Agenda and draft minutes

The Chair welcomed everyone to the meeting and those present introduced themselves.

The Chair will draw attention to the emergency evacuation procedure as set out under Note 5.

The Chair drew attention to the emergency evacuation procedure.

Councillor Dave Harding had sent his apologies to the Panel.

Laura Ambler (BSW ICB) had sent her apologies to the Panel and Lucy Baker (BSW ICB) was present as her substitute.

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 4.4 Appendix 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 Officeror a member of his staff before the meeting to expedite dealing with the item during the meeting.

There were none.

Kevin Burnett raised the following points.

·  Attendance of himself and Chris Batten missing from the front page.

·  Minute 99: Should read CEO of MAT, not Chair.

·  Minute 102: Awaiting Community Summit summary from Director of Education and Safeguarding.

·  Minute 105: Amend paragraph 6 to read ‘The Head of SEND replied that the applications are put before a multi-agency panel to establish whether (i) the child has SEND and (ii) whether their needs are above the level of what the school can normally provide. She added that they need to see a robust record of the offer of what the school has done.

The Chair informed the Panel that Councillor Dave Harding had contacted her regarding the following amendment.

Councillor Dave Harding commented that a recent survey of 3,500 pharmacists had shown that almost half of them were concerned about having enough staff in place to deliver the Pharmacy First initiative. He asked how the safety and wellbeing of patients would be monitored within B&NES.

With these amendments in mind the Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chair.

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 Adult Services addressed the Panel and said she was happy to take questions on the update report that had been provided. A copy of the report will be attached as an online appendix to these minutes.

Kevin Burnett commented that he was pleased that further discussions were taking place with community partners regarding the budget savings and asked if there was a timeline for completing the strategic review of services that they provide.

Councillor Born replied that the process was already underway and that contracts were being reviewed to gain an understanding of the service specification required for contract renewals. She added that the intention is to try to complete the review by September 2024 and that the Panel will be updated on progress where possible.

Councillor Liz Hardman asked what will happen in the next phase of communication with the community partners.

The Director of Adult Social Care replied that the strategic review will take place with the community partners on the services they provide and that principles of future work will be established with them.

She added that a period of procurement would then take place prior to implementation. She welcomed the level of engagement that had been received so far.

Councillor Hardman asked if any further cuts were planned to the Community Support contract.

The Director of Adult Social Care replied that those contracts are currently with HCRG, that the Council was working with them and that they were not expecting to make any further savings. She said that this was an opportunity to try to get more for our money and to focus on early intervention.

Councillor Hardman stated that she was pleased that the Council had passed the recent motion regarding Care Experienced Young People and asked if an update could be provided in six months’ time.

Councillor Paul May, Cabinet Member for Children’s Services replied that work was already underway and he would provide further information at the next meeting.

Councillor Joanna Wright asked if services are overlapping, will any further investment be required.

Councillor Born replied that they are seeking to see services become more strategic / streamlined and to be able to target funding better. She said that the review will try to make sure that any actions taken will not cost the Council more money in the future.

Councillor Wright asked when the Panel could next be updated on the review.

The Director of Adult Social Care replied that an update could be provided in July / August.

Councillor Ruth Malloy referred to the issue of oral health amongst children and asked what percentage of schools within B&NES had signed up to the Supervised Toothbrush Scheme, delivered by At Home Dental.

The Director of Public Health replied that 18 primary schools and nurseries were eligible to take part in the scheme, 13 are participating, 3 have declined and 2 have yet to respond. She added that this equated to 425 schoolchildren taking part  ...  view the full minutes text for item 115.

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues.

Lucy Baker, BSW ICB addressed the Panel and said she was happy to take questions on the update report that had been provided. A copy of the report will be attached as an online appendix to these minutes.

Councillor Michelle O’Doherty wished to share a recent experience of attending the A&E department at the RUH. She explained that initially she had taken her son to Paulton Minor Injuries Unit only to find out that there was no X-ray service available on that day. They then returned to the RUH and had a 7 hour wait before being seen. She said that whilst there she noticed at least 15 ambulances waiting outside the A&E.

She asked what services were in place for patients that don’t need to attend A&E and what is being done to address the backlog of ambulances waiting to deliver their patients.

Lucy Baker replied that a huge amount of work is being done to try to address the issue of ambulance backlog at A&E and that over the past 4-6 weeks the waiting time had reduced.

She said that a review of what services can be provided at the Minor Injuries Units was ongoing and that it does have provision of an X-ray service, but might not have been possible on this occasion due to staffing levels.

She advised that a separate Urgent Treatment Centre is available through contacting the 111 service to book an appointment.

She explained that discussions relating to forming a plan for future provision were due to begin next week with colleagues from Primary Care, Clinicians from A&E and the Urgent Treatment Centre and Community Clinicians.

Councillor O’Doherty said that she had called 111 and the option of the Urgent Treatment Centre at the RUH was not mentioned, they were advised to go to Paulton. She questioned whether having it on the RUH site was the most appropriate location as people would almost naturally go to A&E instead.

Lucy Baker replied that it has been acknowledged that more could be done to make the public aware of the Urgent Treatment Centre. She said that when contact is made through 111 the operator can access a directory of services, of which the Urgent Treatment Centre is one of them, and this now has a separate flow to those patients trying to access A&E. She said that updates on progress can be provided to the Panel.

Councillor Lesley Mansell asked if the Panel could be informed of who was in contention to being awarded the Community Health contract and what form of public consultation will take place.

Lucy Baker replied that as a live procurement process was ongoing, she was unable to provide any further comment.

Councillor Paul Crossley asked if a reply in principle regarding consultation could be given.

Lucy Baker said that in principle they would work with the public on this matter at some stage. She added that more information could be shared when allowed  ...  view the full minutes text for item 116.

This agenda item refers to work undertaken to better understand the rate of deaths from COVID-19 in care homes in B&NES, during the second wave of the pandemic in 2020-2021.

Councillor Alison Born introduced this item to the Panel. She explained that this report follows on from the interim report that had been previously submitted to the Panel that looked at a wider section of data regarding the pandemic and showed that whilst there was a higher than expected number of deaths within Care Homes, there was a low number of deaths within hospitals from Covid-19.

She said that this was a pattern that had been in place for some time locally with many people choosing for their end-of-life care to be with their own home or place of residence.

She said that a decision was taken to ask for an independent review to be undertaken to look at more detailed local data, and also qualitative data by speaking to people who had been working in the Care Homes during the pandemic. She added that she did not feel that any large concerns had been identified in the report, but that it does give an insight into what it was like at the time and what points can be learned in preparation for any such events in the future.

Theresa Redaniel addressed the Panel and shared some presentation slides. These slides will be attached as an online appendix to these minutes, a summary is set out below.

What is an Applied Research Collaboration or ARC?

·  Funded by the National Institute for Health and Care Research (NIHR), the nation’s largest funder of health and care research.

·  ARCs support applied health and care research that responds to the needs of local populations and health and care systems.

·  NIHR ARC West is one of 15 ARCs across England, part of a £135 million investment by the NIHR over five years.

·  Collaborations of local partners, including providers of NHS and care services, commissioners, local authorities, universities, companies and charities.

·  The research is done in collaboration with the partners as well as the public and communities.

What is applied research?

·  Applied health research aims to address the immediate issues facing the health and social care system.

·  ARC researchers do research that addresses the needs of the health and care system, the people who use services and other communities.

The research problem

·  Impact of COVID in care homes – cases 13 times higher than in the community.

·  Vulnerable population – higher risk of death & high number of deaths in care homes.

·  High death rates in care homes in B&NES – in comparison with similar areas.

The research aims

·  Determine why B&NES appears to have higher death rates from COVID in care homes compared to other locations.

·  Whether there are specific risk factors associated with COVID-19 infections and deaths in care-homes within B&NES.

·  To examine what learning from the first and second wave of the pandemic can be used to improve policy and practice.

Study design

·  Quantitative 

o  Risk factors for high COVID infection rates/death, e.g.

§  Care home size / Care home type / Care home ownership / Engagement with B&NES Council  ...  view the full minutes text for item 117.

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. Following a brief discussion, the items below were identified as potential reports to be added to their workplan.

·  Update on Covid-19 study

·  GP Triage service / repeat prescriptions

·  Care Experienced Young People (Cabinet Member Update)

·  3SG invite (June meeting)

·  Dental Bus

·  A&E avoidable admissions

·  Primary Care Access

·  Former Culverhay site

·  Suicide Prevention Strategy

·  Schools Health and Wellbeing Survey results

·  Public Health - Whole system improvement work

·  ICB Children & Young People Programme (inc. Mental Health & Social Media)

Councillor Wright asked if some joint working could take place regarding School Streets.

The Policy Development & Scrutiny Officer replied that this was a matter due to be discussed at the May meeting of the Climate Emergency PDS Panel. He added that they could discuss at the next Chairs & Vice-Chairs meeting whether any joint working should take place.