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 Cathy Martyn, Cabinet Member for Housing and Public Safety, submitted questions on behalf of local residents regarding a) how the NHS Swindon Clinical Commissioning Group (CCG) is addressing the problems currently being faced by the residents in Wroughton who are unable to book doctor appointments; b) what discussions are being held to address these issues; and c) what measures will be put in place to address the health needs of Wroughton’s future increased population.

The Chair thanked Councillor Martyn for the questions and advised that responses would be provided.

Councillor Claire Crilly submitted questions to the Committee questions on behalf of local residents, regarding adult day services and extra care housing. 

The Chair thanked Councillor Crilly and advised that responses would be provided to her after the meeting.

Mr Roy Worman (Swindon resident) asked questions regarding a) the involvement of Integral Medical Holdings Ltd (IMH) in the new hub at Moredon; and b) the conflicts of interest where GPs on the CCG are also partners in the practices involved in the Hub.

Ms Gill May, Director of Nursing at the CCG, responded to Mr Worman’s questions at the meeting.

Councillor Emma Faramarzi asked a question regarding the deadline for expected improvements at the Moredon Hub.

Mr Martyn Diaper, CEO of IMH, responded at the meeting.

Councillor Faramarzi asked supplementary questions regarding a) what the CCG classes as acceptable wait times for appointments; and b) how the CCG is addressing the cancellation of appointments by GP Surgeries, sometimes at short notice.

Ms Gill May and Mr Martyn Diaper responded at the meeting.

To receive the minutes of the meeting held on 6^th November 2018.

            Resolved -That the minutes of the meeting held on 6^th November 2018 be confirmed and signed as a correct record.

The Committee received a presentation from Ms Julie Marshman, Chief Nurse at Great Western Hospital (GWH), regarding the results from the planned Care Quality Commission (CQC) inspection which had taken place over the summer.

During the presentation, Ms Marshman drew the following issues to members’ attention:

·        That the CQC had awarded the GWH with an overall rating of ‘requires improvement’ ..

·         The ‘Good’ rating now being 78% overall on key lines of enquiry, demonstrating that there had been improvement since the last inspection.

·         The successful bid for £30m to help redesign emergency care at the hospital.

Following her presentation, Ms Marshman responded to members’ questions and comments on the following issues:

·        The improvements required in Medical Care, as identified by the CQC inspection, and the plans for addressing them.

·          The outcomes of the peer review that had preceded the CQC inspection, and how GWH measures itself and how the CQC undertakes its inspection.

·         The five departments that had been judged as requiring improvements under the ‘safety’ categorisation of the inspection, and what this meant in practical terms for implementing changes to make those improvements. 

·         The significant improvements made in service areas since the last inspection.

The Committee considered the remainder of the update report on key issues relating to GWH NHS Foundation Trust. Mr Kevin McNamara, Director of Strategy at GWH, responded to members’ questions and comments on the following issues:

·        The purpose of the private patient unit at the GWH, including to assist with any shortage of beds as well as generating income, and the medical conditions it is able to treat.

·         Previous reports provided by GWH on the work being done on sepsis, and the inclusion of an update on this in the report for the next meeting of this Committee.

·         The excellent work done by Mr McNamara in support of the Radiotherapy Appeal.

·         Possible reasons for the increase in attendances at the emergency department throughout December and January compared to the same period over the last three years.

·         The ‘smoke-free site’ at the hospital,

·         How GWH accounts for growth in the number of residents in bordering areas who may want to access its facilities.

Resolved – (1) That the report be noted.

(2) That the GWH be asked to provide a report to the first meeting of this Committee in the next Municipal Year, on the actions being taken to address the improvements required in Medical Care as identified by the CQC inspection, with a subsequent progress report to be given six months later.

 (3) That an update report on the work done by GWH on sepsis, be submitted to the next meeting of this Committee.

(4) That it be noted that a breakdown of emergency department attendance figures for the last three years, and the impact of the night time economy on the emergency department, will be included as part of the update report to the next meeting of this Committee.

The Committee considered a report from the NHS Swindon CCG, which provided an update on performance and a summary of key issues in relation to the planning and provision of health and social care services within the Borough.

Ms Gill May presented the report and drew the following key issues to member’s attention:

·        All registered patients at the five practices in the Moredon Hub had received a letter providing details on the rationale for the changes implemented, and how subsequent issues are being addressed.

·        A learning event is being planned within the next 6 – 8 weeks, to which key stakeholders and those members of the public who have lobbied or contacted the CCG regarding the problems at Moredon Hub, will be invited. The aim will be to work through learning points, and co-produce a plan for improvements.

The Chair invited members’ to put questions to Mr Martyn Diaper (CEO of IMH) on the recent problems experienced by patients of the Moredon Hub GP Practices. Issues raised by members included:

• Healthwatch Swindon’s unannounced observation of the call centre at the Moredon Hub on the 28^th January 2019, which had identified that only six people were answering telephone calls.
• The reasoning as to why IMH had commenced on a contract without enough staff to deliver it, the serious shortage of staff, and the lack of a recruitment drive prior to January.
• How the modelling for the contract had not shown the unmet demand due to the lack of information on missed / lost calls.
• The errors with the computer mail merge that resulted in letters being sent to registered patients at the five GP practices involved in the hub.
• The reasons for introducing a single call centre covering bookings for all five practices.

Ms May continued with the presentation of the report, and drew the following key issues to member’s attention:

• The success of a sustained reduction in delayed transfers of care, and the resilience amongst social care colleagues in coping with winter pressures.
• The introduction of a new model of supporting and caring for people who are at the end of their lives.
• The successful introduction of the ‘Red Bag Scheme’ in care homes, which assists with the admission of elderly people to hospital.
• The successful bid for funding to assist with early intervention on mental health issues in schools in Swindon.

Following the introduction of the report, Ms May and Mr Paul Vater, Chief Operating Officer at the CCG, responded to members’ questions and comments on the following issues:

• Future plans for the roll out of the ‘Red Bag Scheme’, and whether other schemes such as the ‘Bobby Van’ could assist the elderly, in their own homes, with being ready for admission to hospital should the need arise.
• The effect of targets being missed on the standards for cancer treatment, and how patient harm is monitored and measured.
• The reasons for the new model of service provision for the Swindon Walk In Centre and the Urgent Care  ...  view the full minutes text for item 36.

The Committee considered a report providing an update on performance and key issues relating to Adult Social Care commissioning.

Sue Wald, Corporate Director for Adult Social Services, responded to members’ questions and comments on the following issues:

• The current consultation on proposals to reshape day centres, and how those fit in with supporting individuals.
• The success of the recent event on dementia held at the County Ground,
• Work being done to improve the numbers of Learning Disability reviews that are undertaken.
• The 30% increase in referrals being received by the Safeguarding Team, as compared to the same period last year, an analysis of which will be brought to the next meeting of this Committee.
• The plans for improving the nursing home in Swindon which has been rated by the CQC as ‘inadequate’. 
• The low number of carers who have received an assessment or review since April 2018, and plans for increasing the frequency of assessments.
• The plans for diverting people into community based solutions to help ensure they maintain and prolong their independence, including maximising working opportunities with voluntary based organisations and community navigators. Details on case studies will be included in the report to the next meeting of this Committee.
• The funding for the Community Navigators, by the CCG, and how they cover both Swindon and Shrivenham.

Resolved – (1) That the report be noted.

(2) That it be noted that an analysis of the 30% increase in referrals being received by the Safeguarding Team, as compared to the same period last year, will be brought to the next meeting of this Committee.

(3) That details on case studies in respect of community based solutions will be included in the report to the next meeting of this Committee.

The Committee considered a report setting out the key current challenges and successes in the Housing Services.

Councillor Cathy Martyn, the Cabinet Member for Housing and Public Safety, and Mr Mike Ash, Head of Housing, responded to members’ questions and comments on the following issues:

• The excellent work undertaken with the homeless over the winter months.
• The good feedback being received from users of The Haven, a new night shelter in Swindon.
• The attendance at the Breakfast Club of staff in the Housing Options Team, which has been recognised as the best time to engage with the homeless.
• The lack of understanding amongst agencies, such as probation services for example, of the duty to refer homelessness cases to the Council, and the actions being taken to help improve awareness.
• The costs of voids, given that close to £1m was lost in rents last year, and the work being done to ensure improvements in this area, such as the recent change of contractor. More information on voids will be provided in the report to the next meeting of this Committee, to help understand the conditions of houses, and how long they are empty.
• The reasons behind the closing down of repair work that has not met quality standards, tenants waiting too long for repairs, and incorrect information being reported to councillors about repair works. Members noted that there is a reporting mechanism entitled the ‘Right First Time’ report, for properties flagged as being missed or repeat visits. A report on housing repairs could be added to the Work Programme for the next Municipal Year at the Committee’s request.
• The various reasons for a property  being designated as void

Resolved – (1) That the report be noted.

(2) That a report be presented to this Committee at its first meeting of the new Municipal Year on the ‘Right First Time’ reporting mechanism.
(3) That it be noted that more information on voids will be provided in the report to the next meeting of this Committee.

The Committee considered a report providing an update on performance and key issues relating to Avon and Wiltshire Partnership NHS Trust (AWP).

Ms Nicola Hazel, Clinical Director across BANES, Swindon and Wiltshire at the AWP, responded to members’ questions and comments on the following issues:

• The relocation of the health based place of safety to Devizes, and evaluation of the impact this has had on service provision and the residents of Swindon in the subsequent twelve months.
• The positive feedback received in response to Healthwatch Swindon’s current telephone survey, in conjunction with Healthwatch Wiltshire, of those who have used the service in Devizes.
• The number of visitors to the health based place of safety in Devizes who come from outside the area.
• The health based place of safety unit covering the Avon and Somerset Police Force area, and the escalation process in place to transfer people from one unit to the other should one unit be full, to ensure the person receives an assessment within 4 hours.
• The scale of mental health issues amongst the homeless and the consequent importance that AWP attends forums discussing homelessness.

Resolved – That the report be noted

The Committee considered a report by the Interim Director of Law on the results of the work programme consultation, and the suggested priorities for the work for the Municipal Year, 2018/19.

The Committee noted that the meeting date in April had been cancelled, and that the Domestic Abuse Working Group would be presenting its report to the March meeting.

Resolved – (1) That the report be noted.

(2) That it be noted that an update on the Rough Sleeper Reduction Strategy consultation will be added to the Work Programme for the 5^th March 2019 meeting.