Agenda item

Mrs Searle informed the group that, following the national listening exercise, Strategic Health Authorities (SHA) were being kept until 2013, however the geographical area was changing. Mrs Searle informed the group that there was going to be four SHA Clusters, with West Berkshire being in the South SHA. Mrs Searle said that the SHAs still had the same purpose, in that they were holding the PCTs to account and making sure they reached their targets. Mrs Searle mentioned that Berkshire PCTs had clustered together to form one PCT and that her new title was Director of Joint Commissioning, which also meant she was lead officer for Safeguarding and Equalities along with commissioning of mental health and learning disability services, and service for children and young people.

Councillor Quentin Webb asked how many officers there were now in the Executive team. Mrs Searle responded that there were 8, and further mentioned that although the Berkshire PCTs had clustered together, they were still separate statutory organisations with their accounts.

Councillor Julian Swift-Hook asked if there were separate accounts how management of financial performance was undertaken. Councillor Swift-Hook further questioned whether the cluster would solve the issues it was set up for. Mrs Searle responded that it would, by making best use of available management resources, and achieving required management savings, to ensure that  areas such as safeguarding could be protected.

Councillor Carol Jackson-Doerge asked whether Mrs Searle felt there would be difficulty from a commissioning point of view, as Berkshire East and Berkshire West were different. Mrs Searle agreed they were, however she also noted that Berkshire West was very diverse. Mrs Searle said that in her team structure proposal she had proposed a Head of Joint Commissioning in both East Berkshire and West Berkshire. Mrs Searle mentioned that the continued good work with the local authorities would also play a key role.

Mrs Searle said that GP Commissioning groups would be confirming their commissioning support arrangements in the next year, in order to be established in shadow form from April 2012. Following a question from Councillor Webb, Mrs Searle replied that the PCT would be working in partnerships along with the GP commissioning groups however the Chief Executive of the PCT retains his role as chief officer until March 2013.

Councillor Dominic Boeck enquired what GPs attitudes were to the change. Mrs Searle responded that the Commissioning Group leads were  positive and enthusiastic towards the changes suggested.

Councillor Gwen Mason asked Mrs Searle what would happen should a GP consortium and/or cluster straddle different counties? Mrs Searle advised that the national guidance stated that this should not normally happen. However, should it be the case, then it would be important for hospital and primary care colleagues to work together to ensure effective clinical pathways.

Councillor George Chandler asked whether the restructuring  was going to lead to financial savings. Mrs Searle said it would, and although the National Health Service had not received a cut, health costs are continuing to rise, therefore savings are required to break even. Mrs Searle said the PCT was also working on preventative measures, such public health work to reduce obesity and harm resulting from problem drinking. Mrs Searle informed the Panel of the four clinical commissioning groups in the Berkshire West area:

1)     Wokingham

2)     South Reading

3)     North West Reading – this would incorporate areas of West Berkshire; including Pangbourne, Theale etc.

4)     Newbury

However, as discussed earlier, the White Paper said there should not be a cross council boundaries.

Councillor Swift-Hook asked if there were any other health increase problems in West Berkshire that Members should be aware, apart from Over 85s, increase in obesity and alcohol problems. Mrs Searle said that with over 85s there was the increased risk of dementia and other age related health problems. Councillor Swift-Hook said that this could easily affect Local Authority services, as well as the health service.

Councillor Swift-Hook asked what the rate of health inflation was compared to normal inflation. Mrs Searle said she did not have the information to hand but would report back to Councillor Swift-Hook.

Mrs Searle commented that in regards to obesity, and diabetes resulting from obesity, a lot could be done to help. Mrs Searle also mentioned there was a good working partnership between the Local Authority (Social Care) and the health service in regards to reablement.

Councillor Sheila Ellison asked whether the NHS had any diabetes testing units, and further asked what work had been completed on readmitance to hospitals. Mrs Searle said that there was a financial incentive in acute hospitals to complete a full assessment before discharging a patient. Mrs Searle said that acute hospitals were not paid if a patient was readmitted in an emergency 30 days after being discharged. Locally the health service was good at discharge planning and avoiding readmission, however there was still improvements to be made.

Councillor Mason asked whether the problem with readmission and communication was still apparent. Mrs Searle said that this did not appear to be t a problem any more due to regular conversations between GPs and the Local Authority.

Councillor Webb thanked Mrs Searle for her presentation.

Members noted the points raised.