Agenda and minutes

To receive any apologies or substitutions for the meeting.

There were no apologies.

To approve and sign the minutes of the meeting held on 8 June 2023.

The minutes of the meeting held on 8 June 2023 were presented for consideration, and it was,

Resolved:

To approve and sign the minutes as a true and correct record.

To receive any declarations of disclosable interests or dispensations granted by the Standards Committee.

There were no declarations.

To note any announcements through the Chairman.

Through the Chair it was announced that the Committee was holding an inquiry session on 19 July 2023 for committee members to explore the factors contributing to the current demands on urgent care services in Wiltshire. The Chairman encouraged all Members to attend.

Members had also been sent a report from the Avon and Wiltshire Mental Health Partnership since the last meeting. 

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.

There were no statements or questions submitted.

• To update the Select Committee on the progress of the Integrated Community based services Programme, including an outline of the aim and purpose of this programme, the link to the ICP strategy, and key milestones/timelines. 
• To inform the Committee on the ICB and its partners plans to ensure continuity of provision of services to local communities during the programme.

Fiona Slevin-Brown, Director of Place for the Integrated Care Board, was in attendance to provide an update on the integrated Community Based Care programme.

Details were provided on publication of the integrated care strategy setting out key priorities for the integrated care system. This included an increase in focus on prevention and early intervention, with community based services. The integrated community based care programme had been established to secure specific health community services from 2025. The priority was to ensure continuity of services for the next financial year, to ensure partners and communities could be involved for the new contracts.

The Committee sought examples of types of community-based care where contracts were expiring and covered with the new programme, such as community hospitals, physios and other health and care. There was discussion of national issues relating to the non-consolidated pay award for NHS staff, which did not cover those in care services employed by non-NHS organisations.

Detail was sought on what would be different as a result of a greater focus on community-based services. It was stated there would be a focus on expected outcomes, looking at issues like improving access or ranges of services. It was also stated there was no assumptions being made about providers, market engagement was taking place to any interested providers of community services, including the voluntary sector, with an opportunity to have a more flexible model.

At the conclusion of discussion, it was,

Resolved:

To note the content of the paper and to schedule an update to follow progress on the integrated community-based care programme. 

A presentation to describe co-production to date, which has shaped the Council’s all-age Carers Strategy.  It sets out a draft vision, priorities and a set of actions which will help us to realise that vision and support carers of all ages in Wiltshire. 

The presentation won’t specifically address the tender process, as this will follow full engagement with the market.

A presentation was received from Melanie Nicolau, Head of Adults Commissioning, regarding the draft All Age Carers Strategy and delivery plan, as set out in Agenda Supplement 1, supported by Elizabeth Saunders, Interim Director, Commissioning. It was stated that the service had worked with carers to improve the offer for the Wiltshire area.

During the presentation details were provided of the intention to establish online resources for people to access support and resources, conduct assessments, and assist people in navigating through various levels and agencies, such as through family hubs. Potential metrics to measure success of the strategy was discussed, along with priority outcomes established through engagement with carers.

The Committee then discussed the strategy and update. The difficulty in commissioning and providing support for small villages and rural areas with limited transport links was raised. It was stated that providing online materials would assist as part of the model, that commissioned services would be retendered to look at new ways of delivering, with a model to make use of community facilities to improve access for all users.

The importance of outreach to local groups in the service area was highlighted, along with hard copy resources, factsheets and other resources, and asking for development of clear plans on how to establish effective collaborations. There was discussion of the priorities identified and areas of concern, such as people waiting for assessment, the diversity of carers’ needs in relation to time, resource or finances.

Details were sought on whether there would be commissioning for one supplier or many, with the different levels of support and requirements noted. It was stated the strategy would assist in understanding what was needed to deliver on the outcomes, certain priorities might be grouped, and then the council would look toward various partners and providers on how to deliver on those.

At the conclusion of discussion, it was then,

Resolved:

1)    To note the progress that has been made to develop theCarers’ Strategy. 

2)    To request a briefing on the service specification before tender. 

3)    To receive an update in 2024 to understand the impact of the strategy. 

4)    Toencourage engagement of Carer’s Champions with Area Boards

A presentation outlining how the Council plans to use the better care fund to deliver the national conditions as required by government. This is a central government fund aimed at supporting better integration between health and social care services. We are required to submit a two-year plan that sets out how the Wiltshire system intends to use the funding to enable people to stay well, safe and independent at home for longer and to provide the right care at the right place at the right time. 

A presentation was received from Helen Mullinger, Commissioning Manager, as set out in the agenda, in relation to use of the Better Care Fund. This was a pooled fund of the NHS and the local authority which supports delivery of integration of health and social care, with a focus on person-centred care and sustainability. A narrative and financial plan for 2023-25 had been submitted to central government on use of the fund.

It was stated a major aim of the fund was to enable people to remain safe and well at home for as long as possible, providing them the right care in the right place. There was nearly £70m in funding across 66 schemes and contracts. Conditions around joint plans, working with the Integrated Care Board and more were requirements of the fund.

Details were provided on the governance structure, examples of programmes supported through the fund, use of voluntary sector for additional support, cooperation with public health through joint strategic needs assessments. Themes focused upon included schemes relating to hospital discharge, demand capacity, support for mental health and more as set out in the presentation, along with monitoring effectiveness.

The Committee discussed the presentation, raising issues such as the impact on voluntary services, tracking of those discharged beyond 90 days to measure long term issues, and asking for details of the Better Care Plan. It was explained this was shortly to be signed off by the Health and Wellbeing Board, and could be circulated to the Committee.

There were further questions relating to the metrics, including on transfers from hospital, how some schemes were longstanding and in effect part of service budgets, and that further information would be provided as part of inquiry on patient flow and demands on urgent care services.

At the conclusion of discussion, it was,

Resolved:

1)    To note the progress that has been made in bringing the plan together.  

2)    To receive a copy of the plan.  

3)    To receive an update in 2024 on the progress being made in delivering the plan.

The Committee is invited to review its forward work programme in light of the decisions it has made throughout the meeting.

The Forward Work Plan was received. Subject to noting there would be discussion of the budget in January 2024, and the additional updates as resolved relating to the Carers Strategy and Better Care Fund Plan, it was,

Resolved:

To note the Forward Work Plan.

To consider any other items of business that the Chairman agrees to consider as a matter of urgency.

There were no urgent items.

To confirm the date of the next meeting as 5 September 2023 at 10:30 am.

The date of the next meeting was confirmed as 5 September 2023.