Meeting documents

Venue: Mezzanine Room 1, County Hall, Aylesbury. View directions

Contact: Liz Wheaton 

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Note No. Item



Apologies for Absence / Changes in Membership

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Apologies had been received from Mr B Bendyshe-Brown, Ms L Clarke OBE and Ms S Jenkins.


It was noted that Mr M Hussain was no longer a Member of the Committee and Ms J Cook had been replaced on the Committee by Ms C Jones as the Chiltern District Council representative.


Declarations of Interest

To disclose any Personal or Disclosable Pecuniary Interests

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There were no new declarations of interest.  Julia Wassell reported that her interests had already been declared.



Minutes pdf icon PDF 591 KB

To confirm the minutes of the meeting held on Tuesday 30th January 2018.

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The minutes of the meeting held on Tuesday 30th January were agreed as a correct record and signed by the Chairman.


Public Questions

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  Members of the public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 


For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

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There were no public questions.



Chairman's update

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The Chairman updated the Committee on the following:


·         Mr N Dardis had now left his position as Chief Executive of Bucks Healthcare Trust and Mr N Macdonald had taken over as Interim Chief Executive.  The Chairman had attended Mr Dardis’s leaving lunch to wish him well.

·         The Chairman had attended an informal BOBW STP (Buckinghamshire, Oxfordshire and Berkshire West Sustainability & Transformation Partnership) scrutiny Chairmen and Officer meeting.

·         The evidence gathering was coming to an end in the Child Obesity Inquiry.  The final meeting would be taking place next week.

·         Care Home Visits would be arranged for the Autumn.

·         The Chairman asked for volunteers to help in preparing a statement on behalf of the HASC in Bucks Healthcare Trust’s Quality Account.  Mr R Bagge and Ms B Gibbs volunteered to do this with Ms L Wheaton, the Committee & Governance Adviser.


Forthcoming events


·         The Chairman reminded Committee Members of the Centre for Public Scrutiny event being held in Reading on Wednesday 21st March.

·         Bucks Healthcare Trust Board meeting was taking place on Wednesday 28th March at Hampden Lecture theatre in Wycombe.  Julia Wassell agreed to attend this meeting on behalf of the Committee and report back at the April meeting.


Action: Julia Wassell



Committee Update pdf icon PDF 115 KB

An opportunity to update the Committee on relevant information and report on any meetings of external organisations attended since the last meeting of the Committee.  This is particularly pertinent to members who act in a liaison capacity with NHS Boards and for District Representatives.

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Committee Members provided the following updates:


·         Ms T Jervis, Healthwatch Bucks, updated the Committee on the feedback from the recent engagement events carried out by BHT on the development of the community hubs.  Representatives from Healthwatch Bucks attended all the events and the feedback was compiled into the attached report.



Oxford Health pdf icon PDF 502 KB

Mental Health is a key priority for the Health & Wellbeing Board and is high on the agenda for many health organisations so this item is an opportunity for Members to hear from representatives from Oxford Health and Adult Social Care about delivering mental health services across the County.



Lin Hazell, Cabinet Member for Health & Wellbeing

Ms G Quinton, Executive Director, Communities, Health & Adult Social Care

Ms S Westhead, Interim Service Director (Operations), Adult Social Care

Ms S Robinson, Head of Service, Buckinghamshire Adult Mental Health



Report attached


Intended outcomes:

For Members to seek reassurance about the County’s mental health services and to hear from health and social care professionals about the challenges facing them and their plans for meeting future demand on the service.

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The Chairman invited Committee Member, Julia Wassell to lead this item due to her experience in this area.  She welcomed Lin Hazell, Cabinet Member for Health & Wellbeing, Ms S Westhead, Interim Service Director (Operations) and Mrs S Robinson, Head of Service, Buckinghamshire Adult Mental Health.


During the presentation, the following main points were made:-


·         Buckinghamshire’s Mental Health Care was provided by Oxford Health NHS Foundation Trust supported by the County Council through a S75 agreement which had been in place since 2007.

·         The Clinical Commissioning Groups had allocated £40m to Oxford Health and the County Council contributed £3.7m for the social care costs associated with mental health services.

·         The Whiteleaf Centre in Aylesbury was the base for the Adult Mental Health team who support patients in the community.  Whiteleaf was also where inpatient services were located.

·         The Integrated Care System had created opportunities for further integration work.

·         A bid had been submitted for additional funding to support the peri-natal service for patients displaying mental health issues, before, during and after pregnancy.

·         The Psychiatric in-reach and liaison service (PIRLS), based at Stoke Mandeville Hospital, provided wrap around care for patients who were initially being treated for physical health problems but who also displayed mental health conditions such as depression, dementia or delirium.

·         During 2017, there were two safeguarding adults reviews and as a result, Oxford Health was piloting a senior mental health nurse working within the MASH (Multi-Agency Safeguarding Hub) with the Police and County Council staff.  The pilot would be evaluated after 3 months.


In response to questions from Members, the following key points were made:-


·         There was a Physical Health Action plan which included CQUIN targets set by the Clinical Commissioning Groups which aimed to achieve parity of esteem.

·         It was noted that those suffering from mental health issues had their mortality rate reduced by 20 years.

·         As part of the contract monitoring, the dashboard performance data would be reviewing parity of esteem.  It was acknowledged that there was currently no benchmark data around parity of esteem and it was still early days in achieving it.

·         The additional funding made available by the Government was already in the baseline budget and Oxford Health was working with the Clinical Commissioning Groups to identify priority areas.

·         Self-neglect was a priority and Bucks Adult Safeguarding had developed an Improvement Plan around this.

·         In response to a question about the overarching vision for mental health and how the initiatives were working together to achieve the vision, Ms Westhead recognised the need to join-up the vision for mental health with adult social care.  Oxford Health was working with the Clinical Commissioning Group to focus on outcomes and to better understand what the data was showing in order to measure the effectiveness of the interventions.  This was work in progress and it was agreed that comparative data would be presented to the Select Committee in due course.

·         It was acknowledged that there was more work to do around transitions from the Children’s Mental Health  ...  view the full minutes text for item 7.



Direct Payments pdf icon PDF 169 KB

This item provides Members with an opportunity to hear more about the Council’s Direct Payment scheme.



Lin Hazell, Cabinet Member for Health & Wellbeing

Ms G Quinton, Executive Director, Communities, Health & Adult Social Care

Ms S Westhead, Interim Service Director (Operations), Adult Social Care



Powerpoint presentation from Adult Social Care

Guidance leaflet


Intended outcome:

For Members to gain a greater understanding of the Council’s Direct Payment scheme and to ensure that the scheme meets the needs of service users.

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The Chairman welcomed Lin Hazell, Cabinet Member for Health & Wellbeing, Ms S Westhead, Interim Service Director (Operations) and Ms M Smith, Head of Business Improvement.


The following main points were made during the presentation and in response to Member questions:-


·         Buckinghamshire was in the national top quartile of performance on the percentage of clients who had a Direct Payment.

·         Of the 6,000 people who use adult social care services, 1,550 were using Direct Payments of which 900 people were already using the Virtual Wallet.

·         The creation of the Virtual Wallet had delivered savings.

·         Providers were paid within two days through the Virtual Wallet scheme so it had significant benefits for both the provider and the service user.

·         The scheme provided assurance and oversight of a person’s care.

·         People in residential care homes or nursing homes could not use the Direct Payment scheme.

·         The Direct Payment summary page which sets out key information about the Direct Payment would be available in the next few weeks’ (2017/18 financial year).

·         The client and staff access to the virtual wallet would be available in the first half of the 2018/19 financial year.

·         The Direct Payment calculator was currently being tested and would be rolled out over the next few months.  There were also other financial improvements being made to the system to enable an oversight to be maintained on the competitive costs in the marketplace.

·         Work with health partners was currently underway to move towards having one system for health and social care costs to reduce duplication and to provide funds in one place.  Health costs included equipment costs, assistive technology or recuperation treatments.

·         In response to a question about the number of people employed to administer the Direct Payment scheme, Ms Smith agreed to come back with the information.


Action: Ms Smith


·         The service offers were constantly being reviewed and refined and there was external support in place to assist with undertaking these reviews.

·         Feedback from service users and providers showed that there were areas to improve on but providers had indicated that they preferred the Direct Payment scheme.  It was agreed to share more detailed feedback with the Committee


Action: Ms Smith


·         The introduction of the new General Data Protection Regulations (GDPR) would impact on the scheme but Ms Smith reassured the Committee that the service had already made the necessary changes and was mindful of sharing, storing and accessing information.

·         As part of the development of the scheme, social care would support individuals in terms of "how to use the system" and were developing a series of leaflets to help users.



Committee Work Programme pdf icon PDF 19 KB

For Members to note the work programme and to provide possible future items for the Chairman to consider.



Work programme attached


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The Chairman asked the Members to note the following items on the work programme for the meeting in April.


·         12 month progress on the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Partnership and the Integrated Care System.

·         12 month evaluation of the Community hubs, "Developing Care Closer to Home" model developed by Buckinghamshire Healthcare Trust.



Date and Time of Next Meeting

The next meeting is due to take place on Tuesday 24th April 2018 at 10am in Mezz Room 1, County Hall, Aylesbury.

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The next meeting is due to take place on Tuesday 24 April 2018 at 10.00am in Mezz Room 1, County Hall, Aylesbury.