Agenda and minutes

The Chair welcomed all attendees to the meeting and explained the emergency evacuation procedure.

It was noted that apologies had been received from Cllrs Clark, Goggin and Makawi.

To note any declarations of interest from 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 declaration of interest made at the meeting which is not on the register of

interests should be notified to the Monitoring Officer for inclusion.

Cllr Francis advised that she was employed as a social worker in mental health services.

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

The Committee RESOLVED:

That the minutes of the meeting of the Health Scrutiny Committee held on 14 March 2022 be confirmed as a correct record.

To note any announcements from the Chair.

a. The Chair thanked NHS Bristol representatives for attending this meeting and for the clear information and data included within the agenda papers.

b. The Chair advised that he had been pleased to attend the Bristol Community Health Day on 8 October. A wide range of information had been available through this community-led event, including workshops, seminars and booths on a range of healthcare topics, including mental health, lung health, diabetes, maternity, and men’s, women’s and children’s health.

c. The Chair advised that he wished to thank the Friends of Jubilee Swimming Pool for all of their hard work in securing the pool’s future for the community.

d. The Chair referred to the ‘statement of principles’ guidance document for Health Overview Scrutiny Committees as issued by the Department of Health and Social Care in July, in advance of statutory guidance to come; the document essentially set out government expectations about how health overview and scrutiny committees should work with integrated care systems to ensure they were locally accountable to their communities. At the request of the Chair, it was noted that a copy of this guidance document would be sent to Health Scrutiny Committee members.

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 at least 3 clear working days prior to the meeting.  For this meeting, this means that any question(s) must be received in this office at the latest by 5.00 pm on Tuesday 4 October 2022.

Petitions and Statements - Petitions and statements must be received at latest by 12 noon 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 7 October 2022.

Please note that questions, petitions and statements must relate to the remit of this committee.

It was noted that no items of public forum business had been received for this meeting.

The Committee considered the annual business report.

The Committee RESOLVED:

1. To note the Scrutiny Committee’s terms of reference.

2. To note the membership of the committee for the 2022-23 municipal year.

3. To note the Chair and Vice-Chair arrangements for the 2022-23 municipal year.

4. To note the dates and times of meetings for the remainder of the 2022-23 municipal year.

- To receive the enclosed presentations/briefing note followed by an opportunity for discussion and member questions:

a. Update: Health and Social Care – integrated working (15 mins)

Presentation enclosed from Nicola Knowles, Policy & Public Affairs Manager, BCC

b. Locality Partnerships and Community Mental Health Transformation Programme (45 mins)

Briefing note and presentation enclosed.

Attendees for this item will include:

Stephen Beet, Co-Chair of South Bristol Locality Partnership (and Director: Adult Social Care, BCC)

David Jarrett, Director of Primary and Integrated Care, BNSSG ICB

Sharron Norman, Delivery Director - North & West Bristol Locality Partnership

Joe Poole, Delivery Director - Inner City and East Locality Partnership

Emily Kavanagh, Head of Locality - South Bristol Locality Partnership (on behalf of Steve Rea, Delivery Director - SBLP)

At the end of this item, there will be a 5 minute break.

a. Integrated Care System and related governance - update

The Committee received and discussed a presentation providing an update on the establishment of and governance arrangements for the Integrated Care System / Partnership / Board.

Summary of main points raised:

1. In noting and welcoming, in general terms, the purpose and expected benefits of the Integrated Care System, it was noted that there would inevitably also be forthcoming pressures on the Council’s and partners’ budgets given the context and impact of the national economic situation.  These pressures would need to be taken into account as necessary as part of ICP/ICB planning activity.

2. It was noted that tackling health inequalities, improving people’s experience of and access to health services, together with improving outcomes in population health with a particular focus on those ‘most in need’ were fundamental principles for the ICP.

3. The proposal to allocate 8 seats within the 28 seat ICP membership to the voluntary, community and social enterprise sector was welcomed, noting that there was a degree of local discretion in determining these arrangements.   It was noted that careful engagement was taking place in relation to the representation arrangements in line with the commitment to developing a citywide approach to working equitably with the sector in Bristol.  It was hoped that the progressive approach being taken could potentially be seen as a model for elsewhere.  The full detail was being worked through but would include a clear job role/description/application process with a view to ensuring a best practice approach.

4. It was noted that developing an Integrated Care Strategy (within a timescale of December 2022) was a key area of immediate attention for the ICP/ICB. The strategy would include a focus on:

- the challenge of reducing inequalities and disparities in health and social care.

- improving service quality and performance.

- promoting control, choice and flexibility in how individuals receive care and support.

- setting out how commissioners in the NHS and local authorities, working with providers and other partners, can deliver more joined-up, preventative, and person centred care.

- working closely with local people and communities, with a view to delivering

system level, evidence-based priorities in the short, medium and long term.

b. Locality Partnerships and Community Mental Health Transformation Programme

The Committee considered and discussed a presentation providing an update on Locality Partnership development and implementation of the Community Mental Health Framework.

Summary of main points raised:

1. It was noted that the Community Mental Health Framework was being delivered across all 6 locality partnerships within the BNSSG geographical area.  Through mental health teams or integrated personalised care teams, the Community Mental Health Programme Board, in partnership with each Locality Partnership, would evaluate how this approach:

- increased people’s access to high quality and personalised care, close to home.

- affected people’s mental health outcomes.

A phased approach was being taken to an integrated community mental health service that was personalised, proactive and preventative to support individuals in getting the right service, at the  ...  view the full minutes text for item 20.

To receive the enclosed briefing note/presentation followed by an opportunity for discussion and member questions.

Attendees for this item will include:

David Jarrett, Director of Primary and Integrated Care, BNSSG ICB

Dr. Geeta Iyer, GP at Gloucester Road Medical Centre and Clinical Lead for Primary Care Development, BNSSG ICB

Jenny Bowker, Head of Primary Care Development, BNSSG ICB

The Committee considered and discussed an update covering the following key areas of work in relation to timelyand equitable access to healthcare via general practice:

- Background and context to GP access, following the Covid-19 pandemic.

- Current GP access position and ongoing work.

- Workforce issues, including recruitment and retention.

- Recovery / health inequalities update.

- Communications and engagement update.

Summary of main points raised:

1. It was noted that a GP access campaign had been launched in early July with the aim of increasing understanding of and trust in services delivered from GP surgeries across the BNSSG area.  Whilst welcoming this initiative, the Chair suggested that every effort be maintained through communications teams to raise awareness of this type of initiative amongst city councillors.

2. In noting the information provided around communications and engagement, Cllr Massey drew attention to the useful approach taken by the Greenway Community Practice, which included consulting a patients group on proposed communications, e.g. in relation to a leaflet made widely available to residents on accessing services.  The practice had also introduced and provided clear information to make the public aware of the role of Care Navigators; these were not just 'receptionists’ but had a wider role to actively listen and to signpost people to the most appropriate source of help and support.  She also drew attention to the usefulness of the NHS patient app and suggested that every effort should be made to promote its availability and to encourage use. 

3. In response to questions from Cllr Hathway, it was noted that the current (increasing) percentage of 54% of patients being seen face-to-face by their GP compared with a pre-pandemic level of approx. 80%; it was confirmed that if a patient, having initially accessed a GP via an alternative means, asked for a face-to-face appointment, this would be accommodated.

4. In further discussion, it was noted that the experience of whether an alternative means of accessing a GP worked effectively (in comparison with a face-to-face appointment) for both doctor and patient varied, depending on each individual patient’s needs and the nature of each case.  In some circumstances, for example appointments that were more ‘transactional’ or where a GP was very familiar with a patient’s condition and knew the patient well, a phone conversation could sometimes be mutually appropriate for both doctor and patient; alternatively, diagnosis might in some cases not be possible through an initial phone appointment, in which case a follow-up face-to-face appointment would be appropriate.  Practices accepted the need for a flexible approach depending on the nature of the case.  In terms of the length of time taken to secure a face-to-face appointment, it was noted that the timeliness of appointments could sometimes be affected in circumstances where a patient indicated a wish to see a particular GP. 

5. With regard to the telephony statistics reported through the presentation, it was noted that call abandonment data was not currently available.  It was also noted that a new  ...  view the full minutes text for item 21.

The Committee noted the latest work programme update.  It was agreed that it may be appropriate to include an item on the Integrated Care Strategy as part of the agenda for the 20 March 2023 meeting.