Agenda, decisions and minutes

To elect Vice-chair for 2024-2025

Elect Councillor Elwyn Jones as Vice-chair of the Care Scrutiny Committee for 2024/25.

Elect Councillor Elwyn Jones as Vice-chair of the Care Scrutiny Committee for 2024/25.

To receive any apologies for absence.

Apologies were received from Councillors Menna Baines, Angela Russell, Gareth Coj Parry and Anwen Jane Davies.

To receive any declarations of personal interest.

A declaration of personal interest was received from Councillor Rheinallt Puw on item 7, specifically the discussion on Mental Health. He withdrew from the meeting for this discussion only. The interest was not prejudicial to the rest of the discussion. 

To note any items that are a matter of urgency in the view of the Chairman for consideration.

None to note.

The Chairman shall propose that the minutes of the meetings of this committee held on the 21^st November 2024 to be signed as a true record.  (attached)

The Chair signed the minutes of the previous meeting of this committee held on 21 November 2024 as a true record.

To submit the inspection’s findings and the Council’s response to the Committee

To accept the reports and ask for progress reports.

A report was presented by the Cabinet Member for Adults, Health and Well-being, highlighting the full attendance of the Adults Department management team at today's meeting. They were thanked for their time, stating that their attendance demonstrated the Department's strength and commitment to its responsibilities. It was explained that a joint inspection of the services in the Adults Department was conducted by Care Inspectorate Wales (CIW) and the Wales Audit Office (WAO) in October 2024. It was therefore thought appropriate to submit both reports to the Care Scrutiny Committee within the same item.

It was added that during the same period, an inspection of the Department's work commissioned by the Department through the WLGA had been carried out and also the work on the Llechen Lân scheme. It was stated that there was an intention to bring the findings of all the inspections together and create a single detailed action plan for the Department. It was explained that this plan would in time be submitted to the Care Scrutiny Committee in order to receive its input, which was always appreciated by the Department.

CIW and WAO officers were thanked for their continued collaboration with the Adults Department and appreciation was expressed for their input. It was highlighted that a very high percentage of the issues identified were issues that were nationally challenging or were issues that had already been identified and the Department was trying to find solutions for them.

A representative of Care Inspectorate Wales presented the report, detailing the findings. Senior Officers of the Department were thanked for their preparatory work ahead of October and for the work and support during the inspection. The letter included in the Agenda (page 16) was highlighted and it was explained that this letter was the outcome of the visit.

Some matters included in the letter were highlighted such as the praise for the progress that had been made in the area of domiciliary care although there were further improvements to be made. It was thought that the waiting time for assessments needed to be reconciled as there were delays with some assessments for domiciliary care. The strengths and evident improvements in the area of adult safeguarding and assessment of people's mental capacity were also acknowledged.

It was accepted that challenges existed in trying to work in partnership with the Health Board while recognising that efforts were being made, and the importance of continuing those efforts was emphasised. Some areas for improvement were highlighted such as the challenges in recording data on assessments and support for unpaid carers, indicating that there was room to make the data more reliable.

A representative of  ⁠Audit Wales presented an overview of the Audit Wales Report as included in the Agenda (page 37). It was clarified that the inspection work carried out by WAO focused on matters relating to the provision and commissioning of internal and external domiciliary care. They expressed gratitude for the welcome during the visit and for the collaboration.

The Llechen Lân report  ...  view the full minutes text for item 6.

Questions to ask the Betsi Cadwaladr University Health Board

To accept the information received from the Health Board and their responses to members’ questions that will be summarised in the Committee’s minutes.

Representatives of the Health Board  were welcomed to the meeting. The questions that had been asked in advance were asked to the Health Board in the order in which they appeared on the Committee's Agenda, giving Health Board representatives the opportunity to respond and the Members to ask further questions.

Vision

Thanks were given for the warm welcome and it was stated that it was a pleasure to visit the Council to answer questions. It was explained that the 'Well North Wales' scheme had been running for some time but was something that the Health Board was reconsidering. It was explained that it was work that had been taking place with the third sector, with partners in the county councils across north Wales, and in Gwynedd it provided an opportunity to focus on well-being. It was elaborated that the intention was to try to help the people in disadvantaged areas in particular and to address the major problems that could make a difference in the background.

It was acknowledged that problems had arisen with staffing levels in community hospitals across Gwynedd. The Health Board's vision for the future, it was explained, was to establish more minor injuries units to prevent people from going to the larger hospitals for treatment. It was further clarified that the aim was also to set up treatment rooms in the community hospitals to prevent people from having to travel far to get intravenous drugs. It was reported that the 'Tuag Adref' service had had a positive start. It was noted that patients were able to remain in their homes with a little support from the Health Board and community nurses to avoid overcrowding in the hospitals.

The idea of having more community hospitals capable of providing more services to patients was welcomed, but as a consequence, concern was expressed about some services, such as the vascular service, being centralised. It was explained that there was vascular specialisation previously at Ysbyty Gwynedd, but the service was now centralised at Glan Clwyd Hospital. In response it was explained that the vascular service hub was based at Glan Clwyd Hospital and that some other services were at Ysbyty Gwynedd and Maelor Hospital. It was also noted that this was a wider problem as it was not possible to maintain specialist services everywhere in north Wales due to a lack of numbers.

Doctors and other daily services (which are non-emergency services)

It was reported that most of the Health Board's work was done in primary care. Statistics were submitted showing that, over a six-month period, there were half a million primary care appointments in north west Wales. It was recognised that there were problems with recruiting doctors which put a strain on the system but it was hoped that the opening of a medical school in Bangor would help this in the future.

In terms of access to primary care, it was noted that they worked in multidisciplinary teams, with prescribing pharmacists, therapists, nurses and paramedics all working together.  ...  view the full minutes text for item 7.