Agenda and minutes

The Chairman welcomed Panel members and officers who were attending the meeting via Zoom and members of the public viewing on YouTube.

He announced that the meeting was being held under The Local Authorities and Police and Crime Panels (Coronavirus) (Flexibility of Local Authority and Police and Crime Panel Meetings) (England and Wales) Regulations 2020. He stated that the Council had agreed a protocol to cover virtual meetings and that this meeting would operate in line with that protocol.  He explained that the meeting had the same status and validity as a meeting held in the Guildhall.

Councillor Liz Hardman, David Williams (Co-opted Member), Chris Batten (Co-opted Member) and Mike Bowden (Corporate Director) had sent their apologies to the Panel.

Councillor Eleanor Jackson was present for the duration of the meeting as a substitute for Councillor Hardman.

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 in respect of agenda item 13 (Corporate Director’s Briefing) as he is a non-executive Sirona board member.

Shiva Page submitted a question to the Panel as follows:

Is it accepted and usual practice for an employee in the CCG who is a Commissioner of a service to advise said service to withdraw a particular service from a service user?

Dr Brynn Bird, BaNES locality Clinical Chair reply (on behalf of the Panel / CCG):

It is hard to comment on this question without greater clarity of the circumstances being described. Commissioners would not generally be making decisions about individuals and their access to specific services, however there are CCG policies and procedures in place for decision-making in respect of certain treatments and services the CCG does and doesn’t fund (https://www.bswccg.nhs.uk/your-health/what-we-do-and-don-t-fund).

It would be helpful to better understand the specific circumstances that have prompted the question (which would not be appropriate to explore in this public meeting) so that we can provide a more specific answer.  We would ask Shiva Page to contact the CCG either by email BSWCCG.feedback@nhs.net or tel 0300 123 2103 or 0300 01304762 so that this can be looked into or alternatively we can ask a member of our Patient Advice & Liaison Team to make contact with Shiva.  It would therefore be helpful to know which Shiva would prefer.  For transparency, we can report back to the PDS committee in future on the answer provided.

The Chair referred to the question from Kevin Burnett regarding if any further information was yet available from the Secretary of State on the issue of funding pressures in the education system and asked for an updated response from officers.

He also asked for confirmation as to whether maternity services in Paulton had ceased in April.

Councillor Andrew Wait said that he had not yet had a response to his request for a year on year breakdown of the Virgin Care budget balance.

The Director of Adult Social Care, Complex and Specialist Commissioning replied that an update report was due to be presented to the Panel in September and said that this information would be covered in the report.

Councillor Eleanor Jackson asked if the role of the registered nurse within the CCG had been filled.

The Director of Adult Social Care, Complex and Specialist Commissioning and Dr Brynn Bird replied that they would seek a response to this question.

The Panel were informed subsequently that this position had been filled.

Councillor Jackson asked how many panel members had now been recruited to the Our Health Our Future panel.

The Director of Adult Social Care, Complex and Specialist Commissioning and Dr Brynn Bird replied that they would seek a response to this question.

The Panel were informed subsequently that over 800 panellists had signed up and that some more would be welcome as part of an ongoing recruitment campaign. More details can be found here:

https://bswccg.nhs.uk/news-events/news/324-public-invited-to-have-its-say-on-local-health-and-care-as-part-of-new-interactive-citizens-panel

With these comments in mind the Panel confirmed the minutes of the previous meeting as a true record.

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. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

Covid

The Covid pandemic has been a challenging time for everybody. I would like to take this opportunity to acknowledge again the brilliant efforts of the many individual staff and partner organisations across the Council, NHS, Third Sector, Virgin Care, and many more, who have gone the extra mile and worked tirelessly to respond to the unprecedented and rapidly changing circumstances in which the world has found itself. The work of Recovery and Renewal is now proceeding and we need to consider how we can continue to work together to sustain some of the positive initiatives, like the Compassionate Communities Hub, which has provided help to many people in a time of need.

Local Outbreak Management Plan

As we move into the next phase of the response to Covid, it has been important to agree a plan for the way in which any outbreaks will be managed locally. The development of this plan has been led by Dr Bruce Laurence, Director of Public Health and I was pleased to endorse it both through the Health & Wellbeing Board and Cabinet.

Care and Support Charging and Financial Assessment Framework

This framework, which was approved by Council as part of the budget-setting process in February, has been implemented since the panel last met. Whilst there have of course been some queries along the way, I am pleased to say it has largely gone very smoothly and I would like to reiterate my thanks to officers involved in what has been a massive piece of work ‘behind the scenes’.

Councillor Eleanor Jackson asked for the contribution that independent pharmacies have made during the pandemic to be noted.

Councillor Appleyard replied that it should indeed be noted and that he was aware of their work through the Compassionate Communities Hub.

Councillor Jess David asked if the Council were preparing yet for the upcoming Winter challenges alongside tackling the problems of Covid.

Councillor Appleyard replied that the Council will not be complacent and that he felt that the Winter pressures could come in a different form to normal. He added that he has already made enquiries regarding stocks of PPE for Care Homes and Hospitals.

Councillor Michelle O’Doherty asked if adequate Covid testing was taking place within our care homes.  She also asked if the Council was sure that nobody was now being discharged from hospital to our care homes without being tested first.

Councillor Appleyard replied that he believed that testing was taking place in care homes and in hospitals prior to being discharged to a care home. He added that he would seek confirmation on that.

The Director of Adult Social Care, Complex and Specialist Commissioning added that she understood that care home patients were tested for the virus every 28 days  ...  view the full minutes text for item 7.

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

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

Merger of Bath and North east Somerset, Swindon and Wiltshire CCGs

The merger of Bath and North East Somerset, Swindon and Wiltshire CCGs took place on 1^st of April 2020.

The newly merged CCG serves a combined population of 934,000 and will maintain its roots in local communities and continue to be driven by local clinicians from the 94 practices across Bath and North East Somerset, Swindon and Wiltshire (BSW).

Operating at scale across BSW means strategically commissioning services and reducing variation in care so everyone receives high quality treatment, regardless of where they live.

BSW CCG, as part of the wider BSW STP Partnership, is working towards becoming an Integrated Care System (ICS) by April 2021 and will be assessed by NHS England in November.

Response to coronavirus

As part of our initial response to coronavirus, BSW CCG quickly established an Incident Coordination Centre to oversee our health response to the pandemic.

An organisation-wide response to manage coronavirus was also introduced with new work-stream programme management arrangements to ensure a focus on maintaining critical services. 

In BaNES, Swindon and Wiltshire, a Community Response Hub was established to provide a local response to coronavirus and to support community services and care home providers.

Reset and recovery of local services post coronavirus

Services across all providers in BSW were significantly scaled back during the start of the coronavirus pandemic, following the government’s decision to pause all non-urgent healthcare services and redirect 100 per cent of the NHS’s  efforts and resources into responding to what was, and still is, an unprecedented challenge.

However, at the end of April 2020, following a sustained period during which the number of confirmed cases of coronavirus continued to fall, Simon Stevens, Chief Executive of NHS England, issued an open letter that requested all NHS systems to use the next six weeks to look at restarting non-urgent activity.

Work is underway across BSW to find the best approach to restarting, resetting and recovering our services, bearing in mind all of the time, that we need to reassure the public that services are always available for those in need and that services are clean and safe to use.

We will do this through a coordinated communications approach using social media, radio interviews, print and online coverage, videos and paid-for advertising. Working closely with both clinical and commissioner colleagues, the CCG will produce messaging and content specific to cancer, cardiovascular, mental health, maternity and outpatient services.

Nightingale hospital

Another part of the local response to coronavirus was the rapid building and opening of a new Nightingale hospital at the University of West of England Frenchay campus in Bristol. The new facility is one of seven across the country.

Work began on the 300 bed facility on  ...  view the full minutes text for item 8.

B&NES had a full Ofsted Inspection in 2017 under the Single Inspection Framework (SIF). Ofsted accessed B&NES to be GOOD overall, with some areas for further improvement. The aim of this paper is to provide the Panel with assurance that areas for further improvement have been fully considered, that changes have been made and as a result, standards have been retained or improved.

The Director of Children & Young People introduced this report to the Panel. She explained that B&NES had a full Ofsted Inspection in 2017 under the Single Inspection Framework (SIF) and that Ofsted assessed B&NES to be GOOD overall, with some areas for further improvement. She added that the report details our improvement journey to date since 2017, ensuring that a consistently high-quality service is provided to keep vulnerable children and their families safe and supported in B&NES.

She highlighted to the Panel the recommendations from 2017 Single Inspection Framework and the areas for improvement as described in the  Ofsted Focused Visit for Care Leavers in November 2019.

She stated that in relation to the recommendations and areas for improvement, the service had recently revised the Quality Assurance Framework setting out our values, standards and the range of assurance activity; providing a structure and further supporting the work of the Service Improvement Board (SIB). 

She informed the Panel that a new moderating process for audit activity was introduced which was aimed at supporting a consistent application of Ofsted gradings in service audits, whilst also raising the quality standard of auditing from which to draw learning. All managers, Heads of Service, the Director, Principle Social Worker and some IRO’s carry out bi-monthly audits around agreed areas of practice and findings are disseminated across the service and taken to the Service Improvement Board.

She explained that a review of the front door system post inspection was undertaken that informed changes, processes and functionality. She added that this is now being further improved with the help of an internal cross-council Improving How We Work Project that is working with the Service to streamline and support better access to the right level of support at the right time more easily for individuals and professionals alike. 

She said that the Ofsted Focused Visit for Care Leavers in 2019 validated progress in several areas for our Care Leavers since the SIF inspection 2017.  Inspectors noted that the quality and timeliness of visiting and intervention had improved, keeping in touch arrangements are successful and the introduction of a dedicated Unaccompanied Asylum Seeking (UASC) worker was also recognised as a great resource by inspectors with exciting possibilities ahead for this aspect of the service.

She stated that the Virtual School had worked tremendously hard to reduce the number of fixed term exclusions for Children in Care and that this number has reduced but remains an ongoing area of focus for the team. 

She informed the Panel that Children’s Social Care have a successful ASYE programme for newly qualified social workers and a good retainment rate on completion of this programme, although across the service generally, recruitment remains a challenge. She added that it is hoped that the re-design will not only support better outcomes for children and their families but will also be more effective at supporting staff satisfaction and wellbeing impacting on staff retainment.

She said that colleagues in the Commissioning Service are also driving  ...  view the full minutes text for item 9.

The School Organisation Plan 2019 – 2025 at Appendix 1 (the Plan) covers the current level of primary and secondary school provision in the Authority and projected pupil numbers up to admissions in September 2023 for primary and 2025 for secondary, based on births and resident population data.

The Director of Education, Inclusion and Children’s Safeguarding introduced the report and said that it seeks to provide reassurance of the number of school places available over the coming years. He added that there was a separate process for planning for places for those pupils with Special Educational Needs and Disabilities (SEND).

The School Organisation Manager explained that due to the delivery of new schools and school expansions over recent years and to further expansions and new schools under construction and planned, primary school provision is expected to be sufficient for future pupil numbers arising from underlying population growth up to 2023 and housing development allocated in the Core Strategy period.

She informed the Panel that in most areas, existing secondary school provision is expected to be sufficient for future pupil numbers arising from underlying population growth up to 2025 and housing development allocated in the Core Strategy period. She said that additional capacity is expected to be required in the Greater Bath Consortium Planning area and the Norton Hill Planning area.

She added that should a shortfall of secondary school places be projected as a result of future proposed new housing development identified in the Local Plan, the Authority will apply CIL funding or seek S106 Developer Contributions to provide additional school places and that these places are likely to be delivered via the expansion of existing schools.

The Chairman commented that he was aware that Chew Valley Secondary School could expect a further 500 pupils in total.

The School Organisation Manager replied that this was a significant number but that most of those pupils will likely to be living outside of the school’s catchment area, so Chew Valley had sufficient capacity for B&NES residents.

Councillor Eleanor Jackson said that the impact of the Mendip Local Plan if approved would be considerable as it would potentially allow 515 new dwellings on the border of Westfield and Midsomer Norton. She added that around 180 of these dwellings would be in close proximity to Westfield Primary School.

She stated that Section 106 and CIL funding does not follow the pupils across Council boundaries.

She said that she believed that the information provided on page 56 of the report was out of date as the Radstock Railway Line housing development had already been completed and that permission for the approved Old Pit Yard, Clandown had lapsed.

She said that the application for further housing at theformer MoD Ensleigh site referred to in the Plan had recently been turned down by the Planning Committee.

She asked, referring to Whitchurch, where children might be displaced to Bristol, what agreement do we have in place to ensure that spaces will be available in Bristol for these children.

The School Organisation Manager replied that the displaced primary age pupils would be expected to be Bristol residents and therefore the responsibility of Bristol City Council. Also that cross border communication with school place planning colleagues in Bristol is ongoing and constructive.  Whitchurch is  ...  view the full minutes text for item 10.

The report informs the Panel about the number and type of complaints and related feedback, including compliments, received between April 2019 and March 2020.  It demonstrates how the complaints and feedback have been managed and how the outcome is used to inform service improvement.

The Complaints & Data Protection Team Manager introduced this report to the Panel. She explained that the report sets out the number of complaints, compliments and concerns received between April 2019 and March 2020. She informed the Panel that a total of 55 complaints were received; 12 of these complaints were referred to Virgin Care for investigation and four enquiries were received from the Local Government and Social Care Ombudsman.

She added that the report details the type of complaint received, the response to these complaints and the actions taken by services to ensure learning is derived from the complaints and related feedback.

The Chairman commented with regard to section 6.7 of the report and the two complaints that concerned self-funders accessing extra care schemes which resulted in a change of decision. He asked if the change was in their favour.

The Complaints & Data Protection Team Manager replied that it was in favour of the complainant.

The Chairman asked if the complaints referred to at 6.9 and 7.5 of the report were from people who were possibly new to the process.

The Complaints & Data Protection Team Manager replied that she couldn’t recall, but said that a lot of complaints are received regarding care and support funding. She said that often it can be a misunderstanding and therefore there is a need for better communication between both parties.

Councillor Eleanor Jackson that it was striking the number of complaints that were due to processes and said that this must be an area to improve on.

The Complaints & Data Protection Team Manager replied that the report does dwell on process, but was encouraged that complaints were not generally being received with regard to visits and service delivery.

Councillor Ruth Malloy asked if further information could be supplied regarding the system for responding to MP and Councillor enquiries.

The Complaints & Data Protection Team Manager replied that she would be happy to produce something for the Panel.

The Panel RESOLVED to note the contents of the report.

This report provides an update on progress, key achievements to date and presents a draft food poverty action plan for comment.

The Public Health Development & Commissioning Manager introduced the report to the Panel. She informed them that the B&NES Food Poverty Steering group had met three times to date with its first meeting on 25^th March 2020. She explained that as its inaugural meeting was at the start of the government lockdown period in response to the coronavirus pandemic the main focus was on understanding the challenges emerging for residents in relation to immediate food needs and provision of welfare support.

She added that the Steering Group has provided a network for members to share information, co-ordinate activity and both offer and request support in adapting to a rapidly changing situation and growing demand locally.

She said that the Steering Group had agreed its Terms of Reference and a framework for structuring planning and action on food poverty locally.

She added that discussions have taken place with Steering Group members around specific themes outlined in the framework including identity and structure of the group, food for all priorities and barriers to income. She said that it has been agreed that ownership for delivery of these actions is led by three task groups;

·  Income Maximisation

·  Food for All

·  Hear My Voice

She stated that these task groups will guide and develop the work and report back to the steering group at each meeting on progress, challenges and support needs.

She informed the Panel that the key areas around Data and Communications will be co-ordinated by Public Health in the short term with support from Steering Group members.

She explained that members of the Steering Group, our colleagues in the Compassionate Communities Hub and local charities and community groups have seen significant increases in demand for support with food and income related issues over the last 3 months.

She said that Council welfare support team received 956 applications for financial assistance from April to mid-June and 580 awards were approved. Grants totalling £43,000 have been awarded of which £11,000 was for food and £32,000 on essential household provisions.

She added that St John’s Foundation have awarded 366 grants since January 2020 as part of their individual funding programme, totalling £204,000.

She stated that the Council welcomed the Government’s decision to fund free school meal provision throughout the upcoming school summer holiday period.

The Chairman commented that when the Panel began to work on this issue it seemed ambitious, but congratulated those involved for the great work that had been done so far.

Councillor Eleanor Jackson asked what is going to happen next, to fill in the remainder of the Action Plan.

The Public Health Development & Commissioning Manager replied that the Steering Group will continue to meet on a quarterly basis with most of the remaining work being undertaken by task groups on specific themes. She added that these task groups will then report back to the Steering Group.

Councillor Jackson asked where the Action Plan states Review the cap on welfare support provision and criteria for support to meet increasing demand/better  ...  view the full minutes text for item 12.

The Panel will receive a verbal update on this item from the People and Communities Strategic Director.

The Director of Adult Social Care, Complex and Specialist Commissioning introduced this item to the Panel. A copy of the briefing can be found on their Minute Book and as an online appendix to these minutes, a summary is set out below.

Working with Ofsted and DfE

During the lockdown we have continued to be in regular communication with both DfE and Ofsted, who have been monitoring the attendance of vulnerable children at school and we have been able to share any emerging issues and concerns. Ofsted have suspended their normal inspection regime, although they look set to recommence some visits in the autumn.

St Martins Hospital office accommodation

We had already planned to move staff currently based at St Martins to other Council offices which can offer better quality and more flexible facilities for staff. With most staff working remotely during the lockdown period, the office ‘move’ will now be going ahead in the coming weeks without staff returning to their previous desks. Future working arrangements are being looked at across the Council and it is most likely that staff will have a future base at Keynsham Civic Centre or the Hollies, but with an increased emphasis on flexible and home working. CCG colleagues are also looking at their future accommodation arrangements and the aim will be to ensure colleagues working in our integrated commissioning teams can still work alongside each other as appropriate.

Update on transfer of Community Resource Centres and Extra Care Housing Support

Financial service model: The current annual contract value is £6.776m. Financial due diligence work has been completed to ensure the transfer costs remain within the current contract value and that we have a full appreciation of the financial risks. However, ongoing operating pressures mean that the budget will remain a challenge. However, in balance to this the Council will benefit from its tax status particularly in relation to VAT, greater purchasing power, procurement capacity and skills, and direct responsibility for maintaining occupancy.

Bank worker system: The council does not currently operate a bank worker system. To have an in-house bank system presents a real opportunity for council. Once established this could offer a wider role as an alternative or additional avenue to manage temporary staff within the council.  It has been agreed that Sirona will provide the system for up to six months from transfer.  This will allow time for the council to create or contract a bank system operational from April 2021, ensuring minimal disruption at the point of transfer.

Community Engagement:

• Engagement with staff group: We have engaged with staff using face to face, and recently teleconferencing, meetings with union representatives and staff.  They have used dedicated email boxes for questions from staff, residents and carers and other stakeholders. Staff have received regular briefings giving an update on the transfer and answering any questions. The formal Transfer of Undertakings (Protection of Employment) Regulations (TUPE) for staff consultation commenced on 15 June for 30 days.  Staff are in the main positive  ...  view the full minutes text for item 13.

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 and asked for comments from the Panel on the workplan.

Councillor Eleanor Jackson suggested that the Panel receive a report from Dave Francis, SACRE Secretary on the new Religious Education syllabus.

Kevin Burnett suggested the Panel add the following items / reports to their workplan;

·  Operation Encompass Update

·  Future of the former Culverhay site

·  Looked After Children and Exploitation Risks

·  Virgin Care Update

·  School Attainment

·  Autism Board

The Chairman thanked them for these proposals and said that they would be discussed further by himself and the Vice-Chair at their agenda planning meeting with the Corporate Director.