Agenda and minutes

To note any apologies for absence.

Apologies were received from Cllr Stephan Fifield, (Gloucestershire County Council), Cllr Helen Molyneux, (Forest of Dean District Council), and from Nikki Richardson from Healthwatch Gloucestershire.

Cllr Susan Williams substituted at the meeting for Cllr Stephan Fifield, (representing Gloucestershire County Council).

To report any declarations of interest.

No declarations were made at the meeting.

To confirm the minutes of previous meetings

The minutes of the meeting held on 18 October 2022 were confirmed and agreed as an accurate record of that meeting.

At each meeting of the Health Overview and Scrutiny Committee, there shall be up to 20 minutes set aside for members of the public, (including non-committee members), to make representation at the meeting. The process for submitting a representation will follow Gloucestershire County Council Constitution rules for making representation at public meetings.

The Council’s Constitution states that ‘any person who lives or works in the county, or is affected by the work of the County Council, may make written representation on any matter which relates to an item on the Health Overview and Scrutiny Committee agenda for that meeting’. Notification of the intention to make representation is required three clear working days before the date of the meeting, (excluding the day of the meeting). Where the person making representation attends the meeting in person, that individual will be invited to address the committee, (3 minutes per representative), to respond to the information provided in reply to the original representation.

The notification deadline to make representation at the committee meeting on 6 December 2022 is 4.00 pm on Wednesday 30 November 2022.

No public representations were made at the meeting.

HOSC members to receive an update on recent developments in NHS Dentistry Services in Gloucestershire and to note work to progress the delegation of dental commissioning to ICBs in April 2023.

At the Full Council meeting on 9 November 2022, members considered a motion relating to NHS Dentistry, where members expressed concern about the quality and cost of dentistry in Gloucestershire.

At the meeting, councillors resolved to:

1.    Write to the new Health and Social Care Secretary as well as Gloucestershire’s six MPs to express our concern for dentistry provision in Gloucestershire.

2.    Call on Cabinet to ensure that council services work with schools, care homes and the NHS to coordinate dental visits to the people who need it most.

3.    Ask the Health and Wellbeing Board and the Director of Public Health to bring a report to HOSC to explain what they are doing to promote good oral hygiene, specifically in children and young people and our vulnerable residents.

In response to the above motion, members to receive a report on oral health promotion initiatives.

Responding to the request for a further update to be presented to the committee in response to concerns about access to dental services in Gloucestershire and on the work to progress the delegation of dental services to the Gloucestershire Integrated Care Board in April 2023, members were reminded that at the Full Council meeting on 9 November 2022, members had considered a motion in response to concerns about the quality and cost of dentistry in Gloucestershire.

At the council meeting in November, councillors had resolved to:

1. Write to the new Health and Social Care Secretary and to the six Gloucestershire MPs to express the council’s concern about dentistry provision in Gloucestershire;

2. Call on Cabinet to ensure that council services worked with schools, care homes and the NHS to coordinate dental visits to those people in most need;

3. Ask the Gloucestershire Health and Wellbeing Board and the Director of Public Health at Gloucestershire County Council to bring a report to HOSC to explain what they were doing to promote good oral hygiene, specifically in children and young people and our vulnerable residents.

In response to the council motion, it was agreed the members of this committee, (as part of a planned update to the committee on access to dentistry), would receive a report on oral health promotional initiatives at this meeting.

Beth Smout from the Prevention, Wellbeing and Communities Hub (PWC) at Gloucestershire County Council (GCC) informed members that the County Council was statutorily responsible for improving the oral health of its local population. On this platform, there was an expectation for the Council to provide, (or commission), appropriate oral health programmes for the County and to carry out oral health surveys to assess outcomes, (oral health surveys are carried out as part of the Office for Health Improvement and Disparities (OHID) National Dental Epidemiology Programme).

The following information was noted at the meeting: -

1.    Since the establishment of the dental reform programme by NHS England (SW), there had been a slight increase in the number of patients in Gloucestershire who had been able to access an NHS dentist for routine care/treatment.

2.    The total number of adults seeing an NHS dentist in Gloucestershire had slightly increased from 28.6% in December 2021 to 29.2% in June 2022. However, the access rate for the adult population of Gloucestershire at 29.2% was less than the national access rate (England) at 36.9%.

3.    Similarly, the number of children who had seen a dentist in Gloucestershire in the last 12 months had increased from 43.9% in December 2021 to 45.8% in June 2022. However, the proportion of children in Gloucestershire accessing a dentist overall (45.8%) was still slightly lower than the access rate for children across the whole of England (46.2%).

4.    19.5% of 5-year-old children in Gloucestershire had experienced dental decay. This was lower than the average for both the South West (20.4%) and England (23.4%). However, rates of dental decay varied across the county. 26.5% of 5-year-old children in the Forest of  ...  view the full minutes text for item 5.

An update on the delivery of mental health services from the Gloucestershire Health and Care NHS Foundation Trust.

Angela Potter, (Director of Strategy & Partnerships), Karl Gluck, (Head of Integrated Commissioning: Adult Mental Health, Advocacy and Autism), and Hayley Payne, (Programme Manager: Children and Young People’s Mental Health), at the Gloucestershire NHS Health and Care Foundation Trust, (GHCFT), gave a detailed presentation on the delivery of mental health services in Gloucestershire.

It was reported that, whilst the demand for mental health services had increased in recent years, most areas, until now, had been able to absorb the demand without incurring longer waiting lists or without impacting on the effectiveness of treatment. One area of service experiencing a higher level of demand than in previous years, (pre-pandemic), was the number of people suffering from eating disorders in Gloucestershire. Collaboration with the mental health charity BEAT was being explored to develop therapeutic activities from which to address the increased demand.

A member referred to an incident at the Wotton Lawn Acute Mental Health Hospital and enquired about the security arrangements at the hospital. Whilst it was not possible to enter into specific details, it was explained that Wotton Lawn Hospital was not a secure unit. Whilst the hospital included specialised areas with higher levels of security, wards were not locked. Although no information could be given on the anticipated timescales for publication of the outcome report from a recent investigation at the hospital, it was agreed that the report, when available, would be circulated to the committee. Concerns relating to staff wellbeing at Wotton Lawn Hospital were noted by the Health and Care Team, where it was confirmed staff at the hospital had been well supported following the incident.

A member sought clarification on where the Maxwell Centre was based, (where members of the public detained under Section 136 of the Mental Health Act are evaluated). It was explained that the Maxwell Centre had not moved location and was not currently manned 24/7 by default but could be manned at any time by the crisis team, dependant on need. Dependant on the evaluation, patients were either sent to an inpatient bed or supported through crisis resolution and returned home.

Responding to questions on the influence of social media, it was acknowledged that social media was deemed a significant factor in influencing mental health. Members noted that the NHS worked closely with schools to monitor social media influences. A member asked whether interventions, including ‘young minds matter’ could be implemented at home rather than just at school. It was confirmed that interventions for people physically unable to attend school formed part of the Trust’s work.

In response to a question on how the ‘new locality model’ might be applied across the Cotswolds, it was reported that the plan was to create virtual teams made up of different health care workers who could benefit from discussing patients jointly. Using a phased approach allowed this to be implemented in a tailored way across each region. The option of using buildings and schools in rural locations was being explored to help improve access to  ...  view the full minutes text for item 6.

To receive an update on the performance of the Gloucestershire Integrated Care System (GICS) against NHS constitutional and other agreed standards.

Mary Hutton, Chief Executive of the Gloucestershire Integrated Care Board (ICB), presented an update on the work of the Board. The report was taken as read.

Invited to ask questions on the report, one member asked what support was being provided to GP surgeries when identified as needing improvement and what would happen if they failed to improve. It was confirmed that, to date, no GP had failed to improve and that the support offered to GPs was well received.

Another member referred to an absence of data in the report and was advised that benchmarking data would be provided at a later date. When asked when the data would be provided, it was explained that information would be added to the performance report each month and that the reporting of the full data should be ready to commence in March.

Chair of the Committee, Cllr Andrew Gravells, referred to the work of the GHT to support veterans and asked why this hadn’t been referenced in the report. It was confirmed that a small reference to the work was included in the report.

The performance report was noted.

A report from the NHS Gloucestershire Integrated Care Board (ICB), known collectively as NHS Gloucestershire. The report to include updates from Integrated Care System (ICS) partners responsible for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire.

The NHS Gloucestershire Integrated Care Board, (ICB), report was taken as read. The report included updates from Integrated Care System (ICS) Partners responsible for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire.

To note the dates of future meetings and to suggest items to include on the committee work plan.

The committee work plan was noted.