Agenda and minutes

To receive any apologies for absence from Councillors.

Apologies for absence were received from Louise Bates, Healthwatch.  Cllr Chris Matthews attended virtually thereby forgoing any voting rights.

To receive information on any changes in the membership of the Committee.

Note – When a member of a Committee is unable to attend a meeting of a Committee or Sub-Committee, the relevant Political Group Leader (or their nominated representative) may, by notice to the Monitoring Officer (or their nominated representative) prior to the meeting, appoint a substitute member from within the same Political Group. The contact details on the front of this agenda should be used for notifications.

There were no substitute members on this occasion.

Councillors are requested to declare any interests on items included in this agenda. Please refer to the workflow on the preceding page for guidance.

Declarations received will be reported at the meeting.

Cllr J Salmon declared a personal interest as an employee of Dorset Healthcare and a member of Unison and Cllr Carr-Brown declared a personal interest as her husband was a non-executive director on Integrated Care Board for the Dorset area and as a support worker for an autistic man who was in receipt of direct payments from BCP Council.

To confirm the minutes of the Meeting held on 5 June 2023.

The minutes of the meeting held on 5 June 2023 were confirmed as an accurate record and signed by the Chair.

To consider any outstanding actions.

The Chair advised this would be discussed further in the forward planning item later on the Agenda.

To receive any public questions, statements or petitions submitted in accordance with the Constitution. Further information on the requirements for submitting these is available to view at the following link:-

https://democracy.bcpcouncil.gov.uk/documents/s2305/Public%20Items%20-%20Meeting%20Procedure%20Rules.pdf 

The deadline for the submission of public questions is 3 clear working days before the meeting.

The deadline for the submission of a statement is midday the working day before the meeting.

The deadline for the submission of a petition is 10 working days before the meeting.

There were no public issues received on this occasion.

To receive a verbal update from the Director of Public Health, Public Health Dorset.

The Director of Public Health provided a verbal update on the National Suicide Prevention Strategy, which included the following:

• An update was published on 11 September 2023 to the Suicide Prevention Strategy.  It was noted this was the Government setting out a refreshed agenda nationally including actions which were restating the commitment nationally.
• It was acknowledged that suicide rates were not higher today than in 2012 when the Government first launched strategy, however there had not been a reduction and there were still some groups who were at higher risk.
• In terms of the actions for local government and the NHS arising from this refresh of the national strategy, it was noted that there wasn't a huge amount for to be done at this time.
• The Committee was advised of the work locally of the integrated care system group around suicide prevention and mental health and that BCP Council had representatives on that group.
• It was highlighted that locally work had been undertaken to develop an overarching suicide prevention strategy for the Dorset system, with separate plans and actions sitting under it for individual organisations and that BCP Council had its own Suicide Prevention Plan which would be refreshed for 2024.
• It was advised that one of the big changes was around better quality and more timely data around suspected deaths that that were potentially caused by suicide and the impact this would have locally was highlighted to the Committee. Some local work on near real time surveillance was also detailed.
• Another major advancement highlighted was the funding provided by NHS England to local health systems for the provision of timely bereavement support.
• The Committee was advised of suspected clusters of suicides and how more timely data would assist ensuring bereavement support and postvention support was available.
• The Committee was asked to consider a future integrated approach which ensure all partners played a full role in addressing suicide prevention to continue to build on the work already done.
• The Committee was advised of the additional funding that came out with that strategy for the voluntary community sector and that some bids had been prepared locally to access some of that funding.

The Committee asked questions regarding the verbal update, including:

• In response to a query regarding the suicide data, the Board was advised of the current position using near real time surveillance data collected by the Police and developed into a national dashboard.  It was noted that not all reporting was currently complete, and it was highlighted the data would not be available at a personal level.  The local work between Public Health and Dorset Police was outlined which included notifications of sudden death where suicide was suspected to ensure access to timely bereavement support.
• In response to the overarching plans, it was highlighted how the Integrated Care Board ensured system working with a renewed commitment to updated plans for each of the integrated care system organisations to ensure there was a unified approach
• In response to the funding being  ...  view the full minutes text for item 20.

This paper provides an update on the current position of access within practices and PCNs in the BCP area. National comparisons are given where appropriate, alongside the Dorset view and vision. Dorset and BCP appointment activity is rising, and the data does not suggest that the growth will decrease at this time. The increase is noted in face-to-face appointments, telephone appointments and online consultations. Dorset’s appointment activity is reflected as over 10% greater per 1000 population than the national average.

The Deputy Chief Officer, Commissioning and the Senior Lead Primary Care Commissioning and Contracting, NHS Dorset, presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

The report provided an update on the current position of access within practices and Primary Care Networks (PCNs) in the BCP area. National comparisons were given where appropriate, alongside the Dorset view and vision. Dorset and BCP appointment activity was rising, and the data did not suggest that the growth would decrease at this time. The increase was noted in face-to-face appointments, telephone appointments and online consultations. Dorset’s appointment activity was reflected as over 10% greater per 1000 population than the national average.

The report provided an overview of national programmes and their implementation through BCP, aligning to the wider Dorset ambition. Access Improvement Plans had been supported for all PCNs within BCP, supporting the PCNs to utilise the funding through the Capacity and Access Improvement Payment fund associated to the Network Contract. Throughout BCP improvements were expected within three areas of general practice: ease of access, data accuracy and patient experience.

The paper detailed some of the excellent work that was being undertaken at PCN level to improve access.

The report described the implementation of Access Recovery plans through Dorset and BCP, in line with addressing the 8am rush, and aiming to empower patients with understanding more about their access through general practice. The report described a funding stream designed to bring those practices on analogue phone systems on to a cloud based provider, whilst also describing national and local support offers in place from NHS England.

The Committee discussed the report and comments were made, including:

• In response to a query regarding funding through the capacity and access improvement payment and that 70% of it was automatic and 30% was based on performance, the Committee was advised of the planned process for PCN Business Managers to present to the Integrated Care Board to demonstrate their journey through access from the start of the improvement programme to that date.  It was noted the 30% would not be based on targets but consideration of the PCNs bespoke journey.
• In response to a query regarding 14-day access to GPs, the Committee was advised that included all appointments including face to face, over the phone and routine appointments.
• In response to a concern regarding the methodology of the data presented within the report and the need for more interactive data, the Committee was advised that Officers would take this away and consider how to present data in the future.  ACTION. 
• The Deputy Chief Officer wanted to highlight the importance of qualitative data and patient experience which needed to be considered, and what the red flags were regarding PCNs that were struggling.
• In response to a query about the additional roles reimbursement scheme and the funding ending in March 2024, the Committee was advised that there was  ...  view the full minutes text for item 21.

Winton Health Centre closed on 31 July 2023.  A review of the process and outcomes are annotated in this report.

The Senior Lead Primary Care Commissioning and Contracting, NHS Dorset presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book.

Members of NHS Dorset Integrated Care Board had a joint duty to work together on matters relating to the planning, provision and operation of health services in Dorset.

Winton Health Centre closed on 31 July 2023.  A review of the process and outcomes are annotated in this report.

The Committee discussed the report and comments were made, including:

• A Committee Member provided some feedback on the communication with residents including an error on the maps provided and suggested improvements.  The Committee was advised of the mapping work which had been undertaken and ensuring that all residents could still access a GP local to them who had capacity to take on the patients.  It was acknowledged that some feedback could be collected from patients including how many had moved since September.  ACTION.
• It was acknowledged that managing communications and the impact could be considered further, however the Committee was advised that there would always be a lag in the process due to the complexity of the process.
• In response to a query regarding weighted capitation, the Committee was advised how NHS Dorset supported the resilience of the practices during the first year to support the change of additional patients being transferred.
• In response to a query regarding ongoing patient satisfaction for the patients who had moved and those who were in the practices affected, the Committee was advised of the engagement with the patient participation groups and patient satisfaction surveys and it was again highlighted that the first year would always be a challenge.
• A Committee Member expressed concern regarding patients being moved to Winton Health Centre from Leybourne Surgery due to its closure and then being moved again and requested consideration regarding engagement with those patients regarding the impact it had on them. ACTION.
• In response to a query regarding whether practices across BCP would be able to meet the future demand and whether they were any other surgeries which were considered not viable, the Committee was advised that the impact on future demand was considered as part of this project, and that a lot of practices were considering mergers and new business models to work at scale.

RECOMMENDED that the Committee scrutinised the contents of the report and any actions arising be followed up with the Commissioners.

NHS Dorset has approved a merger application from the Adam Practice, Hamworthy, Dorset, and Lifeboat Quay Medical Centre, Poole, Dorset.  The merged contract will be effective from 1 October 2023.

The Senior Lead Primary Care Commissioning and Contracting, NHS Dorset presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'C' to these Minutes in the Minute Book.

NHS Dorset had approved a merger application from the Adam Practice, Hamworthy, Dorset, and Lifeboat Quay Medical Centre, Poole, Dorset.  The merged contract would be effective from 1 October 2023.

There was no Committee discussion on this item. 

RESOLVED that the Committee note the report.

The Health and Care Act 2022 creates a new duty for the Care Quality Commission (CQC) to review local authorities’ performance in discharging their adult social care functions under the Care Act 2014.

As part of the Council’s preparations for these new arrangements, a Local Government Association (LGA) Peer Challenge was arranged and this report sets out the findings of the review and how the learning will be used to ensure the Council is best placed to achieve a positive outcome from a Care Quality Commission review.

The Director of Adult Social Care and the Interim CQC Preparation Lead presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'D' to these Minutes in the Minute Book.

The Health and Care Act 2022 created a new duty for the Care Quality Commission (CQC) to review local authorities’ performance in discharging their adult social care functions under the Care Act 2014.

As part of the Council’s preparations for these new arrangements, a Local Government Association (LGA) Peer Challenge was arranged and this report sets out the findings of the review and how the learning would be used to ensure the Council was best placed to achieve a positive outcome from a Care Quality Commission review.

There was no Committee discussion on this item.  The Chair advised any further consideration could be undertaken at the work programming session.

RESOLVED that the Committee note the report.

To receive a verbal update from the Portfolio Holder for Health and Wellbeing.

The Portfolio Holder for Health and Wellbeing provided a verbal update which included:

• Pleased to advise of the appointment of new Corporate Director of Wellbeing
• Within Adult Social Care, the work undertaken on the LGA Peer Challenge and CQC Assurance work
• Other projects which were progressing included the Day Opportunities and it was highlighted the review would come to this Committee for consideration
• Preparation of the 2024 budget and acknowledgment of the pressures and savings required and the work being done to prioritise areas and how they would be managed
• Ongoing work around the Carers Strategy, including an implementation governance board
• The Learning Disability Partnership Board and a new big plan being co-produced with various different partners
• Attendance at the Dorset and BCP Safeguarding Adults Board
• Meeting with Tricuro to understand its operations for residential care services
• Chairing of the Dorset Joint Public Health Board and BCP Health and Wellbeing Board in addition to work with the Integrated Care Partnership, which was also going to be subject to a CQC Inspection.

In response to a question regarding about risks of change fatigue and staff wellbeing, the Committee was advised that the PFH had been really impressed with all the staff he had met with regards to their dedication and positivity, however it was acknowledged that there were real budget pressures which needed to be managed alongside the staff wellbeing. The need to resolve the pay and reward for Adult Social Care staff as soon as possible was also highlighted.

In response to a query regarding about the lack of data from Adult Social Care and the wider organisations which made up the Integrated Care Board and the need for an ICB wide data strategy and a whole system overview, the Committee was advised this was an area the PFH had not had much involvement with yet.  The PFH concluded that the Integrated Care System was in its infancy but had great promise to be a preventative service with a long-term view of improving the health and wellbeing of residents.

In response to a query regarding the Health and Wellbeing Board and the need for this Committee to have greater sight of its work, the Committee was advised that it was a public meeting, and any Member was able to attend should they wish.  It was noted that there was work ongoing to ensure the role of the Health and Wellbeing Board was clear.

To note the items listed on the Forward Plan however further consideration will be given at the Committee’s work programming session in October.

The Chair advised that the Forward Plan was outlined, however there was a meeting to discuss it further next week.  The Chair advised of the plan for the work programming session.

A Committee Member advised that Prama Life would like to come to the Committee to advise of the work it does.

A Committee Member stressed the need to consider the data around the efficiency and effectiveness of all the services before any consideration could be given to specific items for scrutiny.

To note the dates of the meeting dates for the 2023/24 municipal year as follows:

·       27 November 2023

·       15 January 2024

·       4 March 2024

All with a 6pm start, venues to be confirmed.

The dates of the future meetings were noted.