Agenda item

Cabinet Member Update

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


Lewis Carson, Unison made a statement to the Select Committee on the subject of Sirona. A copy of the statement can be found on the Select Committee’s Minute Book, a summary is set out below.


The dispute over Sirona’s plans to cut the pay of our members continues and there seems to be no end in sight. To briefly re-mind you of the details, our members have been issued with an ultimatum of being dismissed from their job or accepting a cut to their pay of up to £1000 a year or instead work numerous additional shifts completely for free. Our members do extremely challenging jobs looking after elderly residents with complex medical needs, including dementia.


We have just completed 4 full days of strike action, and have just received a mandate for a further 6 months of strike action. Our members remain resolute that they will not accept this cut to their pay. Sirona are maintaining that they are not able to resolve this dispute by any means due their financial shortages.


We still have 6 years remaining of the current Sirona contract, paid at a flat rate, which gave no consideration to inflation, costs rising or any kind of pay award for staff. It is telling that the troubles have already begun now, even before inflation and costs rises take effect. Our concern is 3 fold.


·  In the immediate sense for the threat to our members pay and the ongoing impasse  which renders strike action perpetually ongoing, without Council Intervention


·  The conditions of our members will be further eroded over the following 6 years as there was no scope for pay increases in the contract awarded to Sirona. Our members are extremely low paid in Sirona, some paid as little as £7.85, just 2 pence above the minimum wage. It is extremely likely in the next few years minimum wage will rise beyond the pay of the majority of the care workers who will become minimum wage employees, and the act of paying minimum wage may hurt Sirona’s finances.


It is extremely worrying that in explaining their rationale for this pay cut, Sirona have explained that they have made all of the efficiencies they can out of non-pay budget, so all further efficiencies must come from pay. Within the next 6 years, as inflation and general price rises kick in and any unexpected costs reach Sirona, they will keep on coming back- eroding conditions further, making the lowest paid poorer.


·  For the residents of the 8 affected Care homes across Bath, Keynsham and Midsomer Norton. The deterioration of working conditions and the resultant impact on recruiting good staff is going to impact the residents.


We require urgent action to resolve this on-going dispute and prevent wave after wave of further strikes. We call on the Council to either bring the Residential and Extra Care services back in house, or re-negotiate the contract to a level which not only prevents erosion to our member’s pay and working conditions, but facilitates year on year improvements, as equivalent to their Council employee comparators.


Councillor Robin Moss noted from Councillor Pritchard’s written update that he says that it is rare for a provider to offer paid breaks and that by continuing to retain staff with paid breaks, Sirona were an outlier as a care provider. He said that as he understood it staff would accept unpaid breaks as long as their shifts were 8.5 hours long and were paid for 8 hours work.


He said that he believed that this was a rostering issue that needed to be resolved. He added that the Labour Group will continue to follow this dispute as it progresses and that he intended to talk to the Shadow Cabinet Minister regarding this issue next week.


Councillor Pritchard commented that the update provided shows the Council’s position and set out how the contract was awarded. He said that he was committed to ensure that, within existing budgets and legal and regulatory constraints, Council officers continue to work with Sirona Care & Health to support them in resolving the dispute and moving forwards.


He added that Sirona noted that efficiencies would be expected when the contract was awarded and that the contract would only be revisited in exceptional circumstances.


Councillor Moss reiterated that in his opinion shifts should be increased from 8 to 8.5 hours with appropriate rostering to resolve this issue. He added that he felt this scenario was always likely to happen when a flat rate contract is agreed.


Councillor Pritchard replied that the pattern of shifts was a problem for Sirona to resolve as the Council cannot involve itself in operational issues. He added that the residents within the homes concerned are important to us and that he wanted to see the dispute end as quickly and as amicably as possible.


He then continued with the rest of his update to the Select Committee. 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.


Virgin Care Performance Update


The Service Delivery and Improvement Plan (SDIP) is agreed between Commissioners and Virgin at the beginning of the financial year. In it, both parties outline: key transformation milestones for the year ahead, based on the Virgin transformation roadmap; unmet or unfinished milestones from the previous year; and commissioners’ expectations of the provider. Every milestone has an agreed set of measures, and every three months Virgin Care must provide commissioners with evidence to show that they have met the milestones agreed, which commissioners formally review.


Of the 6 Red milestones in quarters 1 and 2, 5 relate to Virgin’s Integrated Care Record (ICR). The integrated care record platform aims to provide secure access to joined up, timely information from multiple health and social care providers enabling improved outcomes and experience for people whilst driving efficiencies across the local health and care economy as part of the wider transformation programme.


To date, Virgin Care has not met the majority of their delivery timescales for ICR. In September, Virgin Care was made aware that their provider Lumira would no longer be developing their product for an integrated care record purpose and this could therefore no longer be used as the platform for the B&NES system. The need to re-procure a system will now further delay progress against the milestones. Virgin Care currently estimates that they will identify a provider by the end of 2018, with the aim to start developing the system locally from April 2019 onwards.


The 18 Green milestones relate to a number of different work streams where Virgin have made significant progress, namely in relation to developing a performance management tool, embedding a strengths based approach across their Adult Social Care teams and working with key stakeholders to develop a care coordination approach to health and social care service delivery.


Councillor Pritchard informed the Select Committee that a meeting between the Boards of Virgin Care and the CCG took place last week with the Council’s Chief Executive and Councillors Tim Warren, Charles Gerrish and himself present. He stated that there was a commitment from both sides to address issues that had been identified.


CAMHS Local Transformation Plan


The latest CAMHS Local Transformation Plan, dated October 2018, is currently in draft format and is available for review on the B&NES Council website:



Any corrections, omissions and/or comments are welcome and should be emailed to by 7th December 2018.  After this date the plan will be updated and finalised.


Mental Health Pathway Review


Since the last update officers have been continuing to seek the views of a diverse range of groups across B&NES, including people who are seldom heard, and those who are vulnerable or have complex needs.  The feedback they receive from people is being actively incorporated into our work to develop service specifications, ensuring that any new model will reflect the things that people have told us will improve the service for the community.


Commissioners and colleagues in Virgin Care and Avon and Wiltshire Mental Health Partnership NHS Trust have begun work to look at all our existing service specifications, identifying where there are gaps between what is currently commissioned and what people have told us will be important in the new model.


The most recent workshop being held in November focused on the development of a  Collaborative Framework which sets out how those who work to provide mental health services either in the statutory or voluntary sector can work together to ensure that the experience for those who use our services is seamless, and there is ‘no wrong door’.


For further information about the review, please visit the CCG’s website, email or call 01225 831 800 and ask for the Communications and Engagement Team.


Councillor Tim Ball said that he was concerned about the transformation delivery issues raised regarding Virgin Care.


Councillor Pritchard replied that he was aware of the delivery problems with transformation, including the Integrated Care Record, and that all parties had agreed a commitment to work to alleviate these.


Councillor Tim Ball asked if the Council had made more funds available to Virgin Care.


Councillor Pritchard replied ‘no’.


Councillor Robin Moss commented that he was also worried and echoed the comments made by Councillor Ball. He said that he was concerned at the time the contract was awarded and remained so.


Councillor Robin Moss added that regarding the CAMHS Local Transformation Plan it was important to remember that there is a cohort of young people who will need this support who do not attend school and therefore need to be engaged with appropriately.


The Chair thanked Councillor Pritchard for his update on behalf of the Select Committee.