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.

            Councillor Steph Exell made a personal, non-prejudicial declaration of interest in respect of Agenda item 25 (Adult Health and Housing Placement Costs) due to out of borough placements.

            Councillor Junab Ali made a personal, non-prejudicial declaration of interest in respect of Agenda item 25 (Adult Health and Housing Placement Costs) as he was a landlord.

           Councillor Nick Martin made a personal, non-prejudicial declaration of interest in respect of Agenda item 25 (Adult Health and Housing Placement Costs) as he was a landlord.

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. 

No public questions were asked or submitted for this meeting.

To receive the minutes of the meeting held on 11^th September 2019.

Resolved –

1.    That the minutes of the meeting held on 11^th September 2019 be confirmed and signed as a correct record.

The Corporate Director Adult Social Services and Health gave a presentation regarding adult health and housing placement costs.  She referred to the Adult Social Care Budget for this financial year and drew attention to the number of placements for older people, mental health patients and those with learning disabilities.  She proceeded by providing information on the locations and cost of the placements.  The Committee’s attention was particularly drawn to the substantial number of out of borough residential placements for people with learning disabilities and she referred to the collaborative work being undertaken with the Housing Department to try and place people back within Swindon. 

Following the presentation, the Corporate Director Adult Social Services and Health together with the Head of Housing, and the Cabinet Member for Housing and Public Safety responded to members’ questions and comments on the following matters:

• The locations of external placement and how placements were allocated according to the needs of the individual. 
• How some people with learning disabilities had been in stable placements for a long period of time and it would be difficult to relocate them to Swindon.
• How the department would facilitate any request by an individual to move back to Swindon.
• How the Hawthorn Bungalows allow people from residential care to move back to Swindon.
• How means testing for adult social care was undertaken and that a contribution would be made by the individual dependant on their assets.
• How a joint working group with the Housing department is reviewing housing options and how any savings projections would be affected if premises were built to accommodate returning individuals from out of borough placements.
• The provision of specialist and affordable housing by the Council and local landlords.
• The different funding structures between housing options.  These related to those who pay rent and those who enter into a nursing home or sheltered accommodation.
• The Local Plan review would include information about support for older people particularly those wishing to remain in their homes and delay entry into residential care as long as possible. 
• How the data presented were historic and that only two out of borough placements were allocated this year as these met the needs of the individuals concerned.
• How due to the low number of dementia patients, care was provided for Swindon as a whole rather than by ward.

Resolved –

1.    That the Corporate Director Adult Social Services and Health and the Head of Housing be thanked for the informative presentation.

2.    That the Director of Adult Social Care be requested to update the Committee at its meeting on 24^th March 2020 on the progress made by the joint Adult Social Care and Housing working group.

3.    That, as part of the Local Plan review, the Head of Planning, Regulatory Services and Heritage be requested to assess the feasibility of including a number of sheltered accommodation units together with affordable housing units when developers submit site development plans.

4.    That the Director of Housing be requested to update the Committee on  ...  view the full minutes text for item 25.

Ms Gill May, Executive Nurse at NHS Swindon Clinical Commissioning Group (CCG), presented a report advising that Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) was asked to make significant improvements to the provision of two Health Based Places of Safety (HBPoS) in Swindon following two Care Quality Commission (CQC) inspections in 2016 and 2017, which rated these services as inadequate.  She explained that to address the concerns raised by the CQC, the AWP, Swindon CCG and Wiltshire C'CG recommended the temporary closure of the HBPoS suites in Swindon and Salisbury and the relocation of these services to a new, single, larger, purpose-built HBPoS in Devizes.  The Committee’s attention was drawn to the evaluation report that was produced with the aim of understanding the effect of the temporary changes to provision.  Ms May also drew attention to the strong community voice in Swindon who wanted to retain a Swindon place of safety and to Healthwatch’s independent view into the issue contributing to the option presented to the CCG’s governing body. 

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

·        The factors influencing the closures of the Swindon and Salisbury places of safety included the infrastructure, workforce and how the Devises place of safety was purpose built with more capacity than both Swindon and Salisbury to detain and assess patients.

·         How transport home was offered to patients attending the Devises place of safety. 

·         Patient evaluation times were determined by patients’ assessment and needs at the place of safety.

Resolved –

          1. That the report be noted.

The Cabinet Member for Housing and Public Safety with the Head of Housing submitted a joint report updating the Committee on the performance of Housing Services. The Head of Housing explained that the report had been structured to highlight key statistics and headlines reflecting successes of the work undertaken.

The report provided a performance summary in relation to the following key issues:

·        The new affordable housing to be provided in Queens Drive.

·         How the Housing First Team had successfully housed 15 homeless clients.

·         That the Homelessness Prevention Team are now also located at Great

Western Hospital and the Children’s Multi Agency Safeguarding Hub.

·        The department’s ongoing investigations into the level of evictions from private sector tenancies.

·         How tenants were supported when they mutually wanted to exchange properties.

·         The number of void properties and how these were being reduced through the work of an in-house team and new subcontractors.

·         How the housing repairs programme was on-track to deliver key targets including how repairs were being scheduled to increase unit availability.

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

Head of Housing and Rosemary Curtis (Homeless Organisations Standing Together in Swindon), responded to members’ questions and comments on the following issues:

·        Short term private tenancies, the number of evictions and the pressure placed on the Council to house those evicted.

·         How the proposals for three new affordable housing projects would be considered by Cabinet at its meeting in 4^th December 2019. 

·         That this year’s temporary winter housing provision for the homeless in Swindon would be managed by the Swindon Night Shelter.

·         The Swindon charity, Christmas Care, together with the Big Breakfast Plus and Swindon Night Shelter would be providing shelter for the homeless and vulnerable people over the Christmas period.

·         Actions being taken to address the increase in the number of cases resulting from private sector notices.

·         The need to encourage the homeless to take-up the Councils’ and local charitable community groups’ support. 

·         How provision for the homeless was promoted across Swindon to raise the publics’ awareness.

Resolved –

          1. That the report be noted.

          2. That the Head of Housing be requested to update the Council at its next meeting regarding the Resolution approved by Council on the 4^th April 2019 regarding End Section 21 evictions (Council Minute 101, 2018/19 refers). http://sbcvpwmmgv02:9070/ieListDocuments.aspx?CId=284&MId=9506&Ver=4

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 the Chair of AWP.
• The series of events hosted by AWP to celebrate World Mental Health Day on 10^th October 2019.
• How AWP was engaging with partners across Bath and North East Somerset, Swindon and Wiltshire to develop a five year plan for the period to 2023/24. 
• How discussions were on-going with Primary Care networks to improve access to mental health services.

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

• The number of Swindon residents supported at the place of safety in Devizes.
• Assessment times for patients.
• The need to recruit more Section 12 doctors and nursing staff.
• The provision of key worker housing for staff.
• How, through partnership working, mental health provision for the homeless was made more accessible.  

Resolved –

1.    That the report be noted.

2.    That the Executive Nurse at NHS Swindon Clinical Commissioning Group be requested to include an update in her next report to the Committee on the seminar being undertaken in January 2020 between various stakeholders on how to ensure the homeless gain access to health and mental health provision.

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 survey undertaken by attendees of the Swindon NHS Health Centre in Islington Street during July and August 2019 and the changes proposed following this consultation.

·         Understanding the needs of those attending the walk-in centre and the need to guide some patients to access the appropriate service at the right location.   

·         The impact of proposed walk-in centre changes on the Accident and Emergency Department at Great Western Hospital (GWH).

·         How the Homeless Local Enhanced Service scheme enabled the homeless to access services at the Health Centre.

·         How the CCG was continuing to engage with the community regarding the walk-in centre proposals, ensuring information was disseminated.

·         The permanent closure of the health-based places of safety suites at Swindon and Salisbury.

·         How an increase in the number of patients affected the referral to treatment and urgent care targets at GWH.

·         The on-going preparation for a no-deal European Union exit to address areas affected including staffing and recruitment.

·         The successful implementation of new service provision by doctors’ surgeries previously involved with the Integral Medical Holdings.

·        The merger of Bath and North East Somerset, Swindon and Wiltshire CCGs as of April 2020.

·        CCG’s receipt of the Employers Care Award for the second year in a row from the Swindon Carers Centre.

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

·        Patients opting to attend the walk-in centre when they were unable to access primary care. 

·         The need to recruit more primary care doctors in Swindon and how this would aid continuity of care for patients as they would be able to see the same doctor during their care.

·         Understanding the concerns that patients have when unable to have continuity of care.  

·         The need to improve the level of service provided by primary care as the community was seeking alternative provision, mainly from the walk–in centre or the Urgent Care Centre at GWH.

·         The phlebotomy service set up to ease pressure at the walk-in centre.

·         Transport and car parking requirements for those who previously attended the walk-in centre and who would now attend the Urgent Care Centre at GWH.

·         The current position of the workforce in Swindons’ general practices.

·         How primary care networks had been developed to ensure the right level of investment.

·         The work by Healthwatch in supporting asylum seekers at the Harbour Project.

·         How staff within preventive care services would be able to help reduce the demand of patients using primary care services. 

·         The long-term plan to develop an on-line booking facility for primary care appointments. 

Resolved –

1.    That the report be noted.

2.    That  ...  view the full minutes text for item 29.

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 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:

• The increase in demand at the Accident and Emergency (A&E) Department in September 2019 and the challenges faced by all GWH departments.
• The actions being taken by A&E to prepare for the winter months.
• The discussion undertaken with CCG to provide primary care at  Abbey Meads Medical Group and Moredon Medical Centre from 27^th November 2019.
• The plans to expand the GWH site to increase services including rehabilitation of patients after a stroke.
• The Trust’s preparation for a European Union exit.
• Improvements of services including the pharmacy transformational programme and the transfer of care on discharge.

Following his introduction of the report, Mr McNamara, responded to members’ questions and comments on the following issues:

• How the expansion at GWH would see the development of an integrated rehabilitation service, relocation of the private patient facility from the main building and the creation of new parking facilities. 
• The need to review the waiting area in the Accident and Emergency (A&E) Department in order to separate those accompanying patients who are receiving treatment and those who are waiting to be seen.  
• The need for improved bus services to GWH.
• The excellent service provided by A&E staff to a member of the Committee during a recent visit.
• The request for support from the Committee during the development of the business case for the expansion at GWH.

Resolved –

1.    That the report be noted.

2.    That the Interim Chief Executive, Great Western Hospital be requested to circulate the Winter Plan for members’ comments.

3.    That the Interim Chief Executive, Great Western Hospital be requested to extend an invitation to Committee members for them to visit Great Western Hospital and review the clinical model being promoted and observe some of the challenges faced by the Trust.

The Committee considered a report by the Chief Legal Officer on the Committee’s work for the Municipal Year, 2019/20. 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:–

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