Agenda and minutes

Councillor Bryan Organ had sent his apology to the Panel.  Councillor Sally Davis was a substitute for Councillor Organ.

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 other interest as she is Council’s representative on Sirona Care & Health Community Interest Company.

Councillor Sally Davis declared other interest as she is Council’s representative on Sirona Care & Health Community Interest Company.

Councillor Vic Pritchard declared other interest as he is Council’s representative on Sirona Care & Health Community Interest Company.

Councillor Simon Allen (Cabinet Member for Wellbeing) declared other interest on the agenda item ‘Cabinet Member update’ as he is employed by the National Autistic Society in Bristol.

The Chairman used this opportunity to inform the meeting that Connie Wright (BANES LINk member) who had been involved in many of the Health related issues within the area had passed away.

The Panel offered their condolence to Connie’s family and friends.

There will be few speakers to address the Panel under agenda item 11 (Urgent Care Re-Design Impact Assessment).

The Chairman informed the meeting that Peter Jovcic-Sas will address the Panel now in respect of the NHS & Clinical Commissioning Group Update and also just before item 11 on the agenda (Review of Urgent Care).

The Chairman informed the meeting that Sarah Mitchard will also address the Panel just before item 11 on the agenda (Review of Urgent Care).

Peter Jovcic-Sas said that the Clinical Commissioning Group (CCG) appeared to be too secretive about the role of their Board in terms that their job descriptions are not published.  Peter Jovcic-Sas also said that it is unusual that two clinicians are appointed on their Board who have roles of the Chair and Clinical Accountable Officer. Peter Jovcic-Sas asked the Panel to request from the CCG to publish their job descriptions of their senior roles, clarify who is appointed to support Accountable Officer and clarify who is more senior – the Chair or Clinical Accountable Officer.

Councillor Jackson said that the speaker made some important points that should be answered by the appropriate officers/representatives.

The Chairman said that he would be asking Dr Ian Orpen to provide the answer, if possible, under ‘NHS and Clinical Commissioning Group Update’ agenda item.

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

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 Simon Allen (Cabinet Member for Wellbeing) to give an update to the Panel (attached as Appendix 1 to these minutes).

The Panel made the following points:

Members of the Panel queried why some GP surgeries run out of the flu vaccines.

Dr Ian Orpen replied that this was national issue that will be resolved soon and all surgeries will have enough vaccines.

The Chairman, on behalf of the Panel, complimented the Independent Living Service (commissioned by the Council and provided by Curo Housing) which won the National Housing Federation South West Community Impact Award for Better Health.

The Chairman thanked Councillor Allen for an update.

The Panel will receive an update from the NHS and 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).

Dr Orpen also said that he would be happy to take on board comments made by Peter Jovcic-Sas and make the job descriptions of the CCG Board members available.  These job descriptions were created according to the national guidance. 

Dr Orpen added that Corinne Edwards leads on Dementia programme we were successful on three bids submitted to the NHS South of England Dementia Challenge Fund (out of five).  The Prime Minister’s Challenge on Dementia had been published earlier in the year to deliver major improvements in dementia care and research.  This initiative became national priority.

The Chairman thanked Dr Orpen for an update and asked that the Panel be informed when the job descriptions for Board members are published.

This report outlines the plans for the procurement of a Host service for the B&NES LINk (Local Involvement Network) to run from 1st December 2012 to 31st March 2013. The new service provider will replace the previous one, Scout Enterprises Ltd., which ceased trading on 29 September 2012 and formally went into liquidation on 19th October 2012. A formal update is being presented today to ensure the Panel has current and comprehensive information on the way forward for the LINk, and the way in which we will carry out our statutory duty in providing a LINk Host service.

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

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

The Panel made the following points:

Members of the Panel felt that B&NES Local Involvement Network (LINk) had been put in unfortunate position as the former host service, Scout Enterprises Ltd, went into liquidation on 19^th October this year. 

Members of the Panel highlighted the value of the work that the LINk did over the past few years and welcomed that the Council was looking to appoint the new host service from 1^st December.

It was RESOLVED to note the report and instruct the officers to communicate with the Panel the outcome of the procurement for the new host service once it is in place.

This document is to present the Panel with the public engagement report on the proposal to relocate the GP-led Health Centre to the Royal United Hospital.

It is also present to the Panel the health & equalities impact assessment on the proposal.

The rationale for this service change is based on the following factors:

·  An ageing population

·  Increasing demand and expectations

·  People living longer often with several long term conditions

·  Finite resources and inequitable use of existing resources

·  It has the support of local clinicians whose services will be affected by the proposals

·  It supports the principle that patients should have access to the right treatment, at the right place and at the right time

·  It has taken account of clinical evidence and best practice drawn from reports published by the Primary Care Foundation, Royal College of General Practitioners, NHS Alliance, the Department of Health and the Foundation Trust Network.

The Panel is asked to note both reports and agree the proposal to relocate the GP-led Health Centre to the Royal United Hospital to create an Urgent Care Centre can proceed.

The Chairman invited Peter Jovcic-Sas to read out his statement.

Peter Jovcic-Sas said that the NHS belongs to us all and BANES CCG has legal duty to involve people who use health service in decisions about those services.  The CCG did not make meaningful attempt to engage current users of the walk-in centre.  There is also no information how local GPs will take on the pressure if the walk-in service gets closed nor there was information on how the proposed £500k saving would be invested in services elsewhere.  The Equality Impact Assessment did not fully engage with the local representatives or wider communities (i.e. Bath Racial Equality Council).  Over 1,000 people signed the petition to keep the centre.  Over 70% were concerned about the new model based at the RUH.  Peter Jovcic-Sas said that in his view the consultation was too shallow and too basic.  The CCG did not provide enough information to allow people to make informed judgement on what they are planning to do.  Peter Jovcic-Sas asked the Panel not to support the recommendation and ask the CCG to review their proposal in light of the all the comments on this subject.

The Chairman commented that Peter Jovcic-Sas was quite specific that the CCG haven't been effective in engaging the public and then went on to identify certain representations made through the consultation period.  The Chairman said that appears to be conflict in the statement about the engagement process.  The Chairman said that there was consultation period where the CCG went out across the authority to engage with the public and get their opinion.

Peter Jovcic-Sas said that there was no enough meaningful engagement with the public.  The CCG could do more in terms of the public engagement.  The other CCGs across the country take much longer to engage with the public.

Councillor Jackson said that she read in the report about the consultation process and while she thinks that efforts were made to engage with the public the fact is that most of the engagement took place via social media whilst there was no enough information via radio.

The Chairman invited Sarah Mitchard to read out her statement.

Sarah Mitchard thanked the Panel to give her opportunity to speak and also thanked the CCG for their interest in concerns raised and for meeting with Bath Labour Action Team and answer their questions.  Sarah Mitchard also welcomed that the CCG worked hard to record the objections and criticism as well as setting out suggestions for how these could be addressed.  The overwhelming view that came from the public was that they did not want to lose the GP walk-in service in this form, or from this location.  People were worried about the reduction in access to primary care if these proposals went ahead.  Therefore, Bath Labour Action team initiated the petition to enable people to express their views.  To date 1,100 people signed the petition with 500 of them who left their comments.

Sarah Mitchard said that Wellbeing  ...  view the full minutes text for item 66.

Affordable Warmth is a key determinate for wellbeing and is particularly significant for vulnerable low income households.  The inability to benefit from affordable warmth can be described as fuel poverty and this affects 17% of B&NES residents (House Condition Survey 2011).

The purpose of the Local Affordable Warmth Action Group (LAWAG) is to coordinate activities to tackle excess winter mortality, fuel poverty and promote affordable warmth.  It comprises representatives from across the community, voluntary and statutory sector with and interest in solutions to these issues.  The terms of reference for the group are in the report.

The Wellbeing Policy Development and Scrutiny Panel are asked to note and comment on the report and on the action plan.

The Chairman informed the meeting that the Panel will consider this item before Medium Term Service & Resource Planning item.

The Chairman invited Chris Mordaunt (Housing Services Manager) and Sarah Scott (Public Health) to introduce the report.

In addition to what was already included in the report and the Action Plan, Chris Mordaunt and Sarah Scott added that the biggest success was promoting home energy efficiency measures and information alongside the flu jab campaign and that 253 improvements took place this year.

The Panel made the following points:

Members of the Panel welcomed the initiative, action plan and measures that were put in place in order to promote affordable warmth to those who are most at risk of dying during the winter months.

It was RESOLVED to note and welcome the report and also to note and welcome the action plan.

The draft Adult Social Care & Housing Medium Term Service & Resource Plan (MTSRP) is presented for consideration by the Panel:

·  To ensure all members of the Panel are aware of the context for Service Action Planning

·  To enable comment on the strategic choices inherent in the medium term plan

·  To enable issues to be referred to the relevant Portfolio holder at an early stage in the service planning and budget process

The Panel is asked to:

1.  Comment on the medium term plan for Adult Social Care & Housing 

2.  Identify any issues requiring further consideration and highlighting as part of the budget process for 2013/14

3.  Identify any issues arising from the draft plan it wishes to refer to the relevant portfolio holder for further consideration

The Chairman invited Jane Shayler (Programme Director for Non-Acute Health, Social Care and Housing) to introduce the report.

Jane Shayler took the Panel through the report and explained the purpose of each appendix.  On a question from the Panel on what P2P means in the report Jane said that is the reference to Procure to Pay (more efficient way to enable people to pay their invoices for the Council). 

Jane Shayler highlighted the following key proposals in the service impact statement (for the benefit of the Panel):

There are two separate savings against the Council's contract with Sirona Care & Health.  Top of the first page of appendix 3 of the report, Decrease in Sirona contractual values as agreed, is capturing part of the saving that is already incorporated in the contract with Sirona.  Jane Shayler reminded the Panel that there is a three party contract for provision of care and health services between the Council, Sirona and the PCT (CCG as of April 2013).  On the page 3 of appendix 3 of the report there is more significant saving because that is a new savings target against Council's part of the contract with Sirona.  This has not been agreed yet with Sirona so it needs to be worked through in agreement and partnership with Sirona.  One of the areas that need to be explored is relatively recently published national Audit Commission report that looked at the cost in each LA for social care processes which indicates that there are some efficiencies in this area that could be made.  Jane Shayler reminded the panel that Sirona delivers a significant portion of adult social care on behalf of the Council.

The Chairman asked what the Audit Commission exactly determined in their report.

Jane Shayler responded that Audit Commission looked at the cost of adult social care processes around the assessment of individual needs, review processes, provision of the advice to individuals (around eligibility for example), but also looked at the other supporting processes.  Jane Shayler said that she always thought that we should treat benchmarking reports with caution because national organisations, like the Audit Commission, will be pretty skilful in analysing data though benchmarking does not always compare like for like.  Audit Commission report benchmarks cost associated processes prior to the transfer of Sirona.  Jane Shayler reminded the Panel that the AWP also manage some services in partnership with the Council.  The first saving target against that work is not in the next financial year and there is time to work up the detail of how the saving will be delivered and undertake a full impact assessment, including assessing an equalities impacts. 

Jane Shayler also said that one of the things that the Council could consider is whether we would be happy for individuals, who have relatively low level of need, to do something called ‘self-assess’ (i.e. if they need a piece of equipment that doesn't cost very much) to avoid the necessity of a service user going through a lengthy assessment  ...  view the full minutes text for item 68.

The Wellbeing Policy Development and Scrutiny Panel are requested to determine whether the proposal to relocate the Paediatric Audiology Service from the RUH to the St Martins Hospital site constitutes a substantial variation or development.

The Chairman invited Janet Rowse (Sirona Chief Executive) to introduce the report.

The Panel made the following points:

Members of the Panel debated the transport issues for the service users.  The Panel felt that clinical opportunities and space at the new location at St Martin’s site outweigh travel implications.  The proposed changes to Sirona Paediatric Audiology Service are improvements to the current provision.

It was RESOLVED that the proposal to relocate the Paediatric Audiology Service from the RUH to the St Martin’s Hospital site did not constitute a substantial variation or development.

Further to the report to panel of the 18th May 2012 which set out the Quality Assurance Framework for social care services generally, this report is the second in a series of quarterly reports which focuses specifically on the quality of care and performance of residential and nursing homes under contract in Bath & North East Somerset.

The Wellbeing Policy Development & Scrutiny Panel is asked to note the contents of the report and to contribute relevant feedback and articulate clearly the role of the Panel in relation to the QAF.

The Chairman invited Jane Shayler to introduce the report.

The Panel made the following points:

Members of the Panel asked for the rationale of having the Care Homes Quarterly Performance Report.

Jane Shayler explained that this report is the second in a series of quarterly reports which focuses specifically on the quality of care and performance of residential and nursing homes under contract in Bath & North East Somerset.  The report captures the outcomes of the judgements issues by the Care Quality Commission (CQC), activities by the Commissioning and Contracts Team in relation to the quality and performance of care homes and, lastly, the level and type of safeguarding activity recorded.

It was RESOLVED to note the report.

This report presents the latest workplan for the Panel.

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

·  6 monthly update/review on Urgent Care Re-design

·  Alcohol Harm Reduction Scrutiny Inquiry Day to be moved to 22nd March 2013