Agenda and minutes

Members are reminded that at the start of the meeting, they should declare any known interests in any matter to be considered and also during the meeting if it becomes apparent that they have an interest in the matters being discussed.

The Chair reminded members of the need to declare any known interest in any matter to be considered by the Committee.  No declarations were made.

See explanatory note below.  Please phone the Committee Officer whose name and number appears at the top of this agenda if you need further guidance. 

Mr Roy Warman, Swindon resident, asked a number of public questions regarding the future ambitions of the Clinical Commissioning Group (CCG), particularly regarding a) the reasons for the CCG mergers, b) how future statistical measurement of performance would be compared to the current performance structure and c) the current organisational structure of the CCG.    

The Chair thanked Mr Warman for his questions and Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning Group (CCG) responded at the meeting. 

Resolved –

1.    That the Executive Nurse at NHS Swindon Clinical Commissioning Group be requested to circulate a copy of the Clinical Commissioning Group’s structure to include Tier 2 officers. 

2.    That the Executive Nurse at NHS Swindon Clinical Commissioning Group be requested to update the Committee at its meeting in September 2020 on progress made by the CCG following its merger.

To receive the minutes of the meeting held on 5^th November 2019.

Resolved -That the minutes of the meeting held on 5^th November 2019 be confirmed and signed as a correct record.

The Corporate Director Adult Social Services and Health, submitted a report providing an update on performance and key issues relating to Adult Social Care commissioning.  The Cabinet Member for Adults and Health presented the report and explained that the report had been structured to highlight the strengths and challenges of the work undertaken and drew the following key issues to member’s attention:

• The rising demand for domiciliary and residential care and how this has resulted in financial pressures.
• How the implementation of the living wage will also affect the Adult Social Care budget.
• How the work of Planning Live Co-ordinator was to enable young people with additional needs to focus on their wishes and ambitions for adulthood.
• The new safeguarding reporting model had been implemented and that this report only reflected the period between April and 14 November 2019. 
• How the permanent admissions to residential care and nursing homes were above target for adults aged from 65 years onwards and the actions being undertaken to address this.
• The assessment and reviews of carers undertaken between April and December 2019.
• How a range of initiatives by different partners were underway to tackle obesity and promote physical activity.
• How the Local Authority was working with Her Majesty Revenue and Customs to tackle the illegal sale of tobacco in Swindon.
• That “Stoptober” was the 28-day stop smoking challenge launched by Public Health England (PHE) in October 2012, to encourage and support smokers across England towards stopping smoking.
• How free flu vaccination was offered to front-line health and social care workers and Council employees.
• The success of the Live Well Swindon Hub (https://www.swindon.gov.uk/homepage/94/live_well_swindon_hub
• The number of new clients signing up to coaching and support provided by the Community navigators.
• How Swindon Circles continue to match volunteers to people who are unable to leave their home and who experience loneliness. 
• How the Community Health & Well Being Team promoted programmes of activities to attract individuals who are inactive.
• The work of the dementia friendly co-ordinator in promoting areas in Swindon to become more dementia friendly.
• Actions being taken with partners to address mental health and wellbeing issues included the implementation of the suicide and self-harm prevention strategy.
• The focus on reducing the numbers affected by a delayed transfer of care.
• How care homes were being assessed and supported to enable them to be rated as Good or Outstanding.
• How, through monitoring by the Clinical Commissioning Group, the voluntary sector providers make an important contribution to the health and wellbeing of people in Swindon.

Following the presentation, the Cabinet Member for Adults and Health together with the Director of Adult Services and the Interim Director of Public Health, responded to members’ questions and comments on the following matters:

• The need to ensure social workers and staff in care facilities report any injuries sustained at work to the Health and Safety team.
• The benefits of sustaining an active lifestyle by taking part in a range of individually tailored activities provided by various professionals.  
• How social workers  ...  view the full minutes text for item 35.

The Corporate Director Adult Social Services and Health submitted a report outlining how the Health & Wellbeing Board consults and engages with the public on the engagement activities undertaken by Health Watch, the Clinical Commissioning Group and Great Western Hospital.  The Interim Director of Public Health introduced the report and referred to how, where and when the Health and Wellbeing Board promoted greater integration and partnership working between bodies from the NHS, public health and local government.  He also drew attention to the work of Healthwatch Swindon and how it supported the work of the Health and Wellbeing Board.

Resolved – That the report be noted.

The Head of StreetSmart Services submitted a report that provided an update on the current process for needle disposal within Swindon as delivered by StreetSmart Services.  He confirmed that the main aims of the disposal service was to ensure that needle waste was collected in a safe and efficient manner with the aim of limiting the public’s exposure to needles.  The Head of StreetSmart Services explained a) the difference between scheduled and unscheduled collection processes and b) the common areas routinely attended for collection.    

Following the presentation of the report, the Head of Streetsmart Services, responded to members’ questions and comments on the following issues:

• The disposal of needles.
• How sharp boxes were not openly available on Swindon streets and that drug users are encouraged to dispose of needles at appropriate localities that included pharmacies.
• The difference between static and unscheduled collections.
• The need of continued support from Public Health to guide drug users to dispose of needles in a safe manner.
• How discussions with Public Health officers may include the possibility of having needle bins available in hot spots. 
• The Department’s service level agreement ensures collection of needles within a four hour timeframe.
• Regular visits to collect needles were made by StreetSmart services to areas commonly frequented by drug users. 

Resolved –

1.    That the report be noted.

2.    That the Head of StreetSmart Services liaises with the Senior Public Health Manager and the Interim Director of Public Health regarding the feasibility of locating needle bins around hot spots for drug users in Swindon to utilise and report back to the Committee with an update at a meeting in the new Municipal year

The Interim Director of Public Health submitted a report that provided an update on the current needle exchange programme commissioned by the Council and delivered throughout Swindon.  The Cabinet Member for Housing and Public Safety, together with the Senior Public Health Manager introduced the report and advised that the report outlined the purpose and benefits of the programme, and elaborated on the mitigating actions undertaken to address the environmental impact of the programme.  The Senior Public Health Manager drew the following key issues to member’s attention:

·        The needle and syringe exchange scheme being run through 14 participating pharmacies.

·        The role of substance misuse commissioning in tackling needle waste detritus.

·        Future actions to be undertaken included continuing the campaign to raise awareness and a review of the needle exchange provision to ensure it meets the needs of people who inject drugs in Swindon. 

·        Multi-agency involvement in addressing drug related litter.

·        A review of the needles exchange pack.

Following the presentation of the report, Councillor Cathy Martyn, with the Senior Public Health Manager, responded to members’ questions and comments on the following issues:

·        How Turning Point provided support with drug users unwilling to engage.

·        The offer of support by Homeless Organisations Standing Together in Swindon.

·        How alternative options to support drug users could be investigated to provide alternative options and improve the lives of users, reduce the risk to the public and improve the environment of public places.

·        The current benchmarking exercise with other local authorities to identify good practice.

·        How pharmacists taking part in the needle and syringe exchange scheme were trained to provide on-going support. 

·        The need to improve engagement with service users to obtain their view and understanding of the needle exchange programme to ensure the service makes a difference to their lives.  

Resolved –

1.    That the report be noted.

2.    That Councillor Bob Wright forward the list of alternative options, not highlighted in the report, to the Cabinet Member for Housing and Public Safety to enable discussions with external agencies regarding supporting drug users whilst ensuring public safety.

3.    That the Senior Public Health Manager be requested to update the Committee, at a meeting during the next Municipal year, on the needle exchange programme indicating how the Committee was able to provide further assistance in this programme.  

The Cabinet Member for Housing and Public Safety with Corporate Director of Communities and Housing submitted a joint report updating the Committee on the Council’s work in relation to private sector empty homes. The Housing Strategy and Development Manager introduced the report and explained that the report provided an understanding of the myriad reasons why a property may be empty; a) the limited actions the Council could take due to these factors; b) the current number of empty homes in Swindon; c) financial resources available, and d) an update on the enforcement work being undertaken by the Council under Section 215 of the Town & Country Planning Act 1990. The Corporate Director of Communities and Housing confirmed that the Housing Service acted as a co-ordinator for those in the community requiring support when dealing with empty properties. He elaborated on the number of council services offering specialist support that included the environmental health and revenue benefits teams.    

Following the presentation of the report, Councillor Cathy Martyn, with the

Corporate Director of Communities and Housing, responded to members’ questions and comments on the following issues:

• The role of the empty homes project manager.
• The access neighbours of empty houses had to guidance offered by Council staff.
• The impact on community amenities of having empty properties in an area.
• Section 215 powers to address dealing with empty properties in an area.
• The costs associated with legal routes the Council may adopt to convert empty properties.
• Offering financial support to owners of empty properties enabling them to refurbish and sell or bring properties back into use.
• How departments were co-ordinating their work to enable a range of officers to enforce Section 215.  

Resolved –

1.    That the report be noted.

2.    That a cross party motion be submitted to Council to encourage property owners to ensure their properties are occupied.  

3.    That the Housing Strategy and Development Manager be requested to review legal implications and undertake a benefits analysis regarding the use of Section 215 by a range of Council services.

4.    That further to (3) above, the Housing Strategy and Development Manager be requested to update the Committee at a future meeting.

Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning

Group (CCG), presented a report providing the Committee with a performance update and a summary of key issues in relation to the planning and provision of health and social care services within the Borough. Issues reported on by Ms May included:

·         The results of the Diversity Impact Assessment undertaken on the decision to withdraw the walk-in centre, which is based within the Swindon NHS Health Centre on Islington Street.

·         How winter pressures affected urgent care services, particularly regarding the lack of available ward-based beds for emergency overnight admissions. 

·         The increase in the number of patients waiting for an elective procedure or routine operation negatively impacted performance data.

·         Service improvement following the merger of Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Groups into a single organisation. 

·         The new referral process for children living with, and needing support for autism.

·        How Medivo assisted vulnerable patients who frequently visit the Accident and Emergency department.

Following the introduction of the report, Ms May responded to members’ questions and comments on the following issues:

• How a break-out area within the Accident and Emergency waiting room would enable staff to relay information confidentially in a private environment. 
• The waiting space within the Accident and Emergency waiting room being occupied by patients. 
• How whilst there was a successful recruitment exercise to attract primary care staff to Swindon, there was still a shortage to be addressed.
• The benefits of sign-posting patients to alternative treatment sources to primary care
• How information on alternative services to primary care could be accessed through NHS Choices and NHS 111.

Resolved –

1.    That the report be noted.

2.    That information regarding:

a)    Primary care recruitment and

b)    The promotion of self-care and self-selection of alternative services be included in a report to be submitted to the Committee in the next Municipal year.

Mr Kevin McNamara, Interim Chief Executive, Great Western Hospital (GWH) NHS Foundation Trust, submitted a report providing the Committee with a performance update and a summary of key issues in relation to the planning and provision of health and social care services provided by the hospital.

Resolved –

1.    That the report be noted.

2.    That members be invited to submit any questions to the Committee Officer for circulation to the Great Western Hospital (GWH) NHS Foundation Trust.

The Committee received a report by the Operations Manager, Avon and Wiltshire NHS Partnership Trust (AWP) that highlighted the achievements of the organisation and provided a summary of the challenges it was facing. Mr Alex Chesterton, Operations Manager, Avon and Wiltshire NHS Partnership Trust (AWP) presented the report and drew the following key issues to member’s attention:

• The re-appointment of Charlotte Hitchings as Chair of AWP.
• AWP’s continued excellence and outstanding care staff provide to patients and the support they give to families and carers.
• The imminent inspection by the Clinical Commissioning Group.
• Working in partnership with Turning Point to provide clinicians an opportunity to share good practice.
• How AWP staff worked closely with Council staff  on Adult safeguarding
• The successful recruitment drive to ensure quality improvement of projects whilst also supporting teams to focus on commissioned work.
• How the local acute care pathway has reduced the number of Out of Borough placements for Swindon residents.
• The number of people accessing the Health Based Place of Safety under Section 136 of the Mental Health Act 2007 over the last three months.

Following the introduction of the report, Mr Alex Chesterton, Operations Manager for Swindon, responded to members’ questions and comments in respect of the following matters:

• How Child and Adolescent Mental Health Services (CAMHS) services was an early intervention service that provided children, young people, parents and carers with help and advice to deal with behavioural or other problems their child was experiencing.
• How AWP worked with Child and Adolescent Mental Health Services (CAMHS) in Swindon and Oxford to help support families.
• The work being undertaken at the 24-hour staffed, four capacity health based place of safety at Green Lane Hospital in Devizes and how patients were triaged at various points to determine the level of risk.
• The various ways AWP engaged with rough sleepers and homeless people.
• How recruitment was still a challenge and the continued drive to recruit staff.
• The rotation of staff to match demand.

Resolved –

1.    That the report be noted.

2.    That the Operations Manager, Avon and Wiltshire NHS Partnership Trust be requested to include in-depth details of actions being taken regarding issues faced by the Trust in the next report to the Committee and to provide clarity on how the Committee would be able to support the Trust

3.     

The Committee considered a report by the Chief Legal Officer on the Committee’s work for the Municipal Year, 2019/20. The Committee heard that with regards to the Empty Homes report, legal implication and cost analysis should be undertaken and the Committee updated.

The Committee reviewed the work programme and requested that it be updated to reflect actions contained in this report and recommendations of the Committee.

Resolved:–That the details and activities included in the work programme for 2019/20, be noted.