Agenda and draft minutes

Venue: Virtual Meeting - Zoom - Public Access via YouTube View directions

Contact: Mark Durnford  Email:, 01225 394458

No. Item




The Chairman welcomed everyone to the meeting.





David Williams (Co-opted Member) had sent his apologies to 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 Paul May declared an other interest as he is a non-executive Sirona board member.


Councillor Alison Born declared an other interest as she is a board member of B&NES Carers Centre.





There was none.



At the time of publication no notifications had been received.



There were none.


MINUTES - 19th JANUARY 2021 pdf icon PDF 313 KB


The Chair asked if Councillor Ruth Malloy had received any further information relating to the ‘Got Ya Back’ river safety campaign and the #NeverOK Campaign mentioned in a previous meeting.


Councillor Malloy replied that she was aware that the request for the information had been followed up by the Director of Adult Social Care, Complex and Specialist Commissioning via email, but had not yet received anything directly regarding the campaigns.


The Director of Education, Inclusion and Children’s Safeguarding said that neither he nor the Inclusive Communities Manager were aware of the campaigns mentioned.


The Director of Adult Social Care, Complex and Specialist Commissioning replied that she would follow up the matter with Sian Walker-McAllister, B&NES CSSP Independent Chair directly.


The Chair asked if the Panel could be updated in respect of the Inclusion Expert.


The Director of Education, Inclusion and Children’s Safeguarding replied that due to the ongoing Covid-19 restrictions they were not able to return to work in schools. He said that there would be some remaining days that schools could use once restrictions begin to ease. He added that a report on their work will be received by the Council at some point in the future.


Kevin Burnett asked if an update could be provided on the Escalation Protocol.


The Director of Adult Social Care, Complex and Specialist Commissioning replied that the Protocol was currently in draft form and due to be implemented in April.


The Chair asked if the Covid-19 vaccination programme had continued to progress well locally, particularly in terms of residents within Care Homes.


Councillor Rob Appleyard replied that it had.


Referring to Mental Health Services, the Chair asked if allocation date for the additional £10.3m from NHSE had been announced.


The Director of Adult Social Care, Complex and Specialist Commissioning replied that a prioritisation process was ongoing after a substantial number of bids had been received.


Dr Bryn Bird, B&NES Locality Clinical Chair added that over 100 requests had been received.


The Chair asked for clarification on how work will be delivered in Early Years SEND when the vacant post is deleted.


The Director of Education, Inclusion and Children’s Safeguarding replied that a different model has been devised for this work area over the past 18 months by giving training to empower schools which has led to there being no need to fill the vacant post.


Kevin Burnett asked if any update could be given regarding SEND Advocacy.


The Director of Education, Inclusion and Children’s Safeguarding replied that a contract for the service was yet to be agreed.


With those matters raised in mind, the Panel confirmed the minutes of the previous meeting as a true record.


Cabinet Member Update

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



Councillor Rob Appleyard, Cabinet Member for Adult Services addressed the Panel and said that he was happy to take questions on the submission he had provided to them.


Councillor Liz Hardman commented that the Community Resource Centres and Extra Care Services had transferred on 1 October 2020 from Sirona to the Council and that the focus is now on reviewing staff salaries and terms and conditions.  She asked if it was anticipated that there will be any job losses.


Councillor Appleyard replied that he was not aware that there were to be any job losses and said that he felt that the move enhances the position of the staff.


Kevin Burnett asked how people were identified to the Community Wellbeing Hub to receive emergency food parcels


Councillor Appleyard replied that it was a very complicated piece of work and that the Council were supplied with a list of residents who were considered to be vulnerable. He added that nearly 12,000 calls to the Hub had been received since last March and that everyone associated with its work should be immensely proud.


Councillor Jess David asked if the emergency food parcels would be a continuing service that could be provided.


Councillor Appleyard replied that if requests are received we will do all we can to help and that it was ongoing as far as he was concerned.


The Chair asked how this was to be funded.


Councillor Appleyard replied that it would be funded through the Hub and supplies from food banks which are currently well stocked by the people of B&NES.


He said that he was immensely grateful to the work and support of Lesley Hutchinson, Director of Adult Social Care, Complex and Specialist Commissioning who was to leave the Council at the end of the week. He added that he would like to welcome Alison Elliott who will take over the role on an interim basis.


Councillor Kevin Guy, Cabinet Member for Children’s Services addressed the Panel and said that he echoed the comments made by Councillor Appleyard and was happy to take questions on the submission he had provided to them.


Councillor Paul May commented that he supported the work identified with regard to the former Culverhay site to explore how post 16 vocational provision can be accommodated. He stated that he would like consideration to be given to the possibility of a separate Policy Development & Scrutiny Panel for Children’s Services to be setup.


Councillor Guy replied that he would prefer it if a separate Panel could be arranged in the future.


Councillor Alison Born commented that she was also pleased to see the ongoing work in relation to Culverhay and asked if it was likely to return to be used as a school.


Councillor Guy replied that there were no plans for that, but he was pleased with the work surrounding the Alternative Learning Provision for children and young people in B&NES who have been excluded from school or are at risk of being excluded  ...  view the full minutes text for item 75.

Cabinet Members Briefing (Cllr Appleyard) March 2021 pdf icon PDF 107 KB

Additional documents:



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.


Covid-19 mass vaccination programme


Our Covid-19 vaccination programme has been making solid progress since we started offering the vaccine to the first priority groups at the end of last year.


As of 25 February, almost 265,000 vaccines have been given across Bath and North East Somerset, Swindon and Wiltshire, which is the equivalent of vaccinating the entire population of Swindon and the surrounding areas.


We are currently around halfway through the process of vaccinating people in priority groups five and six (people aged over 65 and anyone aged between 16 and 64 with an underlying health condition) and this puts us on track to meet recent government targets.


People who were among some of the first to have the vaccine will begin receiving their second dose from the beginning of March. Health and social care workers will also begin to receive their second dose, and we are working closely with all provider organisation to ensure this happens as smoothly as possible.


The rate for people testing positive locally currently stands at 30 / 100,000.


Twenty cases were still present within the RUH but no new diagnosis had been admitted within the last 48 hours.


BSW Partnership Integrated Care System development


In February the government set out new proposals covering the development of Integrated Care Systems (ICSs) which will have implications for the BSW

Partnership Integrated Care System (ICS).


The proposals have been outlined in a new white paper entitled Integration and

innovation: working together to improve health and social care for all.


Proposals in the white paper include:


·  The creation of an ICS NHS statutory body and an ICS Health and Care

Partnership which will place a duty to collaborate on organisations which are part of the Partnership


·  Proposed reform to the procurement of NHS services in order to give

commissioners greater flexibility in how they arrange services


·  Place-based arrangements between local authorities, the NHS and between providers of health and care services will be at the core of integration. Legislation will not prescribe how these arrangements are put in place or what they need to involve – that will be left to local organisations to arrange.


·  Legislation introduced to help address inequalities in public health outcomes and the need for government to act to help level up health across the country.


The BSW Partnership board is now looking at the implications of the proposals on how partners will work together over the coming months.


There has also been a concerted partnership approach to caring for a spike in the number of people receiving treatment in hospitals in Bath, Swindon and Wiltshire for Covid-19 during January and February. Partners did this by pooling resources and re-allocating staff so they could provide help where it was needed most.


Long Covid Service update


Over 128 patients across  ...  view the full minutes text for item 76.

BSW CCG Update March 2021 pdf icon PDF 308 KB


Virgin Care Commissioner - Six Month Update Report pdf icon PDF 27 KB

Following on from the previous report to Panel in September 2020, attached is an update report on Virgin Care. The report has focussed on the Integrated Reablement Service and the financial performance of the contract in year 4 of the 7 year term as requested by the Panel.


Additional documents:


The Director of Adult Social Care, Complex and Specialist Commissioning introduced this item to the Panel alongside the Head of Contracting & Performance, a summary is set out below.


COVID-19 Impact


COVID-19 has had a significant impact on the Reablement Service and the delivery of reablement within B&NES. Following the release of the Hospital Discharge Guidance by the Department of Health and Social Care, all health and care systems were required to deliver the ambitions of Discharge to Assess (D2A) to ensure the safe and timely discharge of people who no longer needed to stay in hospital.


In response to the D2A requirements, it was agreed in B&NES that the

Integrated Reablement Service would be the service that would support

individuals being discharged on Pathway 1 (home with additional support).


This meant the Service would support all individuals who needed a new or

increased package of care on discharge to be supported and assessed by the

Service, prior to their long-term care needs being determined and arranged. In

addition, the Service would be responsible for the case management of such

individuals, including the administrative processes associated with this.


Due to this change, people who would have traditionally been discharged

from hospital directly into a local authority/self-funded long-term package of

care now have an assessment and support offer from Reablement for up to

six weeks.




Performance and activity for the Reablement Service has been significantly impacted by COVID-19.


After an initial fall in referrals in April 2020, as services and services users were adapting to the national lockdown, the trend since then has been a significant increase. In the year to date to the end of January 2021, average monthly referrals are 7.9% higher than the 2019/20 average. In parallel, the number of discharges from the Service has seen an increase over the past year since January 2020.


While the number of people receiving a service per month has dropped compared to the 2019/20 average by 6.4%, the number of contacts has risen

significantly, with 20.4% more contacts on average per month than the

2019/20 average. As a consequence, length of stay in the Service has increased above average levels for the three years prior to April 2020. While

the monthly average in 2020/21 is 4.0% above the 2019/20 average, the

shorter length of stay in the first quarter of 2020/21 is offsetting the high levels

seen currently. To put this in context, the latest value for January 2021 is

24.2% above the 2019/20 average.


The peak caseload in November 2020, at 662 people, is 37.1% higher than the 2019/20 peak of 483 (January 2020). The latest data shows that the caseload is reducing but it remains high relative to previous years.


Despite the pressures on the Service, performance for the ASCOF measure

(which reviews whether people remain in their usual place of residence 91

days after discharge into reablement from hospital) remains close (82.1%) to the targeted level of 85%.


Reablement Next Steps


For the Integrated Reablement Service  ...  view the full minutes text for item 77.


Care Home Commissioning pdf icon PDF 428 KB

This report provides an update to Scrutiny Panel on the development of commissioning approaches for services for older people in B&NES in respect of home care and care homes.


The Senior Commissioning Manager for Community Health & Care Services introduced this report to the Panel, a summary is set out below.


The pressure of the Covid-19 pandemic has particularly dominated the work of the Integrated Adults Commissioning Team as we aim to provide and maintain services and support for some of the most vulnerable older people in our community.


Since June 2020 the team have been developing two Market Engagement Strategies. These strategies are designed to articulate and set a plan around the way the Integrated Commissioning team engages with the care market.


These Market Engagement Strategies will sit within a broader Commissioning Strategy which will encompass the work of all teams engaged in adult commissioning which will be developed as part of the wider teams that report to the Director for Adult Social Care and Commissioning.


Within the Market Engagement Strategies are commitments to take forward an annual market position statement.


Market Engagement Strategies


The two Market Engagement Strategies focus on home care and on care homes.


Both Strategies are working to three overarching aims:


• We have a clear joint strategy about how home care and care homes contractual and commissioning practice is to be developed in B&NES


• There is evidence of improved outcomes for people receiving home care and residents of homes


• The average price and the overall spend on home care and care homes are reduced


The Chair referred to section 4.3.6 of the report where it said that currently information on care packages held on Liquid Logic is not consistently recorded and asked what steps could be taken to rectify this.


The Senior Commissioning Manager for Community Health & Care Services replied that where possible only one point of data entry will be used moving forward to ensure the data set is consistent.


Councillor Alison Born commented that there appeared to be a focus on costs within the Home Care Engagement Strategy and asked if quality of care would also be considered.


The Senior Commissioning Manager for Community Health & Care Services replied that the aim of the strategy will be to make sure that we can deliver on quality, process and costs.


Councillor Born asked what types of Assistive Technology were being considered with regard to home care.


The Senior Commissioning Manager for Community Health & Care Services replied that it was currently an open agenda on this matter. She added that there had been a 24% increase in use within the last year and that the strategy would seek to enable those that can use it to do so.


Councillor Liz Hardman asked if it could be explained how B&NES is in the bottom quartile of the continuing healthcare league table for the way we undertake assessments and in the top quartile of the Funding Nursing Care table. 


The Senior Commissioning Manager for Community Health & Care Services replied that B&NES is an outlier in terms of the number of people who benefit from CHC funding and as part of a review  ...  view the full minutes text for item 78.


Suicide Prevention Work pdf icon PDF 347 KB

The existing B&NES 2016-19 Suicide Prevention Strategy was refreshed at the start of 2020. In autumn of 2020 we developed a draft action plan and would like to share this with the Children, Adults, Health & Wellbeing Panel before progressing to implementation.

Additional documents:


The Associate Director of Public Health introduced this item to the Panel, a summary is set out below.


There are evidence-based actions we can take to reduce the risk of suicide

across our communities, for example amongst young people, men, people who

self-harm and people known to mental health services.


The purpose of the action plan is to deliver co-ordinated suicide prevention action within B&NES. The plan will be used as a framework to guide strategic direction and priorities for the period of 2020-2023. This is a living document and will be overseen and reviewed by the Suicide Prevention Group, a multiagency group chaired by Public Health B&NES. It will be accountable to the Health and Wellbeing Board and will report progress to the B&NES Community Safety and Safeguarding Partnership (BCSSP) through the Practice Review Group.


Involving those with lived experience and supporting providers is critical when bringing about collective change in suicide prevention, highlighting key gaps and establishing new ways of working. Therefore, one of the key principles of this action plan is to collaborate and engage with people with lived experience over the duration of this action plan.


The scope of this action plan has been informed through consultation with stakeholders, local need, reviewing national and local evidence based recommendations. The plan considers a life course approach and ensures communities of all ages and backgrounds are reflected in the actions.


The action plan and its impact will be monitored by the Suicide Prevention Group on a quarterly basis. Organisations and working groups who have provided actions will be encouraged to consider how they monitor and evaluate their own progress. An annual event will be held each year to showcase learning, provide an update on the progress of the action plan implementation and evolve further thinking.


Councillor Michelle O’Doherty asked if it was known why local self-harm hospital admission rates are higher than the England average.


The Associate Director of Public Health replied that this data needs further analysis and possibly on a national level.


Councillor Michelle O’Doherty asked how much effect it was felt that Covid-19 will impact on people’s mental health.


The Associate Director of Public Health replied that it is likely to directly impact people’s feelings relating to isolation and anxiety and that in the longer term issues such as job loss, relationship breakdown and bereavement could be factors to consider.


Councillor Jess David asked if in recent years if the suicide rates in B&NES had increased. She also asked if the local universities were involved with the work of the Action Plan.


The Associate Director of Public Health replied that the figures for the two previous years had been almost identical and had not seen an increase. He added that both universities were part of the Suicide Prevention Governance Group.


Kevin Burnett asked how could the information that three quarters of people who died were not in touch with secondary NHS mental health services, but many were in touch with their  ...  view the full minutes text for item 79.


Health Infrastructure Programme 2 (HIP2) Update pdf icon PDF 66 KB

This is a follow up presentation from the one in January 2021. The RUH has been developing an engagement plan with system partners to enable the development of a new care model for the future.

Additional documents:


Simon Cook, Programme Director introduced this item to the Panel, a summary is set out below.


The project has had a change of name nationally and is now known as the New Hospital Programme rather than HIP2.


Progress since January


·  Engagement plan ready for the Panel’s comment today

·  Clinical leaders appointed to lead the development with patients and the public

·  Analysis underway of implications of new care model

·  Met with Chair and Vice Chair for informal briefing


Strategic approach: proactive campaigns; three key phases in 2021


Phase 1: Launch and overarching broadcast comms

Phase 2: Purposeful engagement to develop new care model

Phase 3: Launch new care model and next stage of ongoing engagement


The Chair commented on the importance of the engagement programme and demonstrating that service users are on board with proposals.


Simon Cook replied that public engagement is a very important part of the programme. He added that where possible they will look to accelerate projects identified to take place between 2021-25.


Kevin Burnett asked if mental health was included within the Clinical Vision of the programme.


Simon Cook replied that it was.


Councillor Alison Born commented that the engagement programme would be a challenge to those that do not use technology and asked if that following this current lockdown some actual face to face meetings could be arranged. She added that she felt that more involvement from the public would be likely if the information supplied was light on jargon.


David Rose replied that they would be willing to attend Ward / Residents’ meetings and that they intend to work with Age Concern on any paper based information that is produced.


The Chair asked when the engagement programme would physically start.


Simon Cook replied that it would commence next week, which is only two weeks prior to the pre-election period when it would cease until May 10th through to July for the main area of engagement.


The Panel RESOLVED to note and approve the proposed engagement plan.



The Panel will receive an update on this item from the Directors of Adult Social Care & Children & Young People.


The Director of Adult Social Care, Complex and Specialist Commissioning

addressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.


Out of Hospital Discharge to Assess Arrangements


As of the 31st of March the national funding for the D2A (Discharge to Assess) process ceases. People who are discharged up to and on the 31st of March will continue to be supported for no longer than six weeks. However, those discharged on the 1st April will not and there is no indication of funding being available beyond that date. In the  recent policy paper: Integration and Innovation: working together to improve health and social care for all  the government states that there will be a legal framework developed for a  ‘Discharge to Assess’ model to replace the  existing legal requirement for all assessments to take place prior to discharge. There is, however, no indication of whether there will be any funding provided to support these duties. The Council are, therefore, discussing with the CCG how this work can be progressed within current resources.


Specialist Mental Health Care and Support – proposed whole system procurement


The Specialist Commissioning Team have developed a revised strategic commissioning approach for specialist services for adults with complex mental ill health. The team have recommended a phased approach to procurement whereby they identify a partner (or more than 1) to work with to develop a consortium approach. The formation of a consortium is aspirational and will take longer than other procurement methods such as block contracts and Frameworks on a sector-by-sector basis. However, this approach will mean the council will have a co-produced, flexible, adaptable and meaningful pathway of support for people and partners alike.


This procurement delivers on our statutory responsibilities which include the promotion of quality in the provision of services; is a key action in our draft strategic commissioning intentions; will ensure alignment with the transformation of community mental health services; and is a Council Commissioning Intention.


Mental Health White Paper – January 2021


In January 2021 the Government published the Mental Health White Paper -  a set of proposals around changes to the Mental Health Act; it is intended to be a consultation document despite its ‘White Paper’ title.


The Mental Health Act was changed from the 1959 Mental Health Act in 1983 and despite some minor amendments in 2007 the White Paper is considered to be one of the most far reaching reforms of an Act that could be accused of not having kept up with the changing times particularly in regard to a person’s rights and wishes. The principles of 1983 Act are acknowledged to be based on a paternalistic approach to the care and support of people with mental health needs.  The White Paper?is therefore an important step forward.


Consultation is due to end on the 14th April 2021 and Local Authorities, Mental Health Trusts and the Third Sector are currently working  ...  view the full minutes text for item 81.

Adult Services Director Update Report March 2021 pdf icon PDF 193 KB

Additional documents:


Panel Workplan pdf icon PDF 164 KB

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 workplan as printed.