Agenda item

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

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

Chair announced for new Integrated Care Board cluster

Rob Whiteman has been announced as the new Chair of the Dorset, Somerset and BSW Integrated Care Board cluster. Previously Chair of NHS Dorset, Rob’s appointment comes as ICBs across the country, including those in the south west, come together across much larger geographical footprints as part of the government’s planned changes to the form and function of Integrated Care Boards.

While work is continuing at pace to formally establish the new cluster organisations, the three existing ICBs remain focussed on delivering their respective operational plans and developing programmes that will deliver the improvements required by the recently published 10 Year Health Plan.

Hospital passports for members of the Gypsy, boater and traveller communities who have a learning disability and/or autism

The ICB has worked with providers to help more individuals with a learning disability and/or autism, who are at risk of hospital attendance or admission, to receive a hospital passport.

There are a small number of people with a learning disability and/or autism living in Bath and North East Somerset who are members of the Gypsy, traveller and boating communities who have such passports. 

It is currently not possible to provide everyone with a health passport and this work is targeted at those at greatest risk, such as individuals who have frequent attendances and admissions to hospital under the high intensity user programme.

Working together to co-design the future of neighbourhood health, including the delivery of integrated neighbourhood teams, presents further opportunities to develop health passports.

Update on region’s new £20 million specialist mental health facility

Work to put the finishing touches to a new purpose-built specialist mental health inpatient facility in Bristol is well under way. The Kingfisher will be a state-of- the-art care environment, fully equipped to provide personalised support to autistic people and those with learning disabilities whose needs cannot be met by existing community mental health services.

Having this modern facility based locally will help to ensure that more patients living in Bath and North East Somerset, Swindon and Wiltshire receive the specialist care they need closer to home, while also reducing the likelihood of people being cared for out-of-area and away from family and friends.

The Kingfisher has been designed and built with input from service users, people with lived experience of the type of the care the new unit will be providing, as well as their families and carers.

When fully open in 2026, the facility will be able to provide short-stay admissions for those in genuine need of supervised hospital-level care.

Councillor Michael Auton commented that the NHS 10 Year Health Plan was likely to have wider issues for the rural areas of the Council and its older population, in particular regarding the digital changes. He asked if the BSW ICB had a specific plan for the region’s health and care needs.

Laura Ambler replied that she would reply formally to this question via a future update report to the Panel. She said though that there is a requirement to have in place integrated neighbourhood teams to provide community services such as nursing, therapy and personal care to homes, care homes, clinics, schools and community centres to bring more personalised support to local people.

Councillor Lesley Mansell said that the footprint of the new ICB cluster was huge and asked how this would affect local decision making.

Laura Ambler replied that an operating model had yet to be determined and said that the blueprint remains in place with the identified functions to be delivered locally.

Councillor Mansell commented that she welcomed the work carried out regarding health passports and asked if consideration could be given to them also being provided to members of the public with dementia and mental health needs.

Laura Ambler replied that they could consider whether information gathered as part of a Care Act Assessment could be captured as long as the person concerned was able to give their consent.

Councillor Mansell asked if the take up of flu vaccination invites would be monitored and could the information be shared with the Panel.

Laura Ambler replied that she was sure that data would be available and would seek to provide it in a future update report.

Councillor Mansell asked how access to the Kingfisher facility would be measured.

Laura Ambler replied that there is an operating plan that contains some local metrics that has been discussed with the ICB Board and suggested that this be shared with the Panel. She added that ‘lived voice’ feedback would continue to be sought when the site opens.

The Chair referred to the topic of the ICB cluster and said that she was not sure that she had seen the blueprint that was mentioned in an earlier answer.

Laura Ambler replied that this could be shared with the Panel and advised that some elements will have changed since its first publication.

The Chair commented that she had concerns that some local elements of work might be unpicked in the new cluster arrangements as it may move away from provision within Bristol.

Laura Ambler replied that other cluster options were considered, but explained that the patient flow does make sense for the footprint. She said that they were aware of the range of views that need to be considered in the next stage of this process.

Overview of how decisions around local pharmacy provision are made

The purpose of the Pharmaceutical Needs Assessment is to understand the needs of a given population, and to help decisionmakers in that area plan new services and identify any gaps within current provision.

The PNA, which is valid for up to three years and publicly available through the Bath and North East Somerset Council website, is used by NHS England when making judgements on applications to make changes to a local community’s pharmacy provision.

While there may be some changes over time in the location or opening hours of particular pharmacies, the PNA assesses provision across localities as a whole.

It also aims to ensure that gaps are not identified inappropriately, nor in locations where the market cannot sustain another provider. PNAs will consider issues such as future housing developments, GP practice changes and major infrastructure projects which could affect the need for local services.

Victoria Stanley, Head of Primary Care – Community Pharmacy Optometry and Dentistry addressed the Panel. She explained that the PNA had been discussed at the Health & Wellbeing Board earlier in September and thanked them for their comments and observations.

She said that the issue of temporary closures across the Council had been noted by the Board.

Helen Wilkinson, Community Pharmacy Clinical Lead, BSW ICB said that ongoing support is available for Community Pharmacies.

The Chair asked if a definition for the term ‘temporary closure’ could be given.

Victoria Stanley replied that the term is used to allow pharmacies to close temporarily for a number of different circumstances. She added these could range from a pharmacist not being present on site, low number or lack of permanent staff or issues with the pharmacy premises.

Councillor Michael Auton asked if population numbers within certain geographical locations were considered a factor as part of the PNA. He added that he felt there was a low provision of pharmacies in the rural areas, particularly Midsomer Norton and was concerned about the potential growing pressures on pharmacies and GPs.

Victoria Stanley replied that there is an application process to follow for those seeking to open a new premises, but said this was not led by the ICB or the NHS. She added that the onus was on the applicant to address how local services would be improved.

Helen Wilkinson said that pharmacists are in the process of being freed from dispensing roles as pharmacy technicians were receiving training to take on more dispensing responsibilities that will allow them to supply and administer medicines. She added that all newly qualified pharmacists will become independent prescribers from 2026, enabling them to directly treat patients and deliver more clinical services (when these are commissioned).

Councillor Michael Auton commented that recent census numbers have shown that the number of older people is increasing locally and was therefore likely to have an impact on health services.

Councillor David Harding referred to GP dispensaries and lack of access to the pharmacy App in rural areas. He said that GP dispensaries do not receive Pharmacy Access funding, have to pay for their own IT support and he was concerned about the possibility of an increase in the digital divide.

Victoria Stanley replied that they would offer support to a dispensing GP where possible.

Helen Wilkinson asked Councillor Harding to send further information to them regarding his concerns.

Councillor Lesley Mansell commented on the number of pharmacies available in Radstock and Midsomer Norton and their variation in opening hours. She asked if any gaps in provision had been identified / addressed following the PNA.

Victoria Stanley replied that no gaps in provision had been identified. She said that online pharmacies were available to deliver prescribed medication directly to people’s homes.

The Chair asked what could be done to encourage more people to take up roles such as Dentists, GPs and Pharmacy staff as there was a shortage / capacity issue.

Helen Wilkinson replied that work has taken place within schools and colleges to raise awareness of such roles. She added that the previously mentioned pharmacy changes planned for 2026 may help with an increase.

The Chair asked if they had considered a focus on recruiting older people or those potentially seeking a career change for pharmacy positions in particular.

Helen Wilkinson replied that they had not and thanked her for the suggestion.

Councillor Liz Hardman referred to the transfer of services between AWP and HCRG Care Group that took place in April and said she was concerned that no proper transfer plan was in place for people in receipt of the Autism Diagnostic Service or the ADHD Prescribing Service.

She said that she believed that around 5,000 people were still awaiting a diagnosis and asked how the work of HCRG Care Group would be monitored.

Laura Ambler replied that an update had been recently been given to the Wiltshire Health Overview & Scrutiny Panel and that this could be forwarded to this Panel. She said that she was aware of the significant waiting times for a diagnosis and that all who were on the waiting list had been written to at the time of the transfer to make them aware of their choices.

She explained that a lack of a diagnosis should not unduly delay any request for reasonable adjustments.

She said that they were working on a range of strategies to enable and help people to wait well, in terms of their diagnosis and that around 50 cases had been identified as needing to be advanced.

She said that measures were in place to monitor the work of HCRG Care Group through their community based contract. She added that improvements have been noted recently in Children & Young People with learning disabilities. She added that further information could be provided in a future update.

The Chair commented that it was disappointing to see the RUH receive a low ranking in the recently released NHS trusts performance league tables.

Laura Ambler said that she would prefer colleagues from the RUH to provide a response on this matter. She added though that the rank will not always correspond with the experience of the patients.

The Chair said that the Panel should consider inviting representatives from the RUH to a future meeting.

The Chair, on behalf of the Panel, thanked Laura Ambler, Victoria Stanley and Helen Wilkinson for attending and the BSW ICB for their update.