Agenda and draft minutes

To receive any apologies or substitutions for the meeting.

Apologies for absence were received from Councillors Ian Blair-Pilling, David Bowler, Clare Cape, Jane Davies, Howard Greenman and Dr Monica Devendran, Pip Ridout and from Caroline Finch (Chair - Wiltshire Centre for Independent Living). 

Cllr Trevor Carbin was substituting for Cllr David Bowler and Cllr Kelvin Nash was substituting for Cllr Howard Greenman.

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

Resolved:

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

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 to be made at the meeting and to note the attached announcement relating to the Smokefree Generation, Local Authority Grant.

The Chairman referred to the announcement circulated with the agenda as detailed below and highlighted that in November 2023 the Committee received a presentation about the Smoke Free Generation programme and the Committee contributed to the public consultation on how that should be delivered.  Whilst there wasn’t enough new information for it to be an agenda item at this meeting, the Public Health Team wanted the Committee to know that work is progressing as detailed below:

Smokefree Generation – Local Authority Grant 

As presented at the November 2023 Committee, the government is seeking to achieve the first smokefree generation, by bringing forward legislation detailing a multifaceted approach to reducing smoking rates across the county, including making it an offence to sell tobacco products to anyone born on or after 1 January 2009.  

To support existing smokers to quit, the government is more than doubling the budget for local stop smoking services, investing £70 million a year for 5 years, from 2024/25 through to 2028/29. Local allocations will be reviewed annually and be based on the average smoking prevalence over a 3-year period to ensure the allocations are based on the most robust and recent data. 

A report is going to Cabinet on 16 April 2024 to outline the grant income and expenditure requirements. The report seeks to agree that expenditure will be in line with the grant conditions and that delegated responsibility for decisions relating to the distribution of this grant are delegated to the Corporate Director of People, in consultation with the Cabinet Member for Cabinet Member for Public Health, Leisure, Libraries, Facilities Management, and Operational Assets and Director of Public Health. 

If you would like any further information, please contact Gemma Brinn, Public Health Consultant, gemma.brinn@wiltshire.gov.uk  

The Chairman also reminded Committee members to ask any questions following the presentations at the meeting as that was the best way find out more detail about the projects/initiatives.

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 20 February 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 22 February 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 in advance of the meeting. 

To receive a presentation on NHS@Home Wiltshire (Virtual Wards) and Urgent Community Response (UCR) which are two acute healthcare services supporting people at home and in the community aiming to reduce admission into hospital.

The Chairman remarked that it was part of an ongoing focus of the Health Select Committee to review the impact of preventative measures in health and social care in Wiltshire and that this was one of the key outcomes of the Committee’s Inquiry into Urgent Care in July 2023.  Neighbourhood Collaboratives were considered by the Committee in January 2024, and they would today receive a presentation on urgent care support delivered at home and in the community.

Lisa Haywood (Chief Operating Officer - Wiltshire Health and Care) gave a brief introduction to the services to set the scene and the Chairman then introduced Sam Olden (Consultant Physiotherapist) and Gemma Pugh (Head of NHS@Home) from Wiltshire Health and Care to present the item and Emma Townsend (Head of Living and Ageing Well Service, Wiltshire Council).

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

Urgent Care Response (UCR)

·            The types of staff that enable delivery of the UCR and their skills that provide urgent support for a variety of health emergencies such as catheter care, diabetes, palliative care, or end of life care as well as a rapid response for non-injury falls and support for informal carer breakdown, which if not resolved will result in a ‘social’ admission to hospital.  70% of patients are seen within 2 hours of referral and treatment can usually be provided in their own home;

·            The capacity of the service was unpredictable due to varying interventions that may be required.  The service works to prevent hospital admissions and enables patients/carers and those that are cared for to stay at home in most circumstances which is what is usually the preferred option to stay at safe and independent at home;

·            There was an ever increasing pressure in services and with the UCR service they were able to assess and treat referrals swiftly with 94% of those being completed within 2 contacts. Only 1.6% of patients were admitted to hospital after being seen by the UCR service. 

·            There had been over 8000 referrals over the last year which related to 3500 individual repeated referrals which would have otherwise resulted in a hospital admission for a stay or long term intervention.

The Committee asked questions about how the UCR and Virtual Wards services complemented each other and how they were differently resourced, if some patients felt overwhelmed when a number of services were involved in their care, if the planned two hour response time was adequately resourced and the possible challenges around this, and if was planned to extend the current hours of operation beyond 8am to 8pm.  There were also questions on the general awareness of the service and how carers might seek support if they become ill themselves and have concerns about those that they care for at home.

It was further highlighted that the work with a cared for person was for up to 4 weeks in their own home, if possible, with a temporary visiting carer or a live  ...  view the full minutes text for item 18.

To receive a presentation of the Community Area Joint Strategic Needs Assessment tool CAJSNA Wiltshire Intelligence which will give an overview of the resource, its purpose, its strengths, where to find the tool and how to use it to access insight, including health-related data, about the 18 community areas in Wiltshire.

A link to the residents’ survey is here What's the picture in your area? Residents encouraged to view latest data and have their say - Wiltshire Council

The Chairman introduced Rachel Kent (Public Health Consultant) and Sarah Hartley (Public Health Scientist) who were in attendance to present the Wiltshire Community Area Joint Strategic Needs Assessment (CAJSNA) tool.

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

·            That the CAJSNA brings together information from a range of sources to provide useful insight and actional intelligence around Wiltshire’s 18 community areas, providing information on local demographics, needs and strengths.  Its aim was to support local decision making at community area level.  The last document was published in 2020; and

·            The 2022 Wiltshire Health and Wellbeing Joint Strategic Needs Assessment identified 3 key strategic priorities for Wiltshire and these priorities informed the production of the CAJSNA infographic packs.  Directorates and external partners were involved in the selection of indicators and in the provision of data and insight.

Sarah Hartley then gave a brief demonstration of the CAJSNA see link here to the website to the Committee which brings together over 140 indicators spanning 10 different topics to provide a comparison of those topics across the 18 community areas in Wiltshire.

The Strategic Engagement and Partnership Managers were leading on sharing a residents survey which was currently open to encourage Wiltshire residents to look at the information in the CAJSNA and then complete a short survey to share what they think the priorities should be for the future see link to survey here.  This would run until 5 May 2024.

The Chairman thanked Sarah for her presentation/demonstration and encouraged all members to share the survey with their residents.

The Committee asked questions about the team’s engagement with the military and service personnel in the area, the work with Health Watch Wiltshire, the objectives of the resident’s survey, accessibility of the survey and how the findings would inform the work of the Council going forward.

Resolved:

That the Select Committee notes the content of the Community Joint Strategic Needs Assessment and encourages Members and Area Boards to promote and use the resource. 

To receive a presentation from Wiltshire Public Health of the Substance Use Grantsand the work they support in Wiltshire including how grant funding has been allocated to date and plans for future grant arrangements.

The Chairman welcomed Kelly Fry (Principal - Building Resilience) and Lizzie Shea (Projects Officer - Substance Misuse) from the Public Health team who were in attendance to give an overview of how Substance Use Grants were being allocated to support people in Wiltshire.  The Chairman highlighted that the Committee last received an update in late 2022 and would welcome the opportunity to find out how the different initiatives were progressing.

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

Supplementary Substance Misuse Treatment and Recovery Grant

·            There were three key areas – ‘capacity’ with the numbers of adults in structured treatment – the revised 3 year ambitions as for this to be 1861 adults, ‘continuity of care’ which is the % of prison leavers needing support with the ambition to have 60% accessing community treatment within 3 weeks of release and ‘residential rehabilitation’ – these numbers were increasing and this was based on local demand to be covered by the funding available;

·            The 2024-25 grant allocation was £633,699 (up from £358,692 in 2023/24) and this would be used to grow the workforce, additional drug costs, staff and peer mentoring training and development, regional coordination of the Inpatient Detoxification grant and stock for needle dispensing.  The grant would allow the Council to continue the great intervention work;

·            The Priority areas for 2024-25 include increasing the recovery support offer and reducing drug and alcohol related deaths through the monitoring and review implementation of the new recovery support element of the Connect service, the monitoring and review of the Wiltshire HOPE project, the recruitment of 2 FTE post lived experience posts and increased clinical interventions; and

·            The next steps were to await sign off of the supplementary plans for year 3, recruitment to commence new posts and consider succession planning beyond April 2025 when the current 3 year grant funding would end.

The Committee asked questions about what would happen after April 2025 if the grant was not renewed, the anticipated growing levels of need for the service, the risk of synthetic opioids coming into the country, if there was support for drivers that are pulled over and found to positive for drugs, what early preventative work there was in place to prevent the move from soft to hard drugs and heavy drinking to alcoholism, the reasons for the higher grant allocation for 2024-25 and what the grant had enabled the service to do differently/more innovatively.

Rough Sleeping Drug and Alcohol Treatment Grant (RSDATG)

·            The total number of unique individuals engaged with the RSDATG service as at April 2023 identified as in the at risk cohort was 167 of which 25 were rough sleeping.  During quarter 3 2023-24 the number engaged was 119 of which 15 were routh sleeping.  The number of treatment exits from the service for quarter 2 was 26 with 7 of those routh sleeping.  This cohort was challenging to work with;

·            Two case studies highlighted positive outcomes;

·            The indicative 2024-25 grant allocation  ...  view the full minutes text for item 20.

To receive a presentation from Wiltshire Public Health on the Department for Levelling Up, Housing and Communities (DLUHC)’s Domestic Abuse Safe Accommodation Grant and how the grant supports victims of domestic violence in the county.

The Chairman welcomed Hayley Morgan (Consultant - Vulnerable Communities) and Daisy Manley (Projects Officer - Domestic Abuse) from the Public Health team who were in attendance to give an update on the Department for Levelling Up, Housing and Communities (DLUHC’s) Domestic Abuse Safe Accommodation Grant and how the grant supports victims of domestic abuse in the county.  It was noted that this was the final year of the current four year funding programme.

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

·            The Domestic Abuse Act 2021 introduced statutory duties and increased accountability with local authorities being responsible for the delivery of domestic abuse support to victims and families in safe accommodation.  There was a strict criteria of how the grant could be spent and the Team had looked at creative and innovative ways to utilise the funding which was only received on a year by year basis – this meant that it was hard to be able to plan and to commission that funding money in a short period of time and the increase in funding over the four year period had not reflected the demand;

·            Wiltshire’s core domestic abuse support service FearFree, was made up of 5 themes.  During 2022-23 there were 2788 victim referrals and 8669 reports of domestic abuse;

·            Funding was allocated to multiple providers during year 1 and 2 of the grant including the Connect Service, Julian House, Wiltshire Council’s Housing and Social Care Teams and the Wiltshire Bobby Van all to help address the local areas of need;

·            The funding results from November 2021 to October 2023 showed that there had been a positive impact for victims of domestic abuse in Wiltshire including therapeutic support, victims’ homes being target hardened (security measures installed) and Community Connectors supporting victims to rebuild their lives after abuse.  There grant was also used to deliver staff training and enable Engagement Worker projects;

·            In September 2023 the year 3 and 4 proposals were approved by Cabinet and following that procurement processes were carried out with the majority of contracts beginning on 1 November 2023.  The first year 3 multi agency monitoring meeting took place in February 2024;

·            The year 3 and 4 funding allocations would see the continuation of the 2 previous years provisions together with workforce training on domestic abuse in Gypsy, Roma and Traveller (GRT) communities, specialist support within safe accommodation for victims with complex needs, move on funding to support victims to maintain separation from perpetrators and an additional Children’s Worker to support children who have witnessed domestic abuse;

·            Successes included evidence of positive outcomes and impact, stronger relationships with providers and robust monitoring processes;

·            There were some recruitment challenges due to the limited employment pool, employees moving within services and the nature of the temporary posts due to the short term funding.  There was a high demand for services and challenges with delays in obtaining safe accommodation premises; and

·            The next steps included the monitoring of outcomes  ...  view the full minutes text for item 21.

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

The Committee noted that the Forward Work Programme (FWP) would be updated to reflect any changes made throughout the meeting and the following that was highlighted by the Chairman:

·            The Chairman and Vice-Chairman would be meeting with the relevant Cabinet members and Directors in April 2024 to further develop the select committees forward work plan.

·            There would hopefully be two rapid scrutiny meetings taking place before the next Committee meeting in June - Emotional Wellbeing and Mental Health Strategy.  The date was still to be confirmed but would potentially be 26 April 2024.  Committee members would also be notified for expressions of interest before the scrutiny of the implementation plan of the Integrated Care Strategy was scheduled for a meeting.

·            A Committee member had raised a concern about a local issue (relating to access to pharmacies) and this would be followed up.

·            There would be an item on community conversations going to the meeting of Cabinet in March – this is not for decision so it didn’t need to come to this Committee, however an item on community conversations would be added to the to the Forward Work Plan as it aligns with neighbourhood collaboratives and the committee’s interest in involvement.

Resolved

That the Committee approve 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 12 June 2024.

The date of the next meeting was confirmed as 12 June 2024.