given a hospital appointment through 111, it was often the case that the hospital was not aware of the appointment when the patient arrived.  This  ...  view the full minutes text for item 26.

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

Pat Foster (General Manager, The Care Forum) introduced the report.  She distributed copies of the Healthwatch Bath and NE Somerset Annual Report 2013/14, a copy of which can be found on the Panel’s Minute Book.  She explained that Healthwatch was currently working on an enquiry into unsafe discharge.  In the autumn there would be an even for children and young people on obesity and self-image.  She explained how Healthwatch worked closely with many services by raising issues.

Councillor Kate Simmons referred to the social media targets.  She felt that Healthwatch had got these spot on.

The Chair thanked Pat Foster for her encouraging report.

The Wellbeing Policy Development and Scrutiny Panel is asked to note:

·  Continued progress in implementing more service user led, recovery focused community support services.

·  The implementation of the “LIFT Psychology” Primary Care Talking Therapy service.

·  The issues and options to be considered by local stakeholders relating to specialist acute mental health in-patient services.

Andrea Morland (Senior Commissioning Manager, Mental Health & Substance Misuse) introduced Bill Bruce-Jones, Clinical Director on AWP for Bath & NE Somerset.  The Chair welcomed Bill to the meeting.

Andrea referred to the Wellbeing Festival held on 18^th July which had been very successful.  A member of the Panel asked for better advertising of the venues for future events since he had been unable to find out where it was being held.  A member of the Panel asked how often it was intended to hold events such as this.  Andrea said that the team was becoming more confident about the value of these events in the light of the success of the “What Works” conference and the recent Festival.  Plans were therefore in hand to hold a future event on a Saturday in the school holidays.

Andrea referred to a number of areas mentioned in the report showing good progress.  The LIFT Psychology Therapy Service had been very successful in its first year and steps were being taken to build on this.

She referred to the shortcomings identified by CQC in the Sycamore Ward building and said that an immediate action plan was in place to address all the issues identified by CQC.  At the Panel’s next meeting she would report on plans for a longer term solution.

Councillor Vic Pritchard said that some of the options being considered seemed to be very ambitious and asked if they were viable (eg rebuild).  Bill Bruce-Jones replied that the rebuild option is very real and was possibly the only option.

Andrea reported that recent demand for beds had been higher and there might be a need to increase bed capacity alongside the ability to use facilities outside the area short-term.

Councillor Eleanor Jackson asked whether women were still being sent to Salisbury.  Andrea said that the Psychiatric Intensive Care Unit for women was in Bristol but any patients – men or women – might occasionally go to Salisbury short-term when no suitable bed was available locally.  Patients from Salisbury occasionally come to Bath when they are short of beds.

Bill Bruce-Jones said that there was a debate about whether there was a national shortage of mental health beds.  The flexible approach made that manageable but not ideal.

Councillor Sarah Bevan asked whether clients of the LIFT psychology service were keener on group or individual sessions.  Andrea said that clients were initially wary and most asked for individual sessions.  The approach was to encourage them to access “training courses” rather than “group sessions”.  This way, many have found it less threatening.

Pat Foster asked whether LIFT was available for young people.  Andrea confirmed that it was for over-16s but she was aware that Children’s Services made primary care provision for under-16s.

Councillor Bryan Organ asked whether the transition between youth and adult services has been improved.  Andrea said that, particularly for those with complex needs, there had been progress but less so for those with less complex needs.  She would be looking at this  ...  view the full minutes text for item 28.

The Panel are asked to note progress being made with Connecting Families Team and to receive an update about phase 2 (a new five year programme 2015 to 2020) and brief the panel about the suggested new criteria, especially those linked to health.

Paula Bromley (Connecting Families Manager) gave a powerpoint presentation, a copy of which can be found on the Panel Minute Books.  During her presentation she explained that 71% of families had a health issue.

Councillor Anthony Clarke asked whether this made any difference to the number of looked after children.  Paula explained that the data looked only at families living in a household, so did not include looked after children.

Councillor Vic Pritchard asked whether the service was 100% government funded and wondered whether the funding was secure for at least 3 years.  Paula said that except for a very small amount of additional income, the funds came entirely from government.  There was an existing pledge from government to fund 2015-2020 – this took the form of committed funding for 2015-16 plus cross-party support to continue funding after the 2015 election.

Councillor Pritchard asked whether there would be increased funding when the government increased the number of clients, as seemed likely.  Paula agreed that the criteria were set to widen, which would increase numbers of identified clients.  In addition, Ofsted was working with social services to bring about earlier intervention.  The Connecting Families team was also working with other agencies to identify ways to bring about earlier intervention.

The Chair thanked Paula Bromley for her presentation.

 [At this point Councillor Sharon Ball left the meeting]

This report will update the Wellbeing Policy Development and Scrutiny Panel on the prevalence of, and related issues to, HIV infection in Bath and North East Somerset and detail actions the local authority is taking in support of the national Halve It campaign.

Paul Sheehan (Public Health Development and Commissioning Manager) summarised the report. He gave particular emphasis to the major challenge presented by late diagnosis of HIV and explained the actions being taken to address this.

Councillor Tony Clarke said he felt that the authority dealt well with sexual health issues.  He drew attention to the Halve It campaign relating to low CD4 blood cell counts and he proposed that the Panel should ask Council to sign up to the Halve It campaign.

Councillor Vic Pritchard seconded that proposal.

Councillor Sarah Bevan felt that targeting men who have male sexual partners (MSM), the authority was in danger of discrimination.  Paul Sheehan understood Councillor Bevan’s point but he observed that historically the MSM community had been at highest risk.  He acknowledged that HIV did not discriminate and that heterosexual people were also at risk; gay men however were greater risk takers.

Councillor Pritchard felt that the Halve It campaign was aimed at saving lives and should be encouraged.

Councillor Bryan Organ asked why HIV required a special blood test and wondered if the standard blood test could include HIV.  Councillor Tony Clarke observed that to deliver a single blood test for every condition would be extremely expensive and would require very large blood samples.

Councillor Clarke felt that a powerful argument for targeting early intervention was that late diagnosis was very expensive and inevitably led to less positive outcomes.

Councillor Organ supported Councillor Clarke’s proposal.

Councillor Kate Simmons observed that the symptoms of early HIV were often very similar to flu.  Paul Sheehan agreed and added that only 70% would have any such symptoms at all.  Of these, more than half were men.  Less than 3% were under-18.

Samantha Jones (Corporate Policy Manager - Equalities) observed that men with HIV symptoms often present as heterosexual and this should not be a barrier to them receiving health care services.

The Chair thanked Paul Sheehan for his update.

On a motion from Councillor Tony Clarke, seconded by Councillor Bryan Organ, it was

RESOLVED (unanimously)

(1) That this Panel asks Council to sign up to the Halve It campaign to reduce the proportion of people undiagnosed, or diagnosed late with HIV, through policy reform and good practice.

This report presents the latest workplan for the Panel (Appendix 1).

The Panel agreed the Workplan as circulated with the agenda.