Agenda and minutes

Gill Stobart, Co-opted Panel Member had given her 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 Gerry Curran declared an other interest with regard to agenda item 7 (Cabinet Member Update) as he is a former employee of Virgin Care, now HCRG.

Councillor Paul May declared an other interest with regard to agenda item 10 (Draft Budget Assumptions 2022/23) as he is a member of the Avon Pension Fund Committee.

Pam Richards, Protect Our NHS BANES made a statement to the Panel on the subject of the Virgin Care takeover. A copy of the statement can be found as an online appendix to these minutes and a summary is set out below.

Protect Our NHS BANES remain very concerned about the takeover of Virgin Care by a private equity company Twenty20 Capital. The way in which Virgin Care negotiated an extension of their contract with BANES Council and BSW CCG without any mention of this impending takeover was disgraceful and duplicitous.

We are surprised that this Committee has no item on their agenda to review progress and look at options. 

We therefore wish to re-iterate the questions that we posed in December as we believe that the public who fund the contract and benefit from the services that they deliver have a right to know. 

We have several questions about the legality and status of the contract extension

Was the extended contract signed off with Virgin Care and if so is this legally binding?

Is the decision about the contract extension valid in view of the fact that one of the parties ie. Virgin Care no longer exists as a company?

If this contract goes ahead, will HCRG be bound in law to observe all the current provisions of the contract including the agreement to re-invest any profits from the running of the contract back into BANES services?

We are deeply concerned about the possibility of a private equity company now owning and running our community health and social care services. We have looked at the websites of Twenty20 Capital and HCRG and see nothing to reassure us that these companies are anything other than profit driven, asset strippers who buy up and sell on companies with little respect for the services that the companies provide or the staff who work for them.

Protect Our NHS has consistently opposed the privatisation of health and social care services. This latest development confirms our worst fears. There is nothing to prevent this situation occurring again with staff and services regularly packaged up and sold on. The only solution is to insource the services and bring them back into the NHS and Local Authority.

The Chairman commented that he shared many of the concerns and questions raised and that he will await the replies from the Cabinet Member and officers.

Councillor Joanna Wright asked if the Panel should consider holding an additional meeting to discuss this specific matter solely.

The Chairman replied that he felt it was difficult to make this decision at the present time without seeing the answers to the questions raised.

Councillor Liz Hardman said that she felt that there would not be enough time between the Panel’s March 8^th meeting and a decision being made by the end of March. She asked Pam Richards what she knew about HCRG.

Pam Richards replied that they were a newly setup company in 2021 and had links to other companies,  ...  view the full minutes text for item 73.

The Chairman referred to page 13 and asked if the ICS mandatory roles had been appointed.

Corinne Edwards, B&NES Chief Operating Officer, BSW CCG replied that the Health & Care Bill had been delayed and therefore the implementation of the Integrated Care System and the Integrated Care Board will not take place until 1^st July 2022. She confirmed that an appointment had been made to the mandatory role of Chief Executive and that a recruitment process was underway for the remaining roles of Director of Nursing, Director of Finance and Medical Director. She added that an announcement on the future roles of the CCG Executive Team was expected towards the end of January 2022.

Kevin Burnett asked when it was likely that the BCSSP dashboard will be ready.

The Director of Education & Safeguarding replied that it was due to be ready from April 1^st 2022.

Kevin Burnett asked how developments were going re: engagement with the education sector on school representation within the BCSSP.

The Director of Education & Safeguarding replied that following a meeting of the School’s Standards Board on 9th December the CEO of the Palladian Academy Trust has volunteered to be part of the BCSSP Executive. He added that they were also seeking to appoint Primary and Secondary Designated Safeguarding Leads to be representatives on the Education Reference Group.

Kevin Burnett asked when the Panel might have an update on transitional safeguarding and community safety monitoring and evaluation, which was suggested should be a focus for the Panel.

The Director of Education & Safeguarding replied that these elements will be focussed upon during the next BCSSP Annual Report which would be due to be published in Autumn 2022.

Councillor Joanna Wright commented that there quite a lot of acronyms within the minutes and would find it helpful if there was a sheet within the agenda pack that could explain them.

Councillor Paul May referred to page 6 and said that he did not feel that the discussion on the future of the Panel was a true reflection and that a vote had taken place. He added that he had asked a question on the issue at a recent Cabinet meeting and that the matter needs to be officially discussed.

Councillor Rob Appleyard suggested that the Cabinet Members need to be involved in these discussions.

The Panel confirmed the minutes of the previous meeting.

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

Councillor Alison Born, Cabinet Member for Adults addressed the Panel, a summary is set out below and a copy of the update will be attached as an online appendix to these minutes.

System pressures

Since our last meeting, the recent wave of the Omicron variant of Covid has caused significant additional pressure to the health and social care system. This intensified over the Christmas period due to high case numbers, staff absences and the additional capacity needed to deliver the booster programme. The local health and social care system has continued to work together very effectively.

Proud to Care Campaign

The Proud to Care campaign is one of a number of initiatives that have been developed to try to address the shortfall of care staff in the local area. It aims to celebrate the work of carers and to attract more people into the sector. Following an initial recruitment fair, held in the Guildhall in September ’21, a further event was held at Bath University and another is planned for this Friday at Midsomer Norton Town Hall. The recruitment fair will provide an opportunity for potential recruits to meet with a range of local employers and representatives of Bath College who can provide information on job vacancies, apprenticeships and other training opportunities.

Community Health and Care Services

Following the unexpected announcement on December 1^st that Virgin Care had been sold to Twenty20 Capital and re-branded as HCRG, as decision was made to pause the planned contract extension. This was to allow time for comprehensive due diligence to be undertaken on the new provider and for commissioners to reflect on the implications of the change of circumstances.

The Chairman commented that he was concerned that transformation and modernisation would lead to a reduction in services.

Councillor Born replied that a great deal of this work was around how people can potentially receive services in a different way with involvement from the 3^rd sector ahead of statutory provision.

The Chairman asked how much of the £4.6m from government in terms of recruitment and retention would be allocated to Social Workers for an increase in their pay.

The Director of Adult Social Care replied that in respect of modernisation, one element of that is the Transitions Service which is trying to make sure that when young people move into Adult Services that they are able to stay local and have an independent approach to their services.

She added that a providers meeting had been held to discuss the best way to get the funding to our frontline services. She added that for every uplift they would seek for this to result in the minimum payment of £10.50 per hour for carers.

Councillor Liz Hardman asked for it to be confirmed whether the Virgin Care / HCRG contract extension had been signed or not.

Councillor Alison Born replied that the contract extension has not been signed.

Councillor Hardman asked that the questions she has submitted regarding HCRG, alongside those of Pam Richards,  ...  view the full minutes text for item 75.

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.

Current pressures on local health and care system

The Royal United Hospital recently declared an Internal Critical Incident over increasing pressures caused by staff sicknesses, treating Covid and non-Covid patients and the availability of beds.

Although this has now been stood down and things at the hospital are more stable, the position is still challenging and a number of initiatives are underway to alleviate pressure and help with flow through the hospital by discharging patients who are well enough to go home.

A number of options are under review including using a community ward at St Martin’s hospital to accommodate patients, looking to utilise different areas of the RUH to accommodate more beds and setting up a temporary care facility at a hotel in central Bath.

Pressures are also still being felt in our community services and in primary care where staff absences due to covid continue to cause problems.

The main messages are 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.

New community based Paediatric Urgent Service Hub

A new community based Paediatric Urgent Service Hub (PUSH) has been established in in B&NES in order to help reduce pressures on both primary &

secondary care.

The service has been set up by local GP Federation B&NES Enhanced Medical Services (BEMS) and is for children up to the age of 5 with symptoms of fever and who are acutely unwell and need a face-to-face review.

The service will run from two sites, St James’s Surgery and Elm Hayes in Paulton, and will run Monday to Friday, initially for afternoons only between 1pm-6pm with a view to running a morning session too from 8am-1pm, if the afternoon sessions prove successful.

Temporary care facility opened at Bath hotel to help free up beds in local hospitals

Patients well enough to leave local hospitals but who require further care before they can return home are to be accommodated in a new temporary care facility at a hotel in Bath.

The new facility is being opened on a temporary basis as a way of releasing much needed hospital beds as well as providing a more appropriate environment for patients to recuperate before they return home.

The shortage of hospital beds is due to high levels of patients requiring treatment for Covid, other winter illnesses and ongoing winter-related pressures.

Homecare agency Abicare have been contracted to supply live in staff to provide care at the hotel.

Kevin Burnett asked if the Paediatric Urgent Service Hub (PUSH) would take staff away from other existing services and whether this was a temporary service.

Dr Bird replied that  ...  view the full minutes text for item 76.

This report was requested by the Council’s Scrutiny Panel to understand the impact of Covid 19 on women within our workforce. This has been widened throughout to focus on the impact on the workforce as a whole reflecting on differences between male and female staff where possible.

Councillor Liz Hardman asked given the mixed experience of staff working from home whether it was the right decision to remove so much office space at a time of so much uncertainty, in the middle of the pandemic, thereby depriving staff of the opportunity to go back to their previous ways of working even if they wanted to. 

The Director of People & Policy replied that this was slightly outside the remit of the report but said that staff have been able to return to offices when required. She added that some of the 66 staff met as part of this work said there were benefits in terms of saving time on commuting. She said that office use would be kept under review.

Councillor Hardman asked how many members of staff are still waiting for a laptop and what is the timescale for them receiving what they need to do their jobs.

The Director of People & Policy replied that 1,036 new laptops have been issued alongside a significant number of reissued I-pads and laptops. She added that around 900 new laptops were still due to be deployed and that issuing them had slowed down due to the current Omicron wave. She said that they were all expected to be handed out this year.

Councillor Paul May asked if workplace assessments were carried out for staff working at home.

The Director of People & Policy replied that when staff were first asked to work from home all were asked to complete a DSE Self Assessment. She added that within the past month staff have been asked to complete these assessments again to identify any changes in circumstances.

Councillor May asked if the impact on our communities had been assessed due to staff not being in the office and gave Planning enquiries as an example.

The Director of People & Policy replied that the report in this instance is staff focused and that they could look to hold further focus group meetings that might pick up any community issues.

Councillor Joanna Wright asked if the costs to individuals in terms of energy and heating have been addressed.

The Director of People & Policy replied that the Corporate PDS Panel had raised a similar issue and said that there was work to be carried out regarding this.

Councillor Andy Wait referred to section 3 of the report (Council Workforce) and asked if the additional 130 staff within the Council (March 2020 – August 2021) was something to celebrate or did it mean that we were able to do things better or provide extra services.

The Director of People & Policy replied that the bulk of those figures would be staff that have transferred in from the three Care Homes as mentioned in the report. She added that turnover of staff had been relatively constant but not disproportionate given the circumstances.

Kevin Burnett commented that a recommendation within the report suggests having more focus groups. He asked has the Council consulted with mental health specialists in the best  ...  view the full minutes text for item 77.

The Medium Term Financial Strategy was considered by the Cabinet at their 9^th September 2021 meeting. It presents the future years Medium Term Financial Strategy that sets how the Council will need to respond to the budgetary impacts of Covid over the next 5 years.

Kevin Burnett asked are there Services that will provide less than they currently offer after possible savings have taken place.

The Chief Operating Officer replied that a number savings lines involved the rebasing of budgets with Physical Disability & Sensory Impairment Purchasing

Activity as one example.

She added there were also a number of growth areas listed within Appendix 2 such as Home to School Transport and Educational Psychology.

Kevin Burnett commented that there are a lot of ‘amber’ coded proposals. He asked what will happen if these savings don’t materialise.

The Chief Operating Officer replied that in terms of savings being ‘amber’ this was more a timing issue for when they could be achieved.

Kevin Burnett asked what new initiatives will be brought in with this budget.

The Chief Operating Officer replied that interesting work was anticipated around the Transformation projects listed in the report.

Councillor Liz Hardman said that she felt it was hard to comment as there was not enough detail in the report. She asked how savings would be made in Library Services.

The Chief Operating Officer replied that they were looking to introduce a package of measures to increase opening hours for self service use with staff on site at peak demand hours. She added that they were assessing whether outreach services could be delivered differently via Hubs or home delivery.

Councillor Hardman asked if the savings listed for the Bath West Children's Centre Service were linked to Family Hubs.

The Director of Children's Services & Education replied that the savings involved were as a result of reduction in contract value and would have no impact on services. She added that this was not linked to Family Hubs.

She added that a bid for funding in terms of Family Hubs has been submitted to the DfE which if successful would see the remit of this work expand to 0-19. She said that a decision on the funding was likely in March.

Councillor Hardman asked if the proposed saving about home to school transport to alternative provision is linked to the development of Culverhay.

The Director of Education & Safeguarding replied that a feasibility study in terms of site use and possible relocation of services was taking place with respect to Culverhay. He added that if any work was required on the site that would be funded from the Schools Capital budget.

Councillor Paul May said that he would not want to see the quality of our services weaken through any of these budget decisions. He asked if any contingency plans had been made regarding Virgin Care / HCRG.

The Chief Operating Officer replied that the budget remains in place and that they are awaiting outcomes of the ongoing due diligence.

Councillor Andy Wait asked why the proposal relating to the Foster Care Transformation Project / Reunification Transformation Project had not been done before and was it achievable.

The Chief Operating Officer replied that work had already begun in this area to attempt to increase the number  ...  view the full minutes text for item 78.

Geoff Underwood, Programme Director, NHS South, Central and West addressed the Panel, a summary of the presentation is set out below.

Public engagement

• 2nd November – 14th December

• Online survey – 915 responses

• Engagement meetings and workshops, mostly online – 51 events involving over 1,400 attendees

• Interviews and meetings focusing on harder to reach groups

• Final report due 17th January

Emerging themes

• Generally positive response to the model but many wanted more detail, including how the new way of working will be funded

• How will it link with other partners, domiciliary care, care homes, social care, the voluntary sector?

• Overall – strong appetite for future engagement as plans develop.

He said that the term ‘digital by default’ might need amending / clarifying as this was meant to show how we can be smart in the use of data and new apps and was not meant to disadvantage those who are not so familiar with IT or who have connectivity issues.

Simon Cook, Shaping a Healthier Future Programme Director addressed the Panel.

Next steps

January

• Update the model based on feedback from the engagement

• Likely to produce more detailed documents/media to explain the model in more depth

• Initiate work on aligning operational planning and transformation plans with the model

February

• Confirmation at BSW Partnership Executive (18th) and BSW Partnership Board (25th)

March

• Complete alignment of plans for 22/23 to the model

April-June

• Delivery of operational plans and transformation programmes ahead of the formal launch of the Integrated Care System in July

He asked to further update the Panel in March and for them to consider whether a formal public consultation was required.

Kevin Burnett asked if part of the consideration with the term ‘digital by default’ was not only access to technology but the possible loss of human contact and understanding.

Geoff Underwood replied that they recognise the concerns that have been raised and do not want to exclude anyone from taking part or understanding this process or what it means for their services in the future. He added that it was hoped that the programme, for a large number of people, would increase their options to access care.

Kevin Burnett asked what the difference is between the current ‘public engagement process’ taking place and a ‘formal public consultation’.

Simon Cook replied that a formal consultation would take place over 12 weeks and is normally required when major service changes are planned that have a risk of disadvantaging some members of the public in some way, such as closing an A&E or a maternity unit. He added that there is no intention of that with this programme as it is an investment project and in fact the Trust is planning to invest in an Alongside Midwifery Unit and new Integrated Accident and Emergency unit.

He said that a six week period of public engagement had already taken place towards the end of 2021 across BSW and  ...  view the full minutes text for item 79.

The Director of Education & Safeguarding introduced this report to the Panel. He informed them that the co-author of the report Simon Lock, North Somerset Council was also present and that he had been supporting the B&NES Hub for the past 9 months.

He said that he felt that the service was in a much better place now than it had been previously and that in general terms the DfE were looking to increase the footprint size of the service.

He stated that the proposal is for the B&NES Music Service to join a West of England Music (and Arts) Alliance; a tri-hub music alliance (shared service) between B&NES, North Somerset and South Gloucestershire to secure and take forward the existing work of B&NES Music Service. He added that a consultation on these proposals will be carried out.

Simon Lock commented that the proposal would follow a national formula, broaden the vision of the service and aim to give provision to 0 – 25 years of age.

Councillor Joanna Wright asked how the age range of 0 – 5 would be consulted. She said that it is a most important service and should be retained.

Simon Lock replied that this would be done by seeking the views of parents. He added that the intention is to unify the services, to have a shared strategic overview and reduce back office costs.

The Director of Education & Safeguarding commented that officers feel passionate about the service and can see the value that combining their work will have.

Simon Lock added that there was no anticipated reduction in frontline management and that through this process it was hoped that workforce development would be enhanced.

Councillor Liz Hardman asked given the proposals contained in the paper, is it realistic to expect the B&NES surplus to remain static over the next two years and how can we ensure that any surplus generated in B&NES is used to support our priorities. She added that given the low level of surplus in B&NES relative to the other local authorities, will we find it more difficult to have our voice heard in this proposed new arrangement.

Simon Lock replied that the delivery of the service at present is quite traditional through schools, music centres and some events and these are the elements the budget is based upon. He added that if used jointly the surplus that is generated by all three Local Authorities can help deliver better and more impactful programmes that can directly support the wider priorities for each Local Authority.

He said that the basis of the Alliance is that it is an equal partnership with an equal voice and a shared governance.

Councillor Ruth Malloy commented that the partnership was a sensible idea and said that the offer from it needs to inclusive to as many pupils as possible. She asked if any specific consideration had been given to deaf pupils.

Simon Lock replied that inclusivity was at the core  ...  view the full minutes text for item 80.

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 Chairman introduced this item to the Panel.

Chris Batten suggested that Jane Davis, Principal of Bath College address the Panel at a future meeting and give a presentation on the current work of the college.

Kevin Burnett asked if the Transformation Plan Update report would include any information on Voluntary Services.

The Director of Children's Services & Education replied that an Annual Report had been received from the Voluntary Services Network that she could circulate to the Panel.

The Panel approved the workplan as printed.