Agenda and minutes

The Chair welcomed everyone to the meeting.

The Democratic Services Officer will draw attention to the emergency evacuation procedure.

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

Apologies for absence had been received from:

Scott Hill - Avon and Somerset Police

Cara Charles Barks/Joss Foster – RUH

Will Godfrey Chief Executive, B&NES – Mandy Bishop Executive Director – Operations, B&NES was in attendance as substitute.

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting.

(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 4.4 Appendix 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 or a member of his staff before the meeting to expedite dealing with the item during the meeting.

There were none.

The Chair gave the following announcements:

1.  West of England Combined Authority Mayor Election

The Chair reminded the Board that the election was taking place for the WECA Mayor, and he asked that no party-political comments be made during this meeting.

2.  NHS England Letter

The Chair advised that he had sent a response on behalf of the Board to NHSE to report on how the Board was working with ICB BSW.  He undertook to circulate a copy of the response.

Please see agenda note 4 overleaf.

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

RESOLVED that the minutes of the meeting of 6 February 2025 be approved as a correct record and signed by the Chair.

10 minutes

To agree the revised terms of reference (to be circulated separately).

Becky Reynolds, Director of Public Health introduced the item and drew attention to the following:

1.  There had been a few minor amendments including a request for presenters to consider how local people had been involved in their area of work.

2.  There were also proposed changes to membership as follows:

a.  The 3SG representation would be increased with a place being given to the Chief Executive (in addition to the Chair).

b.  There would be 2 additional places for academic involvement from the University of Bath and Bath Spa University. 

c.  There would be a representative from Oxford Health to cover children’s mental health.  This was in addition to the place for a representative from AWP.

In response to questioning, she confirmed:

1.  The reason for academic representation was to give an academic perspective to health and wellbeing issues.  It could also result in funding applications for research linked to issues being discussed. 

2.  The ICB would have 2 representatives, one of whom would vary depending on the items under discussion.

The following comments were also raised:

1.  It was noted that meetings were only quorate when a representative of the Police or Fire Service was present, and this may be a challenge.  Stephen Quinton undertook to ensure that Avon Fire and Rescue Service was represented at future meetings.  Board Members were reminded that substitutes could attend.

2.  There could be further representatives from other organisations such as schools and business.  Representatives could be invited to attend for specific items of interest.

RESOLVED that the revised Health and Wellbeing Board Terms of Reference be approved.

20 minutes

To discuss the Social Prescribing Project.

David Jenkins, Social Prescribing Project Manager, Tim Rawlings, Active Travel Social Prescribing Project Manager and Becky Brooks, Director 3SG,

David Jenkins, Social Prescribing Project Manager, 3SG gave a presentation in relation to social prescribing (circulated in advance of the meeting).

The Board raised the following comments/questions:

1.  It was difficult to explain social prescribing in a way that was easily understood.

2.  It was noted that this was a 2-year project.  The first year to develop a framework and the second year to identify what needed to be in place to fill gaps and to make a business case for future funding.

3.  The University of Bath was using social prescribing to support students and Nic Streatfield undertook to link in with David Jenkins.  Links would also be made with Bath College.

4.  The funding landscape was complex.  If social prescribing was reliant on existing budgets, this was not sustainable.

5.  As well as formal work undertaken as part of the project there was informal work supporting the same aims.  There needed to be a map of provision.

6.  The project was originally focused on adults, but children and young people were now included e.g., the Wellbeing While Waiting programme being delivered by Off the Record.

The Board RESOLVED to request the Social Prescribing Steering Group to feedback to a future meeting.

20 minutes

To approve the B&NES Better Care Fund Plan for 2025 to 2026.

Laura Ambler, (Executive Director of Place, B&NES BSW ICB) introduced the report and drew attention to the following:

1.  The Better Care Fund (BCF) was owned by the Health and Wellbeing Board and Laura Ambler/Suzanne Westhead were the accountable officers.

2.  There was a requirement to submit a plan with a list of schemes and KPIs.

3.  The narrative plan had been circulated to the Board and more details could be provided on request.

4.  This year’s plan had objectives around sickness prevention and was clearer about the link with the NHS plan and how the BCF was making a difference.

5.  The plan would see £27m of investment in various activities focused on prevention, effective hospital discharge and community/home care.

6.  She asked that thanks be recorded to the team working on the BCF.

In terms of the future of the BCF, Suzanne Westhead reported that:

1.  At a recent meeting of Directors of Adult Social Care, Stephen Kinnock MP had stressed the importance of the BCF but confirmed that it would be reviewed.

2.  Baroness Casey would be leading a review of adult social care and there would be an opportunity to feedback views on the success of the B&NES integrated model.  A further comment to feedback was the importance of investing in unpaid carers.

In response to questions, it was confirmed:

1.  The BCF did not target schemes associated with children and young people.  The Government channelled the Disabled Facilities Grant (DFG) through the BCF and there was a separate grant for children which was not funded through the BCF. 

2.  Health and reducing inequalities were embedded in the schemes.

The Board RESOLVED to;

(1)  Approve B&NES BCF plan for 2025 to 2026.

(2)  Recognise the contribution of the Disabled Facilities Grant (DFG), an integral element of the Better Care Fund, which enabled people to remain in their own homes.

20 minutes

To review winter planning arrangements for 2024/25 and discuss planning for 2025/26.

Laura Ambler gave a presentation summarising the key learning points for 24/25 and outlining the plan for 25/26 (slides circulated in advance of the meeting).

She confirmed there had been an exceptional challenge with a 10% increase in demand, however, B&NES locality consistently delivered the target of no more than 20 patients with “No Criteria to Reside” status in the RUH.

In response to questions, it was confirmed:

1.  The definition of “No criteria to reside” was a person who was fit to be discharged from hospital.

2.  The 10% increase in demand was over and above what had been predicted.  There were various improvements and learnings which would be taken forward to further improve resilience next winter, including a deeper understanding of demand, and considering how the HWB could support the analysis of risk. 

3.  There was always a level of unexpected events, but there was support across partners, such as the emergency planning team in the Council and Avon Fire and Rescue Service (AF&RS).  AF&RS would often be involved in triaging people with mental health issues.

4.  Access to pharmacies was continually reviewed.  There was a pharmaceutical needs assessment every three years and the next was due in Autumn 2025.

5.  In relation to the risks for 25/26 due to the proposed changes to the structure of ICBs, an operational plan had been submitted and this would be delivered.  ICB BSW was cautiously optimistic that it had a robust plan and enough involvement from other partners to take this forward.

6.  It was noted that the list of Acute Respiratory CYP Illness Hubs (ARIs) did not include the rural areas of B&NES and LA undertook to check if there were ARIs located in rural areas.

7.  There could be more consistency between services provided in B&NES, Wiltshire and Swindon as there was a variation between the different localities. 

The Board welcomed the assurance and visibility that lessons had been learnt from 24/25 and would be fed into the plan for next winter and requested early sight of the 25/26 plan.

15 minutes

Becky Reynolds and Laura Ambler to share information on recent procurements.

1.  Mental Health

Laura Ambler gave a short presentation and undertook to circulate the slides after the meeting.

The following comments were raised:

1.  It was important to consider people using the services and evaluate how new contracts were working.

2.  A concern was raised that national organisations with resources to prepare bids were winning contracts at the expense of smaller local organisations. 

3.  A concern was raised about the loss of services at the weekend, in particular, there was only a facility for referrals rather than a walk-ins and 111-2 only offered triage rather than interventions.  Laura Ambler responded that the ICB had taken the view that there was now a 7 day a week service including crisis houses and places of calm.

The Chair undertook to continue to discuss this with the ICB.

2.  Public Health

In view of time restrictions, it was agreed that the slides be circulated after the meeting.

Please see the below links to further information on the Active Travel Masterplan and Creating Sustainable Communities in North East Somerset: The Journey to Net Zero

https://www.bathnes.gov.uk/active-travel-masterplan

https://www.bathnes.gov.uk/creating-sustainable-communities-programme

The Board noted the following documents:

https://www.bathnes.gov.uk/active-travel-masterplan

https://www.bathnes.gov.uk/creating-sustainable-communities-programme