Agenda and minutes

The Chairman will welcome everyone to the meeting.

Laura Mayes, Vice-Chair and Deputy Leader of the Council, welcomed everyone to the meeting and explained that in Cllr Richard Clewer’s absence would be chairing the meeting.

To receive any Apologies for Absence.

Apologies for absence were received from:

Cllr Richard Clewer

Cllr Ian Blair-Pilling

Cllr Jacqui Lay

Cllr Phil Alford

Dr Nick Ware

Terence Herbert

Lucy Townsend

Helean Hughes

Fiona Slevin-Brown

Alison Elliot

Clare O’Farrell

Paula Tucker

Claire Thompson

Marc House

Catharine Symington

Stephen Ladyman

Naji Darwish

Cara Charles-Barks

Catherine Roper

James Fortune

Shirly-Ann Carvill

Hazel Malcolm

Margaret Arnold

Edd Rendell

Judith Sellers

Stephanie Elsy

Amina-Marie Marecheau

Simon Yeo

Gina Sergeant

To confirm the minutes of the meeting held on 20 July 2023.

The minutes of the previous meeting on 20 July 2023 were presented for consideration. After which, it was:

Decision

The Wiltshire Health and Wellbeing Board approved and signed the minutes of the previous meeting held on 20 July 2023 as a true and accurate record.

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of interest.

The Council welcomes contributions from members of the public.

Statements

If you would like to make a statement at this meeting on any item on this agenda, please register to do so at least 10 minutes prior to the meeting. Up to 3 speakers are permitted to speak for up to 3 minutes each on any agenda item. Please contact the officer named on the front of the agenda for any further clarification.

Questions

To receive any questions from members of the public or members of the Council received in accordance with the constitution.

Those wishing to ask questions are required to give notice of any such questions in writing to the officer named on the front of this agenda no later than 5pm on (4 clear working days, e.g. Wednesday of week before a Wednesday meeting) in order to be guaranteed of a written response. In order to receive a verbal response questions must be submitted no later than 5pm on (2 clear working days, eg Friday of week before a Wednesday meeting). Please contact the officer named on the front of this agenda for further advice. Questions may be asked without notice if the Chairman decides that the matter is urgent.

Details of any questions received will be circulated to Committee members prior to the meeting and made available at the meeting and on the Council’s website.

A question was received from Cllr Tony Jackson, alongside concerns from the Warminster Health and Wellbeing Forum, submitted to the board as follows:

In light of the transfer of pharmacy, optometry and dental services to the BSW announced at the HWB Meeting on 20 Jul 23 is BSW able provide commentary on the potential Closure of Boots Avenue Surgery Warminster?

The following response was read by the Chair:

Thank you for raising your concerns in relation to pharmacy provision in Warminster. We have linked with our ICB colleagues (working with the Collaborative Commissioning Hub) as they hold the responsibility around commissioning pharmacy provision for BSW to provide an update on the current position for Warminster.

The BSW Integrated Care Board can confirm that the provider (Boots, The Avenue) has given the appropriate notice period for exit and are within regulations for a closure. At present, the Collaborative Commissioning Hub are able to confirm that on reviewing the pharmacy provision in Warminster and in discussion with the remaining two pharmacies, we have had reassurance they will be able to manage demand, as the remaining Boots branch are increasing capacity and will be extending their opening hours to those which were previously available at the Avenue branch. They are also supporting patients to move or transfer pharmacy where this is desired by the individuals. The Hub will maintain an overview of pharmacy provision in Warminster after the closure, working with the other two remaining pharmacies in relation to their capacity and demand, ensuring they remain productive and can manage their demand safely.

There continues to be instability in the pharmacy market nationally and there is work underway to review pharmacy opening hours and clinical services provision for Wiltshire to provide insight into the market. If the reviews provide insight which suggests that provision is not adequate, the Pharmaceutical Needs Assessment (PNA) Steering Group will consider, on behalf of the Health and Wellbeing Board, if an updated PNA is required. The PNA has a three-year lifecycle, with the next version due to be published in Oct 2025.

The PNA is a statutory process and as such must follow a set process in order to address adequacy of provision. In relation to population changes per publication lifespan, each version only considers the timescale of the document, with the assurance that the process is completed on a 3-year rolling basis to ensure any population changes are evidence based and considered in a timely manner. The most recent version considers the projected population changes for 2022-25. 

At the next meeting of the Health and Wellbeing Board in November there is the opportunity to consider a fuller update on the provision of community pharmacy across Wiltshire.

To receive a report from Mel Nicolaou on the Carers Strategy.

The Board received a report from Mel Nicolaou on Wiltshire Council’s Carers Strategy, which is attached to the agenda.

The strategy was described as still in draft format and would inform the commissioning of services going forward once finalised. Conversations had taken place with relevant parties to assist with the strategy which was considered not specific enough and particular attention is paid to answers from an annual national survey that asks carers about their experiences.  Some carers had said they felt isolated and unsupported. The delivery plan is included in the strategy and all feedback and collaboration was considered welcome from the Health and Wellbeing Board.

Debate

The timeline was clarified that the strategy and delivery plan was to be approved by early December.

The draft was considered a good base to build upon and the consideration of carers was welcomed. The strategy was described as having “richness and quality” and the outcomes being people-focused was positively received.

It was commented that the action plan didn’t fully reflect the priorities as set out in the report. The need to consider young carers as well as older carers was stressed as it can prevent young carers getting into crisis through lack of support. A monitoring system to measure outcomes was highlighted as a must for the strategy.

Resolved

i)               To note the report

ii)             To bring the strategy back to the Health and Wellbeing Board after the consultation phase had concluded

To receive a report from Rob Holman on the Dementia Strategy.

The Board received a report and PowerPoint presentation from Rob Holman on Wiltshire Council’s Dementia Strategy. The full report and PowerPoint is attached to the agenda.

There had been a refresh of the previous strategy, and this newer version had in part been written hand in hand with the carers strategy. The strategy was described as prevention based, with the action plan still under development. There was an “all age” focus, including the impact of dementia on young parents with young children.

Debate

It was clarified that the increasing numbers of those suffering with dementia in Wiltshire was mainly due to the increasing elderly population and was in line with the national trend.

The Board stated that the strategy was well structured and easy to follow, but must be beyond a medical model and not focused just through talking to GPs. Prevention needed to be at the forefront and not reinforce the idea of dementia being inevitable. A significant number of carers are in early stages of dementia and signposting support was stressed as important, as was tackling the social stigmas around dementia. The push to being online had the potential to make processes for accessing support extremely difficult and ultimately inaccessible for those with severe dementia and thinking of offline methods was vital.

The Board commented that Wiltshire Council decided a long time ago to be dementia friendly and yet it was felt by the Board that a refocus was needed with increased invigoration and attention.

Resolved

i)               To approve and sign off the Wiltshire dementia strategy 2023-28

ii)             Note the governance arrangements for its implementation.

To receive an update on the Mental Health Crisis Care Concordat (Right Care Right Person) from the Office of the Police and Crime Commissioner/ Wiltshire Police.

The Board received an update on the Mental Health Crisis Care Concordat (Right Care Right Person) from David Minty.

National recognition had been given to the premise that the police had been responding to issues they are not full trained to help with. This brought key resources away from core policing needs and also doesn’t give the vulnerable person the support they need. It was stressed that this didn’t remove any legal responsibilities from the police relating to a duty of care.

Right Care Right Person was about reducing inappropriate police involvement in such issues and its six Core Principles were listed:

1. Members of the public have the right to receive the “Right Care from the Right Agency”.
2. The police should concentrate on Core Policing Duties.
3. Understanding the Police’s Legal Duty to attend.
4. Listening to Feedback from staff.
5. Partnership working.
6. Ensuring staff feel properly trained and supported to make the right decisions.

In general, when there is no reason to suspect that a crime has been, or is likely to be committed, responses to the needs of people with mental ill health and vulnerabilities should be provided by appropriately commissioned health and social care services. The police have a duty to prevent and investigate crime, however, they also provide an emergency response to intervene and protect life and property from harm.

Debate

The Board stressed that it wanted to see evidence of improvement in care through a reduced police response replaced with mental health referrals.

A breakdown of Wiltshire specifically rather than including Swindon was considered important, as was early collaboration between police and health partners.

There was clarification that the Bluebell Ward would continue to receive funding.

Discussion over the Fire Service having a more significant role was had, with concerns raised over more training and funding being needed.

Resolved

i)               To note the report

To receive a report from Caroline Holmes on the Primary and Community Care Delivery Plan.

The Board received a brief summary of the report included in the agenda pack from Caroline Holmes on the Primary and Community Care Delivery Plan.

The primary and community care delivery plan is a strategic document that supports the broader BSW Together Integrated Care Strategy and Implementation Plan and informs operational planning and financial recovery, so that we can better serve our BSW population of children and adults.  It was approved by the BSW ICB Board on 21 September 2023.

The objectives were listed as:

1. Focus on prevention and early intervention.
2. Fairer health and wellbeing outcomes.
3. Excellent health and care services.

Feedback was used from a range of clinical and non-clinical stakeholders and sources and iterated throughout the development of the delivery plan.

Further engagement and developing a clear roadmap for delivery were the next steps and feedback from the Health and Wellbeing Board was welcomed.

debate

The Board stated that a clearer picture was needed of where the funding for these plans was being sourced. “Rightsizing” was seen as important and could be done so by benchmarking with other local authorities and partners to compare and improve accordingly. It was stressed that the voluntary sector needs including in plans.

Resolved

i)               To note the report

To receive the Annual Health Protection Report from Dr Michael Allum.

The Board received from Dr Michael Allum a brief summary on the Annual Health Protection Report. The full report is available in the agenda.

Debate

Kate Blackburn, Director Public Health, stated that she believed that the Council was in the best possible position, and this was testament to Dr Allum and the team.

Resolved

i)  To note and acknowledge the Wiltshire Health Protection Assurance

Group Annual Report 2022;

ii)  Support the recommendations of the Wiltshire Health Protection

Assurance Group Annual Report 2022.

The next meeting of the Health and Wellbeing Board will be on 30 November 2023.

The next meeting of the Health and Wellbeing Board will be on 30 November 2023.

Any other items of business which the Chairman agrees to consider as a matter

of urgency.

There were no urgent items.