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.

Uzoma Ibechukwu, Director of Pharmacy, Royal United Hospitals, Bath was also present at the meeting.

Chief Executive of new ICB cluster appointed

Earlier this month, Jonathan Higman was appointed as the new Chief Executive for the recently-established Integrated Care Board cluster covering Bath and North East Somerset, Swindon and Wiltshire, Dorset and Somerset.

Jonathan, who is currently Chief Executive of Somerset ICB, has more than 25 years of experience in both NHS provider and commissioning organisations.

Winter vaccination programme

Eligible groups are now able to receive a free flu and Covid-19 vaccination. Pregnant women, along with children aged two and three, were among the first to be called forward in early September. On Wednesday 1 October, the flu vaccination offer was widened to include over-65s, people with a weakened immune system, care home residents and frontline health and social care workers.

There are a number of different ways in which people can arrange their flu vaccine appointment, with bookings available online through the NHS App and at www.nhs.uk/bookflu, or over the phone by calling 119.

The eligibility criteria for Covid-19 vaccines has been changed, following a review by the Joint Committee on Vaccination and Immunisation. Now, only those people aged 75 and over, as well as older care home residents and those who are immunosuppressed, will be offered a vaccination against Covid-19.

Closure of the outpatients medicine courier service at the RUH

During the Covid-19 pandemic, the Royal United Hospital in Bath introduced the outpatients medicines courier service to support vulnerable patients who were shielding.

As of 2025, the service is still in operation and currently carries out between 300 and 350 deliveries each month, mainly for oncology, haematology and dermatology patients.

In June of this year, the RUH agreed to decommission the service, and transition to a modern, digitally-enabled model, which aligns with the requirements of the government’s 10-Year Plan for the NHS.

The current model supports only a small number of patients. An electronic prescribing service will be able to support a wider cohort of patients, with the majority of users able to access medicines through other means, such as their local community pharmacy.

She explained that a discussion about the recent hospital league tables would be followed up at a future meeting.

Kevin Burnett referred to the outpatients medicine courier service and asked if patients had yet to be informed and had there been any pre-decision discussion with them.

Uzoma Ibechukwu replied that they have been working with the Patient Advice and Liaison Service at the RUH with regard to how communication with patients could be carried out.

Laura Ambler added that the Panel were being asked their view on the proposal and confirmed that patients in receipt of the service would be written to.

Kevin Burnett commented that as it was a relatively small number of people could a more direct form of communication be undertaken before the letter was sent, particularly in rural areas.

Laura Ambler replied that they would take the suggestion into consideration.

Kevin Burnett asked if there was target for the number of vaccinations to be administered.

Laura Ambler replied that no targets have been set with regard to herd immunity and that currently the vaccination figures in B&NES were above the national level.

Councillor Bharat Pankhania commented that it was good to hear that the uptake locally is good, but said it was important to improve them as the work regarding winter pressures begins now. He asked why there were different criteria for the Flu and Covid vaccinations.

Laura Ambler replied that they do intend to keep raising awareness of the vaccinations that are available and said that teams were in place to do so across B&NES, Swindon & Wiltshire.

She added that she would raise with colleagues the matter regarding criteria to receive a vaccination and update the Panel in due course.

Councillor Pankhania said that he was also concerned about the number of older people that should receive a vaccination for Shingles. He asked if a system was in place to monitor both that and the MMRV vaccine which is a combination vaccine that protects children against four diseases: Measles, Mumps, Rubella, and Varicella (chickenpox).

Laura Ambler replied that she would follow up this point with colleagues in the vaccinations team.

Councillor Onkar Saini asked how B&NES would retain a strong local voice under the new cluster arrangements.

Laura Ambler replied that the new structure had not been fully set out yet, but assured the Panel that the new ICB Chief Executive recognises the importance of Place. She added that the current B&NES Chief Executive was part of the ICB Board and that they work with all respective Council directors and the Health & Wellbeing Board.

Councillor Saini asked if there was a contingency plan should a drop in the uptake occur.

Laura Ambler replied that the vaccinations team were in place to monitor this and suggested a member of the team could attend a future meeting of the Panel to provide further information.

Councillor Saini asked if the ICB and RUH would monitor the proposed change to the medicine courier service and what would be the threshold to trigger a review.

Uzoma Ibechukwureplied that they will be closely monitoring the activity alongside the Community Pharmacies.

Councillor Lesley Mansell asked if work would be undertaken to attempt to increase staff uptake of vaccinations.

Laura Ambler that there is a direct communications plan in place for staff.

Councillor Mansell asked how the closure of the medicine courier service fitted in with the 10 Year Plan and how would it affect those members of the public that have a lack of internet access.

Laura Ambler replied that patient engagement has and will continue to take place and reiterated the rationale behind the proposed change.

Councillor David Harding asked if an update could be provided on the funding status of the ICB following the information received earlier in the year that they needed to reduce their running costs by 50%.

Laura Ambler replied that a reduction in costs was required to be identified by December 2025 and that she was unable to give any further details at this time.

Councillor Liz Hardman referred to the transfer of some adult services between AWP and HCRG and whether this would result in a drop in provision for autism services.

Laura Ambler replied that these services were jointly commissioned between three Local Authorities and two Integrated Care Boards and are formed with an end-to-end design to provide a range of support. She added that a new inpatient facility was due to open next year and would provide 10 beds under a model of shorter, therapeutic interventions.

The Chair asked how confident was she that the new ICB cluster arrangements would be finalised in their current proposed form.

Laura Ambler replied that from an ICB perspective the clusters have been agreed and that formal merger arrangements will be required to be undertaken in the future.

The Chair asked if B&NES should expect to continue to have representation on the Board.

Laura Ambler replied that in her opinion they should.

The Chair thanked Laura Ambler and Uzoma Ibechukwu for their update on behalf of the Panel.