Agenda and minutes

To receive any apologies or substitutions for the meeting.

Apologies for absence were received from Councillor Pip Ridout, Caroline Finch and Councillor Jane Davies.

To approve and sign the minutes of the meeting held on 2 November 2023.

Resolved:

To confirm and sign the minutes of the meeting held on 2 November 2023 as a true and correct record.

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.

The Chairman noted changes to the call-in powers of Health Overview Select Committees due to come into effect on 31 January 2024, and that the amendment had been referred to the Constitution Focus Group.

He also noted recent national guidelines that reinforced the need for Health Select Committees to work closely with NHS colleagues, HealthWatch and committees in neighbouring unitary authorities, adding that he and the Vice-Chairman had accordingly met with the Chairman and Vice-Chairman of Bath and North East Somerset (BaNES) Council Health Select Committee and the CEO and Chairman of the BaNES, Swindon and Wiltshire Integrated Care Board (ICB).

The Chairman remarked that he and the Vice-Chairman received a briefing on plans to recommission a separate Advocacy Service for Adults, for which he suggested adding an update to the Committee’s Forward Work Plan.

Finally, he reminded Committee members of an upcoming scheduled informal discussion of the 2024/25 budget on 19 January 2024 at 10:00am.

 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 10 January 2024 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 12 January 2024. 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.

The Committee received two questions from Mr Chris Caswill. The Chairman read aloud the questions and the Committee’s responses for the benefit of those present. The questions and responses are available as a supplement to the meeting’s agenda pack.

To receive a presentation on the findings of the LGA Peer Review of Wiltshire Adult Social Care.

The Chairman remarked that the peer review of Adult Social Care formed part of the Council’s preparations for an upcoming Care Quality Commission (CQC) inspection and welcomed Debbie Croman to update the Committee on the peer review’s findings.

Debbie Croman noted that while a final report was still being awaited, some of the key themes of discussion that had so far emerged included working with people, providing support and safety within the system and positive leadership.

She observed that there appeared to be a positive direction of travel, with encouraging feedback having been received from providers. Future plans involved sharing the final report amongst the Council’s teams and partners and surveying for further support requirements. Commenting on the CQC’s inspection process so far, Debbie Croman added that there had been five pilot inspections so far with a further three announced. Four of the initial five teams inspected had been rated ‘good’, but all five had been deemed to have scope to improve.

Members queried the very small sample sizes being used in the inspections, with only six cases being examined. Debbie Croman explained that the focus was on a given individual’s journey through the adult social care system rather than on breadth.

Resolved:

To request sight of the findings of the inspection once complete.

To receive an update following the report to HSC in January 2023, including progress on the key aims of transformation and the involvement of service users in the development of maternity services. 

Councillor Gordon King joined the meeting at 10:45am.

The Chairman welcomed the BSW Lead Midwife Sandra Richards and Chaya Tagore from the Maternity and Neonatal Voices Partnership (MNVP) to present an update on maternity and neonatal services.

Summarising their more detailed update included in the agenda pack, the pair noted that the team was now fully embedded within the ICB system, having started off as a transformation team. They had a roadmap to address key issues in maternity and neonatal care, including listening to women and families with compassion, addressing workforce shortages and improving standards of care.

Chaya Tagore explained that the MNVP was a group of parents, all of whom had recently accessed maternity, neonatal or health-visiting services, with three of them covering Wiltshire and acting as a voice to engage with service users and bridge the gap between them and local maternity units.

The pair noted the emphasis on anonymous feedback, co-production and building relationships within seldom-heard communities to ensure equity and equality.

The Committee asked questions about access to hard data showing long-term trends in safety and inequality, on the available support for families who experience a stillbirth, and on the viability of home births.

Resolved:

·         To request further details about the overall impact of the transformation of maternity services in Wiltshire in relation to safety.

·         To request data on the impact of outreach and inclusion work when available to include benchmarking data around outcomes for minority ethnic and care-experienced mothers.

To receive an update on the role and impact of Neighbourhood Collaboratives in Wiltshire.  These initiatives aim to bring people together to reduce health and wellbeing inequalities and are aligned to the Joint Local Health and Wellbeing strategy. 

The Chairman noted that the Committee received information about neighbourhood collaboratives in September 2023 as part of the background to Integrated Care. To provide an opportunity to ask questions on the matter, the item was being brought to this meeting so that members could consider whether there were opportunities to support the initiatives at a divisional level.

The Chairman then introduced Clare O’Farrell and Emma Higgins from the ICB to present the item and field questions from the Committee.

The pair noted that the initiative formed part of a suite of work aimed at moving to a more preventative approach to healthcare, and also added that there was a raft of data available to members upon request.

Councillor Mike Sankey enquired about how to add the Melksham cohort, while Councillor Vigar observed that neighbourhoods will each have different priorities, asking about whether it would typically be an independent organisation responsible for the outreach work or if it could be Wiltshire Council itself. Clare O’Farrell confirmed that it could be either depending on who was best placed.

Diane Gooch expressed her enthusiasm for co-production provided it was genuine, while also remarking on a number of satellite surgeries out of area in Calne, asking about the scope for public engagement.

Clare O’Farrell confirmed that there were individuals in the partnership who scrutinised the co-production element to ensure its validity, and that the programme was first and foremost about gaining an insight into local concerns, with work being started recently on the military population among other things.

The Vice-Chairman asked about the methods in which these collaboratives grow, asking about how community groups could contribute? It was explained that growth was largely through word of mouth for the time being, but that sharing platforms were already active. It was also noted that new joiners represented their own kind of challenge, albeit a welcome one, and that many individuals joined via their GP.

Irene Kohler commented that particularly with regards to the military community, small, grassroots organisations were often best-placed to connect with such hard-to-reach communities, remarking that these organisations were often already under tremendous pressure. She asked if the collaboratives were in a position to assist and empower these organisations to avoid over-burdening them. It was explained that the partnership element of the initiative was not about asking such organisations to do any more than they currently do and was far more about fostering support between such organisations and connecting them to enhance their reach without enhancing their workload.

The Chairman asked how members could get involved. It was explained that members were welcome to be include in circulation lists and conference spaces, and that the collaboratives would also be engaging closely with Area Boards going forward.

Resolved:

·         To request, if available, further information about the community engagement and co-production used in the collaborative process

·         To request an update on the impact of neighbourhood collaboratives in 2025.

·         To support the involvement of members in neighbourhood collaboratives and request a contact list for collaboratives.  ...  view the full minutes text for item 8.

To receive a presentation on the provision of Ophthalmic Services in Wiltshire to include eligibility for NHS services and examples of local initiatives. 

The Chairman noted that ophthalmic services, much like dentistry and community pharmacies, were now commissioned and managed locally. He then welcomed Victoria Stanley, the Programme Lead for BSW Community Pharmacy, Optometry and Dentistry, to update the Committee on the current provision of General Ophthalmic Services (GOS) in Wiltshire.

Victoria Stanley explained that GOS contracts delivered NHS-funded sight tests and NHS prescription glasses and were either mandatory (premises) or additional (domiciliary). She highlighted that Community Urgent Eyecare Services (CUES) were still running, having been commissioned during the Covid-19 pandemic and maintained since, adding that many other authorities had decommissioned the service after the pandemic.

She also highlighted the work being done facilitating sight tests for pupils in special schools, noting that every pupil was eligible for an annual sight test and eye health report.

She noted that there had been over 300 referrals to hospital eye service departments and that optometrists were an undervalued resource and could be doing more.

The Chairman enquired about whether there were any plans to advertise optometrist services to better promote their work to the public, also emphasising that provision to the homeless was an important issue to ensure they could access sight tests.

The Vice-Chairman noted that in using direct hospital referrals from optometrists, Wiltshire was ahead of the curve, as in many other areas, the process would needlessly involve the patient’s GP.

Resolved:

·         To welcome the information about General Ophthalmic Services in Wiltshire

·         To recommend wider promotion of the services available.

Irene Kohler left the meeting at 12:30pm.

Councillor Pip Ridout joined the meeting at 12:30pm and explained that she had been on a Planning Committee site visit and had been unable to find a substitute for the meeting.

To review the Committee’s forward work programme in light of the decisions it has made throughout the meeting.

The Chairman noted that the Forward Work Programme (FWP) would be updated to reflect any changes the Committee made throughout the meeting and discussed at the Overview and Scrutiny Management Committee meeting on 25 January 2024.

The Committee observed that continuing care spend, dementia support and urgent care all warranted attention on the FWP. The Chairman noted that rather than a dedicated item following up on urgent care as suggested by Councillor David Vigar, the matter was instead being taken more holistically as a theme across the entirety of the FWP. It was also noted that a direct report from ambulance services and their quality accounts would be appreciated, with a focus on Wiltshire data.

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 27 February 2024.

The date of the next meeting was confirmed as 27 February 2024.