Agenda and minutes

Apologies for inability to attend the meeting were received from Councillors Dominic Boeck, Alan Macro and Roger Hunneman. Mark Robson substituted for Edward Donald.

To approve as a correct record the Minutes of the meeting of the Health Scrutiny Panel held on 27 March 2012.

To approve as a correct record the Minutes of the meeting of the Health Scrutiny Panel held on 10 May 2012.

The Minutes of the meeting held on 27 March 2012 were approved as a true and correct record and signed by the Chairman, subject to the inclusion of the following amendments:

Page 1, point 5 and page 3, point 6: It was noted by Councillor Tony Linden that ‘mason’ should have a capital letter and read ‘Mason’.

Page 1, point 5 and page 3, point 6: Councillor Gwen Mason commented that ‘a member of the West Berkshire Disability Alliance’ should read ‘an associate member of the West Berkshire Disability Alliance’.

Page 2, 2^nd paragraph: Councillor Mason noted that ‘Apri2’ should read ‘April’.

The Minutes of the meeting held on 10 May 2012 were approved as a true and correct record and signed by the Chairman.

To receive any Declarations of Interest from Members.

There were no declarations of interest received.

Purpose: To receive an update on actions from the previous meeting of the Panel.

The results of the NHS Continuing Health Care Programme were still awaited.

No further actions were brought forward.

Purpose: For the Chairman to draw to the Panel’s attention any urgent items for consideration.

No urgent items were reported.

Purpose: To receive information regarding the Royal Bekshire Hospital’s involvement in the review.

Councillor Quentin Webb expressed concern over Royal Berkshire Hospital’s (RBH) reluctance to take part in the patient survey operated by LINks and that the panel would like to understand the reasoning behind RBH’s position.

Tony Lloyd drew the group’s attention to his discussions with Dr. Lindsey Barker (Group Director, Networked Care) and Sharon Herring (Operations Manager) at RBH and informed the panel that there was now an agreement to run a survey for 500 people across the hospital. The questionnaire was being formatted to make it RBH specific and would cover patients aged 65 and over as they were discharged from any ward. It was not, therefore, West Berkshire specific. However, he assured the meeting that independent surveys generally gathered more honest answers. The aim was to begin the survey at the hospital in July 2012. He noted that this was the first time there had been a partnership between LINks and Royal Berkshire Hospital

The Chairman applauded and thanked Royal Berkshire Hospital for its participation in this endeavour.

In response to Councillor Webb’s query regarding RBH’s earlier position, Mark Robson commented that he had no personal knowledge of any previous decisions, but as the trust had been undergoing a major restructuring, it was possible the survey had been overlooked in the transferring of responsibilities necessitated by this process. However, following discussions with Tony Lloyd and the agreement on wording; he confirmed that the trust was content to take part in LINks consultation and felt it would dovetail into their own continuous survey.

Councillor Webb enquired as to Mark Robson’s role within the newly restructured Royal Berkshire Hospital. Mark Robson informed the meeting that his role was Director of Operation for Networked Care and he was line-managed by Dr. Lindsey Barker. He advised the meeting that the trust was clinically led with managerial support and was organised into 3 Care Groups:

1.      Urgent Care

2.      Planned Care

3.      Networked Care

His group dealt with long term specialities and his role was to provide support in order to ensure that targets were achieved and for quality assurance. Each Care Group had a board which was chaired by a Clinical Director.

The Chairman asked Mark Robson if the areas of dignity and nutrition would fall under his control. Mark Robson confirmed that this concerned all the Care Groups and he would be taking the lead in public / patient involvement. He explained that, in addition to the continuous survey, the hospital consults with patients via the Meridian online system which matches the statutory National Picker Institute survey. RBH endeavoured to ensure a consistent approach in its consultations and his experience had shown that useful variants of opinion emerged from different surveys.

Councillor Webb enquired if LINks had seen copies of the current questionnaires. Tony Lloyd responded that they had been offered sight of Meridian results, but had not yet received them.

Councillor Webb expressed his relief that RBH’s position had changed and asked how the consultation would be progressed. Mark  ...  view the full minutes text for item 8.

Purpose: To receive an update on the anti-child poverty strategy.

Julia Waldman introduced her report to show how the local issues related to the national picture She explained that this was a high level strategy that aimed to be achieved in 2020. Her experience had shown that this was a challenging target. West Berkshire was in a good position when compared with the performance to other councils. However, the results of actions taken now would not be seen for many years. In the short term the Council would endeavour to alleviate and change child / family poverty with the intention that as an adult they would not live in poverty. National guidance was being reviewed. The Coalition Government wanted to re-frame, by autumn, the building blocks put in place by the previous Government to reflect their own objectives, which could make it more difficult to compare data over time. Changes at national level would in-turn impact on local level work-streams.

Councillor Mason asked if national indicators were still being collected. Julia Waldman replied that some were still being collected and that the Government was looking to change the definition of NI 116, which would present a challenge in terms of comparative data. She commented that it was positive that this group had taken on responsibility for this concern. Child poverty was connected to health issues and was part of the NHS outcomes framework. Since she had written the report Child Poverty had been embedded in the Strategy Framework in Berkshire wide health services.

In response to questioning by Councillor Mason, Julia Waldman made the following points

·              Benchmarking with other unitary authorities: the health framework was Berkshire wide, and there was a synergy around early help.

·              Page 16, point 1.7 – annual reporting: The effect of any actions would not be seen for approximately three years. She hoped that when Public Health entered the authority they would take on the responsibility for data capture as there was less resource within the Council.

·              Page 16, point 1.8: as Council resources were stretched and areas overlapped with Public Health and Child Poverty, the inclusion of Public Health with in West Berkshire Council was a positive step.

·              Statutory duties would be carried out. However, the Children and Young People Service had worked hard to protect early help provision and a balance of provision across all areas in a context of reducing resources.

Tony Lloyd asked if there was a correlation between child poverty and subsequent criminality in later life; thereby a reduction in poverty was a reduction in crime. Julia Waldman advised that there was a whole suite of risk factors, with child poverty being one of them. There was also a correlation between out-of work parents and a higher level of accidents to children in their care. She concluded that she was grateful for the support of this group and the Child Poverty Action Group had produced an interesting report which showed a range of ideas of what had worked in the past and what had not (see attached).

Councillor Jackson-Doerge suggested  ...  view the full minutes text for item 9.

Purpose: To receive an update on the Health and Wellbeing Board.

June Graves introduced her report which showed the history behind the creation of the Health and Wellbeing Board (HWB) and an update on its progress.

Councillor Webb enquired if the HWB was replicating what had gone before. June Graves stated that it was a new development and was something very positive. There had been good attendance by clinical commissioning groups and she believed it had established its authority. However there were similarities with the Primary Care Trust (PCT) and it would be interesting to see how it developed further. The Government had acknowledged that there would be a transitional period until the CCG (Care Commissioning Group) formed a view of itself.

The Chairman asked if the board would be reactive or proactive. June Graves answered that it would mainly be proactive but would also be reactive. It was currently establishing itself, but had gained good attendance and commitment, with a completed draft strategy. In the course of a year it had gone from nothing to having a draft strategy prepared. West Berkshire was comparable to other Councils and had made good progress. As the CCGs took their commissioning plans, there might be a challenging period for the board. Health services coming into the local authority might find the democratic aspect challenging.

Tony Lloyd concurred that HWB meetings would be held in public and therefore doctors might have to justify their decisions.

June Graves further discussed the work needed for transition at chief executive level. The model was being developed for Public Health delivering on a Berkshire wide level. Nick Carter and Andy Day were working hard to encourage everyone to sign up; however it was necessary to address staffing issues through a consultation exercise in order to comply with statutory time-frames and enable staff to consider their future.

Councillor Jackson-Doerge inquired whether the consultation document would be led by the Council or PCT. She felt it should be a joint piece of work owned by the Local Authority; however Public Health might have resources that could be utilised.

June commented that there was speculation regarding secondary legislation falling under section 102, which she would support.

Purpose: To consider items for, and prioritise the work programme of the Health Scrutiny Panel for 2012/13.

The following amendments to the work plan were proposed and accepted (see revised programme attached):

·              OSMC/11/125 - Day Centres

The Chairman suggested this item be deleted. Councillor Mason agreed as no feedback regarding gaps in service had been received and there were no Officers available to take responsibility for this subject. She expressed her concern regarding the impact of a reduced service on those in rural areas.

·              OSMC/11/105 - Dignity and Nutrition – Hospitals

June Graves informed the meeting that Nigel Owen was no longer an Officer at West Berkshire Council. The Chairman proposed that LINks should report back to the panel on the results of the consultation taking place this summer.

OSMC/11/106 - Update on the Health and Wellbeing Board

June Graves noted that Teresa Bell was no longer at West Berkshire Council

·              OSMC/11/119 - Continuing Healthcare (CHC)

Councillor Webb commented that the panel was still awaiting the results of this review.

·              OSMC/12/122 – Home Care

June Graves advised that this item was being addressed by the ASC Efficiency Programme and agreed to arrange a meeting with Councillor Webb to discuss what elements would be of interest to Scrutiny.

·              OSMC/12/124 - The effect of health service reorganisation

Tony Lloyd noted that West Berkshire Community Hospital was the only ‘local provision’. The Chairman agreed to readdress this item.