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.





Councillor Tim Ball had sent his apologies to the Select Committee, Councillor Cherry Beath was present as his substitute for the duration of the meeting.


Apologies were also received from Dr Bruce Laurence, Director of Public Health and Alex Francis, Team Manager - Healthwatch B&NES.



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.



John Drake, UNISON Regional Organiser for B&NES had registered to make a statement relating to agenda item 13 (Ethical Care Charter) and would speak directly before that item was debated.


MINUTES - 28th March 2018 pdf icon PDF 115 KB


Councillor Robin Moss raised a point of clarification on behalf of Councillor Eleanor Jackson. He said that with regard to minute number 82 that Councillor Jackson had spoken about previous ‘Homecare studies’, not ‘Care Home’.


He also asked if there was any response regarding the query Councillor Jackson raised regarding an empty ward within Paulton Hospital.


The Director of Integrated Commissioning replied that there are no empty wards within the hospital. She added that for a period of time there may have been a rehabilitation area in the RUH occupied space that was not in use.


With the one amendment in mind 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) during April and May is set out below including the comparative performance with the 2 other Acute Trusts in the Sustainability &Transformation Partnership.













June Actual























There has been a good improvement in performance during May which is thought to be attributable to a strong system wide focus on patients who have been in hospital more than 7 and 21 days.


CCG and Council integration plans


At meetings of the Cabinet and CCG Board in November 2017, BaNES CCG and Bath and North East Somerset Council agreed their intention to pursue closer integration, specifically to develop a single integrated commissioning function. New shadow governance arrangements have been established which includes the creation of a shadow Health & Care Board; the first meeting will take place on 6 June 2018. 


Launch of Homeless Service


Homeless people in Bath and the surrounding area can now access vital healthcare five days a week thanks to the expansion of a key community health service.  From 1 May 2018, the Homeless Health Care Service began providing homeless people with access to a local GP for an additional day each week.


The service is run each weekday morning from the Julian House hostel in Manvers Street, Bath.  The facility has a specially equipped consulting room which is kitted out with all the essentials of a doctor’s surgery. It is staffed each day by either an experienced nurse prescriber or male and female GPs from the newly-established Heart of Bath Medical Partnership, a result of the merger of Oldfield Surgery and St James’s Surgery.


Local increase in measles cases


Since January there has been an increase in the number of measles cases across the South West with 11 people diagnosed in B&NES alone. Measles is an avoidable disease and we are working with Public Health England to encourage everyone to make sure they have had the MMR vaccine. As young people aged 16-25 are particularly vulnerable to the illness, we are working with GP practices to identify registered patients who fall into this category. They will then be contacted and invited in to their practice for their two doses of MMR. 


Breast Screening Programme


You will have seen the recent news when it was reported that about 450,000 women had not been invited for their breast screening due to a problem with the IT. This error went back to 2009 and resulted in women not being invited to their final breast screening appointment.


There will be an independent  ...  view the full minutes text for item 8.

CCG Update May 2018 pdf icon PDF 81 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.


Help shape the future of community mental health services in B&NES


The Council and CCG are reviewing the way community mental health services are delivered locally and are inviting the public to help.


Both organisations are responsible for commissioning mental health services in Bath and North East Somerset, and they are looking at the way things are currently done to determine what is working well and identify any improvements needed.


The review of community mental health services launched last summer when over 60 face-to-face meetings and focus groups were held and more than 100 survey responses received. People told the Council and CCG that community mental health services must focus on preventing people from escalating into crisis, drive parity of esteem (equal value) between medical and social interventions, and make sure that services work together more effectively.


Six working groups, made up of staff from the Council and CCG, Virgin Care, service providers, voluntary sector representatives and Community Champions – who represent the public – are now working on the next stage of the review. This will involve holding workshops in June 2018, to which people who use services, those who deliver services and interested members of the public are invited.


For information about the review, please visit the CCG’s website, email or call 01225 831 800 and ask for the Communications and Engagement Team.


Virgin Care Community Services One-Year On


Between January and December 2015 the Council and Clinical Commissioning Group (CCG) carried out a bold and ambitious review of community health and care services for children, young people and adults. 


The your care, your way community services review looked at the wide range of services providing care and support in people’s homes and communities and the experiences of the people using them.


The results of the consultation were used in the procurement process to test how the bidders intended to deliver the priorities that matter to local people.  Virgin Care Services Ltd (VCSL) were confirmed as the successful bidder and awarded the “Prime Provider” contract.  Under this model, Virgin Care has overall responsibility for the delivery and coordination of services but it can also sub-contract with specialist, third sector providers and small and medium-sized enterprises (SMEs) to ensure that existing knowledge and experience is not lost.


During 2017/18, Virgin Care was required to begin implementing their ambitious transformation programme in order to improve service delivery and achieve efficiencies to enable greater sustainability in future years. 


There are a number of other transformation work streams developing at pace, for example the reablement pathway review and the mental health pathway review. Both programmes of work are looking to improve the offer for people in B&NES while delivering efficiencies, and making the service  ...  view the full minutes text for item 9.

Cabinet Member Update May 2018 pdf icon PDF 192 KB


Public Health Update

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


In his absence the Select Committee noted the update that had been provided by the Director of Public Health. A copy of the update can be found on their Minute Book and as an online appendix to these minutes.

Public Health - Select Committee - May 2018 pdf icon PDF 253 KB


Healthwatch Update

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



The Select Committee noted that on this occasion there was no update report from Healthwatch.


Community Equipment Service Review pdf icon PDF 83 KB

This report provides an update on the current Community Equipment services available to residents of Bath and North East Somerset. 


The Commissioning Manager for Adult Social Care introduced this report to the Select Committee. He explained that it provides an update on the current Community Equipment services available to residents of Bath and North East Somerset.  It also outlines a project underway to review all community equipment services and develop an up to date policy for the provision of community equipment. He stated that the review will inform the re-procurement of the service under a new contract from April 2019.


He informed them that there is a pooled budget arrangement in place for community equipment, totalling £675,730 in 2017-18, which is funded 70% by the Clinical Commissioning Group and 30% by the Council.


He said that Community Equipment is a vital service which supports people to maintain or increase their independence in a range of different ways.  One of the key aims of the Council and CCG is to support more people to remain at home and to do this, consideration and review of the community equipment service is essential to ensure it is fit for purpose and able to respond to increasing numbers of people living at home, especially returning home from hospital without delay. 


He stated that the Community Equipment Policy is due to be published in Summer 2018 and that the review and subsequent procurement of the community equipment services is scheduled to complete in Spring 2019.


He explained that the equipment service currently cleans, disinfects and recycles around 90% of the equipment that is out on loan and returned. He added that in order to be decontaminated, items that have been returned must be stored in the ‘dirty’ area of the Store. Due to space constraints, it is not always possible to keep the items waiting to be cleaned inside the Store building, so some items remain outside the building while they wait to be cleaned and recycled. The size and appropriateness of the current site is therefore also under review.


Councillor Eleanor Jackson recalled that she had informed the Select Committee of the inadequacies of the store following receipt of information from four Westfield residents who were told to put their unwanted Zimmer frames in a skip outside the store. She added that she was not aware of the recent amnesty mentioned within the report.


The Director of Integrated Commissioning replied that the Senior Commissioning Manager for Better Care had addressed the previous issues raised by Councillor Jackson and acknowledged the physical constraints of the current store and difficulties in identifying an alternative, fit for purpose store, which is also affordable.


Councillor Robin Moss questioned the economics of recycling some specific items and asked if there were cases where equipment requests were being denied.


The Commissioning Manager for Adult Social Care replied that the viability of certain items was being assessed. He added that there was a slightly fragmented system in place at the present time, but improvements to logistics have been recognized.


He added that the ‘Three Conversations’ model will allow for discussions to  ...  view the full minutes text for item 12.


Ethical Care Charter pdf icon PDF 97 KB

This paper concerns the potential for the Council to become an Ethical Care Council that commissions its homecare services in a way that is consistent with the Ethical Care Charter (ECC).


John Drake, UNISON Regional Organiser for the B&NES branch, which includes Sirona Care & Health addressed the Select Committee. He said that his colleague Fred Jerrome has sent a detailed briefing document to the Chair.


I am here to update you on a long running dispute between Sirona & low paid, mainly women, workers in care homes and sheltered accommodation across the Banes area.


The basics of this dispute is the requirement of Sirona to make savings and their approach of achieving these savings will mean care workers having to make a choice between taking a pay cut or spending more time at work for the same amount of pay, not a choice anyone should have to make. It is little wonder that a recent study has shown that nationally around 900 workers are leaving the care sector each week. Our members in Sirona are openly talking about leaving a job they love and seeking alternative employment in retail because it pays better.


We accept that Banes Council is not the direct employer in this case, however as the commissioning authority you do have a responsibility to ensure not only the care of the service users but also that staff delivering these services are treated fairly and that includes pay


It is pleasing to note that the Council is seeking to earn the Ethical Care Chartermark and that is a laudable aim, however this dispute is fundamentally about the ethics of austerity and how this politically driven policy is impacting negatively on those carrying out vital work in the care sector.


Following the Your Care Your Way consultation, Virgin was awarded the bulk of the work that had been previously carried out by Sirona. As a consequence Sirona had to radically adjust its finances. We can discuss the way Sirona did this, we can discuss the rights and wrongs of things they should and shouldn’t have done but that is not going to help the immediate situation.


UNISON is all too well aware of the financial plight of Banes and we are actively working with officers to mitigate the impact of the 300 job losses across the council, again due to ongoing austerity, however the monies required to resolve this dispute are relatively small, between £150 & &180 k depending on who you talk to in Sirona.


I must make it clear our members do not want to strike, our members are not militant members of a strike happy union, they are dedicated public sector care workers who have faced 8 years of below inflation pay raises and are now facing another attack on pay are saying enough is enough.


Which is why 95% voted to take strike action in a lawful ballot after Sirona came forward with plans to dismiss and re- engage these staff which would force them on to new contracts that will reduce their pay or make them work longer for the same pay.


We are asking this scrutiny committee to work with us to identify additional funding  ...  view the full minutes text for item 13.


Select Committee Workplan pdf icon PDF 108 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 Robin Moss suggested that a progress report on the integration between the Council and the CCG be given at a future meeting.


The Director of Integrated Commissioning said that a joint report could be produced for the Select Committee.


Councillor Lin Patterson said she would like the Select Committee to receive information on the subject of Eye Care.


Councillor Eleanor Jackson commented that she would appreciate the Select Committee to be given an overview of commissioned services within B&NES. She added she would particularly like information regarding Diabetic Screening, Glaucoma and Macular Degeneration.


The Director of Integrated Commissioning replied that most eye care services are not commissioned by the CCG, they are commissioned by NHS England specialised commissioning. She confirmed she would take the matter away and discuss with CCG colleagues what is possible in meeting the Committee’s request for a report on eye care.


Councillor Eleanor Jackson proposed that the Council compares its local findings relating to pharmacies with the National Pharmaceutical Services report which is due to be published soon.


The Chair thanked the Select Committee members for their comments.