Agenda and minutes

To elect a chairman for the forthcoming year.

Jessica Croman, Democratic Services Officer, called for nominations for the position of Chairman.

Councillor Christine Crisp proposed 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 of Health Select for the ensuing municipal year 2018/19.

To elect a Vice-Chairman for the forthcoming year.

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

It was proposed 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 2018/19.

Following, Cllrs Jerry Wickham, Cabinet Member for Adult Social Care, Public Health and Public Protection, read a statement clarifying his comments at the previous meeting, noting that Mears and Somerset Care were key partners and that the re-commissioning taking place was part of the contracted process and not based on performance.    

To note any changes of membership to the Committee.

To receive details of any apologies or substitutions for the meeting.

Apologies were received from:

Councillor Claire Cape who was substituted by Councillor Trevor Carbin.

To approve and sign the minutes of the meeting held on 24 April 2018.

The minutes for the meeting held on the 24 April 2018 were presented.

Resolved:

To approve and sign the minutes of the previous meeting of this Select Committee held on 24 April 2018.

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, including:

a.    Green paper on care and support for older people

b.    Adult Care Charging Policy update

The Chairman made the following announcements:-

Green paper on care and support for older people

In June 2018, the Health and Social Care Secretary announced a delay to the publication of the Green Paper on social care to the autumn of 2018, following the announcement that a ten-year plan for the NHS would be developed. The Green Paper aimed to ensure that the care and support system would be sustainable in the long term and would include a variety of topics.

Adult Care Charging Policy update

It had been confirmed that all remaining reassessments under the new policy had been completed or are underway.

Local Area Coordinators

The Cabinet Member for Adult Social Care, Public Health and Public Protection gave a further update noting that all 3 coordinators had been recruited and would start in September. The programme had been extended by another 6 areas and would be paid for by the better care fund for the next 3 years. The aim of the coordinators would be to primarily look at social deprivation, coordinate agencies and join up the working. The University of Southampton would be involved from the beginning helping implement and develop the programme.  

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 Wednesday 4 July 2018 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 Friday 6 July 2018. 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 or councillors’ questions.

Cabinet - 24 April 2018 (the same day as the last Health Select Committee)

·         Sexual Health and Blood Borne Virus Strategy 2017-2020

To request that updates on implementation of the strategy be made to the Health & Wellbeing Board and the Health Select Committee as appropriate.

·         Learning Disabilities In-house Respite Services

To approve the closure of 70 Derriads Lane Residential Respite Unit.

Cabinet – 15 May 2018

·         Exemption Request – Extra Care Housing and Housing Related Support

To award the following contracts, under an exemption, to the incumbent providers, Mears Care, Somerset Care at Home, Salisbury City Almshouse, Knightstone, Habinteg Housing, Stonewater Housing:

o   Extra Care Housing: care and support contracts for 4 existing ECH schemes

o   Housing Related Support: 8 contracts for sheltered housing schemes across Wiltshire (covered by the Help to Live at Home (HTLAH) providers)

o   Housing Related Support: 4 additional schemes with individual agreements (outside of HTLAH)

Cabinet – 3 July 2018

·         Local Government and Social Care Ombudsman.

To be considered by Health Select Committee on 11 July 2018.

·         Proposed Changes to the Senior Management Structure.

The purpose of this report is to seek Cabinet’s approval to take steps to make changes to the senior management structure of the council at tier 1 following the decision to reconsider the appointment of the fourth Corporate Director role, which was to be a joint post with Wiltshire CCG, and following discussion with the current Corporate Directors.

The Committee was made aware of decisions made at Cabinet on items relevant to the committee and were outlined within the agenda. 

It was noted that Cabinet had agreed changes to the structure of the council at the top tier and a decision was made not to appoint a fourth Corporate Director role, which was to be a joint post with Wiltshire CCG, due to the future publication of the Government Green Paper. The Green Paper was likely to focus on the continuation of collaborative working to integrate health and social care services. It was also anticipated that the green paper would provide clarity on the future direction for NHS commissioning; particularly commissioning by CCGs of health services. On this basis the council agreed with the CCG not to progress with the appointment to the joint Corporate Director role.

The Cabinet Member for Adult Social Care, Public Health and Public Protection agreed that an update would be provided once more information was available and for now one of the current Corporate Directors would oversee the responsibilities taking due regard to the advice of professional officers.

To receive information on the background and progress on the relocation of Head and Neck Cancer Rehabilitation Services from Oxford to Swindon.

The Chairman explained that the relevant officers were unable to attend the meeting and that officers would be in attendance at the September meeting to answer any questions.

A statement was read on behalf of Nick Crowson-Towers, a survivor of head and neck cancer and Patient Lead for “Care closer to Home project” and attached to the minutes.

To receive an update on the integrated urgent care mobilisation programme.

Jo Cullen, Director of Primary and Urgent Care, Group Director West Wiltshire, Wiltshire CCG, gave an update on the Integrated Urgent Care Mobilisation programme with the key points focusing on:

The programme went live on 1 May 2018, Medvivo was the lead service provider and the NHS 111 service had been subcontracted to Vocare. Over 40,000 calls had been received since the service went live which was more than expected and work was being done to investigate why. Having only been in operation for 2 months more tweaks would occur to smooth out the operations, the winter period would also need to be carefully managed and monitored as well as the different segments such as the under 5s.

The Chairman praised their work noting that avisit to the centre would be a beneficial experience and invited Ms Cullen back in 6 months’ time for a further update.

Resolved

a.    That the committee supports the proposed work

b.    An update would be bought back to committee in 6 months

c.    A visit to the call handlers and clinicians site in Chippenham would be arranged

To receive an update on the Maternity Transformation Plan.

The Chairman introduced the item noting that the previous chair and vice-chair had been contacted by CCG officers who asked to bring an update on the maternity transformation plan and the proposals reached after the investigative work is undertaken. They would be seeking the committee’s endorsement of their proposal, which meant a formal meeting would be required. Unfortunately, the information would not be available until after the next scheduled Committee meeting although an option would be to hold a rapid scrutiny meeting.

The Chair handed over to  Sarah Merritt and Emma Mooney, who gave an update on the maternity transformation plan.

The transformation plan was a national ambition across maternity units to improve customer experience and to make the units more efficient. The offer would include; continuity of care; improved personalised care and choice with parity of access; creation of clinical hubs to provide care closer to home and to deliver seamless pathways across organisation and geographical boundaries.

It had been identified that births at freestanding units had dropped over time and more work was needed on the allocation of staff.

Currently assurance was being sought by NHS England and it was hopeful that assurance would be given. The next stage would be a formal public consultation which would start on the 27 September and finish on the 19 December 2018.

The Chair suggested holding a rapid scrutiny meeting jointly with Bath and Swindon and any other CCG areas, which was welcomed.

Resolved

To hold a Rapid Scrutiny on 27 / 28 September (or close to date). Joint with Bath and Swindon and any other CCG areas.

Volunteers: Gordon King and Chuck Berry

On 6 March 2018 (full agenda and minutes here), the Health Select Committee considered the Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) transformation programme.

The committee supported the transformation programme as it was presented on 6 March 2018 and welcomed an update on implementation at its 11 July 2018 meeting, as well as a statement that could be used to inform town and parish councils of the AWP transformation programme (to follow).

The Chairman introduced the item which had been requested at the previous meeting.

Nicola Hazle, Clinical Director for BaNES, Swindon and Wiltshire, Avon and Wiltshire Mental Health Partnership NHS Trust, gave an update on the implementation of the transformation programme and the next steps involved with the programme.

Points made included:

·         Progress in the following areas was noted; Acute Community Unit, Primary Care Liaison Service, Place of safety, Standard Care and Discharge Packages and Bed Management. 

·         An update of the next steps of the transformation programme.

·         The importance of integrating and sharing information.

In response to questions asked it was noted that: the telephone triage had been working well and enabled a quicker response; The Acute Community Units were voluntary with an offer of support was provided between 4-6 weeks with an expectation that the service use would reduce towards the end of the 4-6 weeks. An out of hours team was also in operation to support the service users and that some detailed work was being carried out on home treatment, crisis care and response.

Resolved

1. Feedback from service users on the place of safety + include profiles of which service users were contacted, to be provided to committee.

2. To receive an update in a year (December 2019).

The Ombudsman published a report on 27 April 2018 finding maladministration against the Council that caused injustice to the complainant.

It was agreed that following consideration by Cabinet, the report would be referred to Overview & Scrutiny and the Standards Committee.

Between publication of this agenda and the actual meeting of the Health Select Committee, the Local Government and Social Care Ombudsman report (Ref 16 015 946) will have been considered by Cabinet on 3 July 2018.

The Chairman introduced the item noting that the report had been considered at Cabinet on the 3 July 2018.

The Cabinet Member for Adult Social Care, Public Health and Public Protection went on to note the response from Cabinet outlining and action plan on how to mitigate the issues going forward. It was explained that complaints within the council should be handled via a 2 stage process and external complaints follow a 1 stage process.

Resolved

To note the report, the findings from the LGO, the response provided by Cabinet and the proposed action plan and to welcome an update in 6 months on outstanding actions.  

On 14 June 2018 the CQC published its review of how local health and social care systems work together in Wiltshire. Further details can be accessed on the CQC website.

This report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The reviews looked at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for people aged 65 and over living in a local area.

The full CQC report can be accessed here and has also been included with this agenda for ease of reference.

The Health Select Committee will also consider a report (to follow) on the CQC review prior to its consideration by the Health and Wellbeing on 12 July 2018.

The Cabinet Member for Adult Social Care, Public Health and Public Protection introduced the item and explained the outcomes of the review and the issues around not having enough carers in the community and the lack of joined up working.

Between receiving the draft report and the final report a lot of work, a long side partners, had taken place. An action plan had been produced, which was included with the agenda and work would start in July 2018.  

Resolved:

To ask the Scrutiny Officer to include update on the actions from the action plan as per their due date on the committee’s forward work programme.

To ask the committee to consider if there are any areas within the report that they feel require further OS involvement – suggestions to be emailed to the chair / scrutiny officer.

Cllrs Groom and Greenman left at 13:00

Diane Gooch left at 13:10

The Rapid Scrutiny exercise on NHS Health Checks took place on 26 June 2018 the outcome report will be circulated as soon as possible (to follow).

Members thanked and congratulated officers and members involved with the rapid scrutiny task for their hard work.

Resolved

To note the report and support the recommendations to the committee and to the Cabinet Member

The award of the Service User Engagement and Healthwatch Wiltshire contracts to, respectively, Wiltshire Centre for Independent Living and Help and Care have created an opportunity to review the current non-elected representation on the Health Select Committee to ensure that all relevant organisations are represented.

Members discussed the non-elected representatives on the committee and it was;

Resolved

1. to agree the following appointments:

WSUN

SWAN

Healthwatch

Wiltshire Centre for Independent Living (WCIL)

With each organisation to nominate its representative.

2. 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 remain representative of service users and / or Wiltshire residents.

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.

There were no further updates given as all of the information was outlined within the report.

The Committee is invited to consider the way in which it wishes to carry out scrutiny of sustainability and transformation plan / partnership (STPs) for Wiltshire.

Information will also be provided to the committee to enable it to determine how it wishes to carry out scrutiny of the Community Area Health & Wellbeing Groups.

The Committee is asked to consider the work programme, taking into account its decision with regards to scrutiny of STPs and Community Area Health & Wellbeing Groups.

The committee considered the forward work plan and ways in which they would scrutinise the sustainability and transformation plan / partnership (STPs) for Wiltshire and the Health & Wellbeing Board.

Resolved

1.    Invite STP to attend a meeting

2.    To include the following on the forward work plan:

·         New Wiltshire health and social care model

·         A single overarching health and social care strategy, improving outcomes with a focus on prevention and early intervention

·         Strengthening joint commissioning across the whole system

·         Improving Wiltshire’s Health and Wellbeing Board effectiveness

·         Unifying and developing whole system governance arrangements

·         Developing a sustainable integrated workforce strategy

·         Implementing digital opportunities and information sharing across the system

·         Developing a single, integrated communications strategy

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 11 September 2018 at 10.30am.

The next meeting wold take place on 11 September at 10:30am.