Agenda and minutes

In the absence of the Chair, the Vice Chair, Councillor Michelle O’Doherty welcomed everyone to the meeting and acted as Chair for the duration of it.

The Chair drew attention to the emergency evacuation procedure.

Councillors Vic Pritchard, Andy Wait, Joanna Wright, Rob Appleyard and Gerry Curran had all sent their apologies to the Panel.

Dr Bryn Bird, B&NES Locality Clinical Chair, BSW CCG had also 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.

There were none.

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

The Panel will receive a presentation on this item.

The Chair invited Nicola Hazle (Avon and Wiltshire Mental Health Partnership), Jane Rowland (BSW CCG) and Kate Morton (Bath Mind) to address the Panel.

Jane Rowland said that they would like to discuss with the Panel the way in which services across B&NES were transforming, gain their views on the approach that has been taken so far and hear any thoughts relating to future plans. She added that it was important to recognise the mental health needs of people post Covid.

Aligning priorities – MH and BSW Model of Care

·  Working together to empower people to lead their best life

o  Starting well

o  Living well

o  Ageing well

·  Personalised care – We want health and care to be right for every individual – not ‘one size fits all’

·  Healthier communities – We want people to live in communities that help them to live healthier lives

·  Joined-up local teams – People from the NHS, local authority, third sector and other partners will form teams together and we will have the right teams in your area

·  Local specialist services – We will provide more access to routine appointments, tests and treatments closer to where you live

·  Specialist centres – Our specialist centres like hospitals will focus less on routine care and more on specialist health and care.

Using digital by default

We will make full use of digital technology and data to improve health and care for people in BSW. We will also make sure that all our teams and services are inclusive for people with limited access to technology.

BSW System: Mental Health Priorities

·  Eating disorders – numbers are on the increase

·  16 – 25 years old – What provision is available through the transition into adulthood?

·  Personality disorders – Emotional trauma that has affected an individual. Sometimes referred to as Complex Emotional Needs

·  Older person services

·  Crisis services – Align with ambulance service and 111

·  Perinatal Mental Health

·  Neurodevelopment / ADHD

Where are we now…….

• Continued need to improve access and referral process – make getting support easier. Integrated approach with third sector and AWP

• Mental Health referrals above pre-Covid levels

• Increase in emotional wellbeing presentations. Increased anxiety in communities –including parental and family anxiety. Impact of wider determinants of Mental Health (e,g, housing, employment, family breakdown, bereavement, returning to school and current financial crisis)

• Priority focus on reduction on Out of Area Placements - a collaborative system response in progress

• Workforce risks – recruitment, retention and sickness. Impact on staff through Covid response and recovery

• Growing trust and confidence between statutory and third sector partners as we develop a different delivery model of care

• Understanding what people, families and staff have thought of the changes we have made and where we need to focus – regular engagement and co-production

B&NES: Key Themes

Nicola Hazle explained to the Panel some of the challenges and what will be seen as different in terms of provision.

High demand across the community services

•  New access model  ...  view the full minutes text for item 21.

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

Councillor Alison Born, Cabinet Member for Adult Social Care 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.

HCRG Care Group

The main focus of activity since my last report has been on the future of the Community Services contract.

Following the sale of Virgin Care to Twenty 20 Capital and it’s re-branding as HCRG, Cabinet and the CCG both had to decide whether to continue with the contract extension agreed in November ’21, or to let the contract lapse at the end of the initial 7 year term.

A further detailed options appraisal was undertaken and the decision not to grant the extension was made unanimously at both the Special Cabinet and the CCG governing Body meetings on 26th May.

Work is starting to establish a Transition Team to determine the future shape of services and to manage the transition over the next 21 months. Suzanne Westhead and I will keep this group updated on progress.

Update on system pressures and recruitment to Care posts

The number of Covid patients requiring hospital treatment has at last reduced significantly and the RUH has closed it’s Covid 19 ward. As a consequence, the social care sector is opening up again and the number of patients delayed in hospital is also reducing. I hope to be able to report further improvements in my next report but we are aware of people still catching Covid so the situation remains uncertain. In addition in the last week all our care homes are back open to admission and for the first time in over two years have no new declared cases.

Good progress is being made on recruitment to the in-house home care service such that a soft start will be achieved on the 6^th of June as new recruits begin their induction. The service is being named United Care B&NES (UCB) and we look forward to an official launch in a couple of week time.

A new tender has also successfully secured additional homecare hours in the private sector and we hope the combination of UCB and this tender will offer some significant support to the care and health system.

Staffing Update - Adult Social Care

I have provided information on a number of additions to the senior team in recent months and am pleased to report that Ann Smith has been appointed to the AD Operations post and will be joining us shortly.

In addition, Vicki Allan will be joining on 4^th July as the permanent Senior Commissioning Manager for Specialist Commissioning.

Englishcombe Lane Site

We are continuing to progress proposals relating to a limited supported housing development for this site and a paper will be presented to Cabinet this month.

Councillor Liz Hardman commented that it was good to see that option three had been chosen regarding the future of the Community Health and Care Services contract. She added that it is particularly  ...  view the full minutes text for item 22.

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

The Chair introduced the report to the Panel and explained that Dr Bird was unable to attend would therefore respond in writing to any questions. A copy of the update will be attached as an online appendix to these minutes.

The Director of Adult Social Care referred to the question that had been submitted in advance by Councillor Liz Hardman and said that she had drafted a response that had been shared with Dr Bird.

Councillor Hardman’s question was as follows.

It was good to see that the BSW CCG group also decided not to extend the health and social care services contract to HCRG. I notice that you are looking at the opportunity to explore integrating adult social care staff and third sector commissioning back into the council. As well as ensuring that the ownership of the contract will not change as happened with HCRG, can this be organised to start as the current contract ends?

The Director of Adult Social Care replied that commissioners will be undertaking a full options appraisal on which services will be recommended to either be in-housed or continue to be commissioned to an external provider. She said that the review will determine if there is a requirement for future commissioning of some Council funded services and the appropriate procurement process to be adopted, this will have a specific focus on sub-contracted services that are in the HCRG Care Group contract.

She added that the Council will review any future contractual arrangements to minimise any risks associated with the sale of the business within the contractual term.  However, any company is unlikely to accept a contract clause that prohibits them from selling the business to fulfil their own business strategy.

This report provides an update on the national legislative, policy and regulatory context that the Adult Social Care service currently operates in. It also describes key strategic activity taking place in 2022/23, alongside an overview of finance, performance and risks based on delivery in quarter four of 2021/22.

The Assistant Director for Integrated Commissioning introduced the report to the Panel and highlighted the following areas from within it.

The national picture

The Health and Care Act received royal ascent on 3rd May 2022 and laid down legislative foundations for an ambitious programme of national reform of Adult Social Care.

The Build Back Better programme aims to create a sustainable adult social care system that is fit for the future. It introduces new charging reforms for people who use social care and brings new statutory duties for local authorities. The programme has entered first phase of implementation, which means we will need more social workers, more financial assessors, and a new system to help ensure we support more people financially from April 2023.

Liberty Protection Safeguards (LPS) – a framework that will replace the Deprivation of Liberty (DoLs) – has now finished its parliamentary journey. Liberty Protection Safeguards will apply to everyone from the age of 16 years. While DoLs applies only to people in care homes and hospital, LPS will apply to people in supported accommodation, shared lives, and their own homes. New code of practice is currently out for public consultation until 4th July 2022. Government confirmed its intention to set a new fixed date for Liberty Protection Safeguards implementation post consultation to ensure that there is adequate time for implementation.

New Care Quality Commission (CQC) inspection regime for Adult Social Care (also referred to as Assurance framework) is expected to mirror the Ofsted inspection process and will begin in April 2023. The Adult Social Care Outcomes Framework that is being currently used to measure and compare performance of local authorities has been refreshed and is expected to be implemented alongside the new assurance framework. This means that we would need to have new performance management systems in place, with greater use of Business Intelligence tools, and develop more mature capability to evaluate customer experience, and evidence outcomes and impact at an individual, locality and system level.

The local picture

Health and Social Care Integration to join up care for people, place and population is continuing at pace nationally and locally. On 1st July 2022, the Banes, Swindon, and Wiltshire (BSW) CCG will be subsumed into the BSW Integrated Care System.

Recruitment to senior leadership posts in the new system is well advanced, with anew team of senior leaders joining over the next two months. New governance

arrangements, such as the Integrated Care Board and the Integrated Care Alliance are beginning to take shape, with system partners frequently coming together to collaborate to develop new ways of working at place and population level.

Our close working with the NHS and our wider community partners ensures we

continue to promote, maintain, and enhance people’s wellbeing and independence so that they are healthier, stronger, more resilient, and less reliant in the future on formal social care services. Doing this is better for people in terms of their longer-term outcomes and better for B&NES Council to help make funding  ...  view the full minutes text for item 24.

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 Chair introduced this item to the Panel and asked if they had any proposals for future agenda items.

Councillor Paul May suggested that the Panel receives a report on School Performance / Closing the gap.

Councillor Ruth Malloy proposed that the Panel has a report on the interaction between the Ambulance Service and the RUH.

The Director of Adult Social Care commented that she believed that the Chief Executive / Chief Operating Officer of the RUH would like to attend a future meeting.

Councillor Liz Hardman said that she would like the Panel to receive further information in relation to Children Missing Education.

Councillor May said that he wanted the Panel to have a discussion on the overall education picture locally and possibly invite a Chief Executive from a large Academy to attend a future meeting.

Councillor Hardman suggested that a representative from the Schools Standards Board be invited to a future meeting.

Councillor Alison Born reminded the Panel that there would likely be an update on the Community Health and Care Services contract in September.

The Chair thanked everyone for their suggestions and said they would be discussed when setting future agendas.

The Panel RESOLVED to note the workplan as printed.