Issue - meetings

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) have been invited to provide an update on All Age Continuing Care (AACC) and the AACC transformation programme since attending the Health Scrutiny Committee in December 2024.

Daphne Barnett (Interim Associate Director of Nursing, BOB ICB) gave an overview of the report on All Age Complex and Continuing Care. Sarah Flavell (Associate Director Nursing, BOB ICB) also answered questions on this item.

During the presentation the following points were highlighted:

·         It was a key objective of the BOB ICB to ensure that Berkshire West did not have unwarranted variation in referral and eligibility for CHC. Early indications showed that Berkshire West was moving closer to the national benchmark and the metrics were improving. However, Berkshire West did remain below the regional and national benchmark for number of people eligible for CHC. The aim was to ensure there was a one stop entry point for referrals across BOB and that there was an equity of approach.

·         Processes were in development for a joint funding approach for individuals who did not meet eligibility for CHC or CYPCC but had unmet health needs not provided through core NHS service provision. A healthcare contribution policy has been in development and Berkshire West were involved in the testing of this policy to gain learning.

·         It was confirmed that the disputes and health care contribution policy were in place. The Strategic Partnership Board had been influential in helping to develop and co-produce local neighbourhood services.

·         The Berkshire West Joint Funding panel for Children and Young People’s Continuing Care (CYPCC) had been in place since December 2024. The aim was to streamline the funding process for continuing health care. It was working in partnership with Wokingham, Reading and West Berkshire Councils.

·         It was advised that many changes had been made including improved collaboration, decision making, addressing back logs and taking a test and learn approach. This had led to improved support for individuals, positive feedback and an ongoing commitment for further improvements.

·         A summary was provided in the report which highlighted working closely with Adult Social Care and Local Authorities to continue to make improvements.

During the discussion the following points were noted:

·         Paul Coe, Executive Director for Adult Social Care and Public Health, advised the Committee that there had been a greater pace of improvements and tangible changes were being seen such as the disputes policy. However, there were still challenges. The referral rates and eligibility outcomes were still below benchmark, and this meant outcomes for people in West Berkshire.

·         It was noted that Local Authority data was not yet available. It was agreed this would assist the BOB ICB to understand where to address concerns.

Action: Sarah Flavell will progress the availability of Local Authority data. 

·         Members raised concern that this variation in eligibility was continuing after many years. Berkshire West remained very low nationally and this needed to be addressed more urgently. This was noted, and it was highlighted that recent developments by the BOB ICB had made some recent change that was welcome. However, whilst improvements had been made, a question was raised whether the reduction in inequity across BOB had been due to increased eligibility rates for Berkshire West  ...  view the full minutes text for item 6

Purpose: To review the progress of the Improvement Programme and services in West Berkshire.

Kirsten Willis-Drewett (Assistant Director of Operation) and Caroline Morris (Transformation Programme Director) presented the report from the South Central Ambulance Service NHS Foundation Trust (SCAS).

During the presentation the following points were highlighted:

·       SCAS remained in the NHS Recovery Support Programme following the 2022 Care Quality Commission (CQC) rating of inadequate. However, significant improvements had been made across the organisation and they were focussed on longer term strategic and cultural change.

·       In terms of patient safety and experience, significant improvements had been made to safeguarding, training in the approach to the Mental Capacity Act and in learning from patient safety incidents.

·       An overview of operational performance was shared. This included reduced handover times at hospitals leading to faster call response times. This was in response to their Release to Respond initiative to reduce handover delays and had resulted in SCAS being the fastest responding ambulance service in the country in January 2025. There had also been improvements in ensuring patients got the right care as quickly as possible. It was highlighted that SCAS were responding to Category 2 and Category 3 calls better than the England average. Category 1 calls were not meeting target and so would be an area of focus for SCAS.

·       It was advised that SCAS also provided the 111 call service. The demand for that had increased significantly. 111 used various pathways to direct patients to. The target was for less than 10% to be directed to 999 services.

·       It was highlighted that SCAS had a strong working relationship with Royal Berkshire NHS Foundation Trust.

The following points were raised in the debate:

·       It was noted how successful the Release to Respond initiative had been for ambulance response times and in reducing the queues of ambulances at hospitals across the SCAS operating area. It was noted that at peak times there were 25 ambulances operating in Berkshire West and about 15 during the night. If there were long queues at hospitals it was not viable for the ambulance service.

·       Members noted there had been immense improvements since the CQC inspection and that the work undertaken was impressive. In particular, the work around culture and wellbeing was highlighted. It was confirmed that there was good evidence that an engaged workforce improved performance. SCAS had used evidence-based ways of making improvements.

·       It was noted that there was a particular challenge around resourcing vehicles. There was a national procurement process, and the government mandate was for only two types of vehicles. They had to replace vehicles every five years and with only two products it was a challenge to get vehicles. A third provider would be beneficial, and it was a long process to acquire new vehicles. In addition, there were only two workshops in the SCAS area and so they were looking for a third workshop. Ambulances needed servicing every six weeks. Particularly during winter, there were fleet challenges.

·       It was confirmed that the non-emergency patient transport service would no longer be provided by SCAS. A new provider  ...  view the full minutes text for item 6