Agenda item

Presentation on Placemaking Plans and Consultation (Simon de Beer

B&NES Group Manager, Policy & Environment, Planning)

Presentation on the Bath and North East Somerset Clinical Commissioning Group (Tracey Cox - Chief Officer and Dawn Clarke – Director of Nursing and Quality, CCG).

Placemaking Presentation

6.1 TT welcomed Simon de Beer to present on Placemaking. 

Action AW to circulate the presentation with the minutes.

6.2 SdeB said the Placemaking Plan Options Document is now on the Council’s website.  Parish and Town Councils will receive a hard copy of the document but it is also available on-line http://www.bathnes.gov.uk/services/planning-and-building-control/planning-policy/placemaking-plan.

6.3 When the Placemaking Plan is adopted, it will complement the Core Strategy, which is a broad requirement – Placemaking provides more detail and gives clarity on applications.  It has been broken down into four areas: Bath; Keynsham; Somer Valley and Rural.  Planning Policy is consulting on the document until 30^th January 2015.  They will then work collaboratively with Town and Parish Councils and local communities to draft the document.  This will be examined externally in a process similar to the adopted Core Strategy.  In terms of the Somer Valley, the sites should be familiar but are they right?  Are any missing?  Are they deliverable?  What will the impact be in terms of access, highways, landscaping etc?

6.4 Over the next six months, there will be a Housing Development Boundary Review and B&NES will work with Town and Parish Councils on this.  As part of the consultation process, B&NES will be holding exhibitions, undertaking publicity and holding drop in events.  If any villages would like to host an event, or combine this with another, contact Planning Policy.  Support with publicity would also appreciated.

Action All

6.5 SdeB said the Council appreciates the work put in by Parishes to date – it is important to get policies right as they will be used by Planning Committees when considering applications.  TT thanked SdeB for his presentation and asked if there were any questions.

6.6 BMc asked SdeB to confirm that the consultation and contributions will not overturn or supersede the Core Strategy.  He said that housing is a key issue and wondered whether Town or Parish Councils could overturn the recommendations in the Core Strategy by identifying other sites – which document has priority?  SdeB said the Core Strategy is strategic and should not be contradicted by Neighbourhood Planning.

6.7 NH said that Peasedown should not have more housing allocated to it – the village’s amenities and services still need to catch up.  Also, Paulton and Peasedown seem to be paired in documents but should be seen separately.  The Somer Valley Forum can work together but also needs to recognise communities’ differences.  Peasedown Parish Council has voted not to change allocations as part of the Housing Development Review – will they be listened to?  SdeB said no new sites have been identified in Peasedown.  He appreciated the feedback re separating Peasedown and Paulton and this can be done going forward.  The Housing Development Review is there to correct any anomalies.

Action SdeB

6.8 WH asked how the Council aims to engage the public in the process?  SdeB said this is not always easy and they usually become more involved when development is planned.  However, undertaking local events should help, as should the support of the Somer Valley Forum in raising the consultation profile locally.

6.9 LH said Paulton is closer to the Cam Valley than the Somer Valley.  She asked whether the development highlighted here is industrial or housing?  SdeB said it is the Old Mills employment site.  The Council supports this designation but the Government requires a view, so a decision needs to be made on whether this use is appropriate.

6.10 BE said some communities do not have the infrastructure in place to support additional development.  This includes the impact on the road networks of neighbouring communities, such as Camerton, which has seen increasing volumes and speed of traffic as a result of nearby development.  There were S106 agreements in place regarding the recent housing development in Paulton but nothing seems to have happened.  SdeB said there are no sites in Camerton coming forward and 50 dwellings allocated to larger villages.  It will be important to speak with Transport and Highways about these issues.

6.11 EJ said local employment, with jobs at a reasonable distance is the answer.  The area seems to be losing employment space to housing.  SdeB said the Council will work with Town and Parish Councils on local communities’ wishes.  However, it is not possible to hold on to undeliverable employment sites as developers may win on appeal.

6.12 BMc said we’ve got a Core Strategy with which we are broadly happy and there is a growing number of employers at Old Mills – a minority wish to see it developed as accommodation.  SdeB said there is Greenfield allocation to the west of the existing employment building which has not come forward in ten years.

6.13 ME asked for clarification of ‘SUDS’.  SdeB said it is a sustainable open drainage system which allows water to be absorbed into the ground first.

6.14 RW said developers will do what they want, even if 90% of people object.  SdeB said the Council was vulnerable when there was no Local Plan in place and some sites were lost.  However, it is now able to resist and refuse applications.

6.15 EJ said she is worried about Greenfield developments in Paulton as it may merge with Midsomer Norton – there does not seem to be enough protection.  SdeB said Greenfield sites are not being looked at in this area – Old Mills exists from the 2007 Local Plan.  Housing boundaries should protect merging of communities.  Developers will try and there are a couple of appeals taking place but the Council is working to resist these.

6.16 CLGM said statistics show the changing pattern of employment to an increase in home-working.  SdeB said the latest Census data relating to commuting should be available before the end of the year.

6.17 SC said that, in Timsbury, there is an industrial owner that wants housing.  SdeB said that rather than engage in detailed disussion about individual communities, he will speak directly with the Parish Council on this.

Action SdeB

6.18 BW asked what would be done to encourage appropriate infrastructure to support development.  There are employment sites that no-one wants because of the road network.  SdeB said employment sites are situated in or near town centres.  There is also an infrastructure delivery plan relating to the Core Strategy, which includes education as well as roads.  It is difficult as the development proposed is low level and the related CIL money will not be enough to fund major road building.  Most new growth has been allocated to Bath and Keynsham to avoid transportation issues.

6.19 RA asked whether 9 weeks, over Christmas, is enough to allow the community and Town/Parish Councils to respond.  SdeB said this is the start of a process and the Council will be working with Town and Parish Councils over the next 6 – 9 months.

6.20 TT thanked everyone and introduced Dawn Clarke and Tracy Cox of the B&NES Clinical Commissioning Group.

CCG Presentation

6.21 TC said the CCG is pleased to have been invited and would like to attend Forum meetings more regularly in future.  As an introduction, they will present this evening on their 5 Year Strategy and Primary Care in the Somer Valley.

6.22 Clinical Commissioning Groups replaced Primary Care Trusts (PCTs) in 2013 as part of a re-organisation of the National Health Service.  More clinicians are now involved in commissioning front-line services.  The CCG is made up of 27 GP practices in B&NES.  There is a Governing Body which is accountable to them.  The Somer Valley is represented on this by a GP from St Chad’s surgery.

6.23 The CCG are not responsible for GPs, opticians, dentistry and some specialised treatments.  They have a £213m budget and work closely with B&NES to join pathways of care.  There are some areas where they jointly commission, such as mental health.  They also commission some services from The Circle Hospital and BMI Bath Clinic as well as the RUH.

6.24 While the CCG is performing well, it will face challenges going forward related to reductions in public sector funding.  It is important to understand local communities when planning current and future services, which is done through the Joint Strategic Needs Assessment (JSNA).

6.25 GP practices are grouped into 5 clusters and regular meetings are held between them.  For the 5 year strategy, they have been asked to set out a plan in relation to the national financial picture.  There is currently a £20m funding gap, so some services will need to be delivered differently.

6.26 Future challenges in B&NES are similar to the national picture – people are living longer so we need to be ready to deal with an increasingly elderly population.  If services continue to be delivered as now, there will be a £60m shortfall.

6.26 The strategy looks at a shift to where care is provided.  Hospital care is expensive, so there is emphasis on preventative care.  The new model also looks at provision in local communities.  There is focus on self-management and care as well as support from third sector providers.

The strategy is on the CCG website http://www.bathandnortheastsomersetccg.nhs.uk/publications.

6.27 There are six priorities:-

-  There is a 7% increase in diabetes, so emphasis on preventative and self-care in relation to this.

-  MSK is musculo-skeletel services – pain and orthopaedics – spending more on that than expected at present.  Solution may be to increase physiotherapy services.

-  Urgent A&E

-  Other priorities relate to community services, mental health etc.  Working with B&NES on how community services might be delivered.

6.28 The CCG want to engage with local communities on their views between January and April 2015.  There will be a series of events and they will be seeking the Somer Valley Forum’s input.

Quality – Dawn Clarke

6.29 DC said the CCG is also concerned with ensuring the care received is safe and of a high quality, delivered by caring staff.  They work closely with providers to ensure this, utilising:-

-  Quality schedules:  safe-guarding/complaints

-  CQUIN:  incentivising providers to improve the patient experience

-  Cost improvements across services:  quality impact of care

-  Site visits:  GP clinical leads, nurses, lay members, wards and departments talk with people about first hand experiences of both staff and providers.

6.30 The CCG doesn’t commission primary care – this is done by NHS England.  GP practices now publish details on their websites of how they are performing.  Grades are 1 to 6, with 6 being the highest.  All those in the Somer Valley are graded 5 or 6.  There is also a GP survey, with the latest published in July.  Practices in B&NES are above the national average.

6.31 TT thanked TC and DC for their presentation and asked if there are any questions.

6.32 BMc said it was a very helpful overview.  He asked why the local cluster had been named Norton-Radstock – it should be Somer Valley now, with all public services ‘singing from the same hymn sheet’.  TC will take this back to the CCG.

Action TC

6.33 LH said she had been informed that services formerly provided by children’s centres will be picked up by health visitors.  TC said there has been an increase in the number of health visitors but the CCG do not commission this – it is the responsibility of the Council.  It is an important role in terms of prevention and early intervention.  A new role will also be created around health visitors for the elderly.  There are only three of these at present but the service will expand.  LH asked who funds the health visitors.  TC said NHS England – the CCG is accountable to them.  The Council will pay when services transfer.

6.34 RW asked whether patients can still choose where they receive treatment.  TC said in some cases private treatment can be commissioned and paid for by the CCG but some specialist care comes from NHS England.

6.35 PDM asked about Out of Hours Primary Care – will patients see the same or different doctors?  TC said GP’s services are generally 8.30am – 6.30pm.  In 2006, GPs could opt out of providing out of hours care.  The CCG do commission this and re-tendered it this year.  It was awarded to Bath Doctors’ Out of Hours Care.  Patients can ring 111 for access.  PDM said, so it could be the same GP but funded from a different source.  TC said yes.

6.36 EJ said she sits on the Scrutiny Panel for Wellbeing and is aware of deficiencies in commissioned services.  The 111 service is not functioning well and asked how they can be held to account?  TC said it depends on the contract but sometimes penalties/warnings are possible.  They can also terminate contracts and go elsewhere.

6.37 LM said there is a rising number of people with dementia and asked what provision there is for care.  TC said work is taking place to identify patients with dementia in the local area.  The CCG has commissioned dementia support workers who will connect individuals and their families to relevant services.  There is also a RICE memory clinic undertaking research in Bath.  The RUH is a dementia pathway.  Sirona provides aids and adaptations and the need to further invest in this is being evaluated.

6.38 WH asked who set the priorities and how flexible the plan is.  Mental Health is not one of the 6 priorities, despite a drive to change this and put it on a par with physical health.  TC said there is a need to provide further beds at Hillview and they are working with the Avon and Wiltshire Mental Health Trust on this.  Priorities were set in relation to areas requiring most transformation.  Stakeholder feedback is important and the setting up a Wellbeing College is planned.

6.39 NH said the challenge for the CCG is being accountable and accessible.  They have a lot of public funding and people need to feel their views matter.  Consultation should not be tokenistic.  Parish Councillors and Officers know what people think and it is important to engage with them.  TC said the CCG has just written an engagement strategy.  There is reference to the Somer Valley Forum and local Town and Parish Councils in it.  NH said it is not possible to vote out CCG reps in the same way as Councillors.

6.40 Alex Francis of Healthwatch B&NES introduced herself and said this was set up in April 2013 to act as an independent consumer champion for health and social care services, such as GP surgeries, hospitals, dentists, pharmacies, care homes and social services.  They speak to members of the public to find out whether the services they have received are good, bad, or could do with some improvements.  They then share this information with service providers and commissioners, including the NHS, hospital trusts, local authorities and the Care Quality Commission, and work with them to shape services based on the needs of the people that use them.

6.41 Healthwatch B&NES is run by The Care Forum, a charity based in Bristol.  The Care Forum also runs Healthwatch schemes in Bristol, South Gloucestershire and Somerset, enabling them to have an overview of a wide geographical area and the provision of health and social care services across it.  Each Healthwatch scheme has its own priorities that are unique to the district and communities within it.

6.42 The priorities for B&NES include: public/patient transport, long-term conditions, older people and dementia, children with physical impairments and the transition from children’s to adult services.  These are specific communities or services that they are particularly interested to hear about, however they are keen to encourage people to get in touch with them about any aspect of health or social care within B&NES.

6.43 AF said her role as Healthwatch Development Officer is to speak to members of the public and gather as much feedback as possible about their experiences.  She does this through visiting groups and attending events, or alternatively people can get in touch directly through the contact details listed below.  Healthwatch B&NES also has a range of volunteer roles available, giving people the opportunity to help shape and improve local health and social care services – for further info visit www.healthwatchbathnes.co.uk.

T:    01225 232401

E:    info@healthwatchbathnes.co.uk

TT thanked everyone for their contributions.