Agenda and minutes

The Chair, Baroness Jane Scott, welcomed all to the meeting.

Apologies were received from Councillor Ben Anderson, Nerissa  Vaughan, Cara Charles-Barks, Dr Bill Bruce-Jones, and Chief Inspector Mike Veale.

To confirm the minutes of the meeting held on 19 September 2017.

The meeting considered the minutes of the previous meeting.

Resolved

To approve for signing the minutes of the meeting held on 19 September 2017.

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of interest.

There were no announcements.

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 Thursday 2^nd November 2017 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 Tuesday 7^th November 2017. 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 public questions.

An update on preparations for winter pressures.

Responsible Officers: Linda Prosser, Alison Elliott

Report author: Jo Cullen

The meeting received an update on preparations for winter pressures.

Matters highlighted in the course of the presentation and discussion included: that an STP area-wide plan had been developed; that series of engagement events had been delivered to spread best practice; how national communication material hac been tailored for local circumstances to make them more relevant; the links to the national plans; the targets and changes in relation to integrated urgent care; how lessons on demand management over bank holiday periods had been used in planning for similar periods in the Christmas and New Year period; that SWAST had been a national pilot for the new Response Programme; how risk is assessed and plans developed; the links to public health activities such as flu vaccination; how elective care planning is maintained through-out the period; the structure of local delivery boards; how scenarios are tested with a range of health and social care partners; how data on capacity across the system is shared; the acknowledgement that there were some workforce issues that needed addressing; that officers were confident that the system was prepared as best it could.

In answer to a question from Cllr Brian Matthew regarding mixed sex wards, James Scott from the Bath RUH said he would seek to respond outside the meeting to the issues raised.

Resolved

That the update be noted.

To receive an update on the trajectory and plans for reducing delayed discharges ahead of winter and an update on the wider delivery of the Better Care Plan for Wiltshire.

Responsible Officers: Alison Elliott, Linda Prosser

Report author: Sue Shelbourn-Barrow

The meeting received an update on the trajectory and plans for reducing delayed discharges ahead of winter and an update on the wider delivery of the Better Care Plan for Wiltshire.

Matters highlighted in the course of the presentation and discussion included: that the plan submitted in October and had been approved; the plan was being delivered, but that more action was required to improve performance regarding delayed transfers of care; the work with partners to accelerate delivery in this area; the progress that had been made against other key areas; the better use of technologies; how best practice has been shared from successful projects; the analysis of the causes of DTOCs and the opportunities to address this; how additional beds would be used to support transition back to community care; how spot purchasing is using to meet extra-demand; how process improvements have resolved community equipment; the additional demand placed on the plan due to winter; and that an additional bed spaces purchased should not be to the detriment of the vision to treat more people in their own home.

Resolved

1.    To note the update;

2.    That the Health and Wellbeing Board, as system leaders, take collective responsibility for delayed transfers of care and regularly review progress in reducing numbers at future meetings

An update on the procurement of integrated urgent care

Responsible Officers: Linda Prosser

Report author: Jo Cullen

The meeting received an update on the procurement of integrated urgent care

Matters highlighted in the course of the presentation and discussion included: the model being delivered in Wiltshire and the different services provided depending on the needs of the patient; the added complexity due to the diverse geography of the area, and the challenges of moving to location based commissioning; how intelligent mapping tools are used to analyse data to locate services appropriately; the focus on delivering care at the appropriate level; how commissioning strategies are aligned to deliver better outcomes; how best practice has been shared across different areas; how patient self-care is a continuing focus; how demographic data is used to plan services; the transition arrangements in relation to the mobilisation of service included in the package of procurement, especially given to the risk of winter pressures;  how links are made through to emergency care through the urgent care hub; and the efforts to expand access to pharmacy based services.

Resolved

To note the update.

To agree the JSNA overarching documentation.

Responsible Officers: Alison Elliott

Report author: Kate Blackburn

The meeting considered the report which sought the agreement for the JSNA overarching documentation.

Matters highlighted in the course of the presentation and discussion included: that since last iteration, the data had been presented in a more user-friendly way; how the structure of the document has changed into five areas and how more detailed data packs were available for each area; how data is benchmarked and analysed by different demographic groups; how presenting key information as infographics is used to disseminate the information consistently and effectively; how the information is made available to download for use; the implications of deprivation and gender on life expectancy; the implications of population change to 2030 and the increase particularly in the older population;  the concerns on what action needed to take in response to the information on premature mortality slide.

The Chair, Baroness Scott, thanked the officer for the presentation and recorded her thanks for team’s efforts.

Resolved

1.    To approve the publication of the Health and Wellbeing JSNA.

2.    To note that the 2018 JSNA product will focus on the CCG JSNA’s and that work to develop this will commence early in 2018 with key partners.

3.    To request that officers attend to present a briefing prior to a future meeting.

To receive an update on the work undertaken by the Alexander Group reviewing s136 pathways across the Avon and Wiltshire Mental Health Partnership footprint and the work going forward.

Responsible Officer: Ted Wilson, MHCCC action group chair

The meeting received an update on the work undertaken by the Alexander Group reviewing s136 pathways across the Avon and Wiltshire Mental Health Partnership footprint and the work going forward.

Matters highlighted in the course of the presentation and discussion included: the continuing work on the project; the locations of the place of safety; the consultation undertaken and the preference to centralise facilities into one suite in Devizes; the ongoing concerns from Swindon regarding the centralisation in Devizes and the ongoing engagement to address these concerns; that there was due to be further round table discussions, with NHS England planning to undertake further consultation.

Councillor Jerry Wickham expressed concern that Swindon Borough Council were not, apparently, adequately helping to facilitate the transition to one site which may place further resource burdens on Wiltshire Council.

The Chair, Baroness Jane Scott, stated that whilst she understood the concerns raised from Swindon, she believed the new model would result in a better service overall, and hoped that the Leader of the Borough Council may be encouraged to visit the new facility.

Resolved

To note the progress update

An update on the development of a whole county Strategic Outline Programme for investment in out of hospital care.

Responsible Officer: Linda Prosser

Report author: Steve Perkins

An update was received on the development of a whole county Strategic Outline Programme for investment in out of hospital care.

Matters highlighted in the course of the presentation and discussion included: that some drivers for the project included having access to capital funding to build some new facilities in North West Wiltshire and the opportunity to review the remaining areas in the rest of Wiltshire; that the timetable was 6 months to identify the requirements and then the asset strategy; and how the housing needs are being taken into account.

The Chair, Baroness Scott, thanked the officers for the update.

Resolved

To note the approach taken by Wiltshire CCG

To receive an update on the development of a Multi-Agency Safeguarding Hub (MASH) for adults.

Responsible Officers: Alison Elliott

Report author: Heather Alleyne

The meeting received an update on the development of a Multi-Agency Safeguarding Hub (MASH) for adults.

Matters highlighted in the course of the presentation and discussion included: that the MASH was part of an overarching transformation project; the development of closer working relationships with partner organisations, and the focus of improving communication through co-location; that increases in reporting was largely due to heightened awareness of reporting mechanisms; that 17% of referrals resulted a formal enquiry; how triage arrangements can be reviewed to sign-post people to the relevant support; how the MASH was building on the existing links with police, and the developing links with health partners; how the partnership was taking a comprehensive approach to safeguarding, and ensuring consistency across different teams; the structure of the MASH and links to those providing initial contact; the changes to processes for dealing with reports, and how best practice lessons will be learnt; the importance of the early sharing of information; how the better management of cases through the MASH will take some pressure of other teams thereby improving retention of staff; and the opportunities for efficiencies and saving; the potential for widening the role of the MASH to include input from other emergency services; and how the experience of the public contacting the service is measured to assess the appropriate level of triage undertaken.

The Chair, Baroness Scott, thanked the officers for the update and stated that she would welcome a further briefing on the matter.

Resolved

To note the progress on the development of the Adults Multi-Agency Safeguarding Hub

To receive the Public Health Annual Report and feedback on the recent roadshows.

Responsible Officers: Tracy Daszkiewicz

The meeting received the Public Health Annual Report and feedback on the recent roadshows.

Matters highlighted in the course of the presentation and discussion included: the statutory duty to present the report to the meeting; the desire to get more interaction from partners in the future; the innovative use of graphics and the interest in the areas of achievement and challenges; and the progress in taking a preventative approach to issues such as suicide.

Resolved

To note the publication of the Director of Public Health’s Annual Report 2016-17

The next meeting will be 25 January 2018

It was noted that the next meeting would be on 25 January 2018.

There were no urgent items.