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 Tim Ball had sent their apologies to the Select Committee. Councillors Sally Davis and Dine Romero were present as their respective substitutes 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 - 24th January 2018 pdf icon PDF 109 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 74.5 per cent in February. Across England there continues to be extremely high demand, compounded by the recent adverse weather, and this is putting local health and care services under significant pressure. The CCG, RUH and Community Providers across B&NES and Wiltshire have worked together to produce a revised Four Hour Recovery Plan which is monitored and reviewed on a weekly basis.  The plan consists of actions for both the RUH and community providers with a significant focus on reducing the numbers of delayed discharges and patients who have been in hospital for more than 21 days.


Maternity update


At November’s Select Committee meeting there was a briefing on the new arrangements being put in place to improve and transform maternity services across B&NES, Swindon and Wiltshire as part of the Sustainable Transformation Partnership (STP). These new arrangements follow the national maternity review and the publication of Better Births and Five Year Forward view. 


A shortlist of options is being co-created with service users and stakeholders by the end of March 2018. These options will be shared with the Health and Wellbeing committee once they are confirmed along with the formal consultation process which would be expected to start in September 2018.


Proposals to restrict access to three non-urgent services


Our Board met on 8th March to review feedback from our public consultation on fertility and sterilisation services and to make a decision on whether to change the existing policies. They agreed that male vasectomies will continue to be available on the NHS and female sterilisations will continue to be funded for women for whom there is no suitable alternative, long-acting form of contraception. On access to fertility services, the Board agreed that:


  1. The female partner receiving treatment must be aged between 23 and 37 years.
  2. The male partner of the woman receiving treatment must be aged 55 years or under.
  3. The female partner receiving treatment must have a body mass index (BMI) in the healthy range for women wanting to conceive, of 19–30.
  4. The male partner of the woman receiving treatment must have a healthy BMI of 30 or less.
  5. Couples must have been trying to conceive for at least two years where the female partner is aged 35 years or younger, and one year where the female partner is aged 36-37 years.


Our financial position


Despite starting 2017/18 with a forecast funding gap of £11.6m, we have achieved a breakeven position at the end of the year. We have delivered efficiency savings through the hard work and dedication of all our staff and support from partner organisations.  We are also grateful to the public  ...  view the full minutes text for item 78.

CCG Update March 2018 pdf icon PDF 388 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.


Councillor Vic Pritchard, Cabinet Member for Adult Care, Health and 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.


Proposals to restrict access to three non-urgent services


He commented on how impressed he was in the way this issue was discussed at the CCG Board meeting and that the decisions taken were governed by the results of the public consultation.


World Social Work Day


20th March was World Social Work Day. Here in Bath and North East Somerset we have a highly skilled and committed workforce of social workers in both children’s and adult’s services, working tirelessly to protect, support and empower families and individuals across the region, often having to travel further afield, for instance to connect with family members or children in care.


Social workers are working in sometimes dangerous, fraught, extremely complex, and very often emotionally charged and challenging situations, but do so with skill, professionalism and compassion, sometimes in an extremely pressurised environment.


As many of you will know there has been recent recognition of this excellent work, for instance through the ‘Good’ OFSTED rating for our children’s services in 2017, being only one of two receiving this rating in the whole of the South West. Our adoption services were especially lauded, receiving an ‘outstanding’ rating.


Community Resource Centres


The reconfiguration of the three Community Resource Centres (located in Keynsham, Midsomer Norton and Bath) is continuing.  The Council is investing £700,000 in improving the buildings and ensuring that they are able to support the provision of registered nursing care, high dependency residential care and specialist dementia care to the local population.


The CRCs are owned by the Council and provided by Sirona Care & Health.  Building works continue in the three CRCs and are due to be complete in August 2018.  Works include clinical treatment rooms, sluices and servery’s to bring the CRCs to a comparable standard to private sector care homes and support a new model of care with greater focus on provision of nursing and high dependency residential care services for people with a complex dementia and physical frailty.


It has not been necessary for any existing residents to move out of the CRCs whilst works are being undertaken and the new care model is being put in place.


Exam Stress Tips for Parents, Carers and students


With exam season fast approaching, the Public Health Team in B&NES has put together a handy information and advice list on exam stress for parents and carers. The sheet (attached) includes reference to useful websites, apps and telephone numbers that can also support students at this time of the year.


He commented on the issue raised recently at the Council meeting regarding a possible proposal by the RUH to create a wholly owned subsidiary. He said that he was a stakeholder governor of the RUH by virtue of his Cabinet Member position  ...  view the full minutes text for item 79.

Cabinet Member Update March 2018 pdf icon PDF 52 KB


Public Health Update

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


Dr Bruce Laurence 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.


Youth Mental Health First Aid


This heavily subsidised two day course is for suitable for anyone working with or supporting children and young people aged 8-18. It teaches the skills needed to spot the signs of mental health issues in a young person and builds confidence to offer first aid and knowledge to signpost to further support needed. The course 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. 


Introducing Lizzie Henden, Heath Improvement Specialist


A new role has been appointed, funded by NHS England and hosted by Virgin Care, for a Health Improvement Specialist with a specific remit for health inequalities in Screening and Immunisations.

This post is part of 12 month project with NHS England commissioners, local commissioners, communities and primary care. The role will include promoting routine NHS screening and immunisation programmes to increase uptake in the local population through public health community promotion and health prevention activities. The core purpose of this role is to reduce health inequalities.  The programme will be delivered sensitively to meet the needs of the local population, especially those persons who are considered vulnerable and may find services hard to reach.




5 measles cases in Bath, including one in both universities. A small number of cases but a reminder that vaccination is still essential, and a high rate of over 95% is needed to prevent outbreaks. Measles outbreaks are occurring in many parts of the UK and larger ones in some European countries with at least 35 deaths in children across Europe in 2017. We use cases to promote vaccination and remind people that anyone born after 1970 who finds that they are unvaccinated should go to their GP for two doses of MMR.


Items of national interest


  • PHE strategy to reduce calorie intake through guidelines, promoting reformulation of food and reductions in portion size.


  • Salisbury nerve toxin event. This demonstrated the difficulty of risk communication and management in an uncertain, fast-moving and pressurised situation.


  • Breastfeeding.. The UK has some of the lowest breastfeeding rates in the world: 34% of babies are receiving any breastmilk at six months compared with 62.5% in Sweden. Only 1% of UK babies aged under 6 months are being breastfed exclusively compared with 34% in Portugal.


In 2015/16, the percentage of infants in England who were receiving breastmilk at their 6-8 week check was 43.15%.


Trauma Informed Care Conference – 26th February 2018


This was a regional conference hosted by B&NES and supported by PHE which brought together a wide range of professionals from health, social care, education etc. to discuss the importance of trauma and adverse child experiences in early life and how  ...  view the full minutes text for item 80.

Public Health - Select Committee - March 2018 pdf icon PDF 319 KB


Healthwatch Update

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



Alex Francis, Team Manager, Healthwatch B&NES 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.




On Tuesday 21 November 2017, a team of three Healthwatch volunteers and two members of staff visited Paulton Memorial Hospital. The purpose of this enter and view visit was to observe services at the Minor Injuries Unit and visit the John Stacey Ward. In addition to observation, representatives also wanted to gather feedback from staff, patients and their families about their experiences of care at Paulton Memorial Hospital.


Healthwatch Bath and North East Somerset volunteers observed good care for patients attending the hospital and using the waiting room. They were very grateful to the staff, patient and relatives that gave the time to talk to us.


Here is a summary of the report findings:




Healthwatch volunteers spoke with patients and their families in the waiting room. Patients were waiting for a variety of services including X-ray, podiatry, dietetics, physiotherapy and the Minor Injuries Unit.



The patients that we spoke with had had bad experiences of parking that morning, as did the Healthwatch volunteers. This appears to be something that resonated with all of the patients that we spoke to. When we spoke to staff they explained that the League of Friends had tried to purchase land to extend the car park but this had been unsuccessful.


Patient experience

Patients were positive about services stating that staff could not be nicer and the reception staff are really friendly. Some of the relatives we spoke to were waiting while their loved one was being seen. Some of the things they felt would improve their experience were: access to a café, access to WiFi, and signage displaying expected waiting times as seen in other NHS services.


Accessible Information Standard

Patients and their families were asked if they were aware of the Accessible Information Standard and whether they had been asked on arrival if they had any communication needs or would require information in a particular format. Of the patients Healthwatch talked with during the visit, none were aware of the Accessible Information Standard, nor had they been asked about their communication needs either before the visit or on arrival.



This ward comprises 28 beds, used for rehabilitation for people aged 18 years and over, although most patients are aged over 65. Healthwatch were welcomed by staff and given a full brief of the work carried out. Healthwatch were told that a patient’s maximum stay on the John Stacey Ward is 21 days, but many stay longer and often for six weeks, particularly when they need social care access and reablement is at full capacity. At the time of the visit, 27 of the 28 beds were in use, with the expectation that the last bed would  ...  view the full minutes text for item 81.

Healthwatch B&NES Update March 2018 pdf icon PDF 278 KB


Market Position Statement for Adult Social Care pdf icon PDF 100 KB

This paper provides a briefing on the Council’s market position statement for adult social care.

Additional documents:


The Commissioning Manager for Adult Social Care introduced this report to the Select Committee. He explained that a market position statement, or MPS, is a strategic document that sets commissioners’ long term priorities for social care, and how it will work with providers and partners to develop services in the future to meet the community’s evolving needs.


He added that the Council has duties under the Care Act (2014) to help shape and oversee the social care market and ensure that its residents can access good quality, sustainable care and support.


He stated that Council’s MPS focusses on specific commissioning intentions for older adults in the following service areas:


·  Accommodation based services (p. 43): care homes, dementia, extra care & sheltered housing.


·  Services at home (p.48): homecare, integrated reablement, live-in care.


·  Other community services (p. 53): direct payments, carers and community equipment / assistive technology.


He explained that further chapters for other service areas will be published over the coming year; including commissioning intentions for mental health, working age adults and substance misuse. Separate to the MPS discussed in this paper, the learning disabilities commissioning team has started consultation with the provider market on an integrated health and social care learning disabilities MPS.


He informed them that the current draft was published on 1st March and the consultation period remains open until 6th May. He added that the commissioning intentions at this stage will be refined depending on the feedback and suggestions received from the market during this time.


He said that providers, developers and key stakeholders have been invited to two consultation events on April 20th (Somerdale Pavilion, Keynsham) and 2nd May (Guildhall, Bath).


The Chair asked if the final version of the MPS would come back before the Select Committee.


The Director for Integrated Health & Care Commissioning replied that the MPS should remain a live document and that the Select Committee can be informed when other chapters become live.


Councillor Dine Romero commented that she worried about the reliance on volunteers within this work area and asked if any current data was able to be used rather than relying on the census of 2011.


The Director for Integrated Health & Care Commissioning replied that the Council commissions the Carers’ Centre and has also sourced data from a number of outlets. She added that the difficulty is that not all people that provide care indicate that they do so and that it was likely that figures both nationally and locally were underestimated.


Councillor Eleanor Jackson commented that it was good to have this information available and proposed that the Development Management Committee receiving a briefing on the matter at some point. She added that comments by developers that care provision was ‘not feasible’ should be challenged robustly.


She stated that reference to the Homecare studies carried out by previous Panels would have been welcomed, but appreciated the evidence provided for long term planning.


The Commissioning Manager for Adult Social Care replied that the process has been useful for officers and  ...  view the full minutes text for item 82.


Select Committee Workplan

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 future item of Eye Care would include information regarding Macular Degeneration.


The Director for Integrated Health & Care Commissioning requested that the report on Care Home Staff Provision be moved from May onto the Future Items section of the plan. She added that a report on the Community Equipment review could possibly be discussed in May.


Councillor Dine Romero asked if a date could be assigned for the Dentistry Services report.


The Director for Integrated Health & Care Commissioning replied that she would discuss that with Tracey Cox as it is an NHS England commissioned service.


The Select Committee agreed to the amendments to the plan.