Agenda and draft minutes

To receive any apologies and note any substitutions or membership changes. 

Apologies were received from Cllr Clare Cape, Caroline Finch and Carol Shirley (Wiltshire Centre for Independent Living), Cllr Laura Mayes, Cllr Ian Blair-Pilling and Kate Blackburn (Director – Public Health)

There were no substitutions.

Cllr Bridget Wayman had been added as a substitute member for the Committee as appointed by Full Council on 23 July 2024.

To approve and sign the minutes of the meeting held on 17 July 2024.

Resolved:

To confirm and sign the minutes of the meeting held on 17 July 2024 as a true and correct record.

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

There were no interests declared.

To note any announcements through the Chairman to be made at the meeting.

The Chairman made the following announcements:

• Organisational changes within the Integrated Care Board (ICB) mean that the Committee will no longer work directly with Fiona Slevin-Brown. On behalf of the Committee the opportunity was taken to thank Fiona for her open engagement with the committee and to wish her all the best for the future.

• The Committee extends a warm welcome to Caroline Holmes who is the interim Place Director for BSW ICB.

• Legacy report – a reminder for all Members to bear in mind between now and May 2025 that consideration would be given to produce a legacy report for the next Health Select Committee.

• Linked to the legacy report mentioned above, the Chair and Vice Chair would focus a little more than usual on the forward work programme for future meetings to ensure that it is as useful as possible for the next council, as well as supporting this Committee to focus the work for the year ahead.  

• There had been no meeting of Cabinet since the last Health Select Committee - some items of interest are on the Cabinet’s forward work programme included:

17 September 2024

ICB Community Health Service Procurement

8 October 2024

Telecare Service Recommissioning

Future Commissioning of Care Homes – For which the Chair and Vice Chair would be attending a briefing on 24 September 2024.

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 Tuesday 3 September 2024 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 Thursday 5 September 2024. 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.

No questions or statements were received from the public in advance of the meeting.

The Committee will receive an update on Technology Enabled Care (TEC) which is the use of technology to support and enhance health and social care outcomes.

The Chairman welcomed Helen Mullinger (Commissioning Manager) who was in attendance to give an update on Technology Enabled Care (TEC), which is the use of technology to support and enhance health and social care outcomes.  It was noted that the committee had received a presentation in September 2023 and asked for a report in 2024 on how the priorities of the strategy are being delivered to meet the needs of Wiltshire residents.

Summarising the more detailed presentation included in the agenda pack, the following was highlighted:

·            The TEC may include pendants and wearable devices linked to a monitoring centre, sensors fixed in the home to monitor movement and changes and health monitoring at home;

·            There had been a huge growth in technology and devices could now be used to enhance people’s independence including apps on phones and tablets, smart home systems and environmental controls, devices connected to the internet and standalone devices;

·            The Council’s vision was to use technology to enable people to fulfil their potential, be actively involved and included in their communities, make informed decisions, have control over their lives and be valued and included within society.  There would be more engagement with carers and there were currently a host of pilot initiatives running;

·            There were four core objectives which included the target that by 2028 60% of packages funded by the Council would be enabled by technology;

·            There had been much progress to date including a recommission of the telecare which would commence from 1 April 2025.  With the new TEC pilots they were able to look at users changes in movement in home, change to home temperatures and they were looking to build a service to expand the use of the technology that is on offer to help support and make a difference to our residents;

·            The Council had joined Swindon Borough Council in a TEC project with Swindon leading the project to secure a TEC partner and they would be working with practitioners and care providers to review 42 individuals in Wiltshire with overnight or 24/7 support needs;

·            There was a strong appetite to innovate and to embed a wider range of solutions into the care and support provision, especially for adults with learning disabilities and/or dementia with a shift to a proactive TEC offer to prevent incidents and crisis’s escalating;

·            There were a number of priority outcomes including improving the quality of care, promoting independence, reducing admissions to hospital and care homes and achieving greater efficiency.  However this was not a way to make cost savings – there were huge benefits to residents wellbeing and sense of independence, with the Council hopefully being able to provide less intrusive packages of care to them; and

·            In delivering the priorities the Council would raise awareness and information sharing, develop clear pathways for TEC, grow the TEC offer, use a test and learn approach whilst utilising pilot opportunities and provide support to stakeholders. 

The Committee asked the following questions which included but were not limited to:

·            It  ...  view the full minutes text for item 58.

The report seeks to provide an update on the Dementia Strategy 2023-28 and an overview of the dementia advisors and community services contracts as well as an update on the dementia diagnosis rates in Wiltshire.

The Chairman welcomed Jo Body (Senior Commissioner), Alison Elliott (Director – Commissioning) and David Leveridge (NHS) who were in attendance to give an on update on the Dementia Strategy 2023-28, following consideration by the committee in June 2023.  The report also included an overview of the dementia advisors and community services contracts and an update on the dementia diagnosis rates in Wiltshire.

Summarising the more detailed presentation included in the agenda pack, the following was highlighted:

·             That dementia was a national challenge with approximately 950,000 people living with dementia in the UK costing £25 billion per year.  Supporting a person to live at home for as long as possible was less expensive than a care home admission and better for a person’s quality of life but this was only possible due to the huge caring contribution made by unpaid carers and specialist support offered by providers;

·            The Wiltshire Dementia Strategy for 2023-28 was an all age, joint strategy supporting people with dementia and their carers – there was a One Council approach with dementia being everybody’s business, not just social care;

·            The priority outcomes included preventing well, diagnosing well, supporting well, living well and dying well;

·            There were 55 actions identified in the Strategy and after consideration of the themes, 8 priority actions were identified;

·            Two community based contracts were being delivered by Alzheimer’s Support – Dementia Advisors and Dementia Community Services.  Whilst the Council hold contractual responsibility for these, they were funded jointly with the Integrated Care Board and the contracts commenced on 1 April 2024;

·            The Dementia Advisors Service provides signposting, information and support for eligible people with/have a suspected diagnosis and their carers who live in Wiltshire.  There were 5 key elements – information, identify needs, support plan, reviews and carers support;

·            Dementia Community Services deliver 800+ session/groups with over 8500 attendees.  The key aims are supporting an active lifestyle, reduce isolation and to provide practical and emotional support; and

·            The present waiting time for a GP referral to a Avon and Wiltshire Mental Health Partnership (AWP) memory nurse is 6 weeks, with a further 3 months wait for consultation and diagnosis.  The Memory Service works closely with Alzheimer’s Support to ensure a speedy referral to Dementia Advisors.

The Committee asked the following questions which included but were not limited to:

·            I think highly of the service that Alzheimer’s Support provides but feel that there is just not enough of it – what are the Dementia Advisors going to do to address the wishes and needs of their users?  It was noted that there were follow on reviews with all those users that are referred to them.  The Dementia Advisors give support and signpost them to additional support and services and they can access to find help in specific areas.  There was data available to give details of how many users receive the help and support they need.

·            Aware that there no support sessions for those dealing with the early stages of dementia to go to but  ...  view the full minutes text for item 59.

The Committee will receive an update on the Implementation Plan of the BSW Integrated Care Strategy.

The Chairman welcomed Leanne Field (Head of Delivery NHS BSW (ICB) who was in attendance to give an update on the Implementation Plan of the Integrated Care Strategy.

Summarising the more detailed presentation included in the agenda pack, the following was highlighted:

·            The original plan was developed and signed off in 2023 and a high level refresh had now been undertaken covering the two years 2024/25 and 2025/26.  The full implementation plan was available in their website and would be circulated the committee following the meeting;

·            The plan had been developed with regard to the Integrated Care Strategy, the ICB Operating Plan and other system partnership key plans, particularly the Joint Local Health and Wellbeing Strategies and they were working with the 11 Delivery Group Leads (Programme Boards);

·            The 2023-24 successes across BaNES, Swindon and Wiltshire included the development of an Integrated Neighbourhood Team in Swindon, a youth worker pilot, unborn children and those under 1 years old system improvements and over 7000 staff completing the Oliver McGowan training on learning disability and autism;

·            Specific successes during 2023-24 for Wiltshire included improvements in obesity levels and in services for children and young people;

·            The Integrated Care Plan objectives for 2024-25 were a focus on prevention and early intervention, fairer health and wellbeing outcomes, provision of excellent health and care services and financial recovery and sustainability;

·            Some of the Wiltshire priorities for 2024-25 would include areas such as healthcare inequalities, neighbourhood collaboratives and system flow; and

·            The ICB were awaiting the findings from the Lord Darzi Rapid Review of the state of the NHS, which was expected to impact on the NHSE refresh of the 10 year plan which is due to take place in Spring 2025.  The ICB would consider the Darzi Review and 10 year plan update in its 2025-26 iteration of the Implementation Plan, ensuring priorities are aligned. 

The Committee asked the following questions which included but were not limited to:

·            It was felt to be important that performance and delivery by health care providers and the Council should be integrated where possible – was there anything in plan to show the Care Boards now being integrated had benefited people and could you reassure us that they are working better than they were before. It was noted that there was a specific section in the implementation plan for Wiltshire which had been co-written by health and Council colleagues and the priorities had been developed through alliance and the wider partners with flow through.

·            On page 55 of the agenda pack shows the Wiltshire priorities for 2024-25, how would these be measured and was there a set of metrics behind those to determine quality and performance.  It was noted that there were national metrics which officers would look into, and it was believed that they were also monitored through the alliance.

·            There were concerns lack of pharmacies in the Amesbury area raised.  It was noted that this would be addressed outside of the meeting.

Resolved:

That the  ...  view the full minutes text for item 60.

The Committee will receive an update on the CQC inspection of adult social care which is due to take place between 24 – 26 September 2024.

The Chairman introduced an update on the upcoming CQC inspection of Adult Social Care scheduled for 24 to 26 September 2024 and it was noted that the Chairman and Vice Chairman had both been invited to attend a meeting with the CQC Inspectors during that time. 

The Chairman invited Emma Legg (Director – Adult Social Care) to talk to the presentation that was shared as part of the agenda supplement pack and the following was highlighted:

·            An overview of the inspection timeline which would include inspectors being on site for 2.5 days and selecting up to 10 of the 50 identified cases to ask for their customer journey feedback and those involved with their care;

·            Staff were working hard to finalise the timetable for the inspectors to speak with front line staff and partner organisations including the Chair and Vice Chair of this committee;

·            The inspection feedback meeting was planned for 2 October and the findings report would be drafted to share with the service.  The final version when prepared would be shared with the committee; and

·            The Senior leadership presentation to the CQC had been their opportunity to explain how the service was organised, the strengths, outcomes and ongoing development areas for each adult social care operational and commissioning service and with a number of spotlight focus areas also being highlighted.

The Committee asked the following questions which included but were not limited to:

·            Whether the service was ready and prepared for the inspection and if everyone understand their object and place in the team.  It was noted that all of the teams involved had worked really hard to get to this position and they were proud of the passion and commitment shown and that they felt that they were in a much stronger position than they were in 12 to 24 months ago.  A lot of time had been spent reflecting on performance and they had been given the opportunities to share their stories and say what they feel works work and what challenges they face.

·            If this was an overall inspection of Adult Social Care or if it would focus on any particular aspect?  It was noted that the overall assessment framework covered many areas which had an enormous scope.  The inspectors would focus on intelligence data which would lead them to look at specific areas.

·            How were the 50 cases shared with CQC selected to be listed for possible further inspection?  It was noted that these were random but covered a range of diagnoses and conditions to ensure that there were some broad categories to cover all of the current population.

Resolved:

That the Health Select Committee

1.          Receives a brief report presenting the outcomes of the CQC inspection at the next available committee meeting and how this compares with the position presented on slide 4 of the agenda supplement (which are the strengths and areas for further development).

2.          Reviews its forward work programme, if required, based on the outcomes of the CQC inspection.  ...  view the full minutes text for item 61.

The report (to follow) will present the options available to the Committee with regards to the appointment of stakeholders and non voting members.

The Chairman reported that the report was circulated in the agenda supplement and presented options available to the Health Select Committee with regards to the appointment of non-elected non-voting co-opted members which he welcomed to show the value recognised in the co-opted members’ contribution to overview and scrutiny.

There were no questions from the Committee.

Resolved:

That the Health Select Committee:

1.          Amends its agenda to reflect the position of co-opted members as “non-elected non-voting members” to offer clarity on the role and align with other committees of the council.

2.          Confirms that the following appointments of co-opted members remain until the in-depth review is concluded:

•    Caroline Finch (Wiltshire Centre for Independent Living)

•    Diane Gooch (Wiltshire Service Users Network)

•    Irene Kohler as a representative of Older Person’s Champions     (previously as a representative of Healthwatch Wiltshire)

3.          Delegates to the Chair and Vice Chair to request an in-depth review of the process for the appointment of co-opted members for all overview and scrutiny committees at the next available meeting of the Overview and Scrutiny Management Committee.

4.          Delegates to the Senior Scrutiny Officer to contact Healthwatch Wiltshire to invite them to nominate a representative.

To review and approve the Committee’s forward work programme in light of the decisions it has made throughout the meeting.

The Committee’s noted the Forward Work Programme (FWP) would be updated to reflect any changes made during the meeting.

A Committee member suggested that there could be a future report from the Adult Social Care service which gave an overview of the major contracts that they tender out, acknowledging that these would be approved by Cabinet but that the Committee should be given the opportunity to be aware of them and scrutinise as relevant.

Resolved:

That the Health Select Committee:

Approve the Forward Work Programme with the additions agreed at the meeting.

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 Wednesday 20 November 2024 at 10.30am.

The date of the next meeting was confirmed as Wednesday 20 November 2024 at 10.30am.