Agenda and minutes

To receive any apologies or substitutions for the meeting.

Apologies for absence were received from Cllr Mary Champion, Cllr Howard Greenman, Cllr Mollie Groom and Cllr Deborah Halik.

The Chairman referred to the sad news of the passing of Clare Evans who had been Chair of the Wiltshire Centre for Independent Living (CIL) and its representative on this Committee. She was leaving an admirable legacy which the CIL would work tirelessly to honour. 

The Chairman then welcomed Sue Denmark, the new Chair of CIL who was CIL’s new representative on this Committee. 

To approve and sign the minutes of the meeting held on 11 September 2018.

Resolved:

To confirm and sign the minutes of the previous meeting held on 11 September 2018.

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

There were no declarations of interest made at the meeting.

To note any announcements through the Chairman, including:

·         Places of Safety

·         Winter preparedness

The Chairman made the following announcements:-

Places of Safety   The Health Select Committee resolved on 6 March 2018 to receive the evaluation of the Places of Safety service, led by the CCG and involving service users, at its December 2018 meeting.

It was agreed this would include the outcome / analysis of the feedback that would be collected by providers, commissioners and Healthwatch to consider the impact the temporary closure was having on the populations of Swindon and Wiltshire and individuals using the service.

Work was currently ongoing this month (December 2018) on the two areas that would inform the report the committee had requested:

•           service user experience (with user consent) and

•           wider stakeholder feedback.

On this basis, a report should be available for the Health Select Committee at its March meeting.

Winter Preparedness  A special meeting of the Health & Wellbeing Board had been held on Friday 14 December 2018 to consider the progress being made to tackle winter pressures. Cllr Gordon King, Vice-Chairman, reported that he had attended that meeting when it had been explained that efforts were being made to encourage the public to consult their GP surgeries or local pharmacies instead of attending hospital A & E departments wherever possible.

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 (Tuesday 11 December 2018) 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 (Thursday 13 December 2018). 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.

Mr A Milroy attended in order to make a statement about the Maternity Transformation Plan.  He opted to make his statement when the Committee considered that item.

To receive the final report of the CAMHS task group.

As this was a joint task group this final report will also be considered at the meeting of Children’s Select Committee on 8 January 2019.

The Chairman invited Cllr Phil Alford as Chairman of the CAMHS Task Group to introduce the Task Group’s final report.

Cllr Alford reminded the meeting that the CAMHS Task Group was established jointly by the Children’s Select Committee and this Committee to look at the re-commissioning of the CAMH service, access and referral points to CAMHS, as well as how this service fitted into the overall mental health offer for children and young people in Wiltshire. This final report would also be considered by the Children’s Select Committee at its meeting on 8 January 2019.

Cllr Alford explained that the Task Group agreed that when comparing the re-commissioned model with the former CAMHS model, the changes to the service had been made in appropriate areas and the commissioners had clearly been very forward-thinking in their efforts. Although there was still work to be done to truly capitalise on these changes and deliver even greater mental health outcomes for children and young people in Wiltshire, progress was being made. The key areas where the Task Group felt that CAMHS could deliver an even greater service related to accessibility, communication and transition arrangements between CAMHS and adult mental health.

During discussion, Members congratulated the Task Group on the valuable and important work it had been undertaking and highlighted the need identified for improved communication at all levels which it was noted would be investigated at greater level by the Task Group when it reconvened in September 2019.

Resolved:

(1)          To endorse the six recommendations as set out in the Task Group’s report, with the addition to Recommendation 2 of “and previously looked after children” and to ask the Children’s Select Committee to include this addition in its resolution when it considers the report on 8 January 2019.

(2)          To endorse the areas the Task Group wishes to explore further to clarify any misinformation previously received.

(3)          To receive a further update in due course in 2019.    

To receive an update on the outcome of the safeguarding adults reviews considered at the Health Select Committee on 24 April 2018, as well as other work undertaken by the board since then.

The Committee received an update from Richard Crompton, Independent Chair of the Wiltshire Safeguarding Adults Board, on the outcome of the safeguarding adults reviews considered by this Committee on 24 April 2018, in addition to other work undertaken by the Wiltshire Safeguarding Adult Board since then.  

He reported that the Council, together with police and health partners, had launched a multi-agency safeguarding hub to improve outcomes for adults at risk.

Two reviews had been commissioned, one of which involved the death of a vulnerable, homeless adult and it was anticipated that valuable learning would be achieved from this exercise.

A self-assessment audit and peer challenge event identified key issues across the local system, including a need to increase understanding of adult safeguarding and of the Mental Capacity Act 2015.  Following the peer challenge, the Board ran a learning event which was very well attended on the application of the Mental Capacity Act.

Wiltshire Council remained the majority funder but Wiltshire Clinical Commissioning Group and Wiltshire Police had increased their contributions to the Board to ensure that its work was multi-agency.

It was noted that one board manager and team now co-ordinated work across the Board and Community Safety Partnership to improve the effectiveness of partnership working.

After some discussion,

Resolved:

(1)          To note the contents of the verbal report.

(2)          To receive the yearly update from the Wiltshire Safeguarding Adult Board and information on the three-year strategy at the Committee’s meeting on 30 April 2019.

(3)          To ask the Cabinet Member for Adult Social Care to draw to the attention of Area Boards, via the Community Engagement Managers, the work of the Adult Safeguarding Board and the ways in which to refer any safeguarding concerns to the Multi-Agency Safeguarding Hub (MASH).

The views of Mr Andy Milroy, a local resident, were received who explained his objections to the Transformation Plan. He considered that the recent decision by Wiltshire Health Care to close Trowbridge Minor Injury Unit at night was a very dangerous precedent and meant that potentially any health service in Wiltshire could be closed arbitrarily with no public consultation. The Trowbridge Minor Injury Unit was the only all-night minor injury facility providing a service throughout the night in the whole of West and North Wiltshire, with patients travelling from surrounding towns including Devizes, Frome, Melksham and Warminster. He stressed the need for detailed statistical information which he considered was currently lacking.  This was vital in order that a valid decision could be made following the public consultation exercise.

The Chairman, on behalf of the Committee, thanked Mr Milroy for his statement. It was reported that officers were in contact with Mr Milroy and it was noted that statistical data was becoming available. Members were informed that due to the costs involved in providing the current level of service maintaining the status quo was not an option.

To consider the outcome report from the rapid scrutiny exercise that took place on 12 November 2018 to consider the proposal for public consultation on the Maternity Transformation Plan. ( report to be circulated)

The Committee received the outcome report from the rapid scrutiny exercise that took place on 12 November 2018 to consider the proposal for public consultation on the Maternity Transformation Plan.

The Chairman reported that the rapid scrutiny received a detailed presentation on the Maternity Transformation Plan, including the reasons for the overall review of the services.

Based on the evidence received, the rapid scrutiny exercise made the following recommendations:-

i)             the public consultation on the Maternity Transformation Plan, as presented, be undertaken

ii)            the relevant Overview and Scrutiny committees for Bath and North East Somerset, Swindon and Wiltshire councils be informed of

a)    progress on the consultation 

b)    the outcome of the consultation

After some discussion,

Resolved:

(1)          To endorse the report and recommendations of the rapid scrutiny exercise.

(2)          To receive an update on, or if available the outcome of, the consultation at the April 2019 meeting of this Committee.

To receive a verbal update on progress with regards to the public consultation on the Maternity Transformation Plan.

The Committee received a verbal update on progress with regards to the public consultation on the Maternity Transformation Plan.  A copy of the slides referred to in the update are attached at Appendix 1.

Resolved:

To note the update from the Clinical Commissioning Group.

To consider two reports from the Rapid Scrutiny exercises which took place on 8 November 2018.

The Committee considered two reports from the Rapid Scrutiny exercises which took place on 8 November 2018.

The Chairman, as lead Member for the two exercises stated that he considered these to be valuable exercises and acknowledged the Cabinet Member’s engagement as well as the enthusiasm and contributions from officers involved. 

The Chairman introduced a report which set out the findings and recommendations of the rapid scrutiny exercise on an extension of intermediate care bed service contracts for 2019-2020.  It was noted that due to the scheduling of meetings, this report was presented to Cabinet on 8 November 2018.

During discussion, it was recommended that the timings of meetings should be addressed to ensure whenever possible that task group recommendations could be considered by a Select Committee prior to proceeding to Cabinet.

On hearing from the Cabinet Member for Adult Social Care, Public Health & Public Protection, it was noted that the review of beds had started in September 2018 and would conclude in February 2019. The rapid scrutiny had therefore invited the Cabinet Member to inform this Committee of the outcome of the review at its next meeting on 5 March 2019.

Resolved:

(1)          To endorse the report of the rapid scrutiny exercise.

(2)          To request that the outcomes of the review, together with the Executive Response, be provided to the Committee at its meeting on 5 March 2019.

Consideration was given to a report which set out the findings of the rapid scrutiny exercise on an extension of specialist commissioning contracts for supported living, floating support and supported housing.

On hearing from the Cabinet Member for Adult Social Care, Public Health & Public Protection,

Resolved:

(1)          To endorse the report of the rapid scrutiny exercise.

(2)          To request that the Committee be provided at its next meeting in March with an update on the model for procurement that would be adopted following this review work, in terms of the “direction of travel” for the contracts, including the feedback from providers and service users and if possible highlighting the main changes from previous contracts.

(3)           To request that the Committee, either at meetings or through its Chairman and Vice-Chairman, be kept informed of progress in terms of key milestones being reached on time for the work to be undertaken prior to tender.

To receive any verbal updates on recent activity for active task groups and from members of the Health Select Committee who have been appointed as overview and scrutiny representatives on programme boards.

Resolved:

To note that there were no task group updates since the last meeting.

The Committee is asked to consider the work programme.

The Committee received a document showing the relevant items from the Overview & Scrutiny Forward Work Programme.

Resolved:

To note the Forward Work Programme for this Committee.

To consider any other items of business that the Chairman agrees to consider as a matter of urgency.

There were no items of urgent business.

Currently future meeting dates for the committee are as follows:

5 March 2019, 2.00pm

 30 April 2019, 2.30 pm

11 June 2019, 2.30 pm

3 September 2019, 2.30 pm

5 November 2019, 10.30 am

14 January 2020, 2.30 pm

3 March 2020, 10.30 am

It has been noted in the past that afternoon meetings are not the preferred option for the committee, alternatives are being investigated and options will be brought for consideration by the committee on 18 December 2018.

Resolved:

(1)          To note that the next scheduled meeting of this Committee was due to be held on Tuesday 5 March 2019, starting at 2.00pm.

(2)          To agree that the June 2019 meeting of this Committee be moved from Tuesday 11 June at 2.30pm to Tuesday 25 June, starting at 10.30am.