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Agenda and minutes

Venue: Council Chamber Council Offices Market Street Newbury. View directions

Contact: Gordon Oliver 


No. Item


Minutes pdf icon PDF 358 KB

To approve as a correct record the Minutes of the meeting of the Board held on 30 September 2021.


The Minutes of the meeting held on 30 September 2021 were approved as a true and correct record and signed by the Chairman.


Actions arising from previous meeting(s) pdf icon PDF 257 KB

To consider outstanding actions from previous meeting(s).


The following actions were noted as being outstanding:

·         153 – The peer review would be undertaken in 2022.

·         160 - Phase 1 of the Covid Recovery Dashboard was complete, but Phase 2 was hold.

·         165 - The transition between CYP and adult mental health services would be addressed as part of the Health and Wellbeing Strategy Delivery Plan.

·         168 - Initial discussions had taken place around data for the Covid Recovery Dashboard, but had yet to be concluded.

·         169 – This was on hold pending appointment of new Engagement Group Chairman

·         174 – Management of Priority 2 of the Strategy would be picked up in the review of the Steering Group ToR

·         175 – Quick wins had been identified in Delivery Plan – timescales would be confirmed when put into the project management software

·         176 – Feedback about communications was awaited from the Place Based Partnership

·         177 – The defibrillator report was on hold due to work pressures

All other actions were noted as complete.


Declarations of Interest pdf icon PDF 306 KB

To remind Members of the need to record the existence and nature of any personal, disclosable pecuniary or other registrable interests in items on the agenda, in accordance with the Members’ Code of Conduct.

The following are considered to be standing declarations applicable to all Health and Wellbeing Board meetings:

·         Councillor Graham Bridgman – Governor of Royal Berkshire Hospital NHS Foundation Trust, and Governor of Berkshire Healthcare NHS Foundation Trust; and

·         Andrew Sharp – Chair of Trustees for West Berks Rapid Response Cars



There were no declarations over and above the standing declarations of interest.


Public Questions pdf icon PDF 164 KB

Members of the Health and Wellbeing Board to answer questions submitted by members of the public in accordance with the Executive Procedure Rules contained in the Council’s Constitution.


A full transcription of the public and Member question and answer sessions is available from the following link: Transcription of Q&As.

a)    The question submitted by Karen Swaffield on the subject of children in  temporary accommodation in West Berkshire.

b)    The question submitted by Karen Swaffield on the subject of the shortest, longest and average time that a family had been in temporary accommodation in West Berkshire.

c)    The question submitted by Paula Saunderson on the subject of referral of the CCG report on Continuous Health Care to the appropriate scrutiny committee.


Petitions pdf icon PDF 302 KB

Councillors or Members of the public may present any petition which they have received. These will normally be referred to the appropriate Committee without discussion.


There were no petitions presented to the Board.


Membership of Health and Wellbeing Board pdf icon PDF 310 KB

To agree any changes to Health and Wellbeing Board membership.


The Chairman asked Members to note that Tracy Daszkiewicz had replaced Meradin Peachey as Director of Public Health for Berkshire West.

Action: Gordon Oliver to circulate the current membership list to all Board Members and to check that substitutes are identified for each Member.


Review of Continuing Healthcare pdf icon PDF 405 KB

Purpose: To update the Board on the review of Continuing Healthcare payments by the Berkshire West Clinical Commissioning Group.


[The Chairman agreed to bring this item forward on the agenda.]

Niki Cartwright (Director of Joint Commissioning for Berkshire West CCG) presented the Review of Continuing Health Care (CHC) (Agenda Item 10). She explained that CHC was funding made available to people with complex health needs and it resulted in a ‘yes’ or ‘no’ answer regarding eligibility.

In April 2021, the CCG had committed to undertake a review and had agreed to report back in six months’ time about the changes they were making to the CHC processes. The processes were found to be convoluted and time-consuming, so they had been revised and a simplified process map had been created. A dedicated team had been created for the management of new applications, with a 28 day standard for response times, and performance had improved. A dedicated review team had been created to focus on overdue reviews and case management. Interim staff had been recruited with experience of change management and ability to present quality applications within the 28 day expectation.

Local authority dispute meetings had been held with reduced delays and there had been improved relationships with stakeholders, with compliments received from all three local authorities. A provider engagement forum had been established with support from CCG leads, which helped to inform commissioning decisions. There had also been a review of Free Nursing Care, which had resulted in improvements.

Achievement of the 28 day target had gone from 25% in Q1 of 2021/22 to 61% in Q2 of 2021/22.

The Chairman noted that concerns had been expressed previously about where Berkshire West sat within the national league table for CHC payments and that Adult Social Care was having to provide support for patients who they felt should be supported by the NHS.

Councillor Jo Stewart asked if local authorities could engage with the Provider Engagement Forum. Niki Cartwright welcomed this.

Action: Councillor Jo Stewart to identify representatives from West Berkshire Council to attend the Provider Engagement Forum.

Maria Shepherd indicated that she would like to see where Berkshire West sat in the national table for CHC payments and indicated that historically West Berkshire had fared worse than Reading and Wokingham.

Niki Cartwright confirmed that the national average was 7% of applications approved and Berkshire West was at 10% and she offered to provide further detail.

Action Niki Cartwright to provide a breakdown of CHC payments by local authority in terms of percentages and actual numbers.

Andrew Sharp welcomed the simplified process as it would help to relieve the burden on carers and asked if support could also be provided for applicants. He indicated that historically applications were likely to be rejected unless applicants could provide supporting evidence and cited an example of one patient who died four days after their CHC application was rejected. He suggested that the opportunity should be taken to consider whether the service was delivering benefits for the people of West Berkshire where there was a higher proportion of people who would be likely to need  ...  view the full minutes text for item 63.


Healthwatch Report - Child and Adolescent Mental Health Services pdf icon PDF 163 KB

Purpose: To present the results of the Healthwatch survey on CAMHS in West Berkshire.

Additional documents:


[The Chairman agreed to bring this item forward on the agenda.]

Michelle Paice and Lesley Wyman presented the Healthwatch West Berkshire Report on Child and Adolescent Mental Health Services (CAMHS) (Agenda Item 13).

The process had started in July 2019 with a focus group to capture initial feedback. Due to the Covid pandemic, Healthwatch was unable to hold further focus groups, so feedback was sought via an online survey for families / carers of service users. Questions were asked around:

·         Waiting times for a diagnosis / to be seen for any other reasons

·         The difference that CAMHS had made

·         Whether earlier access to CAMHS would have made a difference

·         The quality of information provided upon discharge

·         Information about where to get help

The survey attracted 128 responses. This was considered to be a good response, since there had been 1,500 referrals across Berkshire West in 2021. Data was also taken from the Children’s Commissioner report on the state of mental health services. This showed that there had been a very large increase in referrals between 2017/18 and 2019/20, but access to treatment increased at a slower rate. This emphasised that there was a national issue for CAMHS. While some increase in demand was attributable to the pandemic, there was a risk that the increase in demand would continue.

The main issue to come out of the survey was the long waiting times - 93% of respondents had children of school age and of these 9% indicated that they had to wait between three and five years for a referral to CAMHS. Around half of respondents had to wait between one and three years for a diagnosis or access to CAMHS for any reason. Long waits had negative consequences for the children and for other family members. Three quarters of respondents felt that earlier access to CAMHS could have made a difference to their child. Overall, the service was not felt to be making the difference that parents / guardians had hoped for. Respondents also felt that they were not getting good enough information, especially upon discharge, and more information was sought around alternative services or support.

The recommendations were linked to the priorities in the 2019 Local Transformation Plan (LTP), which had been updated in September 2021, and it was  recommended that the LTP aims and objectives be fully implemented. Recommendations related to: reduced waiting times; better support and communication at all stages from referral through diagnosis, treatment and discharge; improvements to staffing to deal with the increase in referrals; and measures related to prevention / early intervention. It was suggested that improvements were required across the whole system, to create a comprehensive approach to address mental health and wellbeing problems for children and young people. While the LTP had excellent medium and short-term goals, Healthwatch West Berkshire called on all Board Members to consider what could be done in the short-term to improve the situation, and to consider the impacts of wider determinants on mental health and wellbeing. Another  ...  view the full minutes text for item 64.


Integrated Care Partnership Transformation Programme pdf icon PDF 1 MB

Purpose: To provide an update on the ICP priority around mental health and wellbeing services for children and young people.


[The Chairman agreed to bring this item forward on the agenda.]

Manu Cuccureddu presented the update on the Integrated Care Partnership (ICP) priority around mental health and wellbeing services for children and young people (Agenda Item 11).

Key points from the presentation were as follows:

·         The updated Local Transformation Plan (LTP) was published in September 2021 – this was a statutory requirement.

·         It built on the 2019 plan and provided an update on what had been achieved, as well as information on local needs and trends.

·         It included the voice of children / young people and their families / carers.

·         It articulated the further work and resources that were needed.

·         Key achievements included:

o   Establishment of three mental health support teams, with further teams to be set up this year, with all pupils to be covered by 2023.

o   Rapid response service was now a  seven day offer to 8pm, with plans to extend this further.

o   Improved data flow to the national system, which would help with understanding needs.

o   Digitised the ‘Little Blue Book of Sunshine’ and distributed in paper form to all pupils in Berkshire West.

o   Increased resources for the eating disorder service.

o   Launched the ASD / ADHD advice and guidance service for families of undiagnosed children.

·         There had been a review of all services, which had informed future priorities – the findings of this review matched those of the Healthwatch report.

·         The ambition was for the promotion of resilience and good mental health and wellbeing to be a priority across all partners and for the right health to be provided when and where needed, with the goal of reducing the number of young people whose needs escalated to crisis.

·         There were nine transformation priorities, including:

o   Building a formal delivery partnership arrangement, with a new website

o   Creating a single access and decision making arrangement

o   Tackling waiting times for specialist and core CAMHS

o   Meeting eating disorder waiting times for response to referrals, with additional resources and training

o   A community home treatment offer with 24/7 access for crisis cases

o   Mobilise two further Mental Health Support Teams by October 2022.

o   Meeting the Covid-19 surge demand as it arises

o   Addressing gaps in access and service offer due to inequalities (i.e. for children and young people with learning disabilities, those from ethnic minorities and those from LGBTQ+ communities)

o   Strengthening the adolescent to young adulthood offer (16-25), with a focus on trans-gender people and those moving from CAMHS to adult mental health services.

The Chairman noted that many of the issues raised were picked up in the Health and Wellbeing Strategy Delivery Plan and stressed the need to avoid duplication of effort.

Councillor Martha Vickers asked if people with eating disorders were still being referred to the specialist centre in Henley-Upon-Thames. Niki Cartwright explained that there was a home treatment service and offered to provide further information on the various elements.

ACTION: Niki Cartwright to provide information on the various components of  ...  view the full minutes text for item 65.


Berkshire West Health and Wellbeing Strategy 2021-2030 and Delivery Plan 2021-2024 pdf icon PDF 245 KB

Purpose: To present the Health and Wellbeing Strategy for approval together with the latest version of the Delivery Plan.

Additional documents:


The Chairman presented the item on the Berkshire West Health and Wellbeing Strategy and Delivery Plan (Agenda Item 8). He noted that the Strategy had previously been endorsed by the Health and Wellbeing Board with the expectation that it would be agreed by Council. However, following a review of the legislation, it was confirmed that the Board had the powers to agree the strategy. He invited questions from Board Members.

Councillor Martha Vickers asked if the list of organisations addressing health outcomes for vulnerable groups in paragraph 4.5 should include the Substance Misuse Harm Reduction Group. She also asked if other groups would be invited to present to the Board in future.

Sarah Rayfield indicated that the groups listed were those that would be focusing on the initial priority groups, including: people with dementia; victims of domestic abuse; homeless people; and people with learning disabilities and their carers. However, over the lifetime of the strategy, different groups would become involved based on the current population need.

The Chairman confirmed that the Board would engage with all parties with an interest in the health and wellbeing of local residents, but he indicated that the Delivery Plan would continue to be developed to reflect changing circumstances. Also, discussions were underway about how the various programmes would be managed to ensure they were not in conflict and to ensure that targets were achieved.


·         The Board formally adopted the Health and Wellbeing Strategy 2021-2030; and

·         The Board noted the update on the development of the delivery plan for the implemenation of the strategy in West Berkshire.


West Berkshire Better Care Fund Plan pdf icon PDF 119 KB

Purpose: To approve the Better Care Fund Plan submission for West Berkshire.

Additional documents:


Maria Shepherd presented the report on the Better Care Fund Plan (Agenda Item 9).

The policy framework had not been published until October 2021 and local authorities had been required to submit their plans to NHS England by 16 November - this had been done with delegated authority from the Chairman. The Plan built on work done in previous years, whilst supporting partners in recovery from Covid and winter planning. It consisted of a narrative and planning template that detailed income and expenditure together with targets. To comply with national conditions, the plan had to be agreed between Health and Social Care, and signed off by the Health and Wellbeing Board. The plan had also been signed off by the Clinical Commissioning Group’s accountable person, Dr James Kent.

There were four national metrics, two of which had remained unchanged - the reablement target and permanent admissions to care homes. There were also two new targets. The target for avoidable admissions had been set at 618, which was slightly below the 2019/20 figure, but remained challenging given the pressures on the NHS. The target on Delayed Transfers of Care had been suspended in March 2020 due to Covid and had been replaced with targets for reducing the length of stay in hospital and increasing the number of people discharged to their normal place of residence. These targets only related to quarters three and four of the municipal year. NHS England had asked for targets to be stretched and it had been agreed that targets would be similar to last year, which were considered to be challenging given current issues in the care market and Covid coinciding with the winter flu period.

Councillor Jo Stewart thanked staff for putting the plan together at short notice. She agreed that the best option was for people to be discharged to their own homes where possible, but acknowledged that there were issues in sourcing care staff. She asked about how residents could return care equipment if they could not get to hospital.

Maria Shepherd suggested that MRS would be able to pick up equipment. However, Andrew Sharp highlighted that they could only pick up a limited range of items.

RESOLVED: The Better Care Fund Plan for 2021-2022 was approved.


Skills and Enterprise Partnership Update pdf icon PDF 1 MB

Purpose: To provide an update on the work of the work of the Skills and Enterprise Partnership.


Iain Wolloff presented the Skills and Enterprise Partnership Update (Agenda Item 12).

The partnership had been running for a number of years, with a diverse range of organisations attending. The aims of the partnership were to support economic development through employment and skills development for under-represented groups by supporting individuals and employers. Target groups included: people with physical disabilities; people with mental health problems; people with learning disabilities; people with long-term health conditions; and young people. Key projects included: identification of key target groups; an awareness campaign on employment of people who were furthest from employment (this had been delayed due to Covid restrictions); Working for a Healthier Tomorrow - Phase 2 (also delayed due to Covid restrictions); Delivering Life Skills; and the Work and Careers Fair (with support from Laura Farris MP). Looking to the future, the Partnership wanted to divide work into two parts – continuing with current initiatives and economic development and skills in general, which was being progressed with the Council’s Economy Manager.

Councillor Martha Vickers asked about the Mental Health First Aid initiative. Iain Wolloff noted that West Berkshire College had a cohort of people who had received Mental Health First Aid training. While it was not a part of the Delivery Plan, there were related actions around supporting small businesses to promote mental health in the workplace, and commissioning services to support users of mental health services to get into work.


Buckinghamshire Oxfordshire and Berkshire West Integrated Care System Update pdf icon PDF 369 KB

Purpose: To provide an update on the formation of the BOB ICS in line with the proposals set out within the Health and Care Bill.


Niki Cartwright presented the item on the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System Update (Agenda Item 14).

The Health and Care Bill was progressing through Parliament and work was ongoing to interpret the guidance based on the draft legislation. It was expected that the ICS would be put on a statutory footing from April 2022, but it would take up to 18 months to become fully functional.

The ICS had four goals as set out in the NHS Long-Term Plan:

·         To improve outcomes in population health and healthcare

·         To tackle inequalities in outcomes, experience and access

·         To enhance productivity and value for money

·         To help the NHS support broader social and economic development

Key components of the new structure were:

·         Integrated Care System (ICS)

·         Integrated Care Partnership (ICP)

·         Integrated Care Board (ICB)

·         Board of the ICB (governance body)

·         Place Based Partnerships (PBPs)

From April 2022, Clinical Commissioning Groups (CCGs) would cease to exist, with all staff transferred to the ICB.

It was noted that the PBP would replace the ICP at Berkshire West Place level and the ICP would operate at System level. Also the ICS Body would become the ICB, and would support both System and Place.

The Buckinghamshire, Oxfordshire and Berkshire West ICS consisted of three Places. Most care delivery would be managed at Place. The System would orchestrate the overall strategy and delegations, while the Place would manage pooled budgets and deliver on urgent and emergency care, long-term conditions, and integrated care. Localities would also have a focus on  addressing inequalities. Provider collaboratives would deliver services beyond the Place level.

The current Integrated Care Partnership / Unified Executive would become the PBP, which would be a formal sub-committee of the ICB. This would take many of the decisions that currently sat with the CCG. ICB Place Teams would support the PBP as they did with the CCG.

The PBP would report to the Health and Wellbeing Board as well as to the ICB, while the Health and Wellbeing Board would feed into the ICP. It was also noted that a new Joint Health Overview and Scrutiny Committee had been set up to provide scrutiny of the System, while NHS England and the Care Quality Commission would also provide oversight.

ICB Board membership was determined by statute, with 10 members defined, including:

·         Chairman

·         Independent non-executive directors (x2)

·         Chief Executive

·         Partner members:

o   Local authority officer

o   Primary Care

o   NHS Provider

·         Finance, Medical and Nursing Directors

Dr James Kent had been appointed as Chief Executive.

The Chairman highlighted that discussions were ongoing amongst the three Berkshire West local authorities about the relationship between the leadership of the councils, the Health and Wellbeing Boards, Health and Wellbeing Portfolio Holders, and the ICB / ICP. He noted that the ICB Board had no political membership, just one local authority officer, but there were five local authorities within the System and the Berkshire West local authorities were concerned that they would not have adequate representation. He highlighted that there  ...  view the full minutes text for item 69.


Royal Berkshire Hospital Development Proposal pdf icon PDF 301 KB

Purpose: To provide an update from Royal Berkshire NHS Foundation Trust on their hospital redevelopment proposal.

Additional documents:


The Board noted the information item on the Royal Berkshire Development Proposal (Agenda Item 15).


North Hampshire Hospital Development Proposal pdf icon PDF 425 KB

To provide an update from Hampshire Hospitals NHS Foundation Trust on their hospital redevelopment proposal.


The Board noted the information item on the North Hampshire Hospital Development Proposal (Agenda Item 16).

Councillor Martha Vickers indicated that local ward councillors were not generally aware of the redevelopment proposals for Reading or Basingstoke and they would welcome an opportunity to put forward their views. She asked if more could be done to keep them informed.

The Chairman noted that there was a micro-site for the Reading proposal, and offered to get a briefing note for Members on each proposal.

ACTION: Councillor Graham Bridgman to ask the Royal Berkshire Foundation Trust and Hampshire Hospitals Foundation Trust to provide briefing notes.



Pharmaceutical Needs Assessment pdf icon PDF 199 KB

Purpose: To provide an update on the preparation of the Pharmaceutical Needs Assessment.


The Board noted the information item on the Pharmaceutical Needs Assessment (Agenda Item 17).


Members' Question(s) pdf icon PDF 305 KB

Members of the Executive to answer questions submitted by Councillors in accordance with the Executive Procedure Rules contained in the Council’s Constitution.


There were no questions submitted by Members to this meeting.


Health and Wellbeing Board Forward Plan pdf icon PDF 218 KB

An opportunity for Board Members to suggest items to go on to the Forward Plan.


The Chairman invited Members to contact Gordon Oliver with any proposed changes for the Forward Plan.


Future meeting dates

·         17 February 2022

·         19 May 2022


The dates for the 2021/22 Municipal Year were noted. It was also noted that the Health and Wellbeing Conference would take place on Friday 21 January 2022, and would focus on the Health and Wellbeing Strategy and Delivery Plan.