Agenda item

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

Laura Ambler, Director of Place for Bath and North East Somerset, BSW ICB addressed the Panel and highlighted the following areas from within the update.

Sulis Elective Orthopaedic Centre

Sulis Hospital is a partner of the Royal United Hospital Bath. The hospital is currently building the Sulis Elective Orthopaedic Centre (SEOC) on its site just outside of Bath, and it is now entering the final build stages with the team now readying the new wing for a December launch.

The new SEOC wing will create capacity for 3,750 non-emergency, orthopaedic operations for NHS patients across Bath and North East Somerset, Swindon and Wiltshire, as well as the wider South West region each year, allowing people to have the surgery they need. NHS patients will see reduced waiting times and waiting lists with increased capacity to offset delays.

A new travel initiative will encourage healthy and sustainable travel habits that benefit everyone. The initiative includes making e-bikes available to all staff for long-term hire, with charging available at Sulis Hospital. There will also be charging points for electric vehicles, a comprehensive overview of bus travel, including WESTlink bus routes, and an extension of the Sulis Hospital car sharing scheme.

The SEOC is also bringing around 100 new jobs to the area, both clinical and non-clinical. This recruitment is in progress and going well. Following a successful open day in July, which attracted more than 110 visitors, Sulis received approximately 700 expressions of interest for all role types. Throughout November and December, Sulis will be inducting more 30 new starters.

Vaccinations

Since the launch of this winter’s campaign to protect people against flu, Covid-19 and Respiratory Syncytial Virus (RSV), more than 450,000 vaccinations have been delivered to eligible people living locally.

Covid-19 jabs were rolled out to those eligible on 3 October, while flu jabs have been available for pregnant women and children aged between two and three- years-old since 1 September.

In BSW, vaccinations have been delivered in walk-in clinics, GP surgeries, pharmacies and community settings, with the initial phase focussing on reaching those unable to leave their home without assistance, such as housebound patients and care home staff and residents.

Pharmacy provision in Bath and North East Somerset

Data from the most recent Community Pharmacy Workforce Survey is now available and provides a snapshot of staffing inside community pharmacies as of autumn 2023.

As it stands, this data is currently the only source of metrics on the community pharmacy workforce. The ICB is in the process of analysing the data, while simultaneously reviewing the impacts of local initiatives to tackle the workforce challenges that have been seen in the region.

Some of the initial results are:

• The number of full-time equivalent pharmacists in BSW has increased from 212 in 2022 to 222 in 2023

• The ICB has increased the number of trainee pharmacists from six in 2022 to 20 in 2023

• The pharmacist vacancy rate in BSW has fallen from 28 per cent in 2022 to 22 per cent in 2023

• The number of independent prescribers within pharmacies has increased from 19 in 2022 to 28 in 2023.

New initiatives to support children and young people

The ICB uses the national CYPCore20PLUS5 framework to underpin all work carried out to support children and young people, with progress measured against the following five clinical areas:

• Children and young people’s mental health

• Asthma

• Epilepsy

• Oral health

• Diabetes

Recently, as part of ongoing efforts to increase focus on mental health, the ICB has launched the BSW Youth Worker Pilot, which involves having a dedicated youth worker in each of the region’s acute hospital emergency department, including the Royal United Hospital in Bath. This is provided by our third sector partners and the service in B&NES is provided by Off the Record.

The ICB has launched an epilepsy specialist nurse pilot at the Royal United Hospital in Bath, which offers additional care for any young people admitted as a result of their epilepsy. The new role also has links into the community, which helps to offer improved clinical outcomes and enables staff to embed new ways of working across Bath and North East Somerset.

To improve diabetes outcomes, the ICB has focused on prevention of obesity by expanding its local complications for excessive weight (CEW) clinics. In addition, teams are working to adopt the latest guidance from the National Institute for Health and Care Excellence (NICE) around managing blood glucose levels in patients with type 1 diabetes, with an emphasis on ensuring children and young people are prioritised.

Councillor Liz Hardman referred to a point raised at a previous meeting relating to a maternity trauma project that had been set up and had asked for any information regarding the waiting list for it of four to six months.

Laura Ambler replied that she has asked for clarification on that matter and would update when she had received a response.

Councillor Hardman commented that it was good to see that the figures in relation to pharmacies were going up slightly, but said she wondered if more were needed. She also believed that some pharmacies were opting out of the NHS scheme and asked if more information was available.

Laura Ambler replied that she would enquire as to whether there was any further information that could be shared.

Councillor Hardman said that the Youth Worker Pilot scheme sounds excellent but asked for some figures on this and what were the hoped for potential outcomes.

Laura Ambler replied that although this work had not been fully evaluated yet, they were already seeing a positive impact.

Councillor Hardman referred to the subject of vaccinations and explained that some residents have said that when schools have had information about a vaccination for their children that schools aren't always informing parents where there is local provision. She said that a resident had received the child's eligibility notice but no information about the local places to get them.

Laura Ambler replied that she was not aware of this issue and would welcome any further details regarding it.

Kevin Burnett asked whether the ICB has been able to maximise the number of vaccinations given during this recent period.

Laura Ambler replied that in terms of the vaccinations they do feel that they have what they need to maximize uptake and that the benchmark data shows that they do very well in terms of getting vaccinations out there to those that need them.

Kevin Burnett asked what the pharmacists were telling the ICB about how they are coping with new demands placed upon them and whether the ICB is content with the pharmacy provision and if they have any particular concerns with any of the 100 hour pharmacies reducing their opening hours.

Laura Ambler replied with regard to pharmacies that they have no immediate concerns around the contracted hours at this moment in time and that there is an ongoing review so an update could be provided in due course.

Kevin Burnett asked if the new initiatives that have been described are being delivered because of new money or was it from existing resources. He also asked if CAMHS would able to cope with the extra referrals or were things being prevented from getting to CAMHS because of these interventions.

Laura Ambler replied that the funding was from within existing transformation resources, and it is a pilot for a period of time, focusing on prevention. She added that they are seeing good initial outcomes and that it is reducing the admissions to our emergency departments in particular, and also supporting those who are in a hospital setting either through mental health or because they have got a long-term condition.

She said that when we talk about children young people with emotional health and well-being needs it is about meeting the need that is being presented and in some instances there may be a clinical diagnosis which means that that child or young person is appropriate for a referral through to CAMHS, but in other instances it may be another type of early support.

Councillor Joanna Wright referred to Asthma Friendly Schools and said that it was interesting that the whole emphasis is put on the school and the young person. She commented that in her opinion it goes back to the matter of School Streets and that essentially there is an air quality issue and it was a question of how do we support that and not get siloed.

She asked if there was a need for a greater conversation to be had across this piece of work that brings the issues together and whether School Streets was also Public Health issue about children getting to school safely and then when they are at school that those spaces have clean air.

Laura Ambler replied that she would discuss the issue with colleagues to make sure this is a joint initiative with the Local Authority.

Councillor David Harding commented that he believed that last year and the year before around only half of children who were eligible for school flu vaccines (Years 7 – 11) received them and asked how the vaccination programme was going this year and were any actions being taken improve it.

Laura Ambler replied that she would need to check the data on this matter, but said she was not aware that the figures were as low as that.

Councillor Harding asked if data could also be provided on the adult covid vaccination rates, how many people are eligible and actually taking it up.

Laura Ambler replied that this information could be shared with the Panel.

Councillor Lesley Mansell asked in any information could be provided to the Panel with regard to measles vaccinations.

Laura Ambler replied that further vaccination information could be provided to the Panel within a future update report.

Councillor Mansell referred to Community Pharmacies and asked if there were any concerns regarding local accessibility.

Laura Ambler replied that they were not aware of any initially but would welcome any feedback from the Panel.

Councillor Mansell asked if the figures in relation to physiotherapy were average waiting times.  

Laura Ambler replied that they were.

The Chair, on behalf of the Panel, thanked Laura Ambler for her report.