Agenda item

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) to provide an update on activities and commissioning plans.

Sarah Webster, Executive Place Director Berkshire West ‘Place’ BOB ICB, gave an overview of the new landscape and her role within it. Sarah Webster explained that there was an Integrated Care Partnership across Buckinghamshire, Oxfordshire and Berkshire West (BOB ICP) made up of 5 lead Local Authorities and the NHS. The NHS body within the ICP was called the Integrated Care Board (ICB). Sarah’s role was as the lead director for Berkshire West within the ICB.

Sarah Webster highlighted some key items. The first was the Strep A news and the impact on the relevant services. There was a significant demand for urgent care services. Over the weekend there was five times the usual demand for out of hours services and 111 services had 150% of their normal activity. Primary Care colleagues also had a significant demand for urgent appointments. The ICB had been monitoring the situation and had contacted primary care providers seeking available additional capacity and there was funding associated with that. Sarah Webster advised they were sending a reassuring message at all opportunities that whilst Strep A is an illness impacting particularly young children, it was only in very rare cases where that could be serious. Regarding antibiotics, the message from NHS England was that there was enough supply but it needed to be appropriately distributed. A lot of information was being shared with services and the prescribing demand was being managed.

Secondly Sarah Webster advised they were anticipating nursing strikes on the 15^th and 20^th of December. She advised the Royal Berkshire Foundation Trust (RBFT) met the threshold for the strike. Plans were being put in place to mitigate the impacts. Emergency care would still be provided. There was a significant administrative resource being used to communicate with patients whose plans were being affected. The RBFT had reassured the ICB that they were confident that safety would not be compromised.

Thirdly Sarah Webster advised that the Urgent Care Centre opened last week at the Broad Street Mall Reading. It was designed to take in 50 on the day self-presentations and 50 referrals from the emergency department and from primary care colleagues. This capacity plus additional GP capacity would really help relieve some of the urgent care demands expected over coming weeks. The Urgent Care Centre was an 18 month pilot.

Sarah Webster advised the Committee that there was a recent announcement regarding Adult Social Care discharge funding. For West Berkshire it was £1,200,000 within a £3,400,000 envelope for Berkshire West. Discussions had been held around how the money would be used to support the continuation of service provision noting the high demand being experienced at the time. Councillor Graham Bridgman explained that he was involved because the money went through the Better Care Fund which was owned by the Health and Wellbeing Board. It was agreed at last week’s Health and Wellbeing Board to give Councillor Bridgman sign off so that the timescales would be met. He advised that roughly £700,000 would be coming down through the ICB and £400,000 directly to West Berkshire Council. Most of the funding would be spent on domiciliary care to help discharge patients safely from hospital. Councillor Moore asked about the availability of domiciliary care and whether the staff were available to deliver it. Paul Coe advised that there was an itemised plan. They were in a good position regarding the availability of care agencies locally. Other funding was on care home beds and staff to carry out assessments. It was to ensure care was available for safe discharges from hospital.

Councillor Alan Macro asked for clarification around how patients were informed of changes to appointments due to the nursing strikes and whether it would be compromised by the postal strikes meaning significant resources were needed to make calls. Sarah Webster advised they were not relying solely on letters, but also phone calls to patients. It was discussed what impact this diversion of staff had on other services. Sarah Webster advised that it was a short term realignment that was appropriate. Councillor Linden noted that digital contact was also used. He also highlighted that the Joint Health Scrutiny Committee would be meeting in January. The Chairman noted the Urgent Care Centre. Councillor Bridgman explained that there had been immense pressure on the Emergency Department at the Royal Berkshire Hospital and by creating the Urgent Care Centre in Reading it was hoped to take some pressure off the Emergency Department.

Sarah Webster moved on to update the Committee on the development of the Integrated Care Partnership Strategy. This was to confirm how the Partnership would work together to make a difference to the people in their populations. The Strategy was a developing document about to go out to wider consultation. It was co-produced and built up from Health and Wellbeing Strategies and how they could make a difference if they came together as a wider collective. There were benefits in working together at scale and other times more sense to work locally in order to retain a local focus and local voice. As a Berkshire West Partnership they needed to ensure they heard the local voice and responded appropriately. The report gave an overview of the higher level areas. The public engagement portal was being launched on 14 December. Sarah Webster encouraged Members and others to take part and to encourage reaching out to the public. Sarah Webster thanked colleagues at West Berkshire Council in developing the strategy and highlighted that Councillor Bridgman was a direct voice at the Partnership table.

Councillor Macro highlighted that there were 18 priorities in the strategy and asked if they were all equal or if the numbering had relevance to priority. Sarah Webster confirmed that the priorities were not ranked but they had received initial feedback that 18 was a large number of priorities and prioritisation might be needed.

Councillor Graham Bridgman added that the draft strategy for BOB would be out soon. He advised that together with the Leader of the Council, Councillor Lynne Doherty, he had met with Steve McManus the Interim Chief Executive Officer of BOB ICB. They were working from similar angles to deliver what they needed to deliver at the right level. What needed to be done at system was done at system and what was needed to be done at place was done at place. They were looking at the needs and desires of the population and seeking to address problems from a partnership of the NHS and from the viewpoint of first tier Local Authorities. Many factors affected the health of the population and in particular the prevent strategy. Further meetings were happening and activity was moving forward.