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, Councillor Emma Faramarzi asked a number of questions covering a) the merger of five surgeries in North Swindon, b) how they were operating, c) the affect this had on patient’s access to their doctors, d) whose responsibility was it for monitoring the new service and e) actions being undertaken to improve services.

          Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning Group (CCG),responded at the meeting.

          Councillor Dale Heenan, Cabinet Member for the Town Centre submitted to the Committee questions from local residents regarding the recent merger of surgeries in North Swindon under International Medical Holdings (IMH) Services and the impact this had on patients registered in the Liden and Eldene area.

          The Chair thanked Councillor Heenan and advised that a response would be circulated after the meeting.

          Councillor Heenan asked supplementary questions on behalf of Councillors Kevin and Barbara Parry and Mr Zachary Hawson, Parish Councillor for Eldene in their absence regarding a) the communication methods used to inform patients of the changes being implemented b) the methods to be used for future changes and c) how the Local Authority would be able to assist the CCG in relation to communicating relevant information to patients.  

          Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning Group (CCG),responded at the meeting and agreed to invite Committee Members and Councillor Dale Heenan to Moredon Medical Practice (the Hub) to review the work being undertaken.

          Resolved – That the Executive Nurse at NHS Swindon Clinical Commissioning Group extend an invitation to Councillors to view Moredon Medical Practice.

          Ms Kate Linnegar, Prospective Parliamentary Candidate for North Swindon, submitted a question regarding the role of IMH in running the following surgeries in Swindon: Taw Hill, Eldene, Abbey Meads, Phoenix, and Moredon.

          The Chair thanked Ms Linnegar for her question and advised that a response was tabled at the meeting.             

            Ms Linnegar was in attendance and asked a supplementary question regarding actions to be undertaken if IMH Group did not meet the required standards. 

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

         Mr Alan Rothwell of Toothill, submitted questions regarding the staffing and financial contributions made by the Local Authority to implement Health initiatives in Swindon and what actions were being taken to address the rise in the number of fast foods outlets in the town.  

          The Chair thanked Mr Rothwell and advised that a response was tabled at the meeting.

          Mr Rothwell was in attendance and asked supplementary questions regarding the training provided for volunteers helping the Local Authority implement Health initiatives in the town. 

          The Director of Public Health responded at the meeting.

          Ms Samantha Wathen, Chair of “Keep our NHS Public Swindon”, submitted a written question regarding the progress made in exploring PS Mike Hughes ideas around a safe assessment area as a viable alternative to the place of safety by both Swindon CCG and  ...  view the full minutes text for item 22.

To receive the minutes of the meeting held on 12^th September 2018.

Resolved -That the minutes of the meeting held on 12^th September 2018 be confirmed and signed as a correct record.

            Councillor Oliver Donachie, Cabinet Member for Economy Prosperity submitted a report updating the Committee on how the Council was helping people with heath and care needs and in receipt of social care to find and maintain employment.  Councillor Donachie presented the report and explained how national studies indicated a link between paid employment and better physical and mental health and that with the right support, employment was an achievable goal and increased independence, improved mental health, and the ability to learn and develop.

The Cabinet Member for Economy Prosperity drew the following key issues to members’ attention:

·         The Council’s Supported Employment Strategy was approved by the Health and Wellbeing Board on 10 October 2018.

·         The work of the Supported Employment Officer to develop an action plan to deliver the five objectives outlined in the strategy.

·         The range of internal and external stakeholders who were consulted with and who noted that a change of mind-set to deliver the strategy would be a challenge.

·         The key activities that had taken place over the past six months to deliver the strategy.

·         The activities to be undertaken over the next six months.

Following the introduction of the report, the Cabinet Member for Economy together with Councillor Brian Ford, Cabinet Member for Adults and the Director of Adult Social Services responded to members’ questions and comments on the following issues:

·         The tendency of volunteers to remain in situ over progressing to paid full time employment.

·         The project being promoted locally by the Routes to Employment Commissioner.

·         Measuring Swindon’s Employment Supported Strategy implementation against other local authorities.

·         Comparison between the current strategy and the previous Youth Training Schemes and the lessons learnt.

·         The Employment Supported Scheme’s impact on the Enterprise Works.

·         Designing training to ensure employers’ needs were met.

·         Provision of targeted career’s advice for people with learning disabilities. 

·         The resources being provided by the Local Authority to the Voluntary Sector. 

Resolved – (1) That the report be noted.

(2) That the Commissioner, Routes to Employment, be requested to circulate information on Swindon’s Employment Supported Strategy implementation against other local authority’s performance.

(3) That the Commissioner, Routes to Employment, be requested to provide information on the quality and quantity of careers advice available for people with learning disabilities.

Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning

Group (CCG), introduced Ms Lucy Baker, Interim Associate Director at Wiltshire CCG to update the Committee on how Bath and North East Somerset, with Swindon and Wiltshire CCGs were improving Maternity Services by providing more choice of maternity services to prospective mothers.  She advised that a consultation exercise with external stakeholders was currently being undertaken and would end on the 24^th February 2019.

Ms Baker responded to questions regarding the following matters:

·         Choices available to prospective parents were not determined by demographics or individual financial constraints.

·         The medical needs of some prospective mothers determine the location of a child’s birth to ensure clinical safety.

·         Engagement with prospective mothers who opt to stay in full time employment until the baby’s due date.

Ms Gill May then 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.  Ms May drew the following key issues to member’s attention:

·       The improvement in the call times for the Prescription Ordering Direct (POD) Service following the recruitment of more staff.

·       The replacement of the IT system which would help monitor patient flow.

·       The achievement of national standards for cancer referrals from doctors.

·       Waiting list for the provision of acute healthcare had improved against targets set by NHS England.

·       The consultation with patients, carers and the local community on the changes proposed when prescribing gluten free products.

·       The implementation of the Swindon and Shrivenham General Practice Forward View Delivery Plan.

·       Monitoring of the Swindon/GWH system Accident and Emergency Sustainability Plan for 2018/19 against key indicators.

·       The consultation of the Maternity Transformation Plan would commence in mid-November.

Following the introduction of the report, Ms May and Mr Kevin McNamara, Director of Strategy, Great Western Hospital (GWH) NHS Foundation Trust, responded to members’ questions and comments on the following issues:

·         Dealing with the increased volume of patient contacting the North Swindon surgeries during the week and how this was addressed by IMH Group.

·         The new technology being used by IMH Group and how the increased demand during some days of the week affected the volume of telephone calls.

·         The consultation being undertaken to review the number of prescriptions being written for gluten free products. 

·         Doctors’ training now included a focus on nutrition to help patients adopt a better lifestyle.

Resolved – (1) That the report be noted.

(2) That the Interim Associate Director at Wiltshire CCG be requested to attend the Committee’s meeting on the 29th January 2019 with an update on the Maternity Consultation exercise. 

Mr Kevin McNamara, Director of Strategy, Great Western Hospital (GWH) NHS Foundation Trust, submitted a report providing the Committee with a performance update and a summary of the following key issues in relation to the planning and provision of health and social care services provided by the hospital.  Issues reported on by Mr McNamara included:

·         Progress made in stabilising and improving Adult Community Health Services with the aim of creating a single integrated community and acute service.

·         The Home First Initiative pilot that saw patients discharged form hospital more quickly.

·         The Older Patients Pathway Pilot that focused on ensuring patients who arrived at the Emergency Department were assessed, treated and discharged with as little time spent in hospital as appropriate. 

·         The Trust’s positive progress against the “Sign Up To Safety” Initiative that helps ensure the NHS is the safest healthcare system in the world.

·         Progress made to recruit staff into the Trust.

·         Financial pressures faced by the Trust. 

Following his introduction of the report, Mr McNamara, together with

Councillor Brian Ford, the Cabinet Member for Adults, and the Director of Public Health responded to members’ questions and comments on the following issues:

·       The work of the Trust in implementing the Older Patient’s Pathway Initiative. 

·       Recruitment of students who were on placements at GWH.

·       The use of technology (Skype) to recruit staff from overseas. 

·       The recruitment campaign that promoted Swindon as a central location to live and work at. 

·       The support of the Asian community in Swindon when new people move into the area.

·       The support given to homeless people on discharge from the Emergency Department.

·       The Trust’s duty to refer homeless people to the appropriate services to enable them to get support. 

·       Planning financial budgets to ensure there was no adverse impact on current and future programmes.  

·       The work of the Primary Care in reducing diseases by promoting the benefits of healthy eating and lifestyle. 

Resolved – (1) That the report be noted.

(2) That the Director of Strategy, Great Western Hospital (GWH) be requested to circulate to the Committee an update on the Older Patients Pathway before the next meeting of the Committee.

The Committee received a report by the Clinical Lead, 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 Paddy McKee, Clinical Lead - Wiltshire Locality, Avon and Wiltshire NHS Partnership Trust (AWP), presented the report and drew the following key issues to member’s attention:

·         Following the implementation of the Trust Transformation Programme, changes to some models of care, which include Primary Care Liaison Service (PCLS) and the Acute Community Unit (ACU) were undertaken.

·         The development of a Trust wide programme to address recruitment and retention. 

·         The improvements within the bed management process that aided patient flow across the various STPs (sustainability and transformation partnerships).

·         Care Quality Commission report and findings pending following their inspection in September 2018.

·         As part of the Trust’s “Listening in Action Programme”, a staff survey was underway with results influencing future projects.

·         The Acute Community Unit pilot project was extended to January 2019.

·         The minimal delays in discharging patients from Applewood Court and offering alternatives to hospital admission.

·         The reduction of out of borough placements.

·         The recruitment to the substance misuse liaison posts.

·         The range of support provided by Swindon LIFT Psychology.

Following the introduction of the report, Mr McKee, together with Councillor Brian Ford, the Cabinet Member for Adults and Paul Vater, Chief Operating Officer, NHS Swindon CCG, responded to members’ questions and comments on the following issues:

·         The support provided by Swindon MIND on recruitment and service provision made available at Swindon’s “Calming Café”.

·         The preliminary comments by the CQC on the provision of internal and external break-out spaces for patients. 

·         The implementation of the Listening Action Programme and how this benefits patients.

          Councillor Brian Ford, the Cabinet Member for Adults informed the Committee that he was in discussion with the Planning Department regarding the infrastructure of the “Calming Café”.

          Resolved – (1) That the report be noted

(2) That Executive Nurse at NHS Swindon Clinical Commissioning

Group (CCG) be requested to include information regarding the environment for Section 136 patients at the next meeting of the Committee.

The Cabinet Member for Housing and Public Safety submitted a report updating the Committee on the arrangements being implemented to support those at risk of sleeping rough during the forthcoming winter months. The Head of Housing detailed some of the reasons for becoming homeless and sleeping rough and confirmed that the Rough Sleeper Reduction Strategy, which was developed in consultation with the Homelessness Organisations Stand Together in Swindon (HOSTS), was submitted to the Health and Wellbeing Board on 10^th October 2018 for their approval.   He also referred to the funding received from the Government’s Rough Sleeping initiative and elaborated on how the funding was to be used.  The Head of Housing advised that the Council voluntarily supports the Severe Weather Emergency Protocol (SWEP) and instigates the service when the temperature drops to 0 degrees or less for 3 consecutive nights.

Following the presentation of the report, Councillor Cathy Martyn, with the Head of Housing, responded to members’ questions and comments on the following issues:

·         The details of the Rough Sleeper Reduction Strategy which were now available on-line.

·         The opening of the Day Centre referred in 3.3 of the report and the arrangements being made to implement the Rough Sleeping initiative.

·         Importance of communication between commissioners and providers to ensure the Day Centre was a success.

·         Training stuff and volunteers at the Day Centre.

Resolved - (1) That the report be noted.

            (2) That the Head of Housing be requested to circulate an update regarding training staff at the Day Centre

The Director of Adult Social Services submitted a report that provided an overview of population change and ageing in Swindon and some of the implications for the economy, public services, society and the individual.  Councillor Brian Ford, Cabinet Member for Adults stated that this report provided positive news and that the community of Swindon would be able to benefit from the programmes being implemented.  Director of Adult Social Services advised that the data was collated in collaboration with the Public Health department and referred to the ageing population and changing structure of the population in Swindon that would bring both opportunities and challenges for the economy, services and society at national and local levels. 

Following the introduction of the report, the Director of Adult Services, with the Cabinet Member for Adults responded to members’ questions and comments on the following issues:

·         The impact on the community due to the declining levels of home ownership.

·         The need for the Planning Department to consider population growth in Swindon when reviewing the Local Plan.

·         The infrastructure put in place when new developments were given planning permission to ensure people did not feel isolated.

            Resolved – That the report be noted.

The Director of Adult Social Services submitted a report that provided an update on performance and key issues relating to Adult Social Care commissioning. She explained that the report had been structured to highlight the strengths and challenges of the work undertaken.  The following key issues were drawn to members’ attention:

·         The Learning Disability Services offering support service to enable those with disabilities to actively contribute to society.

·         The timely identification of adults at risk and robust compliance with adult safeguarding processes to ensure their safety.

·         A higher proportion of Swindon Care Homes judged as good or outstanding by Care Quality Commission.

·         Timely assessments and reviews for carers were being undertaken following the implementation of a new system.

·         The promotion of achieving a healthy weight and an active lifestyle has resulted in the reduction of excess weight prevalence in Swindon.

·         The approach being taken to reduce the number of people who smoke in Swindon.

·         The improvement in the delayed transfer of care provision.

Following the introduction of the report, the Director of Adult Services, with Brian Ford, Cabinet Member for Adults and the Director of Public Health responded to members’ questions and comments on the following issues:

·         The success of the “Beat the Street” exercise initiative and the plan to repeat this exercise next summer.

·         Ferndale School’s crowing as winners of the “Beat the Street” exercise initiative.

·         Robert Buckland MP’s campaign with the Swindon Seniors Forum, the police, the NHS, the Local Authority and the Third Sector to tackle the issue of loneliness.

Resolved – (1) That the report be noted.

            (2) That the Director of Adult Services be requested to include opportunities promoted by the University of the Third Age in the Councillor’s Bulletin.

The Committee considered a report by the Director of Law and Democratic Services on the results of the work programme consultation and the suggested priorities for the work for the Municipal Year, 2018/19. The Committee reviewed the work programme for the current Municipal year and requested that the Work programme for the Municipal year 2018/19 be updated to reflect actions contained in this report. 

            Resolved – That the report be noted.

          (2) That the Work Programme be updated to include the following two items to the Committee’s meeting on 29^th January:

• Joint report from the CCG and AWP on mental health.
• An update on Maternity services.