Issue - meetings

To receive updates from CCG officers on recent, current and upcoming work, projects and changes, including:

a) Social Prescribing – to receive a presentation on how the Primary Care Networks in Wiltshire have been using (or are planning to use) the Directed Enhanced Service funding (including Social Prescribers)

b) Citizen’s Panel – to receive an update on the outcome of the CCG’s investigation of several options for procurement of a market research agency to support the development, recruitment and maintenance of the Citizen’s Panel.

c) Maternity Service Redesign – to receive a response to the rapid scrutiny report considered at the last meeting of the committee (attached for ease of reference) and update.

f) Mental Health transformation – to receive a presentation on progress to date.

Maternity Service Redesign

Lucy Baker, Director of Service Delivery for Banes, Swindon and Wiltshire CCG, gave an update on the maternity redesign rapid scrutiny (RS) exercise. The RS looked at the process followed and found that the CCG’s decision-making process was based on information that was available to them. The report was then taken to a CCG meeting in January, where the feedback of the RS was valuable to ensure the correct information was presented in an improved format. The recommendations were supported and the project was now moving into the implementation stage.

The RS suggested that clear information should be provided to mothers, in response to that, visits to communities had taken place to provide workshops to listen and provide information on what was happening next.

The first community hub was live in Salisbury which had received good feedback especially response to the breast feeding group. The next community pilot hub would be running in Trowbridge by the end of April 2020.

10 community of care pilots would be up and running to support mothers through pregnancy. The first pilot running in Salisbury had been working to support and make a difference to mums who had experienced trauma during a pregnancy and had received very good feedback.

In response to questions asked it was noted that:

The funding for the Salisbury unit had been secured and due to open in December. Bath RUH had a £6M funding gap and a fundraising campaign would be launched. The next grant funding tranche was in April / May. The RUH unit was not expected to open until 2022/23 and the capacity would not be needed until then. Capital funding had been secured and a plan B was in place for fundraising if required.

Mental Health

The mental health project is about doing things differently. The project has involved talking to service users, families, carers and partners to understand what wasn’t working, what was working and what could be better. The feedback from those conversations was used to develop a draft strategy which was now being updated. Thrive MH Programme Board were responsible for the governance and provided oversight for all of the mental health transformation programmes. There were six strategic work streams and each was delivering a key priority.

A key priority action and risk within the service was having a strong workforce and work was being done to design the workforce of tomorrow today. The committee were also informed about the Daisy unit in Devizes which supported people with learning disabilities and had some positive results. Work was also being done to commission a personality disorder service. Mental Health AWP had reviewed 111 calls as part of an investigation looking at how early intervention and prevention could be used to reduce emergency calls. Mental health professionals would also be available on the 111 service with band 7 nurses supporting band 5 nurses in crisis management. A single point of contact service would open on 20th March to provide a place of  ...  view the full minutes text for item 26

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

The Chairman agreed to the following item being taken as urgent business as this was a matter which could not wait until the next meeting.

Rapid Scrutiny Exercise: Maternity Service Redesign

The Committee received a report which presented the findings and recommendations of the rapid scrutiny exercise for endorsement.

It was noted that, based on the evidence it received, the rapid scrutiny exercise recommended that:-

i)             This report be presented to Lucy Baker, Acting Commissioning Director - Maternity, Children and Mental health, Wiltshire Clinical Commissioning Group, STP Programme Director Maternity to inform the CCG’s decision-making process with regards to the Maternity Services Redesign, especially taking into account the conclusions reached;

ii)            The following areas of the proposal, and / or supporting documents, are amended, or expanded, when the proposal is presented to the public:

a.    The feedback from the public consultation is presented in a way that separates the responses between actual (and recent, e.g. in the last year) service user and non-user, as well as including numbers in terms of “use” for the different birth options (home birth, FMU, AMU, Obstetric Unit);

b.    To detail the services that would still be provided at the Trowbridge and Paulton FMU (to avoid any potential confusion over the FMUs being closed);

c.    To better describe the Community Maternity hubs, for example including a description of what is on offer at the Salisbury hub and listing other “add-on” services that may be considered for the other hubs;

d.    To include the Community Maternity hubs on the “recommended changes geographically” map;

e.    To include a timeline for the development of the Community Maternity hubs;

f.     Further explain the evidence considered and mitigations in place with regards to deprivation, including issues of transport;

iii)           The CCG governing body take the following into account when developing its implementation plan of the service redesign:

a.    The next community maternity hub pilots to be in the Trowbridge and Paulton areas;

b.    That the services currently accessed in the postnatal beds are available in the Community Maternity hubs (or elsewhere) are tested and financially secured before the postnatal beds are removed.

iv)           The relevant Overview and Scrutiny committees for Bath and North East Somerset, Swindon and Wiltshire councils be informed of the CCG’s proposal and continue receiving regular updates at key points of the implementation of the Maternity Service redesign, including funding of the Bath AMU and co-design of the services replacing postnatal beds.

Resolved:

(1)          To approve the report from the rapid scrutiny exercise.

(2)          To inform the CCG that the Committee approves the report and would urge the CCG governing body to take the report into consideration when the CCG governing body makes its decision on the Maternity Service Redesign on Thursday 16 January 2020.