Agenda and minutes

Please note: if the alarm sounds during the meeting, everyone should please exit the building via the way they came in, via the main entrance lobby area, and then the front ramp.  Please then assemble on the paved area between the side entrance of the cathedral and the roundabout at the Deanery Road end of the building.

If the front entrance cannot be used, alternative exits are available via staircases 2 and 3 to the left and right of the Council Chamber.  These exit to the rear of the building.  The lifts are not to be used.  Then please make your way to the assembly point at the front of the building.  Please do not return to the building until instructed to do so by the fire warden(s).

The Chair welcomed all parties to the meeting and asked them to introduce themselves. She also explained the evacuation procedure in the event of an emergency.

Apologies for absence were received from Heather Williams, Colin Bradbury, Neil Turvey (Sharron Norman substituting) and Sally Hogg.

To note any declarations of interest from the Councillors.  They are asked to indicate the relevant agenda item, the nature of the interest and in particular whether it is a disclosable pecuniary interest.

Any declarations of interest made at the meeting which is not on the register of interests should be notified to the Monitoring Officer for inclusion.

There were no Declarations of Interest.

To agree the minutes of the previous meeting as a correct record.

The minutes of the meeting held on 25^th May 2023 were agreed as a correct record.

Up to 30 minutes is allowed for this item.

Any member of the public or Councillor may participate in Public Forum.  The detailed arrangements for so doing are set out in the Public Information Sheet at the back of this agenda.  Public Forum items should be emailed to democratic.services@bristol.gov.uk and please note that the following deadlines will apply in relation to this meeting:-

Questions - Written questions must be received 3 clear working days prior to the meeting.  For this meeting, this means that your question(s) must be received in this office at the latest by 4.30pm on Friday 7^th July 2023.

Petitions and Statements - Petitions and statements must be received on the working day prior to the meeting.  For this meeting this means that your submission must be received in this office at the latest by 12 Noon on Wednesday 12^th July 2023.

A Public Forum Statement was received from Councillor Brenda Massey in respect of Agenda Item 10 – Dental Access for Adults and Children in Bristol.

Councillor Helen Holland gave the following verbal presentation on the Integrated Care Partnership:

·       Whilst the strategy had been agreed in principle, the next cabinet meeting was not until September 2023

·       A development day would take place shortly as a means of bringing the strategy to life

·       A key issue would be the use of integrated space to help health outcomes across the region

·       Thanks should go to the editorial group under Matt Lenny to ensure that it aligned with our strategies and ensured that it reflected that strategy in future iteration

·       She confirmed that she was now the Chair of the BNSSG meeting following a recent change from North Somerset and that both Councillors from the other Local Authorities had been replaced following the local elections

·       At a recent meeting involving the LGA and ICP, the issue of prevention had been raised as a concern

·       Tim Swift from Calderdale Borough Council was now the chair of the national network

·       At Councillor Holland’s suggestion, the ICP would be submitting a report to a future meeting of the HWBB

The Board noted that this had been a great achievement so far to have developed a strategy which addressed inequality within it and that a properly aligned integration would add value to it.

Please note the link below to a video concerning Welcoming Spaces.

https://youtu.be/DpfNpCnjnJc

Penny Germon introduced this report and made the following points during her presentation:

·       The report contained a link to video which will give you an indication of the work being carried out

·       Thanks were given to the people who had made the winter event possible including the volunteers

·       The Board noted a series of slides of the event which had involved 120 people and had been very positive and engaging. There were 105 welcoming spaces created through the cost of living response

·       It was estimated that 87% of households in Bristol were 10 minutes walk away from a welcoming space which would provide physical access, wifi, hot drinks, information access and support

·       The Board was reminded of examples of the publicity generated

·       There were 19 community hubs to co-ordinate activity in the particular area including in Brislington and Lockleaze

·       Work was carried out with the centre for the deaf and welcoming people. WECIL had provided advice to all welcoming spaces to improve access for disabled people. There was also access to emotional well being support

·       Membership for the scheme had increased from 300 to 14000 post COVID

·       There had been signposting had taken place on the website and the communications team had worked with all welcoming spaces

·       VOSCUR had organised peer support

·       Avon and Somerset Police had indicated areas where there were no welcoming spaces, following which they had been created

·       There had been a large number of hits on the Bristol City Council website about these spaces

·       Tech support had been received for these welcoming spaces

·       There had been aligned funding of £2.4 Million for the winter response – 62% aimed to keep going

·       Feedback suggested that a move was needed away from a crisis support approach towards a more sustainable approach

·       The principles were for a one city asset based approach focusing on inclusion and social justice and involving collaboration as required

·       Seven key ingredients included neighbourly and citizen action, welcome spaces, positive action, community hubs, leadership and collaboration. It was only possible to do this if conditions were sustained that nurture communities  and provided civic power for community development and building relationships.

·       Since 19th April, a Bristol One City approach supported people most impacted by low income, poverty and inequity

·       A map showing Welcoming Spaces was shown. BCC would maintain a Cost of Living website seeking to maximise aligned funding and to develop a planned approach

·       There were opportunities to develop innovation and a fresh approach to commissioning and to nurture community ecosystems

Board members made the following comments:

·       Discussions with extra care providers at Waverley Gardens Brunel Care Home had revealed the need for resources to be used for those communities which were the most difficult to reach

ACTION: Examine possible additional mechanisms to provide extra resources (such as other care providers) for those communities which are reached less well – Penny Germon

·       In view of the likelihood of increased warming of the climate, the development of cool places was also required

·       There was a  ...  view the full minutes text for item 7.

Clare Cook, Mohamed El-Sharif and Anne Morris presented this report and made the following points:

·       This was a collaborative system working together to support our most deprived communities

·       There was a huge amount of inequity concerning how people access services. The ethos is that we do not leave anyone behind and vaccinate anyone who requires it

·       With the use of levelling up funding, a social determinance approach was adopted using an asset based community development model

·       The support helped to continue with a sustainable model

·       Temple Street acts as a job centre, citizen service point and had also been used as a vaccinations centre

·       Interventions were used there for vaccinations and health care in general – the motto was “It’s amazing what you can do with a cup of tea”

·       A system of integration and leadership was important to help provide a space for some of the most marginal citizens. It was important to adapt to meet the needs and preferences of some of the groups that have engaged and build long-term trust with them

·       In some instances, adaptations were required to meet the needs and preferences of those groups which have engaged and to adapt the learning as required

·       The approach reached a large number of ethnic minority communities and homeless people

·       It was important to start to connect people into communities and ensure they were listened to and valued

·       Some of the first days were only delivered in 2023 and were for people who had never before received the vaccine. The flu vaccine was also co-administered using community pharmacy teams and had worked very well. This had been a wide-ranging approach and had involved lots of pieces of work which went well beyond vaccines

·       Whilst for some groups the experience had fallen short, it helped groups gain confidence that they had failed to achieve in the past. A wide range of reasons for seeking vaccination had been provided by those surveyed

·       A lot of homeless people went to emergency services and frequently the need was to ensure safety, access to food, the correct environment and also literacy

·       Whilst there had been instances of low uptake, this did not mean there was low interest since the first doses were not administered until June 2023. Some people needed time to decide whether or not to seek help

·       Short term funding only provided short term relief and therefore the work of local groups in their communities was important to invest in people who need support

·       A small campaign was currently being carried out with younger people and there would then be an autumn campaign for vaccines

·       The greater people worked together in these areas, the system was improved. This was a cost effective approach

Board members made the following comments:

·       It was important to signpost help to avoid having to repeat information

·       The success of the Community Vaccination Programme was welcomed

·       This had been very successful. There was a significant resource for vaccination. However, immunisations were generally low for all ages  ...  view the full minutes text for item 8.

Reena Bhogal-Welsh presented this report and made the following comments:

·       It was important to speak to a trusted person

·       Following the recent OFSTED/CQC Joint Inspection, a written statement of action has been provided with five key areas set out in the report

·       Following the re-inspection from the 2019 snapshot inspection, significant progress had been made in 4 out of 5 areas

·       The continuing area of difficulty was in relationships. As a result, one piece of action to help address this was the development in May 2023 of a Parent/Carer Forum. It was noted that £18,000 had been provided to enable them to continue the work they carry out

·       As a result, an APP (Accelerated Progress Plan) had been created along with an effective and sustainable structure

·       Hearing and listening to lived experiences was important and the experiences of young people had been heard. The plan set milestones for 3,6, 9 and 12 months

·       The journey behind the story was very important

·       Representation was received from schools, health partners and social carers involving a crosscutting and multi professional approach

·       Rotherham had gone through a similar journey to Bristol but had formed genuine partnerships as a model for how you can develop these

·       The DoE had written to BCC concerning the Really Healthy Workshop

Board members made the following comments:

·       There would be further reports back concerning this and in other areas such as SEND. However, it seemed as if the “tide had been turned”

·       It was acknowledged that children’s issues had not received as high a priority from HWBB as other areas and that this needed to be addressed

·       The work of this team was commended as it had faced three very difficult tears. Even when relationships were heightened, there was a need to ensure our voices were heard from as diverse a range as possible

·       The SEND Improvement Board was now within the responsibility of BCC and no longer the LGA

Wavell Vere and Jenny Bowker gave a presentation on this item and made the following points:

·       The NHS Dentistry Service is now accountable for decision-making and budgets in dentistry involving the commissioning of work

·       Dentistry primary care, high street care, community care and secondary care are all delivered by our service

·       The local context for NHS Dentistry was explained to the Board

·       In common with the situation nationally, access to dentistry was a real challenge

·       National reforms were part of an attempt to ease these problems. Wherever possible local solutions were preferred by developing a local approach

·       The main focus of the presentation related to primary dental care which was significantly different to other care services. Dentists in this area operated as independent businesses, tendering for contracts and delivering both NHS and private dentistry

·       Whilst they provided their own staff and premises, there was some reimbursement for the latter

·       Dental contracts were procured on dental activity but there remained a huge variation in contracts which creates pressures on staff retention

·       The cost of living had created a huge impact on providers. The number of adults requiring the service was increasing and whilst it had dropped, this remained in line with the national average

·       In Bristol, there were 57 practices equating to approximately 235,000 patients which was just above 50% of adults

·       Orthodontic activity requires aesthetic appliances and operated on a national basis so did not allow for much variation.

·       Mandatory care provided cover for patients that participated with 64 patients a week being seen within Bristol. The contract had been extended to March 2024 and it was hoped to extend by a further 36 months to assist with retention of staff to provide a pathway to stabilise oral health

·       Access to 111 enabled an urgent provider for temporary treatment (such as fillings) and then further requisite treatment. 8 practices operated to provide stabilisation treatment with approximately 3.5 hours per session. On average there were about 6 patients per session. Further work was required to address regional concerns and take into account regional priorities

In response to Board Members’ questions, they made the following points:

·       People were sometimes not accessing dental care due to the difficulty in accessing it. There was a need to prioritise what is available for local communities as NHS Dentistry was not being provided

·       St Paul’s surgery has closed by the end of June 2023. Whilst the service had attempted to offer out other activity to dentists to keep it open, there had been some uptake but not enough. The service had received offers from the local Community Action Group and Housing Association in relation to this

·       The service would use and emergency procurement arrangement for the St Pauls Replacement Surgery Service.

·       BUPA was advised that they could not continue. NHS dentistry was no longer competitive in the market as opposed to private dentistry

·       Private and High Street Dentistry were the first dental services to re-appear after the pandemic. Whilst the service was trying to make the  ...  view the full minutes text for item 10.

To note the HWBB Forward Plan for information.

The Board noted the HWBB plan.

The next formal meeting of the Board will take place at 2.30pm on Wednesday 25^th October 2023 in the Bordeaux Room, City Hall, College Green, Bristol.

The Board noted that the next meeting was scheduled to be held at 2.30pm on Wednesday 25^th October 2023 in the Bordeaux Room, City Hall, College Green, Bristol.