Agenda and minutes

To receive any apologies or substitutions for the meeting.

Apologies for absence were received from Terence Herbert, Cllr Hawker, Cllr Groom, Cllr Philips, Tracey Cox and Deborah Noakes from the CCG.

To approve and sign the minutes of the public meetings held on 3 March and 16 June 2020.

Resolved:

To approve and sign the minutes of the public meetings held on 3 March and 16 June 2020.

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

There were no declarations of interest from members of the Committee.

To note any announcements through the Chairman, including:

The Chairman explained items 7 and 8 were updates on the COVID-19 pandemic from Wiltshire Council and the CCG respectively. It was proposed to take these items as one, given that members’ questions were likely to cross over. To allow colleagues from the CCG to attend for this item, it was suggested to take these items after the current item 10.

The Council welcomes contributions from members of the public. During the ongoing Covid-19 situation the Council is operating revised procedures and the public are able participate in meetings online after registering with the officer named on this agenda, and in accordance with the deadlines below.

Guidance on how to participate in this meeting online.

Statements
Members of the public who wish to submit a statement in relation to an item on this agenda should submit this is electronically to the officer named on this agenda no later than 5pm on Friday 8 January 2021.

State whom the statement is from (including if representing another person or organisation), state points clearly and be readable aloud in approximately 3 minutes. Up to three speakers are allowed for each item on the agenda.

Questions
Those wishing to ask questions are required to give notice of any such questions electronically to the officer named on the front of this agenda no later than 5pm on 5 January 2021 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 7 January 2021.

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 members prior to the meeting and made available at the meeting and on the Council’s website; they will be taken as read at the meeting.

No public statements or questions have been received for this meeting.

Since April, the council has been operating streamlined Overview and Scrutiny (OS) arrangements comprising formal, public meetings of the Wiltshire COVID-19 Response Task Group and OS Management Committee. This was to enable efficient and effective scrutiny to be undertaken, while allowing council resources to be focused on the response to COVID-19 and supporting and protecting Wiltshire communities.

To support wider engagement, the select committees held informal meetings to raise issues, which their chairmen then pursued at the formal forums above. The notes of Health Select Committee’s informal meeting on 20 November 2020 are attached.

In December, following discussion with the Leader and Chief Executive, the Chairman of Overview and Scrutiny Management Committee agreed that the full select committee structure would resume formal, public meetings from January 2021. It was agreed that the OS forward work programme would focus on COVID-19 and other priority issues with an emphasis on efficient and effective scrutiny engagement. 

Under these arrangements, each select committee will undertake scrutiny engagement on those aspects of the COVID-19 response that fall within its particular remit. A document setting out which Wiltshire Council Recovery Plan themes fall within this Committee’s remit is attached.

Notes of each select committees’ discussions of COVID-19 will be presented for information to OS Management Committee (which next meets on 26 January 2021), allowing it to oversee overall scrutiny engagement on the topic.

The Chairman explained the Council had been operating streamlined Overview and Scrutiny Arrangements and the approach Overview and Scrutiny would take curing the COVID-19 pandemic.

There were no questions from the Committee.

Resolved:

To note the explanation from the Chairman.

The task group’s second report is attached for endorsement by Committee and referral to the Cabinet Member for Children, Education and Skills and the Wiltshire Clinical Commissioning Group (CCG) for response.

During Children’s Select consideration of the task group’s first report, the committee asked the task group to consider how the voluntary and community sector help to provide preventative services to children and young people in Wiltshire. This addition has been added to the task group’s terms of reference for its second report.

Due to the streamlined overview and scrutiny arrangements under COVID-19, the Health Select Committee is, exceptionally, considering the Final Report of the Task Group at the same meeting as it is receiving the Executive Response. It is also considering the report on behalf of the task group’s joint parent committee, the Children’s Select Committee, members of have been invited to participate in this meeting. The Executive Response is included under the next agenda item.

Cllr Gordon King presented the second report from the Task Group to the Committee. The Committee was considering the report on behalf of the task group’s joint parent committee, Children’s Select Committee. During Children’s Select consideration of the task group’s first report, the committee asked the task group to consider how the voluntary and community sector help to provide preventative services to children and young people in Wiltshire. This addition was added to the task group’s terms of reference for its second report.

Cllr King explained the evidence considered by the Task Group in relation to: Thrive Hubs, Access Coordinators, Self-referrals, NHS Benchmarking, access rates and governance arrangements. Conclusions reached by the Task Group were detailed in the report. Six recommendations were outlined in the report and Cllr King highlighted recommendation two in relation to better management of the self-referral process.

Cllr Berry expressed his support for the report and invited questions from the Committee.

It was questioned whether the data remained relevant during COVID-19, in response to which it was acknowledged the report was written pre-covid, and that work may be commissioned in future to assess the impact of COVID-19 on CAMHS.

Cllr Alford explained the Task Group had felt strongly that a better online tool was needed for online self-referral. It was also noted the referral data was inconsistent, therefore it had been difficult to compare data from different parts of the organisation and the Task Group felt this should be harmonised. Cllr Alford also highlighted there was currently no record of re-referrals into the system, this would be important to demonstrate whether the service was not meeting the needs of those referred. Both new data sets were felt to be beneficial to improving CAMHS scrutiny.

Cllr Hubbard, as Chairman of Children’s Select, expressed a disappointment the report did not have a discussion on the significant voluntary offer in Wiltshire to support mental health services. It was noted there were also sometimes inappropriate referrals to the voluntary sector.  For the avoidance of doubt, Cllr Hubbard declared he chaired a charity that commissioned mental health services in Wiltshire, although this charity had not been involved in giving evidence in the report. 

The Chairman noted the points on the voluntary sector and acknowledged these stakeholders could be more involved, should the work of the task group be recommenced.

Other points raised by committee included that private individuals or companies might also be supporting on mental health issues which perhaps should have been raised with CAMHS. The Thrive Hub was noted as an area of focus. Interest was also expressed in understanding the process where young people move into adult mental health services. Questions were raised on to the equalisation of Thrive Hub provision. Cllr Cape explained that a local Health and Care Record in Wiltshire would make sharing information between partners as appropriate would be easier.

In response to comments, Cllr King, on behalf of the Task Group, gave reassurances that commissioners were already aware of changes needed to  ...  view the full minutes text for item 7.

To present the response of the Cabinet Member for Children, Education and Skills and the Bath, Swindon and Wiltshire Clinical Commissioning Group to the Final Report of the CAMHS Task Group – Part B.

Due to the streamlined overview and scrutiny arrangements under COVID-19, the Health Select Committee is, exceptionally, considering the Final Report of the Task Group at the same meeting as it is receiving the Executive Response. It is also considering the report on behalf of the task group’s joint parent committee, the Children’s Select Committee, members of have been invited to participate in this meeting.

The Cabinet Member expressed support for the Task Group’s recommendation and the request for a continuation of the Task Group’s work. It was explained the Executive would act on the Task Group’s recommendations, and highlighted that some recommendations were already underway, however had been delayed due to the COVID-19 pandemic.

The Cabinet Member was able to update that fortnightly meetings were being held with Oxford Health and all secondary schools now had access to a Thrive worker.

Resolved:

To note the response from the Cabinet Member and target dates.

To receive a briefing on the Government’s Health Infrastructure Plan (HIP);  a long-term, strategic investment in the future of the NHS to ensure healthcare staff have the facilities to deliver cutting-edge care and meet the changing needs and rising demand the NHS will face in the 2020s and beyond.

In October 2019 the second phase of HIP (HIP2) was announced, and the Royal United Hospitals Bath NHS FT was one of 21 schemes selected as part of the programme.  Initial seed funding has been awarded to fund the preparation of a Strategic Outline Case (SOC) which will detail how the money might best be spent. The SOC is the first round in a three-stage business case process to enable the scheme to be formally approved.

The Committee is asked to comment on the development of these plans in preparation for the submission of a SOC later this year.

The Committee received a briefing on the Government’s Health Infrastructure Plan (HIP) from Simon Cook, Programme Director. HIP2 was a long-term, strategic investment in the future of the NHS to ensure healthcare staff had the facilities to deliver cutting-edge care and meet the changing needs and rising demand the NHS will face in the 2020s and beyond.

Key outcomes of HIP2 included building new hospitals and harnessing digital technology. £450m was potentially to be made available for RUH Bath under HIP2, provided three stages of business case were approved. Currently a Strategic Outline Case was being compiled for submission in December 2021. It was highlighted the project was not based on renewing existing infrastructure, but about preparing for the future, including better outcomes and experiences for patients, preventative care and full integration across primary, social care and public health. Mr Cook explained an Engagement Plan was also being developed and the Committee was considered an important stakeholder in the plans.

In response to questions it was confirmed the RUH were considering future trends after covid and it was seeking to be ambitious about the use of technology and use of the RUH estate. Artificial Intelligence was an opportunity that the RUH was investigating.

Resolved:

To note the briefing provided and request the presentation be circulated to members.

A report from the Chief Executive is attached providing a summary of activity to mitigate the impact of the coronavirus in Wiltshire since the last update to Cabinet in December. The report provided here was published on 23 December 2020 and considered by Cabinet on 5 January 2021.

All four of the council’s select committees will receive the report and, to avoid duplication, members are invited to focus their questions and debate within this select committees’ remit.

Emme Legg (Director for Access and Reablement) updated that demand on the service has increased during COVID-19 and adult MASH demand had remained as in previous periods. Virtual methods were being used to deliver services where possible, however a community presence remained for those that are most vulnerable during the COVID-19 pandemic. The officer advised the severity of COVID-19 outbreaks in care homes had been minimal compared to the first lockdown due to sound protective measures in place.

Currently a significant pressure was the need for short term care following discharge from hospital and the service was working with care homes to provide additional capacity. In response to questions, it was explained the Care Home Advisory Group was established in around April-May 2020.

Clare Edgar (Director for Mental Health and Learning Difficulties) provided an update on the council’s Wellbeing Hub to support those that were clinically extremely vulnerable or shielding. 28,000 residents had been supported by the Hub since it was established last year, by phone, email or in person. During the currently lockdown, 150 people currently required support from the wellbeing hub.

The Chairman invited comments and questions which included that LINK drivers should be prioritised for vaccinations to allow them to help others to travel for vaccinations. In response to questions, it was noted the Wellbeing Hub referred those it supported to organisations that could support their mental health and isolation. Wiltshire CIL had been working with Wiltshire Council to understand the needs of young people and those with disabilities. Kate Blackburn updated on communication via radio and print for those vulnerable residents that could not access support online.

Edward Rendell from Bath and North East Somerset, Swindon and Wiltshire CCG provided an update on health care provision during the COVID-19 pandemic. A significant challenge was to continue to provide acute and urgency care, and this was continuously monitored. For primary care, a full telephone triage service was in place to allow surgeries to be open for business. For Adult Community Services, the CCG was working to prioritising care at home as much as possible. Mental Health Services were also under demand during COVID-19. In terms of the vaccination programme, full coverage for vaccinations was now established to vaccinate the four priority groups. Larger vaccination sites local to Wiltshire were due to come online within a couple of weeks. The officer concluded by drawing awareness to an Integrated Care consultation that was currently open.

Gill May updated that 40,000 vaccines had already been delivered to priority groups. It was explained the CCG was currently working on plans for deployment of the vaccine to the homeless and traveller communities. In response to questions, it was confirmed the CCG would work with Public Health to provide more information to councillors about vaccination plans across the county.

Resolved:

To note the update provided from the council and CCG.

To receive an update from the Bath, Swindon and Wiltshire Clinical Commissioning Group (BSW CCG) on:

a)    Current key issues regarding the CCG’s response to COVID-19.

b)    Elective Care – current position on waiting times and recovery actions.

An update was provided under the previous item.

The committee is invited to consider its forward work programme and to take it into consideration when making recommendations on later items on the agenda. This will follow.

The Chairman advised the Forward Work Programme would be considered further at the next meeting.

Resolved:

To note 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 2 March 2021.

The date of the next meeting was to be 2 March 2021.