Agenda and minutes

Apologies were received from Cllr Christine Crisp – Wiltshire Council (substituted by Cllr Robert Yuill), Cllr Howard Greenman – Wiltshire Council, Irene Kohler – SWAN Advocacy and Steve Madern – Wiltshire Council.

To approve and sign the minutes of the meeting held on 9 January 2018.

The minutes of the meeting held on 9 January 2018 were agreed as the correct record.

Note: Cllr Gavin Grant requested answers raised with South West Ambulance re the Non-Emergency Patient Transport Service update.

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:

Cllr Berry requested that it was noted, a thank you to those who delivered care in the adverse weather and army of farmers and 4x4 drivers.

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 28 February 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 2 March 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 was no public participation.

The Committee will be informed of the Transformation Programme for the Avon and Wiltshire Mental Health Partnership.

Sue McKenna - Chief Operating Officer and Liz Richards - Associate Director for BANES, Swindon & Wiltshire gave a short presentation that outlined the Avon and Wiltshire Mental Health Partnership - Transformation Programme.

Points made included:

·       Providing good shared services.

·       Enabling local people to stay in their own local community areas for as long as possible, with a strategy to enable people to receive the right care in the right place.

·       Providing high levels of delivery.

·       One model across all CCG areas, providing a robust community service.

·       A more flexible use of hospital beds.

·       Creating a point of contact for service users.

Resolved

1.    That the committee supports the Transformation Programme as presented and would welcome an update on implementation at the 11 July meeting, with a written report provided.

2.    That a statement to town and parish council to inform them of the transformation programme would be provided by the CCG.

The Chairman thanked Sue McKenna and Liz Richards for attending the meeting.

When the committee considered the Age UK contracts on 19 April 2016, it was agreed that an update on implementation would be provided on the implementation of the contracts and on the implementation of the long-term investment grant in partnership with the CCG with Age UK (for a total maximum term of four years based on a two-year agreement with the option to extend the agreement for an additional two years based on the agreement of the parties).

The committee will receive a verbal update.

Sue Geary - HOD Commissioning - Community Services Commissioning, Wiltshire Council presented a written report which updated the Committee on the current Age UK contracts.

Points made included:

·   Wiltshire Council and Wiltshire CCG established the Long-Term Investment Grant with Age UK in April 2015.  The grant reflected a shift from commissioning a suite of services to an approach based on system wide outcomes and strategic collaboration. 

·   The LTIG was established for a term of two years with the inclusion of an optional extension clause.

·   Commissioners had worked with Age UK to reduce reliance on statutory funding and encouraged a more commercial approach which would mean Age UK could operate as a viable strategic organisation. 

·   During the term of this agreement commissioned community services previously provided by Age UK have been de commissioned delivering an efficiency to the Council of £126,000 in 2017-18.

Resolved

1.    Long-Term Investment Grant: that the committee would receive an update to confirm whether or not the contract was extended.

2.    Home from Hospital scheme:

o   That the chair and vice-chair be briefed on the specification and performance outcomes once they had been finalised by commissioners and Age UK.

o   That the committee would receive an update on implementation of the scheme in March 2019 (one year operational by then), including performance indicators / confirmation that the specification and performance outcomes were being met.

The Chairman thanked Sue Geary for her report.

At its meeting on 27 June 2017 the committee considered the retrospective evaluation of the NHS Health Checks programme in Wiltshire.

It was agreed that the committee would receive an update showing how outcomes for those on the programme compared with those not participating in it.

John Goodall - Consultant in Public Health, Health Promotion & Prevention, Wiltshire Council and Dr Alice Beech – GP Registrar, Wiltshire Council presented the NHS Health Checks update. Which provided an evaluation update on the NHS Health Checks programme to the Committee.

Points made included:

·       NHS Health Checks are intended to identify early signs of cardiovascular disease.  They are delivered by primary care providers (general practice) to adults in England aged between 40 and 74 years without any pre-existing cardiovascular disease every five years.  The NHS Health Checks programme was commissioned by Wiltshire Council as a mandated service required by the Health and Social Care Act (2012).

·       The NHS Health Check programme began in Wiltshire in 2011. This programme was evaluated by the public health team in May 2017.  The evaluation showed an increase in the percentage of the eligible population invited to attend an NHS Health Check: from 21.7% in 2012 – 2013 to 32.2% in 2015 - 2016. 

·       From 2012 to 2016 an average of 45.5% of patients who were invited for an NHS Health Check attended and the percentage uptake increased from 2012 to 2016.  On average from 2012 to 2016, 55.5% of patients who were invited for an NHS Health Check did not attend.

·       In 2017 the results of the evaluation were presented to the Health Select Committee at Wiltshire Council.  The committee requested more information regarding the outcomes of patients who had been invited to attend an NHS Health Check but did not attend.  

Resolved

1.    That the Committee supports the conclusion that this study had highlighted the potential poor health outcomes related to not attending an NHS Health Check when invited.

2.    That a Rapid Scrutiny exercise be carried out to:

a.    Determine how much further the data available could be used to analyse the costs of non-attendance as well as informing a more focused promotion / advertising of the Health Checks based on:

b.    Demographic analysis of those who do not attend and the understanding of the reasons for non-attendance to inform promotion activities.

c.       Review the provision and “advertising” of Health Checks by GPs / surgeries.

d.       Analyse comparative outcome for attendees / non-attendees.

The Chairman thanked John Goodall and Dr Alice Beech for their report.

The committee will consider the final Sexual Health and Blood Borne Virus Strategy ahead of Cabinet’s decision, currently planned for April 2018.

Vicki Lofts– Wiltshire Council presented the report which sought to seek support for the final Sexual Health and Blood Borne Virus Strategy ahead of going to Cabinet in April 2018.

Points made included:

·       That tackling sexual and reproductive health inequality had been a priority both nationally and locally for many years. Improving sexual health and wellbeing presents a significant challenge for public health and the wider health and social care system, as well as for the individuals who experience poor health outcomes as a result of a sexually transmitted infection (STIs), blood borne viruses (BBVs) or an unplanned pregnancy.

·       There was considerable inequality in the distribution of STIs, BBVs and unplanned pregnancies across the population. The 2013 Framework for Sexual Health Improvement placed health promotion and education as the cornerstones of infection and pregnancy prevention by improving awareness of risk and encouraging safer sexual behaviour.

·       Prevention efforts needed to include universal and targeted open access to sexual health and contraceptive services with a focus on groups at highest risk of sexual health inequality such as young people, black ethnic minorities and men who have sex with men.

Resolved

1.    To support endorsement of the proposed Strategy by Cabinet, but also recommend that the strategy includes how the outcomes will be achieved (following the SMART model).

2.    To receive an update around March 2019 on the implementation of the strategy, especially progress achieved on the Strategic Aims (Prevention, Diagnosis and Treatment) and the measuring of their stated outcomes.

The Chairman thanked Vicki Lofts for presenting her report.

To receive an update from the CCG regarding the temporary closure of the Places of Safety in Salisbury and Swindon following the announcement at the meeting of this  Committee on 9 January 2018. 

Ted Wilson – CCG presented the written update from the CCG regarding the temporary closure of the Places of Safety in Salisbury and Swindon following the announcement at the meeting of this Committee on 9 January 2018. 

It was agreed to defer discussion of the written report until the Chairman and Vice-Chairman of the Committee had had the opportunity to discuss with the relevant Wiltshire Council cabinet member.

Resolved

1.    That evidence be provided to the chair and vice-chair that the issues of funding and organisation (especially out of hours provision) for AMHP had been satisfactorily resolved between the CCGs, Swindon and Wiltshire Councils.

2.    That the risk around capacity for AMHP around out of hours service be closely monitored and that the chair and vice-chair are regularly updated by Wiltshire Council’s Adult Care.

3.    To receive the evaluation of the service, led by the CCG and involving service users, in December 2018. This should include the outcome / analysis of the feedback that would be collected by providers, commissioners and Healthwatch to consider the impact the temporary closure was having on the populations of Swindon and Wiltshire and individuals using the service.

4.    To receive updates on progress from the CCG when / if key issues arise during the 9 months period of evaluation.

The Chairman thanked Ted Wilson for the update.

To receive an update on the Integrated Urgent Care mobilisation programme.

This item was deferred as Sarah MacLennan was unable to attend.

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.

The written update and terms of reference of the CAMHS task group were noted.

The Committee is asked to consider the work programme.

The Forward Work Plan was noted.

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 24 April 2018 at 2.00pm.

·         Tuesday 24 April 2018.