Agenda and draft minutes

To receive any apologies or substitutions for the meeting.

Apologies were received from Cllr Pip Ridout and Cllr Mary Champion.  There were no substitutions.

To approve and sign the minutes of the meeting held on 10 September 2024.

Resolved:

To confirm and sign the minutes of the meeting held on 10 September 2024 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, including:

The Chairman made the following announcements:

Change to agenda order

Agenda item 9 – the Cabinet Member’s update would be brought forward to be the first main item of the agenda

Care Quality Commission (CQC) Inspection of Adult Social Care

During the inspection in later September, the Chair and Voice Chair had an interview with CQC inspectors and it was expected that the outcome report would be available to be shared at the January 2025 meeting.

Recent Cabinet decisions to note:

17 September 2024

ICB Community Health Service Procurement – Cabinet committed Better Care Funding of £9,668,777 to the ICB Community Health Contract from 2025-2032 (with a potential for a further 2 years to 2034)

8 October 2024

Telecare Service Recommissioning – the vice-chair and I received a briefing on this on 7 October. Cabinet approved the commissioning of the Telecare Service via the ESPO Framework from 1 April 2025, with a three-year contract awarded to the successful provider, with the option to extend up to a further year.

Cabinet items of interest on the forward plan

There are no items that seem directly linked to the remit of the Health Select Committee in the Cabinet’s current December 2024 to March 2025 forward plan, but an eye would be kept on it.

Marie Gondlach – Senior Scrutiny Officer

Thanks to Marie Gondlach for her support of the Committee and good luck to her in her new role.

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 13 November 2024 in order to be guaranteed a written response. In order to receive a verbal response questions must be submitted no later than 5pm on Friday 15 November 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.

No questions or statements were received from the public in advance of the meeting.  

The Committee will receive an update on urgent care in Wiltshire’s rural communities, which includes the availability of services and response times. 

The Chairman welcomed Heather Cooper (Urgent Care and Flow Director – BaNES, Swindon and Wiltshire Integrated Care Board) (BSW ICB), Helen Wilkinson (ICS Community Pharmacy Clinical Lead, BSW ICB), Jo Cullen (Director of Primary Care, BSW ICB) and Paul Birkett-Wendes (Head of Operations, BSW, SWAST) who were in attendance to give an update on urgent care in Wiltshire’s rural communities.

Summarising the more detailed presentation included in the agenda pack, the following was highlighted:

·            An overview of the urgent and emergency care (UEC) approach across the BSW ICB included the focus and priority to ensure that safe services are provided with a system wide approach.  There were a number of key objectives to improve response times, A&E waiting times and maintain acute bed and ambulance service capacity.  Providers were to deliver key performance outcomes and partners had worked collaboratively to develop the system operational plan for 2024-25;

·            There were four focus areas in the BSW Urgent Care and Flow 2024-25 plan which included Virtual Wards, System Care Coordination, Process Improvement and Locality Plans;

·            There had been an increase in non-elective demand.  Details were shown of the areas where there had been an increase in activity and the actions being taken to address the challenges.  Prevention would play a significant role in the future management of the UEC demand and would be through the delivery groups that relate to Primary Care and Community, THRIVE (mental health) and Children and Young People;

·            Details were given of locality funded schemes to support patients to stay at home and receive the right care from the right clinician at the right time;

·            The BSW primary care services are a vital part of the system serving a combined population of 940,000 which is made up of 84 GP practices and 28 Primary Care Networks.  The map shared in the agenda pack showed where these services were located.  The ICB spend around £175 million a year on primary care services including around £12 million on locally commissioned services;

·            The demand on services was in increasing challenge – 500,000 appointments requested a month across BSW, a mixture of phone calls, online consultations and some face to face appointments.  There was monitoring around this at practice level and they were trying to do what they could to support additional access with the increasing demand.

·            The Pharmacy First scheme had been launched nationally and individual pharmacies could choose whether to participate or not. All Wiltshire pharmacies had signed up to help with seven common health conditions without needing a GP appointment which included sinusitis, sore throat, earache, infected insect bite, impetigo, shingles and urinary tract infections.  This was to enable GPs to have more time to deal with patients who needed to be seen;

·            Local specific data dashboards were in development and the Wiltshire data could be shared at a future meeting.  There was an average of 6000 Pharmacy First consultations a month across 139 BSW pharmacies which can be broken down by clinical condition (e.g. sore throat,  ...  view the full minutes text for item 71.

The Committee will receive an update on the Councils Adult Social Care key performance indicators which is to follow.

The Chairman welcomed Emma Legg (Director – Adult Social Care) and Emma Townsend (Head of Service - Living and Aging Well) who were in attendance to provide an update on the Council’s Adult Social Care key performance indicators. 

Summarising the more detailed presentation shared within the agenda supplement pack, the following was highlighted:

·            From the graphs showing the demand and activity data it was to be noted that there had been an increase in demand for adult social care (ASC) since April 2023 and that the number of new contacts had increased by 41% and the percentage of work requests to be allocated at risen by 26%.  Another graph showed that there was a rise in productivity rates whilst the ASC demand continues to rise;

·            Placements of adults of working age and 65 and over were detailed as to whether they were in permanent residential care, in permanent nursing care or receiving care in their own homes.   It was noted that there was growth in the number of adults of working age ASC were supporting but that more of them were in their own home and there was a steady increase in demand for residential placements for those aged 65 and above;

·            Details of how long people wait for a Care Act Assessment showed that more were waiting longer in the winter months but that the trajectory is reviewed by Performance and Outcomes Board and the wait continues to reduce;

·            At April 2023, there were 67 adults with a learning disability in paid employment who had also had an annual review in the last 12 months.  At October 2024 this was the case for 85 adults.  At April 2023, there were 637 adults with a learning disability living in their own home or with family who had also had an annual review in the last 12 months.  At October 2024 this was the case for 784 adults.  Both graphs showed improvement but the service remains ambitious and they would strive for improvements to continue;

·            ASCOF was the Adult Social Care Outcomes Framework which is designed to measure how well care and support services achieve the outcomes that matter most to people.  The ASCOF 2023-24 results were due to be published in mid December 2024 and so the Wiltshire 2023-24 data is provided alongside the last national survey data and the ASCO’s previous years data was being used as a benchmark;

·            Some of the statutory return data was provided and showed how Wiltshire is positioned out of the 14 local authorities in the Southwest area and the England average in relation to a number of different indicators.  Wiltshire were top for the % of carers who receive direct payments but low in the rankings for the % of service users who receive direct payments.  This was a priority project in the transformation programme work and it was hoped this would improve to reach the England average of - 26% by April 2026;

·            The last slide  ...  view the full minutes text for item 72.

The report seeks to update the Committee with details of the Service User Engagement contracts commissioned by Adults Commissioning and Wiltshire ICB, detailing projects conducted through 2024. 

The Chairman welcomed Alison Elliott (Director – Commissioning, Adults and Children) who was in attendance to update the Committee with details of the Service User Engagement contracts commissioned by Adults Commissioning and Wiltshire ICB.

Alison wished to make an apology to the Wiltshire Centre for Independent (WCIL) as in the report circulated with the agenda referred to the Wiltshire Pioneers project but omitted to say that this is run by the WCIL and that they are a very important partner for the Council in gaining the voice of those people who use our services.

Summarising the more report included within the agenda pack, the following was highlighted:

·            In January 2024, the contracts for Service User Engagement (SUE) were jointly commissioned by Wiltshire Council and Wiltshire ICB.  The SUE for 5 to 18 year olds was awarded to the Wiltshire CIL and the SUE for those aged 18+ was awarded to Voice It Hear It which is a consortium of voluntary sector organisations to get the voice from a health and social care perspective;

·            The Council has made to clear with those organisations what they need from them so that they are hearing the voice from a broad spectrum of the community and that they are consulted and engaged with on new innovations or changes to services that are provided and they inform on how the Council can engage with those hard to reach.

·            The project reports show how those commissioned have engaged and feedback is received from the Voice It Hear It group who did a survey on the Council’s behalf and found that the majority of people would rather remain at home and be supported and going into a care home was the least favourite option, obviously sometimes it is not possible for all wants to be actioned but within the commissioning they consider and reflect what people want;

·            The Voice It Hear It providers work in close collaboration with the Wiltshire Youth Voice and Participation team to ensure there is a joined up approach to delivering engagement activity and they particularly want to hear the 18-25 SEND voice to be able to make improvements;

·            Public Health identified engagement groups and people using The Medley services were set as a pilot project to understand how to support adults with a learning disability and their unpaid carers to complete their health checks due to current health inequalities data;

·            An additional contract was awarded on 1 January 2024 to Healthwatch Wiltshire which is a statutory organisation acting as champions of Wiltshire communities to report health issues and feedback to the Wiltshire ICB, Wiltshire Council and the Care Quality Commission.  They were currently supporting the Council on engagement of Fijian and Nepalese military families and Wiltshire’s understand of childhood vaccines;

·            The Wiltshire Pioneers is run by the Wiltshire CIL and they are a group of residents in Wiltshire with experience of Adult Social Care (ASC) services who work alongside practitioners colleagues in ASC.  The Council is challenged in a positive way by  ...  view the full minutes text for item 73.

To receive a brief verbal update from attending Cabinet Members (or Portfolio Holders on their behalf) highlighting any news, successes or milestones in their respective areas since the last meeting of the committee, not covered elsewhere on the agenda.

The Chairman stated that this was a new item for the Committee and was an opportunity for Cabinet Members (or Portfolio Holders on their behalf) to give us a brief verbal update on any news, successes or milestones in their respective areas since the last meeting of the committee, not covered elsewhere on the agenda.

Cllr Ian Blair Pilling (Cabinet Member Public Health, Communities, Leisure and Libraries) gave an overview, speaking to the slides shared at the meeting (attached to the Minutes) of round 6 of the Household Support Fund and highlighted the following:

·            As part of the funding round to cover 1 October 2024 to 31 March 2025 £2,728,656,41 was allocated and how this was spent was delegated to the Cabinet Member and the Director;

·            A high level of assurance was given that this was a successful programme which was doing good in a lot of places.  A range of different cohorts of people were being supported and there was work across a number of teams of the Council to run the different programmes.  The Department for Work and Pensions had recognised how well Wiltshire was doing to distribute the funding and had been asked to share this with other Local authorities;

·            There was a six month window to spend the allocation and the Council are not notified of the allocation in advance of the spending window.  The Cabinet were immensely proud of what officers had achieved to support the more vulnerable in the community and felt it was a great example of it was good for local government to apply their knowledge of their communities and apply the funding flexibly.

The Committee asked the following questions which included but were not

limited to:

·            What are the standards you are setting to select people to receive the help and are you drilling down to the individual communities to get this information or are your officers out and about doing this and if so how many?  It was noted that lots of the cohorts were defined by the DWP and guidance however when the Council took over the HSF they connected with the internal departments within the Council including adult social care, revenues and benefits, and schools etc and also met with third sector voluntary organisations as they also know our communities well especially as Wiltshire is a rural area.  There were a lot involved in identity cohorts and communities that needed support.

·            Do you have a good level of contact with the Parish Councils?  It was noted that the Public Health Specialist spoke to the Town and Parish Council Chairs on HSF4 last winter and that he had been invited on 26 November to speak to them again.  There would also be different communications for this this round with posters to distribute to Parish Councils and it was hoped that they could share these within the parish magazines or put on local notice boards.  There was also a Members briefing issued last week.

·            To what degree was this anticipated  ...  view the full minutes text for item 74.

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

The Chairman highlighted that the expected reported on the Co-opted/stakeholders members of this committee had not been included on the agenda for the meeting.  This was because it would have seemed illogical to do so before considering fully the Service User Engagement Contract update that was presented at today’s meeting as this was a key factor in inviting groups and organisations to nominate a representative and to ensure we hear the voices of service users at committee level. There would also be a change of supporting officer for this committee, when Julie Bielby would return and present the report on co-opted members at the next available meeting.

The Chairman also highlighted that as agreed at the last meeting, the forward work programme had been extensively reviewed and updated. Further consultations would take place with council officers, partners and stakeholders to carry on fine-tuning the forward work plan once the committee feeds back on the items included in the agenda pack.

The Committee’s noted the Forward Work Programme (FWP) would be updated to reflect any changes made during the meeting.

Resolved:

That the Health Select Committee approve the approve the Forward Work Programme with the additions agreed at the meeting.

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 Wednesday 22 January 2025 at 10.30am.

Future meetings are as follows:

12 March 2025

5 June 2025

9 July 2025

9 September 2025

12 November 2025.

The date of the next meeting was confirmed as Wednesday 22 January 2025 at 10.30am.

Future meetings were noted as follows:

12 March 2025

5 June 2025

9 July 2025

9 September 2025

12 November 2025.