Agenda and minutes

The Chair welcomed all attendees to the meeting.

Councillor Clark sent apologies.

The Chair declared that a member of his family had experience of an autism assessment and Child and Adolescent Mental Health Services.

The Scrutiny Advisor presented the Annual Business Report.

RESOLVED;

That;

·     The Scrutiny sub-committee’s Terms of Reference be noted;

·     The membership of the Committee for the 2021-22 municipal year be noted;

·     The Chair, Cllr Morris, and the Vice-Chair, Cllr Clark, be noted;

·     The dates and times for meetings in 2021-22, 6^th December 2021, 10am, and 14^th March 2022, 10am, be noted.

The Chair advised Members that the Suicide Prevention item, scheduled for today’s agenda, would be presented to the sub-committee as a scrutiny briefing in January 2022.

The Chair noted that Cllr Massey had received a text from the NHS which advised her she was eligible for a booster, although she had already received one; the Chair shared Cllr Massey’s concern that this error, which had happened to others, had provided confusion to the public.

RESOLVED;

That the Director of Communities and Public Health advise the sub-committee whether this was a known error and that it would be addressed.

RESOLVED;

That the minutes of the meeting held on 25 February 2021 be agreed as a true 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 scrutiny@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 5pm on Tuesday 30 November.

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 Friday 3 December.

Questions:

Statement:

There were no supplementary questions.

The Chair commented that the statement showed that the system was complex and sometimes confusing when children had additional support need; and stated that there was a need for a simplified and better signposted services.

RESOLVED;

That the Public Forum questions and statement be noted.

Report to follow

The Associate Director, Specialised, Secure and CAMHS, Avon and Wiltshire Mental Health Partnership, introduced the report.

·         There was a discussion around ethnicity data, and how representative referrals were of Bristol’s communities; Members were concerned that proportionally less Black Asian Minority Ethnic children and adolescents had accessed services, and that 630 referrals were from white applicants, and the combined number from Black Asian Minority Ethnic groups was 119.

·         The Committee was told that it was recognised that the referral route for young people had not been representative of the diverse communities, and that there was ongoing work and initiatives, which included a Quality Improvement Project, to improve equitable access for all and also to ensure staff were representative of the communities.  There had been partnership working, which included work with the Barton Hill Settlement, to improve equitable access.

·         There was a further discussion about access to services and referrals and it was agreed there was need for more clarity regarding the relationship between Bristol’s demographics and access/referrals. 

·         Members were advised that, in terms of Black Asian Minority Ethnic representation in recruitment, the organisation had improvements to make, which included positive action to enable Black Asian Minority Ethnic communities in senior leadership roles, and other initiatives which ensured better representation.

·         Members noted that North and South areas had more referrals than the Central & East area and were advised that there were no concerns about a lower ability to access services than in the other two areas, that there were more third sector and community pathways in Central & East before the need to access CAMHS.

·         Members asked whether building works at the Riverside Unit would prevent access to services and were told that 10 (of the 12 capacity) patients would receive services whilst the works were ongoing, and that there would be close partnership work that would ensure anyone who needed services would receive appropriate services, and that all young people who were not eligible would be monitored by professionals at Tier 3 which included crisis and outreach services.

·         It was confirmed that the building works would enable an increased capacity of 16 (12 inpatients and 4 days patients).

·         The Committee was advised that there was a national challenge to meet the need for eating disorders; and that there had been a sustained increase in referrals for young people with eating disorders.

·         It was recognised that the service required a more sophisticated system to record characteristics, which included Transgender, but that all young people were assessed based on need and the assessment recognised that an individual who identified as Transgender had increased risk of higher need.

·         The Chair commended the approach taken in South Bristol, that he observed that there was a positive outreach service and young people were encouraged to talk.

·         The was a discussion about access to information and Members were advised that CAMHS, as part of the community health partnership, had a single website which was subject to ongoing improvement, which included the introduction of an ability to self-refer; and  ...  view the full minutes text for item 20.

The Area Director (South Gloucestershire and Bristol); Mental Health Programme Manager;  and Delivery Director (South Bristol ICP), Bristol North Somerset South Gloucestershire CCG, introduced the report.

The Cabinet Member for Adult Social Care and Integrated Care Systems said that the integration of health and care should be from a bottom-up approach, and what had been seen by the Health & Wellbeing Board, on which the three Integrated Care Partnerships were represented, was good local representation and voice from local communities, and that there had been great enthusiasm from local partners; and that she hoped ICPs would have the opportunity to raise local need and affect ongoing strategy.  Also social prescribing was highlighted as an important role within the development of the ICPs and how communities accessed services.

·         There was a discussion about how many GPs there were in relation to population across the area, and Members were advised that the numbers related to GP practices, not the GPs themselves, and that some practices had more GPs in them, which meant more of an even relationship between GPs and population across the area. It was agreed that this needed clarifying and updated statistics would be sent to the Committee.

·         There was a discussion around recruitment and retention of the workforce and Members asked what steps would be taken to manage the issues.  The Committee was advised that there were workforce shortages and challenges, and that the plan to introduce integrated teams removed the need for a linear referral process, and so resources and time could be freed up.

·         There was a recognition that peoples’ needs should be met earlier and support mechanisms should be widened with the utilisation for the community and voluntary sector. 

·         The Director for Communities and Public Health clarified that the proposals for charges in parks only referred to commercial activities, and so would not affect social prescribers.

·         A Member of the Committee expressed optimism that the new arrangements would make a positive difference to accessing mental health services,  and stated that their experience was one that showed the eligibility criteria for referrals into services was a high threshold, and asked whether the new framework would mean an expectation of more referrals and better and quicker access to services.  The Committee was informed that the expectation was now a four week wait for the patient from initial referral; this was a national aspiration embraced locally  – the four weeks would be from the point of reach-out for support to an offer of treatment (from a range of offers which included clinical and social prescribing).

·         Members were advised that the new framework brought a fundamentally different approach, which included devolved budgets and demanded closer partnership working, a move away from a linear pathway which would increase access where it was needed and improved service.

·         The Committee was advised that the framework demanded good partnership working which would recognise the differing factors that affected peoples’ mental health, such as access to good housing, food and exercise; that opening up the links  ...  view the full minutes text for item 21.

The Work Programme was noted.

The Director of Communities and Public Health provided an update on COVID-19.

·        The Delta variant was still dominant; it was expected the Omicron variant would become dominant in the next months. 

·        The public health advice was that, if meeting in groups to cover faces, ventilate rooms and use lateral flow tests. People were encouraged to ensure they test themselves regularly, especially if they plan to meet in groups.

·        It was highly likely Omicron will be at least as transmissible if not more so, and so taking precautions was very important.

·        The Mayor was about to sign up to a global vaccine equity statement – it was important to recognise that the more people were vaccinated, the safer everyone would be.