Use the Adobe bookmarks tool to easily access the agenda item reports Meeting in Public of the BSW CCG Governing Body Thursday 18 March 2021, 10:30hrs - Virtual meeting via Zoom - Timing No Item title Lead Action Paper ref. Opening Business 10:30 1 Welcome and Apologies Chair Note Verbal 2 Declarations of Interests Chair Note Verbal 10:35 3 Questions from the public Chair Note Verbal 10:40 4 Minutes from the BSW CCG Governing Chair Approve GB/20-21/138 Body Meeting held on 25 February 2021 5 Action Tracker Chair Review GB/20-21/139 10:45 6 BSW Clinical Chair’s Report Chair, Note Verbal (incl. reports from the Locality Clinical Dr Bryn Bird, Leads) Dr Amanda Webb, Dr Edward Rendell 10:55 7 BSW Chief Executive’s Report Tracey Cox Note GB/20-21/140 11:00 8 Medical Directors Quarterly Report Dr Ruth Grabham Note GB/20-21/141 Business items 11:05 9 COVID-19 Incident Response and Chair, Note Verbal Vaccination Programme Update Tracey Cox 11:15 10 BSW Performance, Quality and Finance Richard Smale, Note GB/20-21/142 Report Caroline Gregory 11:25 11 Urgent and Emergency Care – Current Al Sheward, Approve GB/20-21/143 State and Future Direction Emma Smith, and Karen Baker Note 11:50 - Short break – 10 mins 12:00 12 BSW Academy Sheridan Flavin Endorse GB/20-21/144 NHS Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group Page 1 of 2 Page 1 of 210 Timing No Item title Lead Action Paper ref. 12:20 13 BSW CCG 2020 NHS Staff Survey Sheridan Flavin Endorse GB/20-21/145 Results 12:35 14 Planning for 2021-22 Julie-Anne Wales, Note GB/20-21/146 Caroline Gregory 12:50 15 Governance Peter Lucas Verbal a. BSW CCG Audit Committee Terms of Note Reference b. External Audit Services Note 12:55 16 Risk Management Julie-Anne Wales Note GB/20-21/147 13:05 17 Integrated Care System Developments - Tracey Cox, Note GB/20-21/148 White Paper Briefing and Update on BSW Richard Smale Position Items for information Items in this section will be taken as read and not discussed unless members raise specific points 13:20 18 Summary Report from Governing Body Chair Note GB/20-21/149 Committees Closing Business 13:20 19 Any other business Chair Next meeting: Thursday 20 May 2021 NHS Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group Page 2 of 2 Page 2 of 210 DRAFT Minutes of the BSW CCG Extraordinary Governing Body – Meeting in Public Thursday 25 February 2021, 13:15hrs Virtual meeting held via Zoom Present Statutory Members Name Clinical Chair - Chair of Governing Body Dr Andrew Girdher AG Chief Executive Tracey Cox TC Chief Financial Officer Caroline Gregory CG Registered Nurse Maggie Arnold MA Secondary Care Specialist Dr Paul Kennedy PK Lay Member Audit and Governance (joined the meeting from 9:21hrs) Peter Lucas PL Lay Member Patient and Public Engagement (PPE) Julian Kirby JK Additional Members Lay Member Finance Ian James IJ Lay Member Primary Care Commissioning and Deputy Chair Suzannah Power SP Locality Clinical Lead (BaNES) Dr Bryn Bird BB Locality Clinical Lead (Swindon) Dr Amanda Webb AW Locality Clinical Lead (Wiltshire) Dr Edward Rendell ER Locality Healthcare Professional (BaNES) Dr Tim Sephton TS Locality Healthcare Professional (Wiltshire) (from 14:55hrs) Dr Catrinel Wright CW Locality Healthcare Professional (Wiltshire) Dr Nick Ware NW Locality Healthcare Professional (Wiltshire) Dr Sam Dominey SD Medical Director Dr Ruth Grabham RG Director of Nursing and Quality Gill May GM Director of Strategy and Transformation Richard Smale RS Attendees Interim BSW Executive Director for People and OD (from 9:00hrs) Sheridan Flavin SF Director of Corporate Affairs Julie-Anne Wales JAW BaNES Chief Operating Officer Corinne Edwards CE Swindon Chief Operating Officer David Freeman DF Wiltshire Chief Operating Officer Elizabeth Disney ED B&NES Director of Public Health Bruce Laurence BL Swindon Director of Adult Social Services Sue Wald SWa Wiltshire Director of Children’s Services Lucy Townsend LT Assistant Director of Corporate Affairs Anett Loescher AL Deputy Director of Communications and Engagement Tamsin May TM Board Secretary Sharon Woolley SW Director of Planning and Transformational Programmes Lucy Baker LB (for items 3 & 4) BSW Local Maternity System Midwife (for item 4) Sandy Richards SR NHS Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group Page 1 of 12 Page 3 of 210 BSW Programme Lead for Transition (for item 15 ) Catherine Phillips CP Clinical GP Lead for Mental Health (for item 3) Dr Sarah Blaikley SB Apologies Interim BSW Executive Director for People and OD Alison Kingscott Locality Healthcare Professional (Swindon) Dr Francis Campbell 1 Welcome and Apologies 1.1 The Chair welcomed members and officers to the meeting, and noted apologies. 1.2 The meeting was declared quorate. 1.3 To enable Governing Body meetings to continue as much as possible during these unprecedented times, Zoom was being utilised where possible. The Standing Orders allow for this provision. 1.4 Only those questions raised through the normal submission process of three working days in advance of the meeting would be acknowledged during the meeting. 1.5 The Chair advised Members that the order of the agenda would be amended as follows to enable Catherine Phillips to join the meeting after 15:20hrs; item 13 BSW CCG Inclusion Charter would be taken after item 15 Disciplinary Policy. 2 Declaration of Interests 2.1 The CCG holds a register of interests for all staff, Governing Body and committee members. None of the interests registered were deemed to be relevant for the meeting business. There were no other interests declared regarding items on the meeting agenda. 3 Update on All Age Mental Health 3.1 LB, Director of Planning and Transformational Programme and SB, Clinical GP Lead for Mental Health, were in attendance to present an update on all age mental health and emotional wellbeing challenges, solutions and transformation across BSW. The three year transformation plan would commence from 1 April 2021. 3.2 SB and LB talked through the comprehensive presentation, sharing the CCGs understanding of the mental health crisis, the services in place with providers and within secondary care, and highlighted the following to the Board: • Mental health referrals were now starting to return to pre-COVID levels. There had been a short temporary pause of the referral waiting list in January 2021 due to the third pandemic peak and the redeployment of some staff, but this had reopened as quickly as possible with prioritisation work now underway and escalation processes being reviewed. • The transformation plan had been co-created with the main mental health providers across BSW; Avon and Wiltshire Mental Health Partnership (AWP) and Oxford Health, and third sector support organisations. The additional £3.5m of funding will support this in year, at pace whole-scale transformation. • There was a known national shortage of Psychiatric Intensive Care Units (PICU) and children and young people (CYP) beds, however, AWP had commissioned NHS Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group Page 2 of 12 Page 4 of 210 additional beds for BSW where possible, and alternative solutions were being looked into. • The performance data indicated challenges surrounding the Improving Access to Psychological Therapy (IAPT) services and CYP access. Deep dives would be undertaken on performance measures across localities with the providers to understand the actual waiting times. • Weekly meetings are held with third sector, secondary care providers, and localities to review actions and positions; but it was recognised that a long journey of transition was ahead. • Themes from recent engagement and listening activities have been used to inform the transformation programme. • The demand for future mental health support needs to be better understood at system and locality level to plan and prioritise services. The ‘CReST’ (Children and Young People's Mental Health Referral System Management Tool) demand and capacity model was being used to develop scenarios. • A mental health Operational Pressures Escalation Levels (OPEL) dashboard had been developed, signalling those early warning triggers and pressure points to enable the teams to be proactive and plan for the future. • A co-designed BSW Staff Wellbeing Hub model would be going live in April as a response to the national request to an enhanced psychological offer, providing dedicated support for our health and social care staff. • A multi-agency BSW Suicide Prevention Working Group has been established, to develop targets and universal support and actions. Suspected suicide, suicide rates and trends were being monitored through this group. • The community mental health framework would build further on this multi-agency working – which would see an instant change in the referral process for GPs through the Primary Care Liaison Service (PCLS) to a community support triage officer to one of the three pilots (eating disorders, 16-25 pathway and personality disorders) to support workers placed within the five third sector partners. Holistic management and support would then be provided, not just mental health, and signpost patients to existing support areas. If referrals required IAPT support, these will be directed to psychologists and consultant clinical phycologists as to enable patients to meet the IAPT and therapy goals within eight to ten months. Support would continue through the community multi-disciplinary teams (MDTs) and all services, and at three, six and twelve months support for those discharged would be through the community network programme. The recovery and secondary care teams will be further utilised. A complete 360 narrative change for the mental health pathway. • The new model would bring a person centred approach to emotional, wellbeing and mental health support.