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Agenda and minutes

Venue: Salisbury Room, County Hall, Bythesea Road, Trowbridge, BA14 8JN

Contact: Matt Hitch Email: matthew.hitch@wiltshire.gov.uk  Democratic Services Officer


No. Item


Election of Chairman 2022/23

To elect a Chairman for the forthcoming year.


Cllr Johnny Kidney was elected as Chairman for the forthcoming year.


Election of Vice-Chairman 2022/23

To elect a Vice-Chairman for the forthcoming year.


Cllr Gordon King was elected as Vice-Chairman for the forthcoming year.



To receive any apologies or substitutions for the meeting.


Apologies for absence were received from the following:


• Cllr Pip Ridout (substituted by Cllr Tom Rounds)

• Elizabeth Disney – BaNES, Swindon and Wiltshire CCG

• Cllr Sankey would need to leave the meeting early at 11:30am.


Minutes of the Previous Meeting

To approve and sign the minutes of the meeting held on 16 March 2022.

Supporting documents:




To approve the minutes of the previous meeting, held on 16 March 2022, as a true and correct record.


Declarations of Interest

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


There were no declarations of interests.


Chairman's Announcements

To note any announcements through the Chairman.


The chairman announced that since the committee’s last meeting in March, the Care Quality Commission had found that Patford House GP Partnership was much improved. He welcomed the improvement and stated that he hoped that the improved performance was being felt at ground level.


He reported that the UK Health Security Agency (UKHSA) were leading on the Monkeypox response, and the council would be guided by their advice, namely to direct enquiries to the .GOV Monkeypox website.


It was explained that, on 19 May, Overview and Scrutiny Management Committee had received a report about proposed changes in the way that it engaged with financial, corporate, and organisational matters. The chairman then highlighted the following proposals that had been agreed:


• The focus of the Financial Planning Task Group will remain on the council’s overall financial position, but it will also review, by exception, the financial implications of the council’s biggest contracts.

• Select committees will continue to focus on the service impacts of proposals but retain their ability to query and flag any financial concerns they identify and to refer them to Overview and Scrutiny Management Committee for further investigation.


Public Participation

The Council welcomes contributions from members of the public.



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.



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 Friday 27 May 2022 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 Tuesday 31 May 2022.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 was no public participation.


Wiltshire Health and Care Update

Wiltshire Health and Care is responsible for the delivery of adult community health services in Wiltshire, which includes community hospitals, minor injury units, physiotherapy and speech and language therapy.


The Managing Director and Chair of Wiltshire Health and Care will provide the committee with an overview of the partnership’s plans for the forthcoming year as it emerges forward out of the pandemic.

Supporting documents:


The managing director and chairman of Wiltshire Health and Care Partnership provided an update to the committee about their plans for the forthcoming year.  They explained that they provided adult community care services across BaNES, Swindon and Wiltshire (BSW) and helped to support 22,000 individuals each month, including 6,000 receiving home-based care. They then gave examples of the services that they delivered, including the Long Covid service launched in November 2020 that adopted a multi-disciplinary approach.


Going into further detail about their plans, the representatives explained that they had a strong working relationship with Wiltshire Council and worked in conjunction with broader long-term NHS goals. They highlighted that they had a three-year delivery plan running until 2025, containing 43 different goals set over five set themes, as set out in Agenda Supplement 1. IT modernisation and improvements to the estate at Warminster were examples of work being undertaken to improve the delivery of services to patients and to develop a comprehensive community-based model of care.


During the discussion, the following points were made:


• Members thanked the managing director and chairman of Wiltshire Health and Care Partnership for the update.

• It was explained that it was possible for the majority patients suffering from Long Covid to be self-reliant after support had been provided. Most patients participated in a six-week programme, providing them with peer support and giving them the tools to self-manage.

• It was noted that there was a median 50 day wait for treatment for people with Long Covid but it could take up to 15 weeks. The representatives reassured the committee that waits were not increasing and they had a focus on health inequalities. They were also closely monitoring the demographics of people coming forward, particularly in rural areas. They then offered to share the information available.

• In response to a question about whether the lessons from adopting a multi-disciplinary approach for the new Long Covid service could be applied to longer established services, the representatives felt that they could, citing the examples of streamlining assessments.

• When asked about issues around staffing and the cost of staff travel, the representatives noted that they were providing a temporary uplift that staff could claim for travel expenses to reflect the increase in fuel prices. It was explained that recruitment levels were broadly stable but there had been high rates of retirement amongst nursing staff, so the situation was being monitored closely.




1. To thank the managing director and chairman of Wiltshire Health and Care for the update

2. To invite a future briefing on their work to combat Long Covid to the January committee meeting.


Public Health Nursing Services: Future Delivery Model

Cabinet will be considering the future delivery model for Wiltshire’s Public Health Nursing (PHN) beyond April 2024 at its 21 June meeting. In advance of this decision the committee is invited to review the proposals and feed any comments to the Cabinet member before the report is considered by the executive.

Supporting documents:


The chairman informed the committee that Cabinet would be considering the future delivery model for Wiltshire’s Public Health Nursing (PHN) beyond April 2024 at its 21 June meeting.


The Cabinet Member for Public Health and Public Protection, Leisure, Libraries, Facilities Management and Operational Assets, introduced the report explaining that services were currently delivered by HCRG Care Group (previously Virgin Care Services) as part of Wiltshire Children’s Community Healthcare Services (WCCHS) contract. Under the contract Wiltshire Council contributed 48 percent of the overall cost of PHN.


The cabinet member then outlined the three options being considered for the contract beyond April 2024, as outlined on page 32 of the agenda pack and then delivered an overview of the relative merits of each option. The option of bringing the service in house was not felt to be the best option due to concerns around human resources and data migration. He explained that the option 1a, tendering for a single provider of universal and specialist services across Wiltshire as a single lot, was the most favoured option and a modified version would be recommended to Cabinet. Proposed changes made to option 1a would by allow Wiltshire Council and the CCG to issue their own terms and conditions. The cabinet member felt that this alteration would introduce greater control and create an emphasis on strengthening partnership.


During the discussion the following points were made:


• Members thanked the cabinet member for the update.

• In response to a question about whether there would be separate terms and conditions for universal and specialist providers, Wiltshire’s Director of Public Health confirmed that terms and conditions of staff would be considered as part of the procurement process.

• A Public Health strategist explained that combining universal and specialist contracts would allow for smoother services, as advice from specialists could be used to upskill staff providing universal services.




1. To thank the cabinet member for the update.

2. To note the report.


Care Home Closures

A report is attached from the Director of Procurement and Commissioning updating the recent care home closures in adult social care.


The committee is invited to review the information and feed any comments to the Cabinet member for Adult Social Care, SEND, Transition and Inclusion.

Supporting documents:


The Director of Procurement and Commissioning introduced the report outlining recent care home closures in adult social care. A head of commissioning specialist in the Whole Life Commissioning team reported that six homes for older people had closed within the past 12 months resulting in the loss of 112 beds, with a further 86 expected. It was explained that recent losses were the extension of a longer-term trend for a reduction in the number of residential care placements driven by factors such as the negative media coverage of care homes during the pandemic, changes in discharge pathways and Wiltshire Council becoming increasingly effective in delivering care within their own homes.


The commissioning specialist was pleased to report that improved communication with providers had enabled improved monitoring. A Provider Oversight and Support Team (POST) was in place to log information and allow for earlier interventions. A Provider Assessment and Market Management Solution was also being rolled out across the South West region to enable greater consistency for providers and facilitate more efficient administration.


During the conversation, points included:


• Members thanked the officers for the report.

• The Director of Procurement and Commissioning explained that there had been an increase in the number of self-funders choosing to receive care at home.

• The Whole Life Pathway Team were taking measures to reduce their reliance on residential care by re-registering homes as supported living accommodation.

• In response to questions about recruitment into domiciliary care, the director reassured the committee that the council worked closely with the staff at homes that were closing to encourage them to apply to other care roles. The commissioning specialist added that that there had been a slight improvement in recruitment and the use of an apprentice into nursing was effective.

• When asked about the impact of increasing insurance costs, officers explained that this was a nationwide issue and that insurance premiums had increased significantly for homes requiring improvement. It was reported that the Leader of the Council and the Cabinet Member for Adult Social Care, Transition and Inclusion had raised this issue at the with MPs. Officers did not believe that insurance costs were rising directly as a result of increased complexity of need.

• It was noted that a mechanism was in place to gather stakeholder feedback about mental health referrals. Investigations were also underway about whether a service could be delivered for people whose needs fell between needing residential care and supported living.

• A stakeholder of the committee queried the impact of residential home closures on informal carers. Officers stated that the Hospital Liaison Service were putting support in place to help carers and that additional funding had been provided for Carer Support Wiltshire over the winter.

• When queried about the impact of residential home closures on the wider healthcare system, the director explained that patients were rarely discharged from hospital directly back to residential care homes and that an additional 150 discharge beds had been purchased. Multi-disciplinary teams had also  ...  view the full minutes text for item 37.


Development of the BSW Integrated Care System (ICS) and the Wiltshire Alliance

A statutory Integrated Care System for Bath and NE Somerset, Swindon and Wiltshire commences on 1 July 2022. This paper outlines the development of place-based collaboration between Wiltshire Council and NHS partners through the Wiltshire Alliance.


The committee is invited to comment on the report in advance of its consideration by Cabinet on 21 June.

Supporting documents:


The Leader of Wiltshire Council and the Corporate Director People introduced a report outlining the development of place-based collaboration between Wiltshire Council and NHS partners through the Wiltshire Alliance.


Background information about the Integrated Care System (ICS) would replace the BSW Clinical Commissioning Group from July 2022 and that it would operate at system, place and neighbourhood levels. The Corporate Director People highlighted that there was lots of flexibility in the structure of the ICS at the place level and that the governance structure would continue to develop.


The leader reminded the committee that the ICS at consisted of two main parts:


• The Integrated Care Partnership - through which local authorities in BSW and the NHS would work together to develop an overarching strategy to improve public health

• The Integrated Care Board - an NHS Body with statutory powers and corporate responsibility.


He then stressed that the relationships within the ICS would be critical for Wiltshire Council in the delivery of social care and welcomed the high level of agreement that had been reached so far.


During the discussion, points included:


• Members thanked the leader and the corporate director for introducing the report.

• When asked about the relationships that had been built within the ICS so far, the corporate director reported that Stephanie Elsy had been confirmed as the chair designate of the Integrated Care Board, an appointment which would offer continuity as she had been the chair of the BSW Partnership since 2019. A new Place Director had also been appointed at Wiltshire Council and was having regular meetings with the chief executive.  

• The leader explained that local authorities would also have representation on the Integrated Care Board, including by the Chief Executive of Wiltshire Council. The Integrated Care Board would also be accountable to the BSW Integrated Care Partnership, a joint body run between the three local authorities in BSW and the NHS.

• When asked about the difference that patients would notice on 1 July when the system was implemented, it was stressed that chance would be incremental. The new structure would promote collaborative working to help improve patient experience and reduce health inequality.

• In was noted that representatives from the voluntary sector would have representation at the place level of the ICS. The leader had also met with representatives from the voluntary sector to promote links with the Health and Wellbeing Board.




1. To thank the leader and corporate director for the report.

2. To note the update and to add a future report on ‘ICS development’ to the forward work programme.


Forward Work Programme

The committee is invited to consider its forward work programme.

Supporting documents:


The chairman invited members to make suggestions about items they would like to be added to the forward work programme.


Members expressed an interest in receiving further information about the pressures facing the South West Ambulance Service in the context of health and care system as a whole.


Members stated that they would welcome early notification about health and care related items on the Cabinet forward work plan and that they would like to see the addition of the Cabinet report on Independent Living Strategy to the committee’s forward work programme.


The Corporate Director People stated that she would welcome scrutiny of the Mental Health and Community Transformation Programme as well as the Learning Disability and Autism Board.




To note the forward work programme.


Urgent Items

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


There were no urgent items.


Date of Next Meeting

To confirm the date of the next meeting as Tuesday 5 July, at 10:30am.


The date of the next ordinary meeting was confirmed as Tuesday 5 July 2022.




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