Agenda and minutes

To elect a chairman for the forthcoming year.

Councillor Howard Greenman proposed Cllr Chuck Berry be appointed Chairman of the Health Select Committee for the ensuing municipal year.

There being no other valid nominations, the Democratic Services Officer announced:

Councillor Chuck Berry was elected Chairman for the ensuing municipal year 2019 – 2020.

To elect a Vice-Chairman for the forthcoming year.

Councillor Chuck Berry called for nominations for the position of Vice-Chairman.

Councillor Chuck Berry proposed, subsequently seconded by Councillor Howard Greenman that Councillor Gordon King be appointed Vice-Chairman of the Health Select Committee for the ensuing municipal year.

There being no other nominations, it was announced that:

Councillor Gordon King was elected Vice-Chairman of Health Select Committee for the ensuing municipal year 2019-2020.

To receive any apologies or substitutions for the meeting.

Apologies were received from Cllr Mollie Groom, who was substituted by Cllr Mike Hewitt.

To approve and sign the minutes of the meeting held on 30 April 2019.

Resolved:

The minutes of the meeting held on 30 April 2019 were approved with the following amendment:

Diane Gooch represents WSUN (not Healthwatch as recorded in the minutes).

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

There were no Declarations of Interest.

To note any announcements through the Chairman.

The Chairman made the following announcements

1. Public health annual report

A link to Public Health’s annual report video was to be sent to members of the committee as soon as it is available.

2. Scrutiny statutory guidance

On 4 June the Overview and Scrutiny Management Committee considered the new Statutory Guidance on Overview and Scrutiny in Local and Combined Authorities, as published by the Ministry of Housing, Communities and Local Government on 8 May 2019.  

The key points for improvements were:

1.    To include Overview and Scrutiny reports in Full Council agenda papers when the relevant issue was originally requested for scrutiny by Full Council;

2.    To ask the Overview and Scrutiny Chairmen and Vice-Chairmen and relevant Executive Members to explore a potential framework for requiring contractors to engage in Overview and Scrutiny when requested, and report back;

3.    To advertise democratic meetings in council premises and make greater use of co-opting members to Overview and Scrutiny

3. CCG Merger

The NHS Long Term Plan sets out an expectation for Integrated Care Systems to be established across sustainability and transformation partnership (STP) geographical footprints.  As part of the Integrated Care System development, a further expectation is that strategic commissioning will typically be undertaken by one Clinical Commissioning Group (CCG) within that respective Integrated Care System, and that where more than one CCG exists within the Integrated Care System (as in the case of BaNES, Swindon and Wiltshire), CCGs are expected to officially merge to become one organisation before April 2021. 

In October 2018 BaNES, Swindon and Wiltshire CCGs took a decision to adopt one single management team (with one Chief Executive) across the three organisations, whilst retaining the three separate organisations each with their own Governing Body.  The process to establish the single management team is well underway:  Tracey Cox was appointed Chief Executive in January 2019 and appointments have been made to the posts of Chief Finance Officer and Director of Nursing.  Further appointments to the Executive Team continue. 

On 12 June 2019 the three Governing Bodies took one consensus view that there is now a strong case which supports pursuing full CCG merger by April 2020.  A detailed application to merge needs to be submitted to NHS England by 30 September 2019.

The option must now be put to each Public Governing Body in order for each Governing Body to approve a decision to pursue an application for merger.  Assuming each Governing Body approves the decision, prior to application the CCGs will engage with stakeholders and the GP membership of each CCG will then vote on a final decision to apply for a merger.   Due to the timescales, particularly in relation to conducting this stakeholder engagement in advance of the formal application deadline, the following Governing Body meetings will receive the paper:

Wiltshire – Tuesday 25 June

Swindon – Thursday 27 June

BaNES – Thursday 4 July

The proposed recommendations are:

•         To pursue merger by April 2020

•         To establish an oversight group/Programme Board to steer the programme on  ...  view the full minutes text for item 37.

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 18 June 2019 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 20 June 2019. 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 members of the public present.

The committee is invited to consider its current forward work programme.

The committee was invited to consider its current forward work programme. 

The Chair recommended that the agenda for September be reduced to the following items

-       Dementia

-       Extra care and housing related support service (Cabinet report)

-       Green Paper

-       Intermediate care bed service (Cabinet report)

-       Review of intermediate care bed service

-       Wiltshire Safeguarding Adult Board

• GP recruitment / health staff recruitment and retention

For the January meeting, a pre-meeting briefing on vacancy numbers, willingness of partners to give up their partnerships, and what Wiltshire Council could do.

• Main contracts

For the November meeting, the Chair suggested a focus upon care contracts to share information on main contracts and their monitoring with the committee.

• Better Care Fund

For the September meeting, more information on the Better Care Fund, its management and leadership would be brought to committee.

• Carer support

An update upon the Carers in Wiltshire Joint Strategy 2017-22 for November or January meetings.

• Dorothy House

To invite representatives of Dorothy House to a pre-meeting briefing to inform the committee of the breadth of the work that Dorothy House undertakes.

• Shared Live

That committee receive a presentation on Shared Lives at a pre-meeting briefing.

• Non-emergency patient transport service in the South West

That committee receive an update at November or January meeting on the new provider E-Zec Medical transport.

To receive an update on the implementation of Phase 2 of the Adult Social Care transformation programme.

This also includes a joint report between the Clinical Commissioning Group and Wiltshire Council on Mental Health as agreed by the committee when it considered the executive response to the CAMHS (Children and Adolescents Mental Health Service) task group, on 5 March 2019.

Clare Edgar, Director Adult Social Care Operations, Mental Health and Learning Disabilities and Emma Legg Director Access and Reablement gave an update on Adult Social Care Transformation Phase 2.

The update included a report on Mental Health as agreed by the committee when it considered the executive response to the CAMHS (Children and Adolescents Mental Health Service) task group, on 5 March 2019.

Adult Social Care Transformation Phase 2 was to focus on developing services for individuals with a Learning Disability and Mental Health disorders who require care and support under the Care Act 2014.

Resolved:

To receive information on the CCG bed-base review at the September meeting;

To invite officers and Cabinet Member to consider the appointment of the chairman and vice-chairman of the Health Select Committee to the Adult Social Care Performance Board;

To ensure that the CAMHS task group receives information on and considers the Mental Health strategy;

To circulate the Suicide Strategy to members of the Health Select Committee;

To receive information on the implementation of Phase 2 of the Adult Social Care transformation programme towards “completion”.

Since September 2016, SWASFT Performance in Wiltshire have been presented to the Health Select Committee in the form of annual reports to the Committee on the performance of the ambulance service in Wiltshire. The first edition was presented at the Health Select Committee on 27 September 2016.

The committee has invited SWASFT to present on the following:

a. Progress to date and planned activities in the Trust’s estate review – including outcomes of the 2015/16 audit focusing on impact on Wiltshire, including Amesbury ambulance station.

b. Update on service delivery in terms of performance, projects and activity (last received in September 2017), including work planned for 2019/20

c. Response times, especially in rural areas.

A performance report from SWASFT is included, as well as a letter informing stakeholders of SWASFT’s plan to significantly increase the number of people and vehicle resources across the South West.

The committee had invited SWASFT to present on; the Trust’s estate review, performance and response times.

Paul Birkett-Wendes, County Commander, Wiltshire and BANES

South Western Ambulance Service NHS Foundation Trust and Emma Smith, Interim Head of Urgent Care, NHS Wiltshire Clinical Commissioning Group reported; a funding uplift, work on reducing demand at source, the absence of plans to change the estate and attainment of Category 1 response time targets.

The debate that followed addressed ambulance stations, access to patient records, confidence in reducing demand and the financial consequences of not achieving reduced demand, the opportunity to rationalise resources across partners, the need for like-for-like comparisons in performance management and use of defibrillators.

Resolved

For the CCG and the council to consider efficiency processes and for the outcome of these conversations to be reported to the Chairman and Vice-Chairman of the Health Select Committee.

To receive a performance report from SWASFT in a year’s time. It would be hoped that it would be in the same format as the report received today but including clear targets for the different categories

To request that the following information is provided to the committee as soon as available:

like for like comparison for April last year

split the analysis by geographical locations

To receive a verbal update on the current analysis of the users feedback received to date regarding Places of Safety, following the temporary closure of two units in February and March 2018.

Lucy Baker, Acting Director Commissioning Director (Maternity, Children and Mental health) Wiltshire Clinical Commissioning Group gave a verbal update; the full report is expected in July 2019, 185 surveys completed and 13 telephone interviews, 51% of take-up is out-of-area and that the headline finding was that feedback is positive.

Resolved:

To receive the analysis of the user feedback when available (report expected to be completed at the end of July 2019).

At its meeting on 11 June 2018 the committee agreed to review the appointment of non-elected representatives on Health Select Committee on a yearly basis, at the meeting where the election of chairman and vice-chairman takes place, to ensure that the organisations remained representative of service users and / or Wiltshire residents.

As per the attached report, the committee is invited to review the appointment of non-elected representatives on Health Select Committee for 2019-20.

On 11 June 2018, the committee agreed to annually review the appointment of non-elected representatives.

The debate noted the value of the status quo and the appointment of representatives from the following; Wiltshire & Swindon User Network (WSUN), South Wiltshire Advocacy Network (SWAN), Healthwatch Wiltshire and Wiltshire Centre for Independent Living (WCIL).

The committee was reminded that the Forward Work Plan allows the committee to request additional representation ad hoc.

Resolved:

1. To agree the following appointments, with each organisation to nominate its representative:

Wiltshire & Swindon User Network (WSUN),

South Wiltshire Advocacy Network (SWAN),

Healthwatch Wiltshire, and

Wiltshire Centre for Independent Living (WCIL)

2. To invite relevant organisations and groups to specific meeting as witnesses and consider, at the Chairman’s discretion, allowing them more participation in the meeting (than public participation).

To receive any updates on recent activity for active task groups and from members of the Health Select Committee who have been appointed as overview and scrutiny representatives on programme boards.

To receive any updates on recent activity for active task groups and from members of the Health Select Committee who have been appointed as overview and scrutiny representatives on programme boards.

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To consider the review of the quality accounts and to ascertain future work for the committee, where relevant.

Cllr Gordon King reported that the Quality Accounts reports had been considered, as detailed in the report, and that generally each would benefit from an executive summary. The report also indicated a number of areas for further consideration by the committee.

Resolved:

To add the areas for further consideration by the committee to the forward work programme, as listed in the report.

The Committee is invited to briefly review its forward work programme, taking into account the decisions taken and recommendations made during this meeting.

The Committee agreed to proceed with the Chair’s recommendations on managing the agenda as outlined in Item 39.

Resolved:

The agenda for September would comprise; dementia, extra care and housing related support service (Cabinet report), Green Paper, intermediate care bed service (Cabinet report), review of intermediate care bed service and Wiltshire Safeguarding Adult Board.

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 3 September 2019, at 2.30pm.

The next meeting of the Health Select Committee was to be 3 September 2019.