Agenda and draft minutes

Venue: Council Chamber - Guildhall, Bath. View directions

Contact: Jack Latkovic  01225 394452

No. Item


Welcome and Introductions


The Chair (Dr Ian Orpen) welcomed everyone to the meeting.


Members of the Board were invited to introduce themselves with a brief summary of their background.




Emergency Evacuation Procedure


The Senior Democratic Services Officer drew attention to the evacuation procedure as listed on the agenda.


Apologies for Absence


Councillor Kevin Guy and Dr Ruth Grabham had sent their apologies for this meeting.


Declarations of Interest

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


There were none.


To Announce any Urgent Business Agreed by the Chair


There was no urgent business.


Public Questions/Comments


There were none.


Minutes of Previous Meeting 6th March 2019 pdf icon PDF 67 KB

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


The minutes of the previous meeting were approved as a correct record and signed by the Chair.


Recommissioning of Homecare (Independence at Home) services pdf icon PDF 310 KB

B&NES Council and CCG has an opportunity to take an integrated approach to recommissioning homecare, which is vital to our local health & care system.  This report sets out a proposed framework model which would allow all CQC regulated homecare providers with a base or in operation within the boundary of B&NES to apply to be added to the framework.


Nationally & locally, the homecare sector is fragile with significant concerns in workforce and provider sustainability as well as increasing demand and costs.  In B&NES, long term contract arrangements for homecare have expired and to meet the timeline for the framework model implementation extensions will be put in place with the existing strategic partners.


Mike Bowden introduced the item by saying that B&NES Council & CCG had the opportunity to take an integrated approach to homecare that supports people to live independently at home. The Joint Commissioning Committee has agreed the recommendations (as per report) at its meeting on 25th April 2019.  Mike Bowden invited the Board to agree with the recommendations before commencing with procurement.


Mike Bowden moved the recommendations.


Corinne Edwards seconded the motion by fully endorsing the proposals which would deliver a sustainable homecare sector for B&NES.


Councillor Dine Romero supported the proposals although her concerns were on Brexit impact to staff retention.


Vincent Edwards (Commissioning Manager, Adult Social Care) responded that nationally and locally, the homecare market was fragile, with significant issues in workforce recruitment, retention and training/skills. The officers would be looking to change their approach to the wider market and with high demand from private clients and freedom to develop their services to be more attractive for retaining staff. 


Councillor Rob Appleyard also supported the proposals and expressed his concerns on the workforce development.


Vincent Edwards responded that Workforce development was a high priority going forward given the underlying importance of community care to the NHS long term plan.  Commissioners were involved in a number of regional and sub-regional initiatives aimed at supporting the health and care workforce.  B&NES, along with Swindon and Wiltshire councils, would be supporting Sustainability and Transformation Partnership training development fund for staff training.


Lisa Harvey added that NHS has published a plan to increase nursing staff by looking at overseas recruiting and also to promote nursing careers within the country by making it as more desirable job.


Suzannah Power also welcomed the report by suggesting that it demonstrated potential for a sustainable homecare provision.  Suzannah Power asked how the homecare provision would be measured.


Alison Enever (Commissioning Project Manager) responded that a set of performance indicators would be used to evaluate the provision along with the service users’ feedback.  Carers and service users’ preferences, collected from engagements sessions, were included in the list of outcomes that were presented in the document.


Dr Ian Orpen thanked the Board and report officers for the comments made on this matter.


RESOLVED (unanimously) that the Health and Care Board agreed to:


1)  Ratify the proposals which were agreed by the Joint Commissioning Committee at its meeting of 25th April, 2019, and are detailed in section 2 of this report relating to:

a.  Endorsing the framework and ‘innovation contract’ approach to homecare and actions identified to progress this

b.  Interim contractual arrangements to promote continuity of service while the framework is developed

2)  Note related funding recommendations agreed to come from the integrated Better Care Fund by the Joint Commissioning Committee on 25th April 2019:

a.  An independent fair price of care analysis for homecare

b.  Specialist support to develop innovation pilots and transformation to outcomes based commissioning in homecare.


Overview of Pooled Budget Arrangements and 2019/20 Better Care Fund Financial plan pdf icon PDF 421 KB

This report is to provide Health and Care Board with an overview of pooled budget arrangements between the council and CCG, the associated reporting and governance arrangements. It includes the Better Care Fund (BCF) financial plan for 2019/20 at appendix 1.

Additional documents:


Andy Rothery introduced the report by saying that a new Better Care Fund (BCF) plan must be submitted to NHS England during 2019/20 for a sign off.  The financial plan and the proposed schemes under the pooled budget were put forward in February 2019 and approved by the Joint Commissioning Committee with the agreement of the Finance and Performance Committee and S151 Officer of the Council. 


Andy Rothery moved the recommendations.


Sarah James seconded the motion by saying that the report has provided an overview of pooled budget arrangements between the Council and CCG, and the associated reporting and governance arrangements which would further develop working arrangements.


Councillor Dine Romero welcomed the report with a concern that BCF would be part of the pooled budgets until year 2021, and asked what would happen after that date.


Andy Rothery responded that the Council and CCG would be waiting for an outcome of the Government’s Adult Social Care Funding (England) Green Paper, although there was strong assumption amongst Councils nationally that the funding would continue beyond 2021.


Councillor Richard Samuel commented that BCF started 6 years ago, and that Government’s funding has been shifting every year.  Councillor Samuel expressed his concerns on the considerable risk due to lack of Government’s initiative to set the long term funding.  One of the major risks was current political situation in the country which should not be ignored.  Councillor Samuel hoped that more information on this matter would be available shortly, which would be shared with the Board.


Mike Bowden commented that Council and CCG were trailblazers in terms of the pooled budget arrangements, and that our integrated approach would continue to deliver joint outcomes and services for our residents.


Tracey Cox agreed with Councillor Samuel that national position was not helpful.  Tracey Cox added that NHS funding was not at risk as much as the Council one; nevertheless, B&NES CCG’s commitment to this matter was serious and they would continue to be part of the pooled budgets scheme.


Dr Ian Orpen thanked everyone for their comments by outlining that the benefits of pooled budgets scheme were to provide services for the residents in the best possible way.


RESOLVED (unanimously) that the Health and Care Board noted the contents of the report in particular the funding contributions, management and monitoring arrangements.


Proposed new governance arrangements for community safety and safeguarding in B&NES pdf icon PDF 249 KB

The attached report sets out the rationale for establishing a new B&NES Community Safety and Safeguarding Partnership.


The new Partnership will replace the existing Local Safeguarding Children Board, the Local Safeguarding Adult Board and the Responsible Authorities Group. The proposal has been developed as a change in the statutory requirements has meant that Local Safeguarding Children Boards are to be abolished by

28th September 2019. New arrangements must be agreed and published by 29th June 2019.


The change in legislation has provided an exciting opportunity to create a new Partnership with a commitment and focus on Think Family and Community.


The proposed model is required to be authorised by the three statutory agencies, B&NES Council, NHS BaNES CCG and Avon and Somerset Constabulary.


The proposed new arrangement ensures the Council and CCG meet their statutory duties whilst offering a range of benefits which will be created by merging the existing Boards / Group.


There are limitations to the proposal; however with careful management and continuous review it is believed the benefits that can be achieved strongly outweigh these limitations.


First and foremost the outcomes for children and adults will be improved by having one strategically-led conversation. There will be one operational group which will also benefit from one conversation.


Lisa Harvey introduced the item by saying that the new Partnership would replace the existing Local Safeguarding Children Board, the Local Safeguarding Adult Board and the Responsible Authorities Group. The proposal has been developed as a change in the statutory requirements; which meant that Local Safeguarding Children Boards would be abolished by 28th September 2019.  New arrangements would have to be agreed and published by 29th June 2019.  The proposed model was required to be authorised by the three statutory agencies: B&NES Council, NHS BaNES CCG and Avon and Somerset Constabulary.


Lisa Harvey moved the recommendations.


Mike Bowden seconded the motion by saying that one of the challenges nationally was to hold all agencies to account.  For those reasons, a new B&NES Community Safety and Safeguarding Partnership would be establish for the benefit of more efficient way of working on the safeguarding provision for children and vulnerable adults.


Councillor Dine Romero welcomed the report with a concern that proposed new partnership might lose its focus on children safeguarding.  Councillor Romero asked about scrutiny arrangements within the proposal.


Lesley Hutchinson responded that that the independent scrutiny arrangements for the new arrangement would include:


  Scrutiny of individual agencies and their impact on the Partnership

-  Statutory requirements such as section 11, section 175 self-assessments (validation visits and walkabouts)

-  Review of agencies’ external inspection reports as required


  Scrutiny of the effectiveness of the Partnership functions

-  Independent Chair of the Operational and Executive Group responsible for holding partners to account including shared management of risk

-  Multi-agency audits undertaken by an independent auditor reviewing effectiveness of multi-agency practice

-  Themed deep dive reports into areas highlighted through the Assurance Programme and the Strategic Plan

-  Learning from Practice Reviews, Safeguarding Adult Reviews, Domestic Homicide Reviews and other reviews

-  Lay members scrutiny


  External scrutiny

-  Joint Targeted Area Inspection

-  Peer reviews


Mike Bowden added that the development of scrutiny arrangements has been happening over the last 2 months.


Councillor Richard Samuel expressed his concerns in relation to the funding arrangements.  Councillor Samuel felt that contribution from the Avon and Somerset Constabulary was less than satisfactory this year, and suggested that B&NES Council and CCG should be looking for higher proportion of the funding for next year.


Mike Bowden acknowledged a suggestion from Councillor Samuel.  Mike Bowden explained that funding settings were not set under equal share arrangements.  Nevertheless, the officer would take on board this suggestion as a part of the Health and Care Board recommendation.


Lisa Harvey added that Avon and Somerset Constabulary led the scrutiny arrangements which could be the reason behind lower contributions from their side.


Dr Ian Orpen thanked everyone who contributed to this debate.  Dr Orpen also said that, as general practitioner, he could see a link between adult and children safeguarding arrangements; on some occasions (families, joint living, etc) children may be affected with adult safeguarding matters and it would be much more practical and time efficient by  ...  view the full minutes text for item 10.