Agenda and minutes

The Chair welcomed everyone to the meeting.

The Chair drew attention to the emergency evacuation procedure.

Councillor Geoff Ward had sent his apologies to the Select Committee. Councillor Karen Warrington was present as his substitute for the duration of the meeting.

Councillor Tim Ball had notified the Select Committee that he would be arriving late to the meeting.

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 Paul May declared an other interest in agenda item 13 (Your Care, Your Way Update) as he is a Sirona board member.

Councillor Dine Romero addressed the Select Committee. She asked if they could receive a future report on Dentistry Services and include within that the dental care of children.

The Chair replied that the Select Committee were due to receive a report regarding Dentistry Services at their meeting on September 28^th 2016.

The Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chair.

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

Dr Ian Orpen addressed the Select Committee, a summary of the update is set out below.

Your Care, Your Way

The CCG and the Council are seeking a prime provider of community health and care services to work alongside us to coordinate over 60 different areas of service; sub-contracting to smaller, specialist providers where appropriate.  We are currently in the second stage of the procurement with two organisations remaining in the process:

1. Virgin Care

2. Sirona Care & Health, in partnership with:

·  Avon and Wiltshire Mental Health Partnership NHS Trust

·  Bath and North East Somerset Enhanced Medical Services

·  Dorothy House Hospice Care

·  Royal United Hospitals’ Bath NHS Foundation Trust (RUH)

The two bidders provided written responses to a series of questions on 23 May and a group of evaluators including commissioners, subject matter experts and community champions will convene on 6 June to finalise the scoring of the bids.

Following detailed dialogue with both bidders over the next few months we plan to announce the new provider by early November 2016.

Sustainability and Transformation Plan

The CCG continues to work across the B&NES, Swindon and Wiltshire footprint with key providers on the development of a Sustainability and Transformation Plan.  Plans need to be submitted by 30 June 2016.

Catherine Cottage merger with St James’s Surgery

Dr Orpen noted his interest in this issue as he is a partner at St James’s Surgery.

St James’s Surgery and Catherine Cottage Surgery in Bath will become one GP practice on 1 July 2016 with GPs and staff at Catherine Cottage leaving behind their Catherine Place premises and moving into the St James’s facilities.

The merger will give patients greater access to GPs, nurses and other primary care services in modern healthcare premises at Northampton Buildings or the more traditional branch surgery at Junction Road, Oldfield Park.  Merging the two practices will also create back office efficiencies, increasing the time available for direct patient care.

Patients registered with Catherine Cottage Surgery will automatically be registered with St James’s Surgery and do not need to take any action. Information about other practices in the area has also been provided should patients wish to register elsewhere.

Primary Care Transformation Fund and Statement of Intent

The CCG is working closely with our 27 member practices to develop a bid to the national Primary Care Transformation Fund covering both estates and technology. 

As part of this process the CCG has prepared a draft Statement of Intent to set out how we see primary care services developing in B&NES over the next five years.  The CCG is seeking feedback from practices on the statement, which will form the basis of a draft primary care strategy for B&NES.  We have plans to engage more widely with the general public and other stakeholders later in the year and will be attending the five Area Forums in June /July as well as the Bath City Conference.

Diabetes Roadshow

In April, the Diabetes UK Roadshow came to Bath’s historic town  ...  view the full minutes text for item 8.

The Cabinet Member will update the Select Committee on any relevant issues. Select Committee members may ask questions on the update provided.

Councillor Vic Pritchard, Cabinet Member for Adult Social Care & Health addressed the Panel, a summary is set out below.

Wellbeing House

The Wellbeing House provides a 3-bedded retreat, a place of sanctuary, for people experiencing mental health distress where they can receive low level social support to help them stabilise themselves and prevent a crisis escalating into secondary care. The service is being delivered by Sirona Care & Health in conjunction with Curo Group. The Wellbeing House is now full every week and Sirona continue to receive positive feedback from its service users.

He said that he had recently visited the Wellbeing House and had met the manager and a service user, both of them commenting on how wonderful it was to have such a service locally.

Strengthening Adult Social Care

The Care Act 2014 is now a year old, having come in to force on April 1st 2015.

During the last two months, staff from the Council’s adult commissioning team have joined with practitioners from Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) and Sirona Care &Health to consider how the support we provide to people can be further developed to: 

• Emphasise individual abilities rather than focus on what cannot be achieved, and
• Recognise a person’s support network and promote their wellbeing. 

The sharing of good practice is at the heart of the challenge the Care Act sets us and all partners are committed to responding to this challenge. A regular newsletter has been developed to share details of service developments, national requirements and local good practice. The newsletter reminds staff of how the work they do every day with people in our communities contributes to the performance of the Council in key areas including financial accountability, the provision of information and advice and the development of the social care “market”.

Accessible Information Standard (AIS)

The AIS is a new standard that comes into force in July 2016. It aims to ensure that disabled patients and service users receive information in formats that they can understand and have appropriate support to help them to communicate.

The standard will apply to people that have a disability, impairment or sensory loss (including their carers or parents) and will cover all information that is needed for a person to access, understand and use health and social care services, making sure that they get information in the format they need (i.e. large print, braille, audio, easy read British Sign Language interpreter, deafblind manual interpreter or advocate).

By 31 July 2016 all relevant organisations must have fully conformed to the AIS by law under section 250 of the Health and Social Care Act 2012. The AIS is also in line with the Equality Act 2010, the Care Act 2014, the NHS Constitution and the Equality Delivery System.

Councillor Paul May said that he valued and supported the work of the Wellbeing House.

Councillor Lin Patterson asked if funding would be available to bring into use the other two rooms within the Wellbeing House.

The Director  ...  view the full minutes text for item 9.

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

Dr Bruce Laurence, Director of Public Health addressed the Select Committee, a summary of his update is set out below.

Inequalities Summit

A long planned health inequalities summit meeting, held on behalf of the Health and Wellbeing Board, took place on May 11^th in the Guildhall. It was organised by members of the public health and strategy and performance teams and chaired by the board’s co-chairs. About 70 people from many organisations participated and there were a wide range of speakers from individuals giving their own personal stories, to community workers, a local GP and a DPH from Coventry. Feedback from the event was very positive and a lot of information was obtained.

A meeting was then held the following week to decide how to make use of the energy and ideas coming from this event to influence policies across the B&NES partnerships and an action plan will come from that meeting that will endeavour to thread the reduction in health inequality through the work of the Council, NHS and wider partnerships. There will be a presentation on this meeting and outputs at a forthcoming Health and Wellbeing Board and then a further update to the select committee if wanted.

Health improvement

An important function of some of the public health workers that we fund, are those developmental health improvement roles that are not directly client-facing but work with a range of organisations and businesses whose work impacts on the health of residents. Elements of these services which include work with schools, businesses, licenced premises, food outlets and other partner organisations have till now been based in the public health team, the public protection team and in Sirona. In order to realise savings from these functions the number of staff is being reduced (without any redundancies), but to retain the maximum utility from the resource, the remaining staff will have more generic job descriptions and will be more closely coordinated so that they can focus flexibly on priority areas at any given time.

This team will eventually be managed by the public health department, through a phased transition. Anticipating this we have now adopted a shared work programme and created a  virtual team of health improvement  practitioners across the Council  which includes the  sport and active  lifestyle team and  the food policy work  and the  Director of Public Health award  team  together with the staff in the public health team and Sirona.

NHS Health Checks

BEMS+ (ex-Bath Emergency Medical Service, who are now a provider organisation drawing on B&NES primary care staff) were appointed as our Outreach Provider for NHS Health Checks and are preparing to start delivery in June 2016. They are approaching local workplaces to offer the free checks and particularly targeting male workforce in routine and manual labour. If Councillors have any connections to local businesses that they know of it would be great to have some leads. BEMS + will be offering Health Checks to front line staff from the Place Directorate as  ...  view the full minutes text for item 10.

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

The Chair announced that Alex Francis from Healthwatch B&NES had circulated her update to Councillors but was not able to be present at the meeting.

She wished to thank Alex for her update on behalf of the Select Committee.

This report provides an update on the delivery of care at home to the people of Bath and North East Somerset (B&NES).

The Senior Commissioning Manager introduced this report to the Select Committee. She explained that the Local Authority has a rolling five year contract in place with four key Strategic Partners namely:

·  Care South

·  Care Watch

·  Way Ahead

·  Somerset Care

She said that the contract contains a five year break clause with the next occurring at the end of March 2018.  She added that future contractual arrangements are being considered as part of the Your Care, Your Way community services review being undertaken jointly by the Council and Clinical Commissioning Group (CCG).

She informed them that the Council commissioned a total of 4963 care hours on behalf of 468 people at the time this analysis was undertaken (30^th April 2016).  Of the total, 2174 care hours were being commissioned from either Spot Contract or one-off Agreement providers on behalf of 150 people (with approximately one-third of people receiving a 24 hour care package). 

She explained that in an effort to support the Strategic Providers in recruiting and retaining staff and start to address the capacity shortfalls, the Council agreed to fund early implementation of the National Living Wage from January 2016 on the understanding that the increase would be used to increase the rates of pay directly offered to frontline domiciliary care staff and on the assurance that travel time would be paid at the same rate. This has had a positive effect so far on both staff retention and staff recruitment.

She stated that since October 2015, a new electronic system called DCAS (Domiciliary Care Access System) has been in operation.  The system allows Social Workers to request care packages on a secure site that the Strategic Partners are able to access.  This system is still under development but early reports are being developed that will help the Council and CCG to understand the capacity needed for the population now and in future years and plan this with Strategic Partners.

She said that in order to provide more assurance about care commissioned under a one-off Agreement the People and Communities Adult Commissioning Team are currently working with colleagues in Trading Standards to register all providers who deliver Council commissioned care packages onto the Buy with Confidence and Care Scheme.

She informed Councillors that a project is underway reviewing direct payments across adults, children’s and health, to try to streamline the policy into one across all three areas, and to also streamline the support that is available to people choosing to use a direct payment. She added that the project is also looking to introduce pre-paid cards for direct payment recipients, which will hopefully make them a more attractive offer for people.

Councillor Tim Ball asked why Trading Standards were being used to register providers.

The Senior Commissioning Manager replied that forms of accreditation such as ‘Buy with Confidence’ help to provide additional assurance to those making decisions about which provider they chose. Trading Standards ensure that all those registered must satisfy conditions and standards, which are clearly set out  ...  view the full minutes text for item 12.

The Select Committee will receive a presentation on this item at the meeting.

The Select Committee received a presentation from Your Care, Your Way Project Lead, a summary is set out below.

Procurement Update

Two organisations remain in the procurement process.

·  Sirona Care & Health (in partnership RUH Bath NHS Trust, Avon & Wilts Mental Health Partnership NHS Trust, Dorothy House Hospice Care and BEMS+)

·  Virgin Care

Their previous experience and model of operation will be assessed and tested against our identified priorities.

Prime Provider Partnership

Could be one or multiple organisations, but will be commissioned through a single commissioning contract

Will be the Commissioners’ key partner in the delivery of integrated community services for the contract term, and take on a leadership role in the wider community health & care system

Will be responsible for supporting the Commissioners in the further commissioning of some services under Dynamic Purchasing Systems (DPS)

Continuing Engagement

20 Community Champions have been involved in the whole of the procurement process.

Publish as much information as possible on our website.

Outcomes Based Accountability

People are healthy.

People have a good quality of life.

People have equal life chances.

Lessons Learnt

Rigorous evaluation and assessment of risks within the procurement, including re-assessment of bidders where there are material changes to their arrangement during the process, and a full awareness of ownership and legal structures associated with partnership arrangements

The appropriate use of Parent Company Guarantees or other performance warranties

Clear accountability and relationship management between the Commissioner and the Prime Provider, and from the Prime Provider to all other providers

Prime Provider – Key Milestones

June 2016 – Final Procurement Stage / Draft Contracts Assessed

August 2016 – Preferred Bidder 

November 2016 – Full Business Case / Contract Award 

Councillor Tim Ball asked how will due diligence be carried out regarding the two remaining organisations.

The Your Care, Your Way Project Lead replied that a panel of evaluators will oversee the process so that it is equitable, fair and transparent. She added that all members of the panel have been assessed with regard to any interests.

Councillor Lin Patterson asked to be assured over the financial arrangements of the two remaining organisations.

The Your Care, Your Way Project Lead replied that the last three years of their accounts will be scrutinised and we will ensure that appropriate tax arrangements are in place.

Councillor Lin Patterson asked if the public can become involved in the consultation process.

The Your Care, Your Way Project Lead replied that people were still able to become Community Champions and that she would welcome hearing from anyone interested in the role. She added that they were also in the process of designing a ‘Dragon’s Den’ type event for both bidders to attend where they would present their models separately and be involved in a Q&A session.

Councillor Vic Pritchard asked what would happen if adverse information were discovered during the preferred bidder stage of the process.

The Your Care, Your Way Project Lead replied that if a stalemate were achieved in this part of the process we  ...  view the full minutes text for item 13.

This report presents the latest workplan for the Select Committee. Any suggestions for further items or amendments to the current programme will be logged and scheduled in consultation with the Chair of the Select Committee and supporting officers.

Councillor Eleanor Jackson asked if the Select Committee could add the subject of Eye Care to their workplan.

The Select Committee RESOLVED to agree with this proposal.