Agenda and minutes

The Chairman will welcome those present to the meeting.

The Chairman welcomed all to the meeting.

To receive any apologies or substitutions for the meeting.

Apologies were received from Angus Mcpherson, Gareth Bryant, Dr Andrew Girdher, Toby Davies, Terence Herbert, Cllr Baroness Scott of Bybrook OBE and Carlton Brand.

Cara Charles-Barks was represented by Andy Hyett.

To confirm the minutes of the meeting held on 21^st March 2019.

The minutes of the previous meeting held on 21^st March 2019, previously

circulated, were considered.

Resolved

To approve the minutes as correct.

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of interest.

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 16May 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 on20 May 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 questions from the public.

To receive any announcements through the Chair.

There were no Chairman’s Announcements.

To receive a report on the latest performance information (including delayed transfers of care), along with an update on the refresh of Wiltshire’s Better Care Fund plan for 2019/20.

Responsible Officers: Linda Prosser, Carlton Brand

Report authors: Tony Marvell, James Corrigan, Jeremy Hooper

James Corrigan and Jeremy Hooper presented a report on the latest performance information (including delayed transfers of care), and gave an update on the refresh of Wiltshire’s Better Care Fund plan for 2019/20.

Matters raised during the presentation/discussion included: non-elective admissions continued to increase; delayed transfers of care remained slightly over the NHS trajectory; Permanent Admissions to Care remained low; the percentage of people at home 91 days post discharge from hospital into reablement remained below the national target and the ongoing work to refresh Wiltshire’s Better Care Fund plan for 2019/20.

In answer to a question raised by the Board it was noted that zero length of stay refers to someone who is admitted and discharged within 24 hours. This is typically someone who is admitted to A&E.

In response to an issue raised by the Chairman it was noted that many patients are still using A&E as a substitute for their local GP as they believe they will be seen in a shorter timeframe.

It was noted that the focus of better care has historically been on older people. However, going forward, work needs to be done to focus on the 16-40 population too.

Resolved

1.    To note the performance levels contained in the Integration and Better Care Fund Dashboard.

2.    To note the progress being made to refresh the Better Care Fund plan for Wiltshire.

3.    To approve the request to delegate authority to the Executive Director (Wiltshire Council), Interim Deputy Chief Executive (Wiltshire), and the co-chairs of the Health and Wellbeing Board in the event that timing of the July Health and Well-being Board does not coincide with the national submission deadlines.

To receive an update on numbers of s136 detentions and the latest performance dashboard.

Responsible Officers: Linda Prosser, Carlton Brand, Kier Pritchard

Report authors: Lucy Baker, Sgt Mike Hughes

Lucy Baker presented a report on numbers of s136 detentions and the latest performance dashboard.

Matters raised during the presentation/discussion included: the delivery of care for those experiencing a mental health crisis; the Wiltshire & Swindon Crisis Care Concordat; Wiltshire Place of Safety activity;  the East Wiltshire Place of Safety NHS England review; BaNES & Wiltshire Crisis Accommodation; the High Intensity User Network and its local model the Police & Health Integrated Monitoring Scheme (CMHT); BaNES, Swindon & Wiltshire Place of Calm Cafés and the Learning Disabilities & Autism Crisis Pathway Review.

The Board sought clarification on the graphs provided in the report and it was noted thatthe means of conveyance is high for both the police and ambulance because of the nature of many of the incidences.

In response to an issue raised by the Chairman the importance of providing mental health services to staff across the partnership spectrum was noted. Early intervention and prevention is key, and a proactive approach to workplace mental health needs to be developed. For example, post-traumatic stress is an issue in both the Police and Fire Services. Tracy Daszkiewicz will be setting up a task and finish group to take this work forward with unanimous agreement from across the NHS, Council, Police and Fire Services.

Resolved

To note the Mental Health Crisis Care Concordat update.

Proactive approach to work in mental health.

To agree a proposed response to the government consultation on this subject as well as provide an update on the existing work of the Community Safety Partnership in this area.

Responsible Officers: Linda Prosser, Carlton Brand, Terence Herbert, Kier Pritchard

Report author: Tracy Daszkiewicz

Tracy Daszkiewicz provided an update on the government consultation on this subject as well as the existing work of the Community Safety Partnership in this area.

Matters raised during the presentation/discussion included: the Home Office consultation to introduce a new legal duty to support a multi-agency approach to preventing and tackling serious crime; supporting a ‘Public Health’ approach to serious crime and Wiltshire Council’s support for a new duty on specific organisations to have due regard to the prevention and tackling of serious violence.

In answer to a question raised by the Board it was noted that the new approach seeks to tap into universal structures and this included primary care networks.

It was noted that this new approach would work with and alongside current structures such as Social Prescribers, Health and Wellbeing Champions and Local Area Coordinators to identify vulnerable people.

Resolved

1.    To support the draft response to the Home Office consultation on the basis that Option 1 is made clear to be the desired option in the report.

2.    To note the ambitious and forward-looking nature of our approach to ensuring that our partnership working is effective.

3.    To agree that, by developing our own local response, we will be able to ensure our system meets local needs and that it uses our combined resources intelligently.

4.    To ask the Community Safety Partnership and the Safeguarding Vulnerable People Partnership (SVPP) to keep the Health and Wellbeing Board informed work which enables a multi-agency approach to preventing and tackling serious violence.

To receive an update on progress with transforming care for people with learning disabilities including the new facilities at the Daisy.

Responsible Officers: Linda Prosser, Carlton Brand

Report authors: Lucy Baker, Claire Edgar

Claire Edgar and Lucy Baker provided an update on the progress in transforming care for people with learning disabilities including the new facilities in Daisy.  

Matters raised during the presentation/discussion included: Wiltshire Council’s ‘Learning Disability Inhouse Provider Services’; the three residential respite units of Bradbury House, Bradbury Manor and Meadow Loge; five-day services of The Meadows, the Yarn, the Wave, The Medley and Riverbank; the Share Lives Schemes; the review of the current Learning Disability an Autism Spectrum (ASD) pathway; the review of the Daisy Uni and the current Learning Disability offer.

In response to a question from the Chairman it was noted that Wiltshire Council understands the importance of working with those with learning disabilities to develop the services that they use. It can be useful to find out what they expect the services to look like and what they want to get out of the services.

In answer to a question from the Board it was noted that while there was a strong specialist offer already in place, the basic principles around independence need to be reviewed. There needs to be more flexibility in when people need help and how they receive this help.

In response to an issue raised by the Board it was noted that work still needs to be done to ensure that there are suitable metrics in place to measure the success of the offer. The offer would need to be one that meets a range of needs and as such its success needs to be robustly monitored and fed back to the Board on a regular basis.

It was noted that there was concern amongst blue light services that there are many vulnerable people that do not necessarily fit into the traditional thresholds to receive help. They were assured that conversations are being had to decide how to help these people.

In response to an issue raised by the Chairman it was noted that mental health services for prisoners at Erlestoke Prison were under review. While there are difficulties in diagnosing inmates, there were missed opportunities regarding early intervention before this stage. Also, work needs to be done to ensure inmates are well equipped to leave prison and do not re-enter.

Resolved

1.    To note the decision to co-produce a review of Learning Disability service delivery, which will be incorporated into a Whole Life Pathway approach via the FACT programme.

2.    To update the Health and Wellbeing Board within the next five or six months on the progress being made in transforming care for people with learning disabilities.

To bring to the attention of the Board the updated Air Quality Strategy ahead of its consideration by Cabinet.

Responsible Officers: Carlton Brand

Report author: John Carter

Cllr Ben Anderson presented a report on the updated Air Quality Strategy ahead of its consideration by Cabinet.  

Matters raised during the presentation/discussion included: the existing Air Quality Strategy needed to be refreshed as it was originally published in 2011; Wiltshire enjoys very good air quality in general and the areas of concern are very localised and improving areas of poor air quality can only be achieve by working collaboratively across the council, and with local communities and other relevant agencies and organisations and the effect of air pollution on public health.

In answer to a question raised by the Board the importance of working collaboratively with local communities and other relevant organisations and agencies to improve areas of poor air quality was noted. Residents were encouraged to engage with the plan and report any local concerns.

In response to a question from the Chairman it was noted that air quality was measured across the county at different times of the day. As outlined in the report, there are currently eight Air Quality Management Areas where traffic pollution levels exceed national standards. This includes Bradford-on-Avon, Calne, Devizes, Marlborough, Salisbury and Westbury. It would make sense to include maps of these areas and hyperlinks within the strategy itself to other documents that are referred to (e.g. core strategy policy 55) and information for residents such as air quality monitoring data.

Resolved

1.    To bring to the attention of the Board the updated Air Quality Strategy ahead of its consideration by Cabinet.

2.    To ensure the formatting and content issues raised by the Interim Cabinet Member for Adult Social Care, Public Health and Public Protection are addressed before the Strategy’s consideration by Cabinet.

To update the board on new procedures in place for handling self-neglect and on the functioning of the multi-agency hoarding protocol which has now been in place for a year.

Responsible Officers: Linda Prosser, Carlton Brand, Kier Pritchard

Report authors: John Carter, Emma Townsend

Tracy Daszkiewicz presented a report on new procedures in place for handling self-neglect and on the functioning of the multi-agency hoarding protocol which has now been in place a year.

Matters raised during the presentation/discussion included: the WSAB county-wide learning event about self-neglect; awareness sessions within Wiltshire Council to introduce the guidance and protocol and support their implementation; Self-Neglect Leads within the Wiltshire Adult Care Service and Safe and Well Advisors in Dorset and Wiltshire Fire and Rescue Service.

Resolved

To note the approach taken on self-neglect and hoarding.

A presentation on the Fire and Rescue Service’s Safe and Well visits to the most vulnerable in our communities and its work with partners to reduce community risk and support people to live safe and independent lives for longer in their homes.

Responsible officers: Ian Jeary, Area Manager, Dorset and Wiltshire FRS

Ian Jeary gave a presentation on the Fire and Rescue Service’s Safe and Well visits to the most vulnerable in our communities and its work with partners to reduce community risk and support people to live safe and independent lives in their homes. 

Matters raised during the presentation/discussion included: why Safe and Well visits are made; what a Safe and Well visit is; the aims of the visits; the delivery of the visits; referral to the Safe and Well initiative and working together to reduce community risk. It was noted that there were significant opportunities to consider this offer within the discharge process and promote with Local Area Coordinators, Care Coordinators, Community Engagement Managers and others. Partners were encouraged to make contact with Ian Jeary to take this forward.

Resolved

To note the update.

Any other items of business which the Chairman agrees to consider as a matter of urgency.

There were no urgent items.

The next meeting will be held on Thursday 25^th July 2019 at 9.00am.

The Board extended its best wishes to Cllr Jerry Wickham, who has taken the decision to resign as Cabinet Member for Adult Social Care, Public Health and Public Protection due to ill health.

The next meeting will take place at Thursday 25^th July 2019 at 9.00am.