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 interests in any matters to be considered at the meeting.   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. 

In accordance with Standing Order 28, Mr Roy Warman, Swindon resident, submitted written questions regarding Medvivo’s performance and ambulance handover delays. 

The Chair thanked Mr Worman for his questions and advised the Committee that a written response had been provided.  Mr Worman was at the meeting and asked supplementary questions regarding a) lack of information about Vocare on Medvivos’ website; b) the publication of a CCG report regarding Medvivos’ performance; c) Great Western Hospital (GWH) capacity following the increase on Swindons’ population; d) any grants to be received from Central government.  Mr Kevin McNamara, Chief Executive, Great Western Hospital NHS Foundation Trust, Mr David Freeman, Chief Operating Officer, NHS Bath & North East Somerset, Swindon and Wiltshire Clinical Commissioning Group and Ms Emma Smith, Head of Urgent Care, NHS Bath & North East Somerset, Swindon and Wiltshire Clinical Commissioning Group, responded at the meeting.

In response to a question from the Chair, Mr McNamara confirmed that GWH was reviewing the possibility of becoming a university hospital in the future.

Resolved - That the Head of Urgent Care, NHS Bath & North East Somerset, Swindon and Wiltshire Clinical Commissioning Group be requested to circulate information regarding the patient engagement groups set-up.

To receive the minutes of the meeting held on 3^rd September 2020.

Resolved - That the minutes of the meeting held on 3^rd September 2020 be confirmed and signed as a correct record.

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 arrival of Covid 19 has resulted in a change of working practices where the majority of appointments with patients were being conducted virtually.

·         The recommencement of quality governance following a hiatus in the beginning of the year due to Covid-19. 

·         The launch of the staff wellbeing initiative where the staff was provided with a wellbeing booklet.

·         Details of the work being undertaken by the Interim Director of Transformation.

·         How AWP signed-off increased spending to cover the growth in mental health services.  

·         Its recent successful recruitment drive.

·         The increase in demand for services, particularly for patients with Autistic Spectrum Disorders.

·         The impending decision by Trust Ligature Reduction Group regarding funding for work to be undertaken at Applewood Ward.

·         The trust-wide staff survey currently being undertaken that will shape the development of future plans.

·         The effective management of caseloads by community teams.

·         The recommencement of virtual group and 1:2:1 meetings by LIFT Psychology Services. 

·         How the use of various technology packages was allowing the Trust to continue close engagement with service users.

·         The partnership working with Medvivo.

·         How the local acute pathway continued to minimise out of borough placements.

·         The number of people detained under Section 136 of the Mental Health Act over the past quarter.

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 patients with medical needs other than mental health issues are being supported, particularly during the current pandemic, to ensure their needs were met.
• How staff health and well-being was part of the Human Resources function and that staff were being supported by external agencies best able to supply specialist advice.
• That funds that were earmarked for new services. 
• How services for mental health patients with Autism Spectrum Disorder (ASD) were supported by a range of specialist agencies and was driven by patient need.   
• That whilst there was no dedicated rough sleepers point of contact at the Trust, targeted support for the homeless in Swindon was provided with the assistance of other partners.
• The Trusts’ focus on obtaining additional digital resources, particularly as a number of staff were working remotely.
• The distinction between registered and unregistered staff, their range of skills and qualifications. 
• The Apprenticeship programme and how the Trust supported agency staff if they wanted to become permanent members of staff. 
• Waiting times for ASD assessments.
• How demand currently outstrips capacity and that additional funding will provide an extension of existing services.

Resolved - (1) That the report be noted.

(2) That the Operations Manager, Avon and Wiltshire NHS Partnership Trust (AWP) be requested to circulate information before the next  ...  view the full minutes text for item 11.

The Corporate Director of Adult Social Services, Health & Housing, the Chief Operating Officer, Chief Operating Officer, NHS Bath & North East Somerset, Swindon and Wiltshire (BaNES) Clinical Commissioning Group (CCG), and the Chief Executive at Great Western Hospital (GWH) Trust presented a report updating the Committee with pertinent information relating to the Council’s, CCG’s and GWH and Community Services response and recovery from the coronavirus pandemic. 

The Corporate Director of Adult Social Care, Health & Housing set the background to the report in a global, national and local context, in particular elaborating on the number of cases and deaths in Swindon. From an Adults Services, Health and Housing perspective, she referred to the following:

·        Daily hospital discharge services being provided that will continue as part of the recovery work.

• The Learning Disability Services has focused on short term breaks for some families at Firehorn.
• Opening of OK4U whilst still ensuring social distancing.
• Financial support to care providers.
• Continual monitoring of Personal Protection Equipment for social care providers.
• Working with partners to implement government regulations that are part of the Winter Plan.
• The management of Covid-19 cases and outbreaks.
• The location of Covid-19 testing sites in Swindon. 
• The work of Covid- 19 Marshalls in the town centre.
• The Council’s lead in supporting rough sleepers during the pandemic as the volunteer sector was currently restricted in what services they were able to offer.
• Dedicated support provided by the Housing Department to support tenants in difficulties and rent arrears due to Covid-19. 
• The recent recommencement of non-urgent repairs for Council tenants. 

The Chief Executive (GWH) drew the Committee’s attention to the following points:

• The number to date of Covid-19 patients cared for and how the rate of discharge was less than cases in March and April 2020.
• The push for greater laboratory capacity to ensure quick turnabout testing of potential Covid-19 patients.
• Increase in the number of control room meetings continue to oversee care capacity.
• Reiteration of government guidance regarding the use of personal protection equipment and social distancing.
• The adverse effect on undertaking routine medical procedures due to Covid-19.
• How the community could help by contacting the hospital when appointments cannot be kept.
• The dedication and hard work of staff during this difficult time.

The Chief Operating Officer, Chief Operating Officer, NHS Bath & North East Somerset, Swindon and Wiltshire Clinical Commissioning Group drew the Committees’ attention to the following points:

• Partnership working to tackle the demands of Covid-19 on Swindon residents and how recently published guidance indicate the measures to be undertaken by partners.
• The make-up and remit of the BaNES, Swindon & Wiltshire (BSW) Sustainability and Transformation Partnership (STP) Urgent Care & Flow Board.
• The planning and roll out of the flu vaccine.
• How out-of-hospital demand and capacity modelling was being undertaken.
• Primary Care networks established hubs to manage demand from patients presenting with Covid-19 symptoms.
• The hard work of primary care to support those in the community by targeting health needs that may have gone unmet, increased,  ...  view the full minutes text for item 12.

The Chief Operating Officer, NHS BSW Clinical Commissioning Group, presented a report that provided the Committee with a report on the earlier closure of Swindon’s Walk-in Centre as the local health services responded to the unprecedented challenges posed by the first wave of the coronavirus pandemic.  He explained how this enabled staff to be re-deployed to the Urgent Care Centre at Great Western Hospital (GWH).   Members noted that to comply with social distancing rules, a permanent needle exchange point was set up at an alternate location within the Swindon NHS Health Centre, while a dedicated phlebotomy clinic, which had previously been running from the centre, became a mobile operation as part of the Covid-19 response.   He concluded that the Walk-in Centre’s withdrawal did not impact on any of the other services based in the Swindon NHS Health Centre, such as the pharmacy, sexual health clinic and emergency dentist, all of which have continued to run as normal. 

Following the presentation of the reportthe Chief Operating Officer (BSW), responded to members’ questions and comments on the following issues:

·         How patients would benefit by enhancing the current transport available to Moredon Centre by utilising a one bus system.

·         The support available via the Carfax Street Centre and Wellbridge Centre to the homeless. 

Councillor Cathy Martyn, Cabinet Member for Housing and Public Safety reminded the Committee that the report regarding the needle exchange programme will include information on rough sleepers and will be submitted to the Committee meeting on 28^th January 2021.  Additionally, the report regarding homelessness and meeting housing needs of the vulnerable will be submitted to the Committee meeting on 22^nd April 2021.

Resolved - That the report be noted.

The Committee considered a report by the Chief Operating Officer, NHS Bath & North East Somerset, Swindon and Wiltshire (BSW) Clinical Commissioning Group, providing an update on ambulance handover delays at Great Western Hospitals (GWH) NHS Foundation Trust and the actions being taken to reduce any implications this has for Swindon residents awaiting an ambulance response. 

The Chief Operating Officer, (BSW) CCG,together with the County Commander, Wiltshire and Swindon, South Western Ambulance Service NHS Foundation Trust and the Head of Urgent Care, (BSW) CCG, drew the Committee’s attention to the following points:

·         South Central Ambulance Service Foundation Trust also transfers patients to Great Western Hospital (GWH) from Oxfordshire and Berkshire routes.

·         The handover delay risks were associated with increased demand and reduced capacity and how these were mitigated by BSW CCG.

·         How each Trust were assessed against the ECIST (Emergency Care Intensive Support Team) Ambulance Key Lines of Enquiry. 

·         The partnership working between South Western Ambulance Services Trust (SWAST), together with Commissioners, the hospital trust, and health and social care partners to reduce Emergency Department and ambulance demand and improve patient flow through the system.

·         An explanation of the triage process undertaken following a 999 call.

·         Employment of an additional nurse at Salisbury, GWH and, Bath United

Hospitals to manage queues and support staff and patients on arrival at the acute centres. 

Following the presentation of the report, the Chief Operating Officer (BSW), the County Commander, Wiltshire and Swindon, South Western Ambulance Service NHS Foundation Trust, the Head of Urgent Care,  BSW), and the Chief Executive at GWH responded to members’ questions and comments on the following issues: 

• How ambulances are staffed by fully qualified paramedic teams and deployment to a patient does not rely on the medical issue the patient is experiencing.
• How community first responders support and compliment the work being done by ambulance paramedics.
• Performance details of the South Western Ambulance Service Foundation Trust regarding the “call stack” in September 2020 (patients waiting for an ambulance but for whom there is no available ambulance to be dispatched).
• The methods used to undertake Covid-19 testing for patients arriving by ambulance at emergency department and how resources are shared nationally. 

Resolved - That the report be noted.

The Committee considered a report by the Chief Legal Officer on the results of the work programme consultation and the suggested priorities of the work for the Municipal Year, 2020/21. 

At the Chair’s invitation, Councillor Cathy Martyn, Cabinet Member for Housing and Public Safety referred to an aspect of her portfolio.  She drew the Committee’s attention to the Prevent duty: Safeguarding from radicalisation.  The Counter Terrorism and Security Act 2015 placed a duty on specific groups, including local authorities, police, education and health.  She confirmed that the Prevent Duty’s objective is to respond to the ideological challenge of terrorism, prevent people from being drawn into terrorism and to work with sectors and institutions where people are risks of radicalisation. Members noted that the Community Safety Partnership team was working together with partners on this duty.

Resolved - (1) That the details and activities included in the work programme for 2020/21, be updated to reflect actions contained in this report and recommended by the Committee.

(2) That the Development Manager Risk Enablement officer be requested to present a report on the “Prevent Duty” at the Committee meeting on 22^nd April 2021.

(3) That further to (2) above, members of the Children’s Overview and Scrutiny Committee be invited to the meeting in April.

(4) That the Committee Officer be requested to liaise with the Cabinet Office regarding the circulation of meeting dates for the Cabinet Member Advisory Group set up to monitor such things as:- community engagement; relevant powers that officers can use; the threat that is posed to the wider community if lockdown continues for an extended time; any potential reduction in services; transfer of responsibility for someone in care; ensuring there is sufficient quality PPE for all those requiring it, etc.

(5) That the multi-agency report on Obesity be postponed from the January 2021 to 22^nd April 2021 meeting.