Agenda and minutes

To receive any apologies for absence from Councillors.

There were no apologies received.

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.

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.

Councillor C Johnson declared a personal interest as a Staff Nurse employed by the University Hospitals Dorset NHS Foundation Trust, Councillor L-J Evans declared a personal interest as a bank employee for University Hospitals Dorset NHS Foundation Trust and Councillor C Matthews declared a personal interest as a Governor of Dorset Healthcare University NHS Foundation Trust and as a carer.

For transparency Cllr L-J Evans reported that she did not work for 111 First or 111 Online Service but had been on committees when the service was first discussed.

To confirm and sign as a correct record the minutes of the Meeting held on 23 May 2022.

RESOLVED that the minutes of the Health and Adult Social Care Overview and Scrutiny Committee held on 23 May 2022 be agreed as an accurate record and signed by the Chair.

The Chair advised that the Action Sheet normally included with the agenda would be updated and circulated to the Committee by email and any questions on the Action Sheet to be forwarded to Democratic Services to arrange a response.

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 [DAY DD MMMM YYYY].

The deadline for the submission of a statement is 12.00 noon, [DAY DD MMMM YYYY].

The deadline for the submission of a petition is 12.00 noon, [DAY DD MMMM YYYY].

There were no public questions, statements or petitions for this meeting.

To receive an update regarding Covid, from Sam Crowe, Director for Public Health.

The Director of Public Health provided an update on issues regarding Covid-19. It had been announced that Covid-19 booster vaccinations for over 50s and the clinically vulnerable would be co-administered with flu vaccinations during Autumn 2022. Nationally the rise in rates of infection due to Omicron variants was starting to level off and local rates (currently 1 in 17) were expected to follow. It was noted that two thirds of hospital patients testing positive (currently 121 across Dorset) had been admitted for other reasons, rather than as a direct result of Covid-19.

The Director of Public Health was asked about the latest reports of Monkeypox in the UK and explained that the handful of cases (mainly around London and the South East) were being managed by the UK Health Security Agency with only limited input required locally from Public Health.

In response to questions the Director explained that the efficacy of the Covid-19 vaccine was based on reducing the number of cases where people became seriously ill. He confirmed that the co-administration of the flu and Covid-19 vaccines was deemed safe and he agreed to circulate the latest studies on this to the Committee – ACTION.

RESOLVED that the update of the Director of Public Health be noted.

To receive an update on the Combating Drugs Partnership Board, from Sam Crowe, Director for Public Health, and agree a date in 2023 for a progress update.

The Director of Public Health provided an update on the establishment of a Pan Dorset Combating Drugs Partnership Board to oversee the delivery of the Government’s Drugs Strategy and its three main aims of treatment/recovery, enforcement and prevention. The Director was working with Dorset Police and Crime Commissioner (the identified lead officer), the Chief Constable and the Chief Executives of Dorset and BCP Councils to finalise the initial membership and terms of reference for the Board and report back to Government on progress to date.

It was explained that the Strategy and the Partnership Board offered a new approach and that the treatment/recovery element was being supported by additional Government funding at a local level, with BCP receiving its funding a year ahead of Dorset. The Director of Public Health agreed to keep the Committee updated on developments.

RESOLVED that the update of the Director of Public Health be noted.

This report outlines the background, performance, challenges, and future developments of the Dorset Integrated Urgent Care Service (DIUCS) to date. At the meeting there will be a presentation that will enhance this report.

The Head of Urgent and Emergency Care, NHS Dorset, presented a report accompanied by a presentation, 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 and presentation outlined the background, current performance and challenges and future developments of the Dorset Integrated Urgent Care Service (DIUCS) to date, including the operation of the NHS 111 First and NHS 111 Online services.

The Head of Urgent and Emergency Care responded to questions and comments on a number of issues, including:

• How to address the staff shortfall in clinical roles. This was a known national issue and recruitment was ongoing. At the moment other selected staff were being used to answer clinical assessment calls. This reflected a longer term approach to ensure a more multi-disciplinary workforce.
• Whether pay, terms and conditions were being looked at. The Workforce Team were checking that there were no discrepancies between services in terms of equal pay.
• How to deal with minor injury bookings. These were mostly managed in Emergency Departments but the Urgent Care project offer were looking at whether these could be dealt with in other ways.
• The Healthwatch representative asked how patient feedback was used to improve service. There were a range of ways including contract reviews, complaints, friends and family feedback, etc. It was also planned to engage with Healthwatch on the Out of Hospital project to better understand why people did not use 111 services more. The Healthwatch representative suggested that more publicity on improved response rates may help overcome previous negative experiences.
• Reasons for the increase in calls. This was partly attributed to better promotion of 111 and an increasing pressure on primary care. It was noted that where it would be beneficial to patients, they could be booked back into the primary care system.
• A Committee member commented on the reality of struggling to meet high demand and that people often did not ring again if their first call went unanswered. She endorsed the need for more publicity on recent improvements and more clarity on what the service was for. The Head of Urgent and Emergency Care acknowledged the points made and agreed they needed further work.
• How to assess if 111 First has improved patient experience. This was being evaluated as part of the urgent care project and there had been some positive feedback. Improvements were ongoing, Healthwatch was engaged and the importance of listening to people to ensure equitable service was noted.
• How to promote 111 services to people on holiday and using the beaches. A Committee member highlighted a recent experience in a very busy Emergency Department. It was confirmed that hotels and bed and breakfast accommodation was targeted and that there was also prevention work on sun exposure, etc.
• It was confirmed that anyone accessing 111 services who required 999 would be directly transferred or an ambulance sent, without any further delay in the system.
• The Portfolio Holder  ...  view the full minutes text for item 22.

A Carers Services Review has been undertaken in collaboration with carers and key stakeholders. The findings will inform the new BCP Carers Strategy. This report provides the committee with an update on current progress.

The Commissioning Manager – Prevention and Wellbeing presented a report accompanied by a presentation, 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.

The report provided an update on how the findings from the Carers Service Review were being used to inform the new BCP Carers Strategy. The Commissioning Manager explained the background and context of the review and how this had been carried out. She presented an overview of the five key priorities which had been developed through engagement with carers and key stakeholders and explained the intended steps to implement them and the associated timescales.

Officers responded to questions and comments on a number of issues including:

• Response rates. 742 carers had responded to the survey. The five priorities had been discussed at various groups, with detailed comments received from 26 individual carers to date.
• How to ensure carers ‘take a break’. It was noted that carers had access to home-based support and there were flexible options to take breaks, away from the home environment if preferred, with the person cared for going into a care setting.
• A Committee member stressed the importance of carers being able to take shorter, more regular breaks to ensure respite while reducing the concern of having to leave a loved one for too long.
• How to raise awareness of what being a carer involves. A Committee member talked about his own experience as a carer and highlighted the value carers add to society and asked if there were any plans to educate employers and wider society. It was noted that in addition to supporting national campaigns the Council was working to promote the role of carers all year round. The Council was aiming to work with Carers UK on its employers programme to support businesses and there was also a carers discount card for local businesses.
• How to ensure equality of access across Dorset which was a large area with diverse needs. The Committee was assured that equality of access did not mean the same service for all regardless of need, it was about providing a similar response in terms of how someone was assessed and their support needs identified. It did not prevent BCP from responding locally to local needs.
• A Committee member highlighted the low level of neighbours as carers identified in the survey and the risk that some people may not class themselves as carers and could slip under the radar as a result.
• A Committee member suggested that skills and training should be available in ‘bite size’ sessions as many carers had time constraints.

Overall, Committee members were very positive about the approach being taken to recognise and value carers in the new strategy and thanked officers for their work. It was noted that this work would make a real difference to residents and that training and planning would serve to relieve some of the anxieties for carers.

As the report  ...  view the full minutes text for item 23.

A review of day opportunities, including buildings-based day services is currently underway, in collaboration with key stakeholders, which will inform a new BCP Council Day Opportunities Strategy. This report provides the committee with an introduction to this piece of work and update on current progress.

The Commissioning Manager – Day Opportunities presented a report accompanied by a presentation, 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.

The report summarised the work underway to review day opportunities including buildings-based day services in collaboration with key stakeholders, which would inform a new BCP Council Day Opportunities Strategy. The Commissioning Manager presented an overview of the project including the key principles, the governance structure and the proposed timeline leading up to the production of a Case for Change report in December 2022.

The Commissioning Manager was asked about the Day Opportunities co-production group and it was noted that this had an important role in bringing together service users and groups, providers and councillors to influence service development. Membership of the group which met bi-monthly was set out in Appendix 2, with an open invitation extended to Committee members wishing to participate. Cllr D Butler confirmed that she would be interested in attending.

RESOLVED that the Committee requests an update once the view seeking exercise has been completed and a case for change report has been drafted.

To receive a verbal update from the Portfolio Holder for Communities, Health and Leisure.

The Portfolio Holder for People and Homes gave the following updates:

• Day Opportunities Co-Production Meetings – The Portfolio Holder encouraged Committee members to consider participating.
• The recent launch of the Proud to Care Campaign which seeks to celebrate adult social care workers and inspire more people into the sector. For further information see Proud to Care (bcpcouncil.gov.uk)
• The excellent multi-agency response to supporting the homeless and the vulnerable during the recent heatwave.
• Forthcoming challenges for the Committee to be aware of included the cost of care, charging reforms and the Care Quality Commission assurance process.

The Portfolio Holder for Communities referred to the latest position regarding Covid-19, in terms of hospital admissions, staff absences and the Autumn roll out of booster vaccines.

RESOLVED that the Portfolio Holder updates be noted

To receive an update regarding Tricuro, from Phil Hornsby, Director for Commissioning for People.

The Director for Commissioning for People provided an update on actions taken by BCP Council and Tricuro to ensure a smooth transition once Dorset Council exited the agreement and governance arrangements were updated. He assured the Committee that BCP Council maintained a strong relationship with Tricuro. Tricuro would continue to provide services and nothing would change for BCP residents as a result of Dorset’s decision.

The Director responded to questions about staff recruitment and the timeline for Dorset’s exit. He confirmed that Tricuro faced the same challenges as other providers in recruiting and retaining staff and was taking steps to encourage prospective employees to follow this as a career path. He advised that the transition from Dorset would be complete by September/October this year. The name ‘Tricuro’ may or may not be reviewed in due course but was being retained for the time being for consistency and reassurance. The Director also provided further details of buildings and services under the Tricuro umbrella.

RESOLVED that the update of the Director for Commissioning for People be noted.

To note the Committee’s Forward Plan and make any amendments as necessary.

The Chair provided an update on the following items:

• Dentistry provision – While it was noted that NHS England had recently announced new reforms to provide better access to dental services, this item would be retained on the Forward Plan
• Supported Living Services Cabinet report – add to Forward Plan
• SWAST Improvement and Financial Investment Plan – awaiting response from Sue Seddon regarding possible joint scrutiny item with Dorset Council.

The Chair asked the Committee to agree its meeting dates for the remainder of the municipal year, taking account of the need to reduce from six to five scheduled meetings per year. Once agreed items on the Forward Plan could be allocated to specific meeting dates.

RESOLVED that the Committee retains the meeting dates currently scheduled for 26 September and 28 November 2022 and 6 March 2023 and deletes 16 January 2023 from the calendar.