Agenda item

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues. The intention is that the update will be circulated to the Panel in the preceding week of the meeting.

Laura Ambler, Place Director, B&NES, Swindon & Wiltshire Integrated Care Board addressed the Panel and highlighted areas from within the update report that had been circulated. A copy of the update will be attached as an online appendix to these minutes.

Integrated Community Based Care programme update

The Integrated Care System (ICS) has recently published its Integrated Care Strategy which describes the key priorities and ambitions for the ICS. An integral part of this is to increase the focus on prevention and early intervention, delivering this through the BSW Care Model and providing excellent community-based services for people in BSW.

This future model will enable better integration of local services to meet the needs of our communities, helping to address the challenges facing health and care services including increasing demand, workforce recruitment and retention, and financial sustainability.

The BSW Integrated Care Board (ICB) has established a programme of work called the Integrated Community Based Care Programme (ICBC) to lead the process of securing specific community services from 2025 onwards, working on behalf of the Councils and BSW ICB. The ICBC is governed by a programme board made up of representatives from BSW ICB and the BSW Councils.

The ICBC programme will start with ensuring the immediate continuity of service provision for the people of BSW and the workforce for the financial year 2024/25. This allows sufficient time to ensure people and communities, clinicians, professional staff and providers of services are involved as appropriate in the process.

Our plan for engaging with the public on this subject is in development and we will be in a position to offer an update on this over the coming months.

Royal United Hospital Urgent Treatment Centre

BSW ICB and the RUH have been reviewing the Urgent Treatment Centre (UTC) model of care delivered from the Royal United Hospital. Following feedback from patients and staff, we plan to amend the service provided in the UTC during the hours of 10pm-8am to respond to the needs of people presenting during this time from September 4^th  2023. This will not change access for our local population and aims to provide more rapid assessment and, in particular, advice, guidance and signposting for patients who may be more appropriately treated elsewhere or at different times.

The aim is to support more timely assessment and interventions for patients who do require urgent care support at the RUH. The new streaming pathways do not include children, young people and people with a learning disability and/or autism who will be seen in line with current arrangements.

We will be developing a communication plan over the next few weeks prior to this change to ensure people are aware of how the service will be delivered. We will be monitoring the change to understand any impacts.

Paul Boyle, Transformation Director, BSW Elective Care Programme addressed the Panel regarding the Sulis Hospital, Bath. He informed them that the hospital currently provides for approximately 50% private patient activity and 50% NHS activity and is seeking national funding to become an Elective Orthopaedic Centre.

He explained that a range of specialities are provided at the hospital: General Surgery, Ophthalmology, ENT, Urology, Plastics and Orthopaedics.

He stated that they plan to add to new theatres to the site by June 2024 that will enable around 1,500 joint operations to take place per year.

Andrew Holland, Chief Medical Officer, RUH added that the quality of care that can be provided for patients will be enhanced.

Paul Boyle said that the demand for orthopaedic surgery is increasing and that potentially some surgeons could choose to bring their patients to the hospital from across the local area.

Councillor Dave Harding asked if the funding that will be received would be recurring.

Paul Boyle replied that it would be capital funding for the building of the new theatres and that subsequently it would then be payment by results.

Kevin Burnett asked if this funding was in any way related to the HIP2 programme that the Panel had been briefed on previously.

Laura Ambler replied that the HIP2 programme pre dated the structure of the Integrated Care Board. She added that she would make enquiries on behalf of the Panel.

Councillor Liz Hardman commented that she was concerned about the practical arrangements for signposting patients from the RUH Urgent Treatment Centre.

Laura Ambler replied that a communications plan would be put in place to advise members of the public. She added that the amendments would allow for patients to be directed to another facility if appropriate and in some cases to have timed appointments.

Councillor Liz Hardman asked for the Panel to receive a report on Dental Services at a future meeting as it is a major issue for many residents in relation to being able to access these services.

Laura Ambler replied that a report on Dental Services can be provided to the Panel in due course.

Councillor Liz Hardman asked if the beds within the Homeward unit at St Martins Hospital are being used and is the scheme seen as being good value for money.

Laura Ambler replied that Homeward is seen as a successful and valuable scheme and is enabling people to be discharged from acute hospital beds and to then have time to gain support before returning to their home.

The Chair asked if there was a high percentage of students using the Urgent Treatment Centre as they may not be registered with a local GP.

Laura Ambler replied that she had not heard that this was a current factor with regard to the Centre but would confirm for the Panel.

The Chair asked if measures were in place to monitor the progress and work carried out at the Sulis Hospital.

Andrew Holland replied and said that there is an Oversight Committee in place and that he and Paul Boyle both sit on it. He added that they are currently looking at the governance arrangements and will make changes if they felt that they are required. He said that they could provide the Panel with regular updates through the report they receive from the ICB.

The Panel RESOLVED to note the update that had been received and thanked those present for attending.