Agenda and minutes

Venue: Council Chamber - Guildhall, Bath. View directions

Contact: Mark Durnford  01225 394458

No. Item




The Chair welcomed everyone to the meeting.




The Chair will draw attention to the emergency evacuation procedure as set out under Note 6.



The Chair drew attention to the emergency evacuation procedure.





Councillors Geoff Ward and Lin Patterson had sent their apologies to the Select Committee. Councillor Peter Turner was present as a substitute for Councillor Geoff Ward for the duration of 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.


There were none.




There was none.



At the time of publication no notifications had been received.



There were none.


MINUTES - 29th November 2017 pdf icon PDF 130 KB


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


Clinical Commissioning Group Update

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


Dr Ian Orpen addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.


A&E performance


Local system performance against the A&E waiting time target (95 per cent of attendees to be seen within four hours) was 76.9 per cent in December. Across England there has been extremely high demand and this is putting local health and care services under significant pressure.


Some non-urgent hospital appointments and operations have been postponed in line with national guidance to help hospitals deal with the sustained pressure. 


Proposals to restrict access to three non-urgent services


We have extended our consultation on proposals to restrict access to fertility treatment, vasectomies and female sterilisations. The consultation will now run until 31 January 2018.


This decision is in response to feedback at a public meeting held on Monday 8 January where people raised concerns that the CCG had not allowed sufficient time for the consultation and had not taken into account the Christmas break when people would be too busy to respond to the proposals.


National plans to further restrict access to over-the-counter medicines


We are raising awareness of a national survey from NHS England and NHS Clinical Commissioners.


Locally the NHS spends approximately £935,000 on prescriptions for medicines which can be purchased over the counter from a pharmacy and other outlets such as supermarkets. These prescriptions include items for self-limiting, minor health conditions which will often clear up of their own accord or that the patient can treat themselves by buying over-the-counter medicines, sometimes at a lower cost than that which would be incurred by the NHS.


The survey asks for feedback about medications used to treat 33 minor, self-limiting health conditions. These medications have been selected as they may be considered low priority for NHS funding and it is proposed that they should not be routinely prescribed in GP practices. Products included as part of the consultation include treatments for head lice, infant colic, mouth ulcers, cold sores, mild cystitis and nappy rash.


In Bath and North East Somerset we have already reviewed our prescribing policy for two types over-the-counter medicines (painkillers and hay fever medicines) when they are used to treat short-term minor ailments. Following consultation, we are advising GPs not to prescribe these medicines – when used for short-term, minor ailments such as mild hay fever, headaches, coughs and colds.


We are encouraging everyone to feed back on the national survey by following this link here (Please note the national consultation closes on 14 March 2018).


Councillor Tim Ball queried the practise of not prescribing certain medications.


Dr Orpen replied that the duty for GPs to prescribe remains, but they also have a duty to make best use of resources. He added that, as part of this, new guidance on vulnerable patients so as not to disadvantage patients will be made available. He stated that some medications however  ...  view the full minutes text for item 65.

CCG Update January 2018 pdf icon PDF 68 KB


Cabinet Member Update

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


On this occasion, on the conclusion of the update officers will give a briefing and show a video regarding the ‘Three Conversations’.


Councillor Vic Pritchard, Cabinet Member for Adult Care, Health & Wellbeing addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.


‘Three Conversations’- Update on local progress


At the November 2017 meeting, Committee members were provided with a brief introduction to our ambition to improve social care practice, by adopting the ‘three conversations’ approach and changing the way we support people.


Since then, the programme has developed significantly and is gathering pace. A governance structure is in place, and the first two collaborative design sessions were successfully attended by over 30 stakeholders.


Locally, it was decided to rename this programme ‘Strengths Based Social care’ as its main aim is to define people’s strengths and work with them to identify how they can be supporting through local networks, rather than automatically aligning them to existing support packages


On a fortnightly basis, stakeholders from the Council and CCG’s commissioning team, IT, Finance, Performance, Legal, Social Care practitioners from Virgin Care and AWP, Virgin Care transformation team colleagues and community champions are coming together to take part in the ‘Making It Happen’ group.


The current priority is to identify a number of ‘innovation sites’ to test the new approach locally. Virgin Care staff are enthusiastic at the prospect, and a number of teams have put themselves forward to be part of this exercise. Innovation sites for AWP will also be identified in the coming weeks with a view to have all test sites ready by March.


To date, feedback has been positive with practitioners looking forward to spending less time tied up with bureaucratic processes, community champions eagerly anticipating a shift to truly personalised social care and commissioners curious to see the wider impact on social care practice and budgets.


The Select Committee were then shown a video regarding the ‘Three Conversations’ from Cornwall Council.


Councillor Eleanor Jackson asked how the model would work for a resident she knew who receives dialysis treatment and has an 86 year old partner.


The Council’s Principal Social Worker and Safeguarding and Quality Assurance Lead replied that support would be in place to look at all arrangements regarding the needs of the resident in question. She added that essence of the model is to have timely conversations and to engage with people directly.


Councillor Peter Turner commented that he welcomed the recent Government appointment of a Minister for Loneliness.


The Director for Integrated Health & Care Commissioning said that a key priority following the review of Community Services through Your Care, Your Way was tackling isolation and loneliness. She added that it isn’t just older people or people living in more rural areas who experience loneliness it can be younger people including those living in B&NES urban locations.  The changes in progress and planned from the Your Care, Your Way review  including ‘Three Conversations’ will help to tackle loneliness and isolation.


She added that a  ...  view the full minutes text for item 66.

Cabinet Member Update January 2018 pdf icon PDF 49 KB


Public Health Update

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


Paul Scott, Assistant Director of Public Health addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.


New Change4Life Campaign - ‘Look for 100 calorie snacks, two a day max’


Change4Life has launched a new campaign to help families choose healthier snacks when shopping and to reduce children’s sugar intake. The campaign is reminding families that fresh or tinned fruit and vegetables are a healthier choice for a snack but if you are providing packaged snacks, the simple tip is: ‘Look for 100 calorie snacks, two a day max.’ Families are encouraged to sign up to the campaign to receive helpful tips, ideas and money off vouchers. The B&NES Sugar Smart team are encouraging more organisations to take ‘pledges’ to get Sugar Smart.


Youth Mental Health First Aid Training (YMHFA)


YMHFA teaches the skills needed to spot the signs of mental health issues in children and young people aged 8 – 18 years. It helps participants to build the confidence needed to offer first aid and knowledge to signpost to further support.  YMHFA won't teach you to be a therapist, but it will teach you to listen, reassure and respond, even in a crisis - and even potentially stop a crisis from happening. This two day course is suitable for anyone working with or supporting children and young people aged 8-18 who has not undertaken mental health training before.  In particular it will be of interest to primary and secondary school and college staff, children and family services youth workers etc. 


Free Making Every Contact Count (MECC) training


Bookings are currently being taken for the Make Every Contact Count (MECC) training course on April 12 and 26 (Both morning ½ day sessions – Guildhall, Central Bath). This course is free at point of delivery and will be of relevance to anyone and everyone who has the opportunity to have conversations with others about their health and wellbeing, however brief that may be.


Bath and North East Somerset Pharmaceutical Needs Assessment 2018  to 2021


All relevant stakeholders and the public are being invited to take part in a Pharmaceutical Needs Assessment (PNA) consultation for Bath and North East Somerset. The PNA is a document which assesses whether the provision of local pharmaceutical services across the area is sufficient to meet the health and wellbeing needs of the local population. It considers whether we have enough pharmacies, and whether they provide the right services for local people now and in the future. It is also intended to assist the NHS and other local commissioners to develop future pharmaceutical services. The consultation provides an opportunity to help shape the future of local pharmacy services and ensure that the information included within the draft PNA is accurate. The consultation launched on 11 December 2017, and runs until 18 February 2018.


Dry January


If you’re thinking of stopping drinking and are  ...  view the full minutes text for item 67.

Public Health - Select Committee - January 2018 Briefing pdf icon PDF 492 KB


Healthwatch Update

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



Alex Francis, Healthwatch was unable to attend the meeting. The Chair thanked her for her written report on behalf of the Select Committee which can be found on their Minute Book and as an online appendix to these minutes.

Healthwatch Update January 2018 pdf icon PDF 190 KB


Council Operational Plan pdf icon PDF 98 KB

This report presents the Council’s Operational Plan to the Select Committee for consideration and feedback as part of the Council’s operational planning and budget development process.

Additional documents:


The Director for Integrated Health & Care Commissioning introduced this item to the Select Committee. She spoke of the fast-changing social and economic landscape that we are seeing means increased demand for services and growing expectations of the Council at a time when there’s less money and fewer resources to help. She added that all Councils in the country are facing similar pressures, particularly if they deliver social care.


She stated that the Council has invested in and improved the efficiency and effectiveness of social care services for adults and young people and that in the future we will continue to prioritise caring for our most vulnerable residents.


She stated however, it was important to understand the impact of rising costs and growing demand in this area. She informed them that social care services already account for almost 75 pence out of every pound we spend and that by next year (2018/19) we forecast that this will rise to 80 pence in every pound (net). She added that prioritising these services means that all of our other services need to be funded from what’s left - requiring some really tough decisions on where our money is best spent.


She set out some of the reasons for the rising costs of care.


·  More people are living longer with complex conditions

·  More children and young people are living with complex care and educational needs – an individual care package can cost up to £250,000

·  Recent care home closures have pushed up local costs

·  The national living wage is rising faster than inflation, which has a big impact on highly staffed services such as social care

·  We have more responsibility for children with special educational needs and disabilities (SEND). The number of SEND statements rose from 692 to 1062 between 2014-2017


She said that the increasing demand for services – particularly social care, but also in other areas – is placing unprecedented pressure on the Council. She explained that there are areas where individuals and communities can help to manage demand in the future and make our money go further.


·  Working Together - Increased collaboration between the Council and local communities, parish councils, partners and voluntary organisations will become increasingly important.


·  Staying well - Looking after your health by exercising and eating well increases your chances of staying well for longer – reducing the pressure on care services in the future. Together with our health partners we are delivering a lot of programmes to help.


She addressed the key changes that the Council is proposing, explaining

the plan doesn’t intend to capture every activity that the Council carries out, but focuses on the key changes over the coming years and highlights key projects that will help achieve our vision for the future.


The Chair asked how many beds had been lost due to the recent care home closures.


The Director for Integrated Health & Care Commissioning replied that over the past 12 – 18 months approximately 110 beds have been lost. She added that there  ...  view the full minutes text for item 69.


Select Committee Workplan pdf icon PDF 110 KB

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 suggested that a Governor of the RUH be invited to the Select Committee to discuss their role and priorities for the hospital.


The Director for Integrated Health & Care Commissioning said that she would take advice from Tracey Cox, CCG Chief Officer on the appropriateness of the invitation.


She said that as mentioned in the Operational Plan discussion that the draft Market Position Statement could come to the Committee in March for their engagement.