Agenda and minutes

The Chairman will welcome those present to the meeting.

The Chairman welcomed all to the meeting.

To receive any apologies or substitutions for the meeting.

Apologies were received from Cllr Philip Whitehead, Cllr Ben Anderson, Cllr Gordon King, Cllr Pauline Church, Gareth Bryant, Kier Pritchard, Linda Prosser, Nicola Hazle, Terence Herbert, Carlton Brand, Kevin McNamara, Toby Davies and Suzanne Tewkesbury.

James Scott was substituted by Alison Ryan and Cara Charles-Barks was substituted by Andy Hyett.

To confirm the minutes of the meeting held on 25 July 2019.

The minutes of the previous meeting held on 25 July 2019, previously circulated, were considered.

Resolved

To approve the minutes as correct.

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

There were no declarations of interest.

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 19 September 2019 in order to be guaranteed of a written response. In order to receive a verbal response questions must be submitted no later than 5pm on16 September 2019. 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 questions from the public.

The Board received a statement from Vincent Mobey whose wife, Maggie, had been diagnosed with Parkinson’s disease in 2016.

Vincent highlighted a service gap in specialist Parkinson’s nurse provision for North Wiltshire patients which had been vital in influencing the proposal to enhance Parkinson’s nurse provision in the GWH Community Neurology Team; and support the next steps to agree the recommended way forward and commission enhanced service with the support of Parkinson’s UK as detailed in the report.

·       #EPIC Talk - Sir Al Aynsley-Green confronts and explores the reality of childhood

The Chairman made the following announcement:

·       #EPIC Talk - Sir Al Aynsley-Green

#EPIC Talks invite you to join Sir Al Aynsley-Green on 26 September 2019 17:30 pm - 19:00 pm as he confronts and explores the reality of childhood in one of the most unequal societies in the developed world.

A must-read for those engaged in children’s services, policy and parenting in the UK.

Sir Al confronts the obstacles and attitudes faced by young people today with tact, honesty and compassion, to offer his vision of a society in which each and every child is valued.

• The Board noted its gratitude to Linda Prosser for all she had done for the Health and Wellbeing Board and wished her luck with the rest of her career.

To provide an update on nursing and other support for those living with Parkinson’s disease.

Responsible Officer: Linda Prosser

Report authors: Ted Wilson

Ted Wilson gave an update on nursing and other support for those living with Parkinson’s disease.

Matters raised during the presentation included existing specialist Parkinson’s provision in Wiltshire; a service gap for North Wiltshire patients and options to enhance the service to deliver greater equity of access.

In answer to a question raised by the Board it was noted that there are expected challenges in recruiting for the specialist nurse roles required. There is, however, general training offered nationally and many people are known to move from one specialist role to another, for example physiotherapists.

The Board noted its gratitude to Vincent Mobey for highlighting this issue and playing such an active role in developing the proposals to enhance Parkinson’s provision in North Wiltshire.

The Board also extended its gratitude to Jerry Wickham, who was heavily involved in beginning the process with Ted Wilson and Vincent Mobey.

Resolved

1.    To note the proposals to enhance Parkinson’s nurse provision in the GWH Community Neurology Team

2.    To support the next steps to agree the recommended way forward and commission enhanced service with the support of Parkinson’s UK.

A verbal update on progress with the consultation on maternity services.

Responsible Officer: Linda Prosser

Report authors: Lucy Baker

Lucy Baker gave an update on the progress with the consultation on maternity services, noting that the consultation had been completed and the findings had been subject to rigorous academic analysis with an independent panel looking at recommendations. A decision-making case will be put to the October BSW STP meeting and the outcome will be shared at a future Health and Wellbeing Board meeting

Resolved

To note the progress of the consultation on maternity services.

To consider the findings of the recent Ofsted inspection of Wiltshire Council.

Responsible Officer: Terence Herbert

Report authors: Lucy Townsend, Helean Hughes, Helen Jones

Martin Davis presented a report on the findings of the recent Ofsted inspection of Wiltshire Council.

Matters raised during the presentation included the impact of leaders on social work practice with children and families; the experiences and progress of children who need help and protection; the experience and progress of children in care and care leavers; the Council’s overall effectiveness and what it needs to improve going forward.

In answer to a question raised by the Board it was noted that Wiltshire Council had recognised the need to raise awareness of private fostering in the local community before the Ofsted report’s recommendation. It has worked specifically with GPs and practices to raise awareness but there is an acceptance that more needs to be done in regard to engagement with schools.

The Board congratulated the service for the work they had put in to achieve a “Good” judgement from Ofsted’s inspection of Wiltshire Council.

Resolved

To note the findings of the recent Ofsted inspection of Wiltshire Council. 

To hear from commissioners and Virgin Healthcare on progress made delivering the contract for children’s community health services. 

Responsible Officers: Terence Herbert, Linda Prosser

Report authors: Helen Jones, Lucy Baker, Tracy Daszkiewicz

Lucy Baker, Tracy Daszkiewicz and Helen Jones gave a presentation on progress made delivering the contract for children’s community health services.

Matters raised during the presentation included quality and performance data across the whole service; overviews of each individual service within the contract and performance issues currently being managed.

In answer to a question raised by the Board it was noted that the children had not been receiving their initial health assessments in a timely manner for some time now. There are several reasons for this delay in assessment and a designated review board had been established with membership from Virgin Care, commissioning representation and Wiltshire Council as well as social care colleagues to find solutions.

The Board raised its concerns over capacity within the service. It was noted that there were skill shortages in some areas but that by January 2020 the service all positions in the Community Paediatric Team and Community Therapy Team would be filled. The Looked After Children team is also fully recruited.

It was noted that following the release of the latest staff satisfaction survey in October 2019, further work will be required to consolidate any improvements in performance or to address areas of concern.

In response to a question from the Chairman it was noted that Virgin Care’s contract would up in 2021 and the parties were nearly at a point in which it could inform the Board on whether its contract would be extended.

Resolved

To note the summary provided.

To receive an update on the local plan and delegate sign off to the chair in consultation with the Families and Children’s Transformation Board.

Responsible Officers: Linda Prosser, Terence Herbert

Report author: Judy Edwards

Lucy Baker gave an update on the local plan and delegate sign off to the chair in consultation with the Families and Children’s Transformation Board.

Matters raised during the presentation included the key achievements over the past 12 months; the funding of services and the key priorities for 2019-20 and beyond.

It was noted that a recent Healthwatch Wiltshire study found that there was a great deal of frustration amongst young people regarding Child and Adolescent Mental Health Services (CAMHS). However, many of these frustrations had been addressed in the report.

It was noted that plan aims to recommission a ‘mental health early intervention service’, to include talking therapies, that offers greater equality of access and which targets young people at high risk of developing mental health disorders. 

In response to a question from the Board it was noted that the transition from child and adolescent to adult mental health service continued to be a challenge for the service. There are early discussions being had about how the transition for 16-25-year olds can be improved and the development of a whole life pathway Similarly joint work plans, for example for those with eating disorders, were needed.

It was suggested that a further update on CAMHS be provided in six months’ time with further information on benchmarking against other areas and historically – covering aspects such as rates of self-harm. 

Resolved

1.    Note the progress to date on the implementation of the CCG local transformation plan for children and young people’s mental health and wellbeing.

2.    Review and support future proposals identified in this paper and in the draft refresh of the transformation plan.

3.    Delegate sign off to the HWB Chairs following consultation with the Families and Children’s Transformation Board and finalisation of the 2019 refresh.

To receive an update on the implementation of the concordat in Wiltshire and across the BSW STP.   

Responsible Officers: Linda Prosser, Carlton Brand, Kier Pritchard

Report authors: Susan Shallis, Sgt Mike Hughes

Lucy Baker and Angus Mcpherson presented a report on the implementation of the concordat in Wiltshire and across the BSW STP.

Matters raised during the presentation included:nobodyunder s136 had been placed in custody in the last two years; development of Health Based Places of Safety ; the Bluebell Health Based Place of Safety evaluation; rotas for s12 doctors; BaNES & Wiltshire Crisis Accommodation and successful funding bids. Lucy Baker undertook to circulate to the Board the options appraisal on Health Based Places of Safety.

In answer to a question raised by the Board it was noted that there were challenges in the way those with learning difficulties and autism had been treated. There would be a whole review of the LD/ ASD pathway which would focus on prevention work and what the service can provide in crisis situations.

It was noted that there is an imbalance in the number of crisis patients the Wiltshire and B&NES area takes from Bristol and the surrounding areas than vice versa and work needs to be done to address this.

Resolved

To note the Mental Health Crisis Care Concordat update.

To agree the Better Care Plan 2019/20 for submission and consider the latest information on the performance of existing initiatives.

Responsible Officers: Ted Wilson, Helen Jones, James Corrigan

Report author: James Corrigan

Helen Jones, Ted Wilson and James Corrigan presented a report on the Better Care Plan 2019/20 and the latest information on the performance of existing initiatives.

Matters raised during the presentation included the absence of NHS England at the meeting indicating a lack of concern with the proposals; the co-produced model for the Better Care Plan 2019/20 and the Better Care Submission 2019/20.

It was noted that while new priorities are in development, an existing programme of schemes funded by the Better Care Plan continues to be implemented with the objectives of contributing to NHS England’s high-impact changes and to the specific performance objectives.

Resolved

To agree the Better Care Plan Submission for 2019/20 and agree its submission to NHS England.

To consider the initial winter plan for 2019/20.

Responsible Officers: Jo Cullen, Helen Jones, Emma Legg

Jo Cullen gave a presentation on the initial winter plan 2019/20.

Matters raised during the presentation included: the services covered; assurance and signoff deadlines; lessons learnt in 2018/19; the additional social care winter capacity; that GWH and RUH perspectives are fed in alongside SFT.

In answer to a question raised by the Board it was noted that engagement has begun with relevant teams and services and the initial winter plan 2019/20 proposals are based on a confidence in these to quickly and efficiently change to the new social care bedding capacity.

Resolved

To note the initial winter plan for 2019/20.

To agree a new Joint Health and Wellbeing Strategy.

Responsible Officers: Linda Prosser, Carlton Brand, Terence Herbert

Report authors: Tracy Daszkiewicz, Kate Blackburn, Hayley Mortimer

Tracy Daszkiewicz presented a report on the new Joint Health and Wellbeing Strategy.

Matters raised during the presentation included its background and purpose; amendments and comments for future discussion.

Resolved

To note the consultation feedback at Appendix 1 and approves the JHWS at Appendix 2 for publication.

To receive an update on the obesity strategy.

Responsible Officer: Carlton Brand

Report author: Tracy Daszkiewicz, Steve Maddern

Steve Maddern presented a report on the obesity strategy.

Matters raised during the presentation included its background; the strategic priority areas; strategic target outcomes and future plans. It was noted that there is a healthy weight and diabetes conference on the 07 November 2019.

Resolved

1.    To note the positive outcomes that have been achieved since the strategy was published in 2016.

2.    To approve the proposal for a legacy programme to support Wiltshire residents to achieve and maintain a healthy weight.

To receive an update on the sexual health and blood borne virus strategy.

Responsible Officer: Carlton Brand

Report author: Tracy Daszkiewicz, Steve Maddern

Steve Maddern presented a report on the sexual health and blood borne virus strategy.

Matters raised during the presentation included its background; Wiltshire Sexual Health and Blood Borne Virus Strategy 2017-20; strategic oversight; sexual health strategy outcomes; key priorities and options going forward.

In answer to a question raised by the Board it was noted that late diagnosis for those living with HIV is at times due to a stigma.

It was noted that sexual health should be managed within the military but it is understood this isn’t fully supported at times. The strategy seeks to provide some support and recognise that some military personnel may prefer to come to public practices than those provided by the military.

It was also noted that teenage pregnancy levels remained low. There many factors that have driven this including more effective contraception and changes in local policy. However there had been a recent rise in terminations and repeat terminations which was a concern.

Resolved

To note and acknowledge the Sexual Health and Blood Borne Virus strategy implementation update and agree the way forward post-strategy based on the recommendations in this paper.

To consider the WSAB annual report and priorities for 2019/20. 

Responsible Officers: Richard Crompton, WSAB chair

Richard Crompton presented the WSAB annual report and priorities for 2019/20.

Matters raised during the presentation included the outcome of the 2019 Safeguarding Adults Review regarding Adult E; the work done by WSAB in 2018/19 and its strategy for 2019-2021. With respect to adult E it was noted that commissioners need to consider a continued role for care providers while LD patients are in hospital; commissioners need to look at the way in which advocacy services are provided to residents when they attend acute hospitals out of the area and the RUH reiterated its apology for what had happened in this case.

In answer to a question raised by the Board it was noted that every healthcare professional needs to understand more about mental health and not just leave that area of work to specialists.

The Board noted that it was impressed with level of debate and engagement with partners and service providers at Wiltshire Safeguarding Adults Board meetings.

Resolved

1.    Notes the outcome of the 2019 Safeguarding Adults Review relating to Adult E and acts to ensure that this learning has an impact on the work of its member agencies.

2.    Notes the work done by WSAB in 2018/2019 and commits the necessary partnership resources to ensure that the WSAB’s three-year strategy for 2019-2021 can be delivered effectively.

3.    Continues to support the work of the Board to safeguard vulnerable adults in Wiltshire.

The next meeting will be on 28 November 2019 at 9.00am.

The date of the next meeting will take place on Thursday 28^th November 2019 at 9.00am.

It was noted that James Scott, Chief Executive of Royal United Hospitals Bath NHS Foundation Trust, was to retire and would not at the April 2020 meeting of the Board.

It was also noted that Clinical Commissioning Groups (CCGs) had engaged with partners about the forthcoming merger. The CCG will be submitting a formal merger request effective from April next year.