Agenda and minutes

Gill Stobart had sent her apologies to the Panel and had informed them also that she would be standing down from her role on the Panel.

The Chairman, on behalf of the Panel, thanked Gill for the work she had carried out whilst being a member of the Panel.

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

Councillor Gerry Curran declared an other interest with regard to agenda item 12 (HCRG Care Group Options Appraisal) as he is an employee of HCRG.

Councillor Paul May declared an other interest with regard to agenda item 12 (HCRG Care Group Options Appraisal) as he is a non-executive Sirona board member.

Paula Riseborough made a statement to the Panel on the subject of HCRG Care Group. A copy of the statement can be found as an online appendix to these minutes and on the Panel’s Minute Book. A summary is set out below.

I’m speaking today to highlight one of the many issues that I object to regarding the outsourcing of BathNES health and care services to private provider HCRG Care Group (formerly known as Virgin Care).

Most recently we have objected to the behaviour of Virgin Care executives in secretly negotiating a takeover of their company by Twenty20 Capital, without informing the commissioners (the Council and BathNES CCG) of this until after they had approved a 3-year extension of Virgin Care’s prime provider contract.

Protect our NHS members have raised questions with our local councillors and with the health scrutiny panel about the procedures involved in the contract negotiations and were reassured when the Council announced that due diligence work and a revised options appraisal would be carried out regarding this contract extension.

However, on reading the Scrutiny Panel’s Agenda for its 17 May meeting, together with the HCRG Care Group Options Appraisal document, I was dismayed to find that the long awaited report is to be presented to the Panel ‘in private session due to the commercial sensitivity of the decision to be taken’. This represents one of my major concerns about outsourcing of publicly funded health and care services to private companies – there is a breakdown of transparency in the functioning of democratic and statutory organisations when the commercial interests of private providers are placed ahead of essential public interest.

If the full Options Appraisal document is not to be published, then the commissioners should provide for public scrutiny, at the very least, a summary of the Options Appraisal document. This should include a list of the people consulted for their views (and their job roles), what criteria they were looking at when deciding on a recommended option and, if a decision is made to extend HCRG’s contract, what measures the commissioners have in place to prevent the prime provider company being sold on again during the BathNES contract period.

Councillor Liz Hardman commented that the Options Appraisal had not yet been shared with members of the Panel and that they were not asked to be part of that process.

Paula Riseborough said that she found that alarming and felt there was a democratic deficit in the process.

The Chairman thanked her for her statement on behalf of the Panel.

Theresa Franklin made a statement to the Panel on the subject of the High Common, Bath. A copy of the statement can be found as an online appendix to these minutes and on the Panel’s Minute Book. A summary is set out below.

My subject is the dangers of sharing golf with the public on The High Common which is a park. One of the things about golf being played in a public park is the obvious  ...  view the full minutes text for item 6.

Councillor Andrew Wait asked again for the RAG ratings in relation to the Community Mental Health Framework to be circulated to the Panel.

The Director of Adult Social Care apologised and said that she would send them to the Panel.

Councillor Joanna Wright asked if there was any update on whether the Wiltshire Adopters Networking, Development & Support (WANDS) can be used to support families in B&NES.

The following reply also formed a response to a question asked by Councillor Wright at the 5^th May Cabinet meeting.

A proposal is with Adoption West (AW) Board of Directors to commission WANDS to grow the service in other areas of the AW region, to include B&NES. B&NES Adopters can join groups commissioned by Adoption West in Bristol, via CSS Adoption https://www.ccsadoption.org/

B&NES adopters and residents are encouraged to contact AW duty team directly to discuss specific adoption support needs and to determine if the child / family need an assessment which they are entitled to request.

https://adoptionwest.co.uk/

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

The Cabinet Member(s) will update the Panel on any relevant issues. Panel members may ask questions on the update provided.

Councillor Dine Romero, Cabinet Member for Children and Young People, Communities and Culture addressed the Panel. A copy of the update can be found as an online appendix to these minutes.

Councillor Liz Hardman commented that the OFSTED report on Children’s Services is extremely pleasing and said that it highlights the excellent leadership we have in B&NES and how our services are good - well done to all.  However, she said that from reading the report at agenda item 11, it is clear that substantial financial investment and increased capacity in the team is needed and asked what plans have been put in place to address this.

The Director of Children’s Services & Education replied that the report makes recommendations in terms of the Council’s Care Leavers Duty and said that new legislation is expected later in the year with regard to extending the age range from 21 – 25.

She added that the Service Improvement Board will oversee all of the recommendations and that the team will be reviewed to consider what additional capacity is required to accommodate our post 21 offer.

Councillor Hardman asked if she was concerned about the increase in the number of children being electively home educated (EHE) in B&NES and if we have the right services in place to support these families appropriately.

Councillor Romero replied that she was concerned about the increase, though it has stabilised. She added however that we do not have an increase in the number of children EHE who are known to social care. She said that the EHE team provide support in line with the Council’s responsibilities and have positive relationships with the EHE community. She stated that additional resourcing has been put into the team to manage increased numbers, however, we will need to look at this area again if the Education White Paper’s proposals around EHE are implemented.

Councillor Hardman said she was very pleased to see that the three-year plan for social prescribing and an active travel program includes the Somer Valley and will include pop up hubs in places like her ward of Paulton. She asked when are these likely to happen.

The Director of Public Health and Prevention replied that we are expecting to hear from the DfT by the end of May, but can’t guarantee that national timescales won’t slip.

Councillor Andrew Wait commented that the report states that 97.9% received one of their up to five preferences in relation to School Admissions. He asked how many received their first choice and do you have comparisons with that statistic for previous years.

Councillor Romero replied that the following figures were recorded for 2021/22 and 2022/23.

Secondary:

Primary:

Kevin Burnett asked how the inspection of host families was being carried out with regard to the Ukraine refugees.

The Director of Children’s Services and Education replied that this work was being carried out  ...  view the full minutes text for item 8.

The Panel will receive an update from the B&NES, Swindon & Wiltshire Clinical Commissioning Group (BSW CCG) on current issues.

Dr Bryn Bird, B&NES Locality Clinical Chair addressed the Panel. A copy of the update can be found as an online appendix to these minutes, a summary of the update is set out below.

Pressure on health and care services continues in BaNES

Pressures related to Covid-19, staff absence and high demand for hospital beds have continued across BaNES over the past few weeks. A number of measures remain in place to help address these issues.

The main messages being for people to use our health services appropriately, support hospitals by collecting loved ones as soon as they are ready to go home, using our pharmacies for help and support wherever possible and using the online 111 service in the first instance.

He said that currently the RUH was operating under OPEL 4 (Operations Pressure Escalation Levels) and that cross-working meetings have been held to discuss how to relieve pressure.

BSW ICS and ICA update

The Health and Care Bill which set out plans for the formation of Integrated Care Systems received Royal Assent at the end of April. The Bill will now pass into law as the Health and Care Act 2022 and paves the way for the BSW Integrated Care Board (ICB) to become a statutory body on July 1st and the formation of the BaNES locality Integrated Care Alliance (ICA).

The Health and Care Act introduces measures to tackle the COVID-19 backlogs and rebuild health and social care services following the pandemic. It will also contain measures to address health inequalities and create safer, more joined-up services that will put the health and care system on a more sustainable footing.

The latest version of the BSW Partnership System Development Plan for 2022/2023 has been submitted to NHS England. The plan has been developed by lead and programme support teams from our key workstreams and focuses on the continued development of our BSW Integrated Care System and the transition activities that will be required during 2022/23 to align with the legislative changes planned.

Councillor Liz Hardman asked if any update could be given on the crisis affecting the ambulance service locally.

Dr Bird replied that support for the hospital discharge is intended over the coming year.

Kevin Burnett referred to the Healthy Start Scheme and asked if anything further could be done to support those in receipt of the paper vouchers to transfer to the prepaid card now being offered.

The Public Health Development & Commissioning Manager replied that an automatic registration process would be welcome, but this was not currently possible. She added that a lot of support and awareness is being carried out locally to make people aware of the changes.

Kevin Burnett asked how are messages about accessing GP services being managed given that more people will now likely want to return to face to face appointments.

Dr Bird replied that communications work has been carried out on this matter and that from his point of view he has always been willing to see people  ...  view the full minutes text for item 9.

B&NES Fair Food Alliance has been in operation since March 2020 and this report reflects on the achievements of the alliance since its last report to PDS (May 2021) and, following a review of progress and consultation with stakeholders, presents its refreshed priorities and action plan for the period 2022 – 2025.

The Public Health Development & Commissioning Manager introduced this report to the Panel and asked for their feedback on the proposals.

Councillor Liz Hardman wished to congratulate the B&NES officers who with the Fair Food Alliance group, have put in place a structure to drive the strategic direction and coordination of food insecurity work locally. She asked as the B&NES Fair Food Alliance does not have an operational budget, would this hinder its future work especially in developing income maximisation.

The Public Health Development & Commissioning Manager replied that the Co-ordination role carried out by the Health Improvement Officer gives us significant benefit and has been crucial to the success of the work. She added that the Co-ordination role was secure until July 2024 and additional funding would need to be found to secure this role longer term.

The Chair asked if it was sustainable for this work to rely on public support.

The Public Health Development & Commissioning Manager replied that the support received through the Voluntary Sector is fantastic, but that there is a need for solutions to become more sustainable through, for example, provision of better paid jobs or available healthy products at affordable prices. She also added that we need to ensure that our local services are accessible and dignified and support the voluntary sector in their response.

The Chair asked how would a member of the public approach a Food Bank if they needed to.

The Public Health Development & Commissioning Manager replied that people need to get a referral to a food bank before they can use it. Referrals can be made from, eg, a Health Visitor or Children’s Centre.

Kevin Burnett asked for any further comment on the Poverty Proofing Schools

Audit.

The Health Improvement Officer replied that the Audit is being piloted through 10 schools in B&NES and that the plan is to then to give all schools access to it to help them to recognise where students may need support.

Kevin Burnett asked if Free School Meals (FSM) was the only measure available to use.

The Public Health Development & Commissioning Manager replied that receipt of FSM would identify those on a low income, but that the Audit tool would seek to show schools how they can identify those in need and to work with other agencies where necessary.

Kevin Burnett asked if they have worked with SACRE on any projects.

The Public Health Development & Commissioning Manager replied that SACRE are part of the Fair Food Alliance, but that they have not been that active currently.

Councillor Rob Appleyard said that there was much to commend about the work that has taken place so far and that the Council needs to provide support to enable it to carry on.

Councillor Joanna Wright asked how residents can be helped to identify the support they are able to receive.

The Public Health Development & Commissioning Manager replied that Citizen’s Advice will have a role to play in this process as there will be families that  ...  view the full minutes text for item 10.

This report outlines the findings from the Ofsted ILAC Inspection of Children’s Services in February 2022.

The Director of Children’s Services & Education introduced this report to the Panel. She said that she was pleased to have received such a positive report and thanked all officers within Children’s Services for their work.

Councillor Liz Hardman gave her congratulations to the Children’s Services officers and management in receiving a really excellent report. She stated that all areas are judged to be good with recommendations on three areas of our practice. She added however that the report states that to carry out the recommendations of the OFSTED report, and our new statutory duties from April 2022, substantial financial investment and increased capacity within the team will be required. She asked what plans are being made to ensure that this financial investment is made and that capacity is increased.

The Assistant Director for Children and Young People replied that Children’s Services have considered the recommendations in the Ofsted ILAC Report and that the Service has taken some immediate actions following the Ofsted Inspection and the Deputy Team Manager is acting up in a Team Manager capacity.

She added that the Service Improvement Board will oversee all of the recommendations and we will review the team to consider what additional capacity is required to accommodate our post 21 offer and this will be worked through in our ongoing finance planning.

The Chair on behalf of the Panel wished to commend all staff for their work.

The Panel RESOLVED to;

i)  Recognise the improvements made within Children’s Social Care as outlined within the Inspection report.

ii)  Acknowledge the recommendations made within the Ofsted report and work collaboratively with Children’s Services to address the recommendations identified.

iii)  Agree the proposal for overseeing ongoing progress within Children’s

Services.

Bath & North East Somerset Council and Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group, as joint commissioners entered into a contract with Virgin Care Services Limited for the delivery of a range of health and social care services with effect from 1 April 2017. The Contract is in the sixth year (2022/23) of the initial seven year term with an option for the Commissioners to extend the initial term by three years, taking the full extended term contract term to 2026/2027.

The final decision on whether to extend the contract or not will be made at the Council’s Cabinet meeting and CCG Governing body meeting on 26th May 2022.

The Director of Adult Social Care introduced this report to the Panel and gave an outline of the timeline that had taken place so far.

·  The Commissioners each took a decision on 11 November 2021 (through the Council’s Cabinet and the CCG’s Governing Body) to approve exercising Option 3 to extend the contract term for the three-year period until 31 March 2027.

·  On 1 December 2021, the Virgin Care Services Limited notified the Commissioners that the business it formed a part of had been sold to T20 Pioneer Holdings Limited which is in turn ultimately held by Twenty20 Capital Limited (via another company) (T20). T20 is a private equity investor.

·  The change took effect from 30 November 2021 with the formal change of control notice referred to above. The change in ownership is several steps removed from the Provider with intermediate companies being retained but names changed. The Provider is now known as HCRG Care Services Ltd. The Provider has stated that it “has no intention or proposal to make a consequential change to its operations”.

·  Following the announcement on 1st December 2021, the Commissioners paused formal confirmation and notification of the extension decision until the Council and CCG had undertaken a full due diligence review of the change in control and understand its legal implications.

·  The Commissioners instructed BDO LLP (BDO), to undertake due diligence on T20 and the implications of the acquisition of the Provider for the Contract, the Commissioners, and the delivery of services.

·  On 8 March 2022, it was agreed to defer the notification of the contract extension decision deadline until 30th June 2022 (subject to CCG and HCRG Care Group mutual agreement) and for a new options appraisal to be undertaken which will allow for discussion of other extension options with supporting rationale for each.

·  On 4 April 2022, BDO facilitated an Options Appraisal Workshop in order to gather views and opinions from Commissioner representatives as part of the options appraisal process of the Contract based on the following four options:

o  Option 1 – Extend the Contract term for the 3 year period (until 2026/27)

o  Option 2 – Extend for an alternative period

o  Option 3 – Allow contract to end with no Contract extension beyond 31 March 2024

o  Option 4 –Termination of the Contract before 31 March 2024

Paula Riseborough said that it was difficult for her to add to her previous statement as the Options Appraisal report itself has been classified as exempt.

Councillor Joanna Wright asked for an explanation of the legal advice that the Council had received on this matter.

The Director of Adult Social Care replied that she was not able to share that information in the public domain. She added that the decision to hold an exempt session is not to protect the commercial aspects of HCRG but to safeguard the future decision that the Council and CCG make.

Councillor Wright asked if the decision regarding the contract was primarily about the Council obtaining best  ...  view the full minutes text for item 12.

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

The Panel approved their current workplan as printed.