The Children, Adults, Health and Wellbeing Policy Development and Scrutiny Panel met on Monday 18 May 2026 to discuss a range of critical issues affecting local services. Key decisions included the panel's unanimous agreement to refer the outsourcing of RUH bank staff to the Secretary of State for Health and Social Care, and the noting of the council's participation in a bid for Regional Care Cooperatives. The panel also reviewed updates on the SEND reform plan, regional fostering hubs, and the BSW ICB's activities.

Outsourcing of RUH Bank Staff to Private Provider

The panel heard significant concerns from public speakers Nicola James, Baz Harding-Clark, and Paula Rysborough regarding the Bath Swindon and Wiltshire (BSW) Hospitals Group's decision to outsource its NHS bank staff to a private company, Pulse (part of Acacium Group), from 1 August 2026.

Speakers highlighted that this decision would lead to bank staff losing their NHS employment, with the only option to continue working bank shifts being to register with Pulse. This would result in a loss of NHS terms and conditions and significantly reduced pension accrual, with an estimated loss of tens of thousands of pounds in retirement income for some staff. Nicola James stated that the projected savings of £3.3 to £5.4 million come entirely from cutting employer pension contributions from 23.7% to 6%.¹ Baz Harding-Clark described this as privatisation by stealth, arguing that once a service like this moves into private hands, they are very hard and very expensive to bring back.²

Concerns were also raised about the impact on patient care, with speakers suggesting that the loss of experienced bank staff, who fill gaps in staffing and cover sickness and holidays, could lead to increased reliance on expensive agency staff and potentially impact patient safety. Councillor Joanna Wright questioned how this decision could impact public health, noting that if bank staff are unavailable, hospitals might rely on agency staff at a much, much higher cost.³

A significant point of contention was the perceived failure of governance. Public speakers and councillors highlighted that the panel, the Cabinet Member for Adult Services, and the BSW Integrated Care Board (ICB) were not informed of the decision until shortly before the meeting, despite the decision being made in March and the RUH being in Segment 4 oversight status since late last year. Nicola James stated, If the trust was in Segment 4 and the ICB was the oversight body, how is it possible that the ICB did not know?⁴ Representatives from BSW Hospitals Group, including Jude Gray (Chief People Officer) and John Palmer (Managing Director of RUH), apologised for the lack of timely communication, attributing it to the organisation finding its feet as a group and the ICB undergoing significant change. They maintained that the decision did not trigger a statutory consultation requirement as it was considered an operational governance issue, not a substantial variation of health services. However, they acknowledged that the panel should have been informed sooner.

The panel also discussed the potential impact on staff pensions, with Toby Simon, Chair of the Avon Pension Fund Committee, questioning whether staff would retain NHS pension benefits under the new arrangements, particularly in relation to the Fair Deal agreement. Jude Gray clarified that existing NHS employees who work bank shifts would continue to be NHS employees and retain access to the NHS pension scheme, with the option to join the People's Partner Pension. However, for bank-only workers, who represent approximately 15% of the bank workforce, their NHS pension accrual would end, and they would be offered access to the People's Pension.⁵

Following extensive discussion, the panel unanimously agreed to exercise its power of referral and write to the Secretary of State for Health and Social Care, outlining concerns about the decision-making process, the potential impact on staff and patient care, and the perceived failure of governance. They also requested a pause on the decision, which BSW Hospitals Group stated they would take back for consideration.

SEND Reform Plan and Schools White Paper

The panel received a briefing on the Department for Education's (DfE) Every Child Achieving and Thriving White Paper and the accompanying SEND reform proposals. Chris Wilford, from Children's Services and Education, presented the key changes, which aim to improve academic outcomes and halve the disadvantage gap for children from low-income backgrounds. The reforms focus on three shifts: a move from a narrow to a broad curriculum, from sidelined to included provision, and from withdrawn to engaging school environments.

A significant aspect of the reform is the requirement for local authorities to develop a Local SEND Reform Plan by 19 June 2026, underpinned by a Local Partnership Maturity Assessment. This plan will outline how local areas will improve their SEND system, with a focus on early intervention and inclusion. The DFE has indicated that successful submission of these plans will unlock a Stability Grant to help reduce SEND deficits.

The Local Partnership Maturity Assessment Tool rated the local area as Developing (a score of 2) across most pillars, with Emerging (a score of 1) for effective partnership working across education, health, and social care. The plan will focus on four key areas: the Experts at Hand Offer, sufficiency and place planning, effective practice universal offer, and effective partnerships.

Councillor Liz Hardman questioned the potential success outcomes of the SEND plan, particularly regarding improving the attainment of disadvantaged young people with special and complex needs. Chris Wilford explained that the reforms aim to halve the disadvantage attainment gap in 10 years by intervening earlier and focusing on universal and targeted support. Councillor Joanna Wright sought clarification on what enrichment opportunities means and expressed concerns about the lack of engagement from multi-academy trusts in partnership discussions.

The panel was assured that the draft SEND Reform Plan would be scrutinised by the panel before it goes to Cabinet in July.

Regional Care Cooperatives and Regional Fostering Hubs

The panel discussed B&NES' participation in a South West regional bid to establish Regional Care Cooperatives (RCCs) and the development of regional fostering hubs. Jean Kelly, Director of Children's Services, and Ian Tomlinson, Strategic Commissioner, explained that RCCs are DfE-supported regional partnerships aimed at improving the planning, commissioning, and delivery of care placements for children. The primary goals are to improve placement sufficiency, stability, value for money, and outcomes for children, while retaining local statutory responsibilities.

B&NES is participating due to existing sufficiency pressures, rising placement costs, and the need for better forecasting and regional market shaping. Councillor Toby Simon raised concerns about the legality of the arrangements and the potential impact of private equity in the sector. Jean Kelly confirmed that the bid supports the Council's statutory duties under the Children Act 1989 and that participation does not involve the transfer of statutory responsibilities or pooled budgets at this stage.

Regarding regional fostering hubs, the panel was informed that the government aims to recruit 10,000 extra foster carers nationally. The current regional hub is primarily a front door for expressions of interest, with local authorities still undertaking assessments. The DFE has asked regions to develop plans for end-to-end regional fostering hubs, with a submission deadline of 31 March. B&NES has indicated it will likely be ready by March 2027 for a full regional hub bid. Councillor Lesley Mansell asked for evidence that regional working is helping to recruit more foster carers and how the hub would prevent B&NES children from being deprioritised. Jean Kelly acknowledged that evidence of regional hub success is variable and that B&NES has experienced a low transition rate from inquiry to approval. She stated that the intention is to move towards a sub-regional approach to ensure all authorities are supported.

BSW ICB Update

Lucy Baker, B&NES Place Director for the BSW ICB, provided an update on several key areas. She confirmed that any returned NHS dental funding is ring-fenced and reinvested into dental services, and offered a dedicated briefing on dental funding flows. Updates were also provided on blood pressure roadshows, neighbourhood health planning, the new interim call handling arrangement for NHS 111 Press 2 (Mental Health), the revised opening date for the Kingfisher Unit, and the response to the meningitis outbreak in Kent.

Regarding the new HCRG Care Group service identity for BSW Community Health, Lucy Baker acknowledged feedback about residents struggling to access the new Single Point of Access (SPA) and assured the panel that communications would be reinforced locally. She also confirmed that the ICB is reviewing the national women's health strategy and that Lucy Baker herself has joined the West of England Women's Commissioning forum.

Councillor Joanna Wright raised concerns about alleged misogyny within the NHS, specifically regarding access to IV iron infusions for anaemia, and Lucy Baker stated that the ICB is reviewing this pathway. Councillor David Harding inquired about the communication of vape sharing risks in relation to the meningitis outbreak, and Lucy Baker noted that the direct cause was unclear but that universities were highlighting risks.

Panel Workplan

The panel reviewed its workplan and noted several upcoming items, including a response from the BSW Hospitals Group regarding bank staff outsourcing, an update on the ASC Improvement Plan, and the Complaints and Feedback Annual Report. New proposals for future reports included a session on legal responsibilities under the Health and Social Care Act, clarity on what issues require scrutiny, a visual map of local clusters and hubs, and an investigation into the provision and location of food pantries. Councillor Eleanor Jackson also raised concerns about transport to the RUH, particularly the impact of bus service changes, and Lucy Baker agreed to relay this to colleagues.