Agenda and minutes

The Chairman welcomed everyone to the meeting.  The Chairman welcomed Councillor Lisa Brett as the new permanent member of the Panel in place of Councillor Sarah Bevan.

Councillors Kate Simmons, Anthony Clarke and Loraine Brinkhurst sent their apologies.  Councillors Brian Simmons, Martin Veal and Gerry Curran were their substitutes respectively.

Councillor Katie Hall sent her apology but no substitute was allocated for her absence.

Councillor Simon Allen (Cabinet Member for Wellbeing) and Ed Macalister-Smith (B&NES and Wiltshire PCT cluster Chief Executive) sent their apologies.

Councillor Eleanor Jackson declared personal and non- prejudicial interest on the agenda item ‘Service Action Plan 2012-13 for Adult Social Care and Housing’ as she is Council’s representative on Sirona Care & Health Community Interest Company. 

Councillor Vic Pritchard declared personal and non-prejudicial interest on the agenda item ‘Service Action Plan 2012-13 for Adult Social Care and Housing’ as he is Council’s representative on Sirona Care & Health Community Interest Company.

There were none.

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

The Panel confirmed the above minutes as a true record and they were duly signed by the Chairman.

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

The Panel confirmed the above minutes as a true record and they were duly signed by the Chairman.

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

The Chairman invited Jane Shayler (Programme Director for Non-Acute Health, Social Care and Housing) to give an update in the absence of Councillor Simon Allen (Cabinet Member for Wellbeing).

Jane Shayler took the Panel through the update (attached as Appendix 1 to these minutes) and provided further detail on the actions being taken in respect of a small number of care homes.  Improvement Action Plans are in place and the implementation of the necessary improvements/changes are being closely monitored in liaison with the regulatory body, CQC (Care Quality Commission).  CQC has been satisfied with the progress made to date.

Jane Shayler added that in light of recent high profile cases, including Winterbourne View, CQC have started to issue very strong, standard press releases that do not always give an accurate picture of the required improvements and associated risks to service users. Nevertheless, the Council does always take all CQC Improvement Notices seriously and works closely with CQC to ensure that the appropriate action is taken.

The Chairman said that we do have to be aware of the possible adverse perceptions of the public after reading such strong CQC press releases but that it was acknowledged that it is important that CQC takes a rigorous approach to its regulatory role.  The Chairman said he was concerned that it was CQC, not the Council, who identified the areas for improvement.

Jane Shayler replied that the CQC has different role and greater powers than Council in the regulation of care services.  The commissioning and contract team does regular contract reviews, taking a risk-based approach to the frequency of those reviews.  Jane acknowledged that the team does not have sufficient capacity to undertake contract reviews of all providers as frequently as it would ideally want but capacity in the team has been increased in recognition of this really important area of work.  Also, there is close working between the Council and CQC with regular liaison designed to share concerns and any actions to be taken.

The Chairman felt that this issue should be on the agenda for the next meeting of the Panel in the format of the report with the background information.  The Panel agreed with the Chairman’s suggestion.

It was AGREED that ‘Care Services Quality Assurance’ be on the agenda for March 2012 meeting.

The Chairman asked about the Department of Health one-off additional payment of £457,275 to Primary Care Trust for immediate transfer to the Council for investment in social care services which also benefit the health system.

Jane Shayler responded that, on an urgent basis, it was agreed to invest in transitional beds (one of the areas highlighted by Sirona).  It was also agreed to employ an additional Social Worker in the Hospital Team on a 12-month basis.  The other proposals from Sirona and other partners and 3rd sector providers are being considered.  All these investments will have to be short term as the money is one-off payment.

The Chairman asked how carry-forward money sits with the Service Action Plan.  ...  view the full minutes text for item 67.

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

The Chairman invited Ian Orpen (Clinical Commissioning Group - CCG) to give an update.

Ian Orpen took the Panel through the update (attached as Appendix 2 to these minutes) and added that the CCG received one-off fund of £300k to spend until March this year.  The CCG would have to decide until 8th February where to spend this fund.  Unfortunately this fund cannot be used for long term planning. 

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

The Panel welcomed that the Strategic Health Authority (SHA) took on board recommendations made by the Panel at their meeting on 29th November 2011 in terms of the BANES and Wiltshire PCT Board Cluster arrangements.  The SHA has agreed that the date for implementation of the Board Clustering changes may be deferred until March 2012.

Some Members of the Panel expressed their concern that BANES PCT will become junior partner when clustered with Wiltshire PCT.

Ian Orpen understood the concern and added that Clustering arrangements are short term arrangements.  Ian Orpen also said that their colleagues in Wiltshire study with interest the arrangements between our CCG, PCT and Council and would like to achieve a similar level of integrated working.

It was RESOLVED to note the update.

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

The Chairman invited Mike Vousden to introduce the update from BANES Local Involvement Network (LINk).

Mike Vousden took the Panel through the update, as included in the agenda, and added that the LINk had some concerns on Home Improvement Agency which they (LINk) will bring in the update for the next Panel meeting.

Jane Shayler commented that she was contacted with the request for further info on Home Improvement Agency and that Councillor Simon Allen (Cabinet Member for Wellbeing) will respond to that request.

Members of the Panel commented that they expressed their concerns on the contracting process with Home Improvement Agency at a previous meeting.  The Panel also welcomed that residents could feed their concerns through LINk but felt that it would be a good idea if the same residents are notified how they receive feedback.

It was RESOLVED to note the update.

The Panel are asked to consider and comment on the presentation from the Great Western Ambulance Service (GWAS) representatives.

The Chairman invited Kerry Pinker and Brigid Musselwhite (Great Western Ambulance Service representatives) to give a presentation to the Panel.

Kerry Pinker and Brigid Musselwhite gave a presentation in which they highlighted the following points:

•  Great Western Ambulance Service (GWAS) current position

•  Why is GWAS proposing this change?

•  How did GWAS reach this decision?

•  Why would South West Ambulance Service NHS Trust (SWAST) make a good partner?

•  Benefits

•  Who is involved?

•  Overall objectives

•  What has happened so far?

•  The existing GWAS map

•  The existing SWAST map

•  Key facts for GWAS and SWAST

•  Next steps

•  Sharing the plans

A full copy of the presentation named ‘GWAS – the future’ is available on the minute book in Democratic Services.

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

The Panel commended the work of ambulance call centres and asked if they will stay the same.

Kerry Pinker replied that nobody would know the answer on that question now, not until the planning part of the process starts.

The Panel commented that they do understand the financial viability of the merger but that they don't want to lose the service that we have at the moment and hopefully the merger will enhance that service.

Members of the Panel commented that both GWAS and SWAST will have to be utterly transparent with the staff and members of the public on their plans for merger. 

The Panel also commented that SWAST, once merged with GWAS, will cover vast area (whole of the South-West of England) and for that reason the Panel recommended that the future board, or similar body, should have independent voices from each area in the region.  Different areas will have different interpretations and also different service needs.

The Panel asked about the consultation timescale.

Brigid Musselwhite replied that according to her assessment the consultation will run from March until June 2012 and Local Involvement Networks will be involved in consultation.  Consultation will not be open for the public as this is change with leadership.

It was RESOLVED to note the presentation and for the GWAS representatives to take on board suggestions from the Panel that any future body should have one representative from each area in South-West region.

The Panel are asked to consider the attached consultation briefing and proposal from the Coroner to:

1)  Conduct all Coroner post mortems at Flax Bourton i.e. to cease the current practice of some Coroner post mortems taking place in the Royal United Hospital in Bath (RUH).

2)  No longer pay for deceased patient storage at the RUH for ‘Coroner Form A’ cases (i.e. HM Coroner, after investigation, decides the patient died a natural death and informs the Registrars to proceed with death registration).

These proposals are in line with Coroner provision across the rest of the ex-Avon area.

The Chairman informed the meeting that the Panel are asked to consider the consultation briefing and proposal from the Coroner to:

 1)  Conduct all Coroner post mortems at Flax Bourton i.e. to cease the current practice of some Coroner post mortems taking place in the Royal United Hospital in Bath (RUH).

2)  No longer pay for deceased patient storage at the RUH for ‘Coroner Form A’ cases (i.e. HM Coroner, after investigation, decides the patient died a natural death and informs the Registrars to proceed with death registration).

These proposals are in line with Coroner provision across the rest of the ex-Avon area.

The Chairman welcomed the representatives from Bristol City Council, Zillah Morris and John Pitchers, and also the RUH representatives - Howard Jones, Dr Andrew Taylor and Dr Chris Meehan.

The Panel asked the following questions:

The Panel asked if the Equality Impact Assessment was conducted considering that the briefing listed lot of positives and hardly any negative impact.

Howard Jones commented that significant negatives will be for families in BANES and Wiltshire.  The proposal will potentially undermine pathology services in the RUH and also the training provided within the RUH.  The RUH conducted 400 post mortems per year and the proposed change will have major impact on families of deceased.  Chief Executive from the RUH will be asking Wiltshire Scrutiny to also look at this issue even though Wiltshire was not included in the consultation. 

Samantha Jones (Corporate Policy Manager for Equalities) informed the Panel that the Equality Impact Assessment Form from the Bristol City Council is in Appendix B of the report (page 102 and 8).  However, the form only listed positive effects of the proposal but not the negative impact.

Zillah Morris said that Bristol City Council had been asked to review this matter.  The review highlighted potential duplication in service provided by Flax Bourton and the RUH.  Zillah Morris reminded the Panel that Bristol City Council is the lead partner on Coronary provision and Bristol City Council believed that proposal would have positive impact on ex-Avon area.  Consultation process that took place was under Bristol City Council guidelines and as such it did not require to flag negative effects.  Zillah Morris gave more background on the proposal (as per the briefing included in the agenda) and added that she understood concerns about the transport issues between the RUH and Flax Bourton.  However, the proposal would have no impact on families – the viewing of the deceased would still be held in the hospital.  There is also nothing to stop clinical professionals to come to Flax Bourton when they need to and the training has been quite successful in Flax Bourton.  There would be no additional costs for any of four local authorities that fund Flax Bourton.

The Panel asked if the proposal is suggesting that the RUH facilities should continue to exist in case of the requirement for additional storage.

Zillah Morris replied that she would not know what the specific arrangements would be.  ...  view the full minutes text for item 71.

This paper describes the results of the impact assessment on the proposal to not re-open the High Dependency Unit beds on Hillview.

The Wellbeing Policy Development and Scrutiny Panel is asked to agree that the provision of mental health acute assessment and treatment services takes place in the acute in-patient ward and Psychiatric Intensive Care Units rather than The Cherries High Dependency Unit and that the six High Dependency unit beds on The Cherries are permanently closed to that function.

The Chairman invited Andrea Morland (Associate Director for Mental Health and Substance Misuse Commissioning) to introduce the report.

The Panel made the following points:

Some Members of the Panel, who visited Hillview, welcomed the report by saying that they now have a better understanding of the issues and of the proposal not to re-open the High Dependency Unit beds on Hillview.

The Panel gave very positive feedback on the quality of the Impact Assessment, which they considered to be rigorous and very clearly recorded.

Members of the Panel also welcomed the comments (all positive) from the Care Quality Commission (CQC) unannounced visit to Hillview.  The Panel asked to be recorded that they congratulate to all staff members on this achievement.

Andrea Morland thanked BANES LINk for their contribution in the impact assessment.

It was RESOLVED to accept the recommendations of the report and to congratulate AWP and Hillview staff members on positive inspection report from the CQC.

This report provides an update on the work and activity of the Strategic Transition Board, noting areas of achievement and highlighting future priorities.

The Wellbeing Policy Development and Scrutiny Panel is asked to agree that:

·  It receives an update report from the Strategic Transition Board on the work of the board and progress toward improving transition planning and outcomes for children with a Statement of Educational Need.

·  The summary and conclusions of the report are accepted by the Panel.

The Chairman invited Mike MacCallam (Joint Commissioning Manager) to introduce the report.

The Panel made the following points:

Members of the Panel were pleased to see the progress made on transition processes for the transfer of young adults from Children’s to Adult Services.  Mike MacCallam informed the Panel that the following key milestones and achievements of the Strategic Transition Board and Core Group were accomplished:

Transition Protocol

Appointment of Transition Champion

Revised Transition Pathway

Training Strategy

Engaging young people

Information

Strategic Commissioning and service planning

Priorities for further action identified by the Strategic Transition Board (as per the report).

Mike MacCallam also informed Members of the Panel that the Equality Impact Assessment on Strategic Transitions Planning will be completed soon.

Members of the Panel suggested that the Strategic Transition Board should conduct a survey with young people on what their perception of the Board is and get back to the Panel in near future with a further update.

It was RESOLVED to note the report and to receive an update on one of the future meetings.

Service Action Plans to support the Adult Social Care & Housing Medium Term Service & Resource Plan is presented for consideration by the Panel:

•  To enable issues to be highlighted for consideration by Cabinet in February as part of the annual budget setting process.

•  To enable issues to be referred to the relevant portfolio holder in advance of Cabinet's consideration of the overall budget.

It should be noted that there is a special meeting of the Resources Policy Development & Scrutiny Panel on 6th February, at which time it is intended to take an overview of all of the comments that have been submitted by each of the Policy Development & Scrutiny Panels.  This will be the final opportunity for the Resources Policy Development & Scrutiny Panel to highlight issues and options for Cabinet.

Equality Impact Assessments for Financial Plans are available on Council’s website on the following link

 http://www.bathnes.gov.uk/communityandliving/equality/Pages/FinancialPlans.aspx .

The Chairman invited Jane Shayler to introduce the report.

Jane Shayler introduced the report and informed the Panel that the Equality Impact Assessment for Adult Social Care and Housing Service Action Plan is published on Council’s website and available on this page http://www.bathnes.gov.uk/communityandliving/equality/Pages/FinancialPlans.aspx .

Members of the Panel asked for and received clarification on issues as follows:

•  There appears to be a significant projected increase in the number of transitions of young people, particularly those with Autism, from Children’s Services to Adult Care.  Is this as a result of parents moving into B&NES in order to enable their children to access very good services in the area?  Jane Shayler advised the Panel that this was unlikely to be the case, as reported to a previous Panel, it is more likely to be a combination of an increase, both locally and nationally, in the number of children with a learning difficulty and/or autistic spectrum disorder who are living into adulthood and, also, better identification/diagnosis of autistic spectrum disorders.

•  Could there be an explanation of the terms “Market Shaping” and “Framework Contract” on page 8 of the Service Action Plan?  Jane Shayler explained both terms to the Panel.

•  There was a query about the “saving” of £100,000 Council funding of Home Adaptations & Aids and whether this meant reduced provision of Home Adaptations & Aids.  Jane Shayler advised the Panel that Somer Housing Group’s agreement to fund an increased proportion of adaptations and aids to eligible Somer Tenants would not mean a reduction in access; indeed, it was likely to improve timely access to adaptations and aids.

Some Members of the Panel expressed a slight concern that approximately 72% of non-residential social care service users would see an increase in their contribution to the cost of their personal social care.  Jane Shayler advised the Panel that the new Fairer Contributions Policy had been through extensive consultation, including with service users and carers as previously reported to the Healthier Communities & Older People Overview & Scrutiny Panel.  The new policy both addressed historic inequalities and inconsistencies in the local policy framework, brought B&NES closer to the South West benchmark for income from contributions (historically B&NES income was significantly below average), and, also complied with new national guidelines.  Jane Shayler also confirmed that if the service does not get the additional income then the savings would have to be made in other areas, potentially with the cuts or reductions in some areas of service provision.

It was RESOLVED to note the report.  The Panel had no issues requiring further consideration at the special meeting of Resources PDS Panel on 6th February nor did the Panel have any issues to refer to the relevant Cabinet portfolio holder for further consideration.

This report presents the latest workplan for the Panel.

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

·  Care Services Quality Assurance (date to be confirmed)

·  Update on the outcomes of Improving Access to Dental Services Review (date to be confirmed)

·  Mortuary Service change update (date to be confirmed)

·  Strategic Transition Board update (date to be confirmed).