Agenda item

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues.

The Director of Place, B&NES, BSW ICB addressed the Panel and highlighted the following areas from her update. A copy of the update will be attached to these minutes as an online appendix.

Sulis Elective Orthopaedic Centre (SEOC) Update

A planning application has been submitted to BaNES Council by the RUH for a new wing at Sulis Hospital in Peasedown St John. If approved, this will allow for an increased capacity at Sulis for non-emergency orthopaedic surgery.

Surgery would be protected from disruption and cancellations caused by surges in emergency hospital admissions because Sulis is not an acute hospital with an emergency department, and as such the SEOC will enhance the resilience of services into the future.

The SEOC would serve patients from the Bath and North East Somerset, Swindon and Wiltshire (BSW) area, and beyond, from the whole of the South West region.

Dyson Cancer Centre

Work is also continuing at the hospital to build the new Dyson Cancer Centre which is now expected to welcome patients in spring 2024 rather than at the end of 2023.

Once open, the Dyson Cancer Centre will bring together the majority of the RUH's cancer services, including research, under one roof. It will provide oncology, chemotherapy and radiotherapy services and a 22-bed inpatient ward as well as a Macmillan Wellbeing Hub.

The centre will provide a nurturing and therapeutic environment, with a 'land, water, sky' theme, making extensive use of natural light and external spaces as well as the work of local artists and designers.

The £50m Dyson Cancer Centre is backed by over £40m in Government New Hospitals Programme funding and supported in part by a £4m donation from The James Dyson Foundation to create a cancer services hub for half a million people in the South West of England.

A further £1m was donated by the Medlock Charitable Trust, £1.5m by Macmillan Cancer Support and £5m was also raised by RUHX (formerly known as The Forever Friends Appeal), the official charity of the Trust, thanks to the kindness and compassion of thousands of supporters.

RUH - CQC inspection

The Care Quality Commission (CQC) report published in October on the RUH followed its focused inspection of aspects of Medical Care in July 2023.

The inspectors had many positive things to say about their visit, including particular praise for the ‘outstanding programme’ for international nurses and how managers and ward leaders were supported to make the wards a welcoming place to work.

The report however also reflected some areas requiring more attention resulting in a reduction of the rating of Medical Care Services at the RUH from ‘good’ to ‘requires improvement’.

An action plan to address these is already well underway including improving storage space on wards, ensuring consistent completion of fluid chart documentation and a continuing focus on Healthcare Support Worker recruitment.

Integrated Community-Based Care Programme

The BSW Primary and Community Care Delivery Plan is seeking to redesign the way community-based health and care services operate. It supports the delivery of the ambitions set out in the BSW Together ‘Integrated Care Strategy’ and to drive forward the implementation of elements of the BSW Care Model.

The Integrated Community Based Care (ICBC) Programme is the method by which services will be procured in support of the ICP strategy and Primary and Community Care Delivery Plan.

The Programme lies at the heart of our aspiration to implement a greater focus on prevention and early intervention in our approach to supporting the health and well-being of the BSW population. The approach being undertaken aims to enable BSW to achieve fairer health outcomes for the whole population and to deliver excellent health and care services.

BaNES Integrated Care Alliance Winter Update

BaNES Integrated Care Alliance has developed a joint approach to delivering services and supporting citizens across BaNES during winter 2023/4. It will focus on maximising capacity through the following measures:

• Two virtual wards have been established in B&NES – step-up model to reduce avoidable admission provided by HCRG and step-down model provided by RUH to expedite discharge.
• Our step-up virtual ward includes access to diagnostics including imaging and rapid blood tests working in collaboration with the RUH. The team, which includes specialist nurses and paramedics, also provide IV medication at home.
• Funding confirmed to run PUSH (respiratory illness) clinics for children and young people in areas of known deprivation and prevalence – with the BaNES GP federation BEMS. Start date Dec, 105 clinics between start and March 31^st.

Kevin Burnett referred to the Integrated Care Programme and asked if any points of contact had been established, for example, was it to be a GP.

He also spoke in relation to Community Pharmacies and asked if this would lead to an increase in independent prescribers.

Furthermore, he asked if the technology was in place to link records between GPs, Pharmacies and Hospitals.

The Director of Place, B&NES, BSW ICB replied that she was not able to offer a full update at the present time as work relating to this was still ongoing. She added that it was about getting the care co-ordination right and making sure it is seamless. She stated that across the BSW footprint they were looking at a central care co-ordination approach.

Addressing the technology issues, she explained that a number of digital workstreams were being pursued, including Integrated Care Records.

She added that when the Community Pharmacies update is formally presented to the Panel that the Primary Care view is also addressed.

Councillor Liz Hardman welcomed the update regarding Community Pharmacies and asked how they are chosen and would every area of the Council have one.

The Director of Place, B&NES, BSW ICB replied that she would need to discuss this matter with colleagues and then respond to the Panel.

Councillor Joanna Wright informed the Panel that she had recently attend a further seminar on Dental Deserts and explained that there was a shortage in NHS Dentists due to the numbers that were retiring and working privately.

She stated that a large number of newly qualified dentists could not afford to work through the NHS due to their level of student debt and asked if there was anything the Council could do to help with this situation.

She said that due to the increasing age of patients there are now simply more teeth to look after.

She stated that she felt that the issue of Oral Care needs highlighting, especially for children.

The Associate Director of Public Health replied that work is carried within school settings in terms of what level of cleaning needs to be done and the good types of food to eat. He added that work with specific groups of families was also ongoing. He offered to send the Panel further information in writing following the meeting.

Councillor Lesley Mansell asked for further information on the Community Wellbeing Hub.

The Director of Place, B&NES, BSW ICB replied that it is based in Peasedown St. John and also has a space within the Atrium at the RUH. She explained that the Hub provides a central place for people to access a range of services to improve their health and wellbeing.

She added that it is run in partnership with many local voluntary groups, including Age UK, Bath Mind and the Council. She explained that a range of services are offered from the Hub and include Housing Advice, Cost of Living Support and Access to Food.

The Chair said that it was a fantastic establishment to have in place for the Council and was able to provide a wide range of support to the public. She asked if a briefing note regarding the Hub could be circulated to the Panel in due course.

Kevin Burnett asked if the findings of the RUH CQC Inspection Report were of particular concern.

The Director of Place, B&NES, BSW ICB replied that they were aware of the issues that had been raised and were already addressing them.

Councillor Dave Harding asked if figures relating to dental hygiene could be included in a future report that comes to the Panel that issue.

Councillor Paul May commented that the Community Wellbeing Hub was a credit to all involved and said that the funding for it would be retained.

The Chair, on behalf of the Panel thanked the Director of Place, B&NES, BSW ICB for her report.