The Health Select Committee of Wiltshire Council met on 12 June 2024 to discuss several key health and social care initiatives. The committee reviewed the progress of the NHS@Home Wiltshire and Urgent Community Response services, the Wiltshire Community Area Joint Strategic Needs Assessment, the allocation of Substance Use Grants, and the impact of the Domestic Abuse Safe Accommodation Grant.

Reducing Hospital Admissions - NHS@Home Wiltshire and Urgent Community Response

The committee focused on the impact of the NHS@Home Wiltshire and Urgent Community Response (UCR) services. Lisa Haywood, Chief Operating Officer of Wiltshire Health and Care, introduced the services, followed by presentations from Sam Olden, Consultant Physiotherapist, and Gemma Pugh, Head of NHS@Home.

Urgent Care Response (UCR)

The UCR service provides urgent support for various health emergencies, including catheter care, diabetes, palliative care, and non-injury falls. The service aims to prevent hospital admissions by treating patients at home. Key points discussed included:

• 70% of patients are seen within two hours of referral.
• The service has handled over 8,000 referrals in the past year, preventing many hospital admissions.
• Only 1.6% of patients were admitted to hospital after being seen by the UCR service.

The committee raised questions about the integration of UCR and Virtual Wards services, the adequacy of the two-hour response time, and the potential extension of service hours beyond 8am to 8pm.

NHS@Home (Virtual Wards)

The NHS@Home service allows patients to receive acute care at home, particularly benefiting frail patients with respiratory or heart conditions. Key points included:

• Patients receiving care at home are less likely to acquire infections and experience a decline in mobility.
• The service aims to prevent hospital admissions by providing daily care for acute conditions.

The committee inquired about the service's collaboration with neighbouring areas, its involvement in end-of-life care, and plans to extend the service to 24 hours a day.

The committee resolved to thank Wiltshire Health and Care for the overview and recommended promoting the UCR service to increase awareness, particularly among carers. They also requested updates on the services, including performance data.

Wiltshire Community Area Joint Strategic Needs Assessment 2024

Rachel Kent, Public Health Consultant, and Sarah Hartley, Public Health Scientist, presented the Wiltshire Community Area Joint Strategic Needs Assessment (CAJSNA) tool. The CAJSNA provides insights into local demographics, needs, and strengths across Wiltshire's 18 community areas. The committee discussed the engagement with military personnel, the objectives of the resident survey, and how the findings would inform the council's work.

The committee resolved to note the content of the CAJSNA and encouraged members and area boards to promote and use the resource.

Substance Use Grants

Kelly Fry, Principal of Building Resilience, and Lizzie Shea, Projects Officer for Substance Misuse, provided an overview of how Substance Use Grants are being allocated. The discussion covered several grants, including the Supplementary Substance Misuse Treatment and Recovery Grant, Rough Sleeping Drug and Alcohol Treatment Grant (RSDATG), Inpatient Detoxification Grant (IPD), and Individual Placement Support Grant (IPS).

Supplementary Substance Misuse Treatment and Recovery Grant

The grant aims to increase the number of adults in structured treatment, support prison leavers, and provide residential rehabilitation. The 2024-25 grant allocation is £633,699, up from £358,692 in 2023-24.

Rough Sleeping Drug and Alcohol Treatment Grant (RSDATG)

The grant supports rough sleepers and those at risk, with a 2024-25 allocation of £568,770. The committee discussed engagement strategies for those unwilling to seek support and the cooperation with the police.

Inpatient Detoxification Grant (IPD) and Individual Placement Support Grant (IPS)

The IPD grant supports inpatient detoxification, while the IPS grant aims to help individuals find paid jobs, training, and volunteering opportunities.

The committee resolved to note the overview of the work funded by the Substance Use Grants and requested an action or succession plan before the end of the grant period in early 2025.

Domestic Abuse Safe Accommodation Grant

Hayley Morgan, Consultant for Vulnerable Communities, and Daisy Manley, Projects Officer for Domestic Abuse, updated the committee on the Domestic Abuse Safe Accommodation Grant. The grant supports victims of domestic abuse in safe accommodation and is in its final year of a four-year funding programme.

Key Points

• The Domestic Abuse Act 2021 introduced statutory duties for local authorities to support victims in safe accommodation.
• Wiltshire's core domestic abuse support service, FearFree, received 2,788 victim referrals in 2022-23.
• Funding has been allocated to multiple providers, including the Connect Service and Julian House, to address local needs.
• The committee discussed the challenges of recruitment, high demand for services, and delays in obtaining safe accommodation.

The committee resolved to note the overview of the work funded by the grant and requested an update in 2025, including post-grant plans to support victims of domestic abuse.

Forward Work Programme

The committee noted the Forward Work Programme, which will be updated to reflect changes made during the meeting. The Chairman and Vice-Chairman will meet with relevant Cabinet members and Directors in April 2024 to further develop the select committee's forward work plan.

For more detailed information, you can refer to the Minutes Public Pack 27022024 Health Select Committee.