Agenda and minutes

Councillor Paul May and Chris Batten (Co-opted Member) had both sent apologies to the Panel

Apologies were also received from Councillor Alison Born (Cabinet Member for Adults and Council House Building) and Dr Bryn Bird (B&NES Locality Clinical Chair, BSW CCG).

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 as he is employed by Virgin Care.

The Chairman raised the subject of the Serious Violence in B&NES Scrutiny Inquiry (Half day) and asked for nominations from members of the Panel to be part of the working group for developing and preparing for this meeting.

The following Councillors agreed to take part - Liz Hardman, Michelle O’Doherty, Rob Appleyard and Andy Wait.

There were none.

Kevin Burnett referred to page 6 of the agenda and asked if there was an update on the Escalation Protocol.

The Director of Children's Services & Education replied that she believed that this was to be signed off by the B&NES Community Safety and Safeguarding Partnership by the end of July.

Kevin Burnett referred to page 6 of the agenda and asked how the £1.2m savings from Virgin Care had been delivered.

The Interim Director of Adult Social Care replied that Virgin Care, in conjunction with the Council, carried out a Quality Assurance exercise to assess how placements / services were received and to provide alternatives to funded services.

Kevin Burnett referred to page 7 of the agenda and asked to be updated on the procedure that detailed public accountability for how MATs (Multi Academy Trusts) are run.

The Director of Education & Safeguarding replied that he has requested that the Regional Schools Commissioner (RSC) provide an update at a future PDS Panel, that they have replied positively to this and that a future date will need to be agreed.

Kevin Burnett referred to page 7 of the agenda and asked if the expansion of the early help offer into schools and colleges through Mental Health Support Teams was a national or local initiative.

The Cabinet Member for Children and Young People, Communities and Culture replied that she believed that it was a national initiative.

The Director of Education & Safeguarding added that a pilot project on Mental Health in schools had now expanded and that Public Health England had delivered training to all staff within schools in B&NES.

Councillor Andy Wait referred to page 21 of the agenda and his proposal that a Corporate Parenting report should be received by a future meeting of Full Council.

The Chairman replied that he would enquire as to whether this would be possible for the 16^th September 2021 meeting.

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

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

Councillor Dine Romero, Cabinet Member for Children and Young People, Communities and Culture 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.

Free School Meals (FSM)

I have been lobbying for FSM vouchers to continue over the summer holidays and I am pleased to announce that the central government has now provided grant funding to do this. The amount received for summer holiday FSM is less than hoped for. She added that she would be looking at what measures can be taken to resolve any shortfall in the funding.

These vouchers will now be distributed in the same manner as previously, enabling a high uptake by eligible parents. Alongside this, we will be promoting the Holiday Activity Fund (HAF) to FSM children and families.

Mental Health

The Mental Health Audit in schools has been completed and a review and update of mental health resources is taking place and will be available via the Hub. She added that she felt that Mental Health in general was such an important issue for the Council that she was looking to bring together a body of agencies to collaborate on specific areas of work.

Councillor Liz Hardman commented that the head of OFSTED, Amanda Spielman, recently said that at least 100,000 children are being home-schooled and that this will seriously derail efforts to catch up on children’s missed education.  She asked if the Council has figures for the number of children in B&NES currently being home-schooled and are we making any extra provision for them to catch up on their missed education.

The Director of Education & Safeguarding replied that the Inclusion Service makes contact with all parents that choose to home-school their children and that they are encouraged to join a parental network. He added that there had been a rise in numbers during the pandemic and that the DfE do monitor these figures.

He added that the Council would help with appropriate resources where possible and that some funding had been received through the Covid-19 fund. He said that there were around 120 children in B&NES currently being home-schooled.

Councillor Michelle O’Doherty referred to the written update supplied by Councillor Alison Born, Cabinet Member for Adults and Council House Building and said that she supported the proposal to form a Transformation of Adult Care Services Working Group.

The Chairman said that he felt that the Group should comprise of members of this Panel to have an element of governance and that it may be possible to extend the membership at a later point.

Gill Stobart asked how children were referred to take part in the Holiday Activity Food (HAF) Programme and how would the work be evaluated.

The Director of Education & Safeguarding said that the Programme is led by Public Health and Bath Rugby Foundation and that referrals were made direct from school. He added information would be supplied to those families in  ...  view the full minutes text for item 24.

This is an update on the support model development that has been taking place during May and June in relation to the Shaping a Healthier Future Programme.

Simon Cook, SaHF Programme Director and Geoff Underwood, Programme Director, SCW CSU introduced this item to the Panel and highlighted the following areas from the report.

Overview

·  RUH working with partners and the public across its catchment to develop a vision and support model for the population to deliver excellence

·  The new model of how we deliver support and care will inform our investment needs for the future and underpin any business case that bids for infrastructure investment

·  We want to do this with the local population for the local population so your support in this is vital

Progress

·  2019-20  Clinical strategy principles developed

·  March 2021  Trust launch of high-level clinical vision

·  April 2021   Workshops held with staff and members

·  April 2021   Development of patient champions group

·  July 2021  Preparation for wider public involvement

Context - national and local drivers

·  A more complex population - The over 75 population in B&NES is anticipated to rise by 36% by 2029; comparable rises will be seen in Wiltshire and Somerset

·  Changing workforce - Expectations and needs of our staff are changing, reflecting generational shifts and the impact of Covid-19. What we need from our staff is also changing.

·  Digital innovation - Offers new ways to provide services, share information and communicate with patients and families

·  Mental health/vulnerable people - Parity and integration with physical health, for service planning and delivery

Key local challenges

·  26% children with unhealthy weight Increases risk of developing a range of chronic diseases such as heart disease and diabetes

·  18% of local population in B&NES experiencing mental health condition

·  43% Expected increase in numbers of men with dementia by 2025

Design principles

Creating a new future of outstanding healthcare with prevention and intervention when and where it is needed, working together to help our communities enjoy healthier lives.

·  Provide holistic and flexible care seamlessly as one system with embedded innovation and continual improvement

·  Provide person centred care and empowerment to put the person in control of their health and wellbeing, and ensuring that each interaction adds value to the person

·  Provide care at home or in the community wherever appropriate, coordinated through strong primary care networks and multidisciplinary teams, and supported by sufficient emergency and specialist capacity in hospitals

·  Deliver an efficient way of working to ensure financial sustainability of the system and value for money of services

Summary model – Work in progress

·  Single point of access

o  Preventative and proactive population health management

o  Enhanced out of hospital care and co-ordination

o  Community based care and escalation

o  Hospital of the future and specialist care

Engagement – RUH workstreams and BSW health & care model work

·  RUH Staff - 23 staff are actively involved in clinical working groups

·  14 members of the public are actively involved in health and care model working groups (Patient Champions)

·  System Partners / 3^rd Sector / Subject Specialists

Staff & Public feedback on vision and aims

·  ‘It promises a great deal but to implement it will need creative thinking and  ...  view the full minutes text for item 25.

The report informs the Panel about the number and type of complaints and related feedback, including compliments, received between April 2020 and March 2021.

The Complaints & Data Protection Team Manager introduced this report to the Panel and highlighted the following areas.

·  A total of 65 complaints were received; 16 of these complaints were referred to Virgin Care for investigation; and 1 enquiry was received from the Local Government and Social Care Ombudsman.

·  The number of complaints has increased compared with the previous two years, but the increase is not significant. It was anticipated that the impact of Covid-19 and the lockdowns that have happened during the year would have an impact on the volume of complaints, but this did not materialise.

·  Any learning identified is captured by the Complaints and Data Protection Team when the complaint is closed and shared with the Service. The service is asked for feedback about the actions taken and evidence of this.

·  The average response time for complaints in 2020 – 21 was 17 working days and 80% of complaints received a response within the 15 working day time scale. Although this does not meet the target of 90% it is a significant improvement from the previous year when only 24% were responded to within 15 working days. This was also despite the challenges to the service caused by the pandemic.

Referring to the section of the report on Advocacy Support, the Chairman asked if POhWER, who currently provide this service, were used by any other Councils.

The Complaints & Data Protection Team Manager replied that they work across a number of Local Authorities and that B&NES has a contract with them under The Care Act.

Councillor Rob Appleyard commented that with the many interactions that take place across the Council the report shows how well our services are run overall.

Councillor Liz Hardman asked if it was felt that the Council were happy that there is sufficient awareness about how to make a complaint or was there more that could be done locally.

The Complaints & Data Protection Team Manager replied that she would discuss the matter with other members of the service and staff working within the Community Resource Centres. She added that it was hoped that closer work with the Advocacy Service would help.

Gill Stobart asked if any signposting is done through the Citizen’s Advice Bureau.

The Complaints & Data Protection Team Manager replied that the Council does do some work with them and will signpost to them where appropriate.

The Panel RESOLVED to note the contents of the report.

The report describes the implementation of the Community Mental Health Services Framework across BSW and locally within Bath and North East Somerset.

The Interim Director of Adult Social Care introduced the report to the Panel and highlighted the following areas.

·  In the NHS Long Term Plan mental health services are a key priority and this framework is focused transforming the model for community mental health services for people aged 16+.

·  The framework implementation is being led by BSW (Bath and North East Somerset, Swindon and Wiltshire) Clinical Commissioning Group and will create a very different way of working. It is an exciting opportunity to transform the way community mental health services are delivered, creating a new model of mental health care in our communities with joined-up services and an approach which is focussed on the needs of the whole population and which supports the development of Primary Care Networks (PCN) and personalised care.

·  There is a recognition nationally and across BSWCCG on the need to improve mental health services. There is a need to improve early access and make getting support easier for people. The experience of the pandemic and the subsequent lockdowns has increased demand for mental health services.

·  To meet the transformation challenge there is £10m new money across BSW over the next three years and the system response has been to bring partners and localities together to co-design the response to the National Community Mental Health Services Framework to meet the needs of local people and support them in their local communities.

·  There are three system priorities for 2021/22.

o  The first is to build a new workforce by the implementation of the named wellbeing coordinator roles across Primary Care Networks, investment into Clinical Associate Psychologist trainee posts and investment in key leadership structures.

o  The second priority is to pilot the new model from Quarter 1 and key to this is building trust and confidence in the Primary Care Network (PCN) and provider relationships. There are seven PCNs across BSW who will work more closely with the BSWCCG to pilot the new model and in Bath and North East Somerset the two PCNs involved are Heart of Bath and Bath Independents. The focus will be improving the advice and guidance pathway and understanding the impact of existing practices in relation to mental health formulary and shared care prescribing.

o  The third priority is the development of the Personality Disorder, Eating Disorder, 16-25 and older adult pathways

• This is a provider led transformation, the Council can influence but is not able to determine where monies are allocated.

The Chairman asked how the £10m will be allocated.

The Interim Director of Adult Social Care replied that we have asked for clarification on our allocation but said that as the transformation is provider led most of the allocation will go to Oxford Health and AWP.

The Chairman asked if there was a need to recruit further staff for this work.

The Interim Director of Adult Social Care replied that this is a significant area of priority and that a focus will be put upon Recruit, Sustain & Retain.

Councillor Liz Hardman asked  ...  view the full minutes text for item 27.

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

The Director of Children's Services & Education addressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.

Care Review

Josh McCallister, Chair Independent Review of Social Care has now published The Case for Change. B&NES are actively involved in the Care Review.

Virtual School

Our virtual school for looked after children has been part of a national pilot to support children in care and children on child protection plans. We have been pleased to be able to offer this support and it has been invaluable during school lockdowns and has enabled us to provide additional support to some of our most vulnerable young people. In late June, we were notified that the DFE would be funding all LA’s across the country to expand their Virtual Schools. This is positive news and we like to consider that our work on the pilot locally (1 of 3 in the country) has influenced this national rollout.

Children’s Social Care Covid-19 Regional Recovery and Building Back Better Fund

Children and Families Minister Vicky Ford announced in her Association of Directors of Children Services (ADCS) Conference speech on 8 July 2021, the Children’s Social Care Covid-19 Regional Recovery and Building Back Better Fund.  Each Regional Improvement and Innovation Alliance is invited to submit a single response on behalf of the region, with each Local Authority, including B&NES, contributing to the regional recovery plan.

The Interim Director of Adult Social Careaddressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.

Virgin Care Contract Extension

BSWCCG Governing Body and B&NES Council, as joint commissioners, have requested a report setting out an options appraisal to help to decide whether it wishes to extend the Virgin Care contract.  This is a seven-year contract from 2017/18 to 2023/2024 with the option for BSWCCG and B&NES Council to extend the contract term by three years, taking the contract term to 2026/2027.  Virgin Care would need to be notified of the decision to extend or not to extend the contract by no later than end of March 2022.  The aim is for the options appraisal report to proceed through the decision-making governance for both BSWCCG and the Council by September 2021, but we recognise that this is an ambitious timescale and the decision-making process may require longer.

Specialist Social Prescribing Service

One of the strategic priorities for both the B&NES locality and across BSW CCG is to ensure that people can access NICE compliant Autism Diagnostic Assessments in a timely way.  Unfortunately, as a result of the pandemic local diagnostic services delivered by BASS were suspended because clinical staff were redeployed.  The waiting list for assessments has now grown.  Some people have been waiting more than a year and referral rates for assessments are rising, as we return to ‘business as usual’.

To help mitigate the risks associated with long waits  ...  view the full minutes text for item 28.

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 acknowledged that the six-monthly Virgin Care update report was due in September and that at that meeting it was likely that the Panel would receive a further report on the Shaping a Healthier Future programme.

The Panel approved the workplan as printed.