Agenda and draft minutes

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

It was noted that apologies for absence had been received from Cllr Graham Morris and Cllr Jerome Thomas.  It was also noted that Cllr Ellie Freeman was in attendance as a substitute for Cllr Thomas.

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.

None.

On the motion of the Chair, seconded by Cllr Bailes, the Committee RESOLVED:

- To confirm the minutes of the meeting of the Health and Overview Scrutiny Committee held on 15 October 2024 as a correct record.

To receive any announcements from the Chair.

The Chair drew attention to the following matters, noting that supplementary information had been circulated alongside the agenda pack:

a.  A briefing paper providing an overview of the Care Quality Commission (CQC) assessment of Urgent and Emergency Services at Bristol Royal Infirmary, and on the 2024 National Urgent and Emergency Care survey.

b. An update in respect of the ACER Detox facilities.

Up to 30 minutes is allowed for this item.

Any member of the public or councillor may participate in Public Forum. Public Forum items must relate to the remit of the committee and should be addressed to the Chair of the committee.

Members of the public who plan to attend a public meeting at City Hall are advised that you will be required to sign in when you arrive. Please note that you will be issued with a visitor pass which you will need to display at all times.

Please also note:

Questions

1. Written public questions must be received by 5.00 pm, at least 3 clear working days prior to the meeting. For this meeting, this means that questions must be received at the latest by 5.00 pm on Friday 24^th January. Public Questions should be submitted via our webform: www.bristol.gov.uk/publicforum
2. Any individual can submit up to 3 written questions.
3. Written replies to questions will be available on the Council’s website at least one hour before the meeting.
4. At the meeting, questioners will be permitted to ask up to 2 oral supplementary questions.

Statements

1. Written statements must be received at latest by 12.00 noon, at least 2 working days prior to the meeting. For this meeting, this means that statements must be received at the latest by 12.00 noon on Tuesday 28^th January. Public Statements should be submitted via our webform: www.bristol.gov.uk/publicforum
2. Statements, provided they are no more than 1,000 words in length, will be circulated to all committee members and will be published on the Council’s website at least one hour before the meeting.

Petitions

1.      Details of the wording of any petitions, and the number of signatories to petitions must be received at latest by 12.00 noon, at least 2 working days prior to the meeting. For this meeting, this means that petition details must be received at the latest by 12.00 noon on Monday 27^th January. Please email petition details to policycommittees@bristol.gov.uk

2.      At the meeting, individuals presenting petitions may be required to read out the objectives of the petition.

When submitting a question or statement please indicate whether you are planning to attend the meeting to present your statement ask your question

Public questions:

It was noted that 7 public questions had been received for this meeting, as follows:

Questions 1, 2, 3 - Lucy Taylor (on behalf of Bristol Inner City Primary Care Network) - GP practice funding and S106 funding for developments

Questions 4, 5, 6 - Ruth Jones: BNSSG NHS talking therapies provided by VitaMinds

Question 7 - Sally Kent: CAMHS Report

It was noted that written responses had been sent to the questioners and published on the Council’s website alongside the agenda papers for the meeting.

In relation to NHS talking therapies, it was noted that it would not be possible for ICB representatives to respond at this meeting to supplementary questions about an individual provider; however, ICB representatives indicated that, if contacted separately about particular matters of concern, they would endeavour to respond appropriately.

Public statements:

It was noted that 2 public statements had been received for this meeting, as follows:

Statement 1 - Peace Handovsky: ACER NHS detox unit

Statement 2 - Frances Robertson (on behalf of Cherington Road Neighbourhood Watch): Bristol Pharmaceutical Needs Assessment

Peace Handovsky and Frances Robertson were in attendance at the meeting and presented their statements.

In relation to the issues raised in Statement 1, the Chair advised the meeting of the contents of a communication received from Alison Smith, Deputy Chief Executive, Avon and Wiltshire Mental Health Partnership NHS Trust (AWP).  It was noted that a decision had now been taken by AWP to continue running a service at the Acer NHS detox unit beyond 1 April to enable a period of time to engage and consult widely on the longer-term viability, sustainability and demand for the service.  The intention was that a decision on the longer-term future of the service could then be taken in partnership.  Further details about this process, which would include engagement with staff, patients, partners, stakeholders and the wider community, would be shared as soon as possible.

The Chair welcomed this updated position statement from AWP, noting that the detail of the further consultation, including the timescale, was awaited.

Following discussion, it was suggested that an update on the position regarding the ACER unit should be brought back to the next meeting of the Committee.

The Committee considered a report providing an update on elective care and the recovery work underway across Bristol, North Somerset and South Gloucestershire, including progress with the hospital group model, building capacity and performance.

Summary of main points raised/noted in discussion:

1. It was noted that elective care across BNSSG was delivered by the NHS Trusts (North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust), a number of independent sector providers (through a combination of ICB and Trust sub-contract arrangements) and also through local community-based providers.

2. It was noted that elective care in BNSSG prioritises treating the most clinically urgent patients first followed by those people who have been waiting the longest for surgery or other treatments.

3. It was noted that nationally set ambitions and targets were in place for elective pathways, diagnostic pathways and cancer pathways.

4. It was noted that BNSSG had been building capacity throughout 2024/25, including two community diagnostic centres opened in 2024.  The BNSSG Elective Care Centre at Southmead hospital was also in construction and would open in 2025, facilitating an additional 6,500 operations peryear.

5. National targets were being met in relation to diagnostic, routine elective and cancer pathways. The performance position had been consistent and BNSSG was currently achieving 69% of patients completing their pathways in under 18 weeks.

6. In response to a question, it was noted that commissioning policies were in place across all pathways.  These were kept under review but there were no currently planned changes to these policies.

7. In response to a question, it was confirmed that where appropriate, triage and prioritisation took place through multi-disciplinary teams.

8. It was noted that in taking forward future investment, emphasis would be placed on targeting investment that would reduce health inequalities across BNSSG’s communities.

9. It was noted that in terms of prioritisation, there was a constant tension in terms of carefully managing the balance between elective care and emergency care.  Work was also continuing across adult social care to increase ‘out of hospital’ capacity and with the reablement service to help patients leave hospital as soon as possible following treatment.

10. It was suggested that in future updates, it would be helpful to include information about how delayed elective surgery is managed, e.g. in cases where patients need to delay the timing of treatment.

The Committee agreed to note the update and the above information.

The Committee considered a report providing an update on progress being made within general practice and assurance in relation to the collaboration to date regarding collective action mitigations.

Summary of main points raised/noted in discussion:

1. It was noted that the report (and accompanying slide deck) set out details on:

a. an overview of general practice structure.

b. the monitoring of practices.  The ICB had developed a dashboard that monitored quality and resilience across practices, incorporating a number of metrics including workforce and quality. This was ‘RAG’ rated to help early identification of practices which might need support from the Practice Support Team and/or the Access, Resilience and Quality Team.

c. access and workforce challenges. It was noted that some practices serving areas of deprivation faced challenges with recruitment and retention.  Targeted work was underway with these practices to support the understanding of processes, care navigation, appointment book mapping, population need and workforce planning.

(Note: Cllr Martin arrived at the meeting at this point.)

2. In response to a question, further detail was outlined on work taking place (including work through a training hub) to assist those practices facing recruitment and retention challenges.  In discussion, it was suggested that work should continue with schools to raise awareness amongst young people and promote potential future work opportunities/training pathways in the sector.

3. In response to a question, it was noted that the ICB was engaging with the Council’s planning service to understand the impact of planned new development in the city (including any funding opportunities through section 106/community infrastructure levy).

4. In response to a question, it was noted that telephone call contact with residents was proving useful in terms of triage; ‘face to face’ contact was though available for those preferring that form of contact.

5. It was noted that key next steps being taken across general practice services included:

- accelerating work planned through the Primary /Secondary Care Interface Group.

- continued collaborative working with system partners around the prioritisation of work and moving to new ways of working.

The Committee agreed to note the update and the above information.

The Committee considered a report providing an update on the Child Adolescent Mental Health Service (CAMHS).

Summary of main points raised/noted in discussion:

1. It was noted that recent successes within the CAMHS service included:

- the development of a telephone support line, including ‘waiting well’ calls.

- meeting the urgent performance targets and maintaining treatment waits.

- development of the young persons’ transition service.

2. It was noted that key challenges to the service were:

- adequate bases to meet the needs of service users.

- accessibility of services to meet the needs of children and young people.

- vacancies within some teams, which had impacted some wait times for services.

3. It was noted that the CAMHS emergency response line offered a 24/7 service, with consistently good feedback from acute hospitals, carers, young people and CAMHS colleagues.

4. It was noted that a new, enhanced service had been created to support the transition of

young people from CAMHS to post-18 adult mental health services and mental health services in primary care.

5. It was noted that Riverside Tier 4 General Adolescent Unit was closed at the end of January 2024, due to patient safety concerns. The unit remained closed.  Since the closure, however, significant improvement work had been undertaken.  The aim was to reopen the unit, following on from co-production work and collaboration with service users, carers and taking account of wider stakeholder engagement and feedback.

6. Members generally welcomed the breadth of information and detail included in this update.

7. In response to a question, it was confirmed that improving access of children and young people to mental health services remained a key priority.  This included work in and with schools and a commitment to further develop this.  An improvement project was also being taken forward on improving experiences and access for black and brown young people.

8. In response to a question, it was confirmed that the transition to use of the NHS crisis line 111 was aimed at improving ease of access to services.

The Committee agreed to note the update and the above information.

It was noted that a supplementary update had been circulated and published (as part of the agenda pack for this meeting) providing information on the Children, Young People and Families Neurodiversity Transformation pilot.

The update was noted.

This is a discussion item.

It was noted that the Chair would be discussing the content of the proposed Memorandum of Understanding with representatives of the ICB.  Members were welcome to feed any comments into this process.