Agenda and minutes

To approve as a correct record the Minutes of the meeting of the Board held on 29 September 2022.

The Minutes of the meeting held on 29 September 2022 were approved as a true and correct record and signed by the Chairman.

Councillor Martha Vickers noted in the minutes that the Healthwatch Report on Asylum Seekers was supposed to be presented at the December meeting. It was explained that the report had been submitted too late to make the December meeting. It would go through the Locality Integration Board and Health and Wellbeing Board Steering Group before being brought to the next meeting in February. Healthwatch indicated that they wanted to give partners the opportunity to comment prior to publishing the report, but they stressed that there were some urgent actions that needed to be progressed quickly, before the report was formally presented to the Board. It was noted that there were concerns about some of the wording in the report.

To consider outstanding actions from previous meeting(s).

Progress on actions from the previous meetings was noted. Observations were made in relation to the following actions:

·         Action 153 – The Peer Review would take account of the timescales for establishing the Place Based Partnership.

·         Action 197 – It was noted that this would be progressed through the Place Based Partnership.

·         Action 205 – Sean Murphy to confirm if the issue of swans had been discussed at the Water Safety Partnership.

·         Action 208 – It was noted that the conference would be considered later in the meeting.

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.

There were no declarations of interest received.

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.

There were no petitions presented to the Board.

To agree any changes to Health and Wellbeing Board membership.

It was noted that membership of the Health and Wellbeing Board was on an

organisational basis. A standing item was retained on the agenda to note any changes in personnel. Changes since the last meeting included:

·         Sarah Webster replaced Belinda Seston as one of the two Integrated Care Board ICB representatives;

·         Belinda Seston and Helen Clark were the named substitutes for Sarah Webster.

·         William Orr would be deputising for Dr Janet Lippett while she was acting Chief Executive for the Royal Berkshire NHS Foundation Trust.

·         Rachel Peters was the named substitute for Garry Poulson.

It was noted that this would be the last meeting for Andrew Sharp and Dr Zakyeya Atcha. The Board thanked them for their contributions.

RESOLVED to note the report.

Purpose: To provide an update on the Integrated Care Partnership Strategy and seek input from Health and Wellbeing Board Members.

Rob Bowen (Deputy Director of Strategy) and Profession Tracy Daszkiewicz (Director of Public Health for Berkshire West) presented the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB) Update (Agenda Item 8), which focused on the draft Integrated Care Strategy.

It was acknowledged that the Integrated Care Strategy needed to be aligned with the strategies and delivery plans at Place and Locality levels.

It was noted that the Strategy had not yet been formally signed off by the Integrated Care Partnership, but it was felt to be saying the right things.

A point was made about needing to use language that was accessible to residents.

Some concern was suggested that the ICB may be over-reaching its areas of responsibility, since services around obesity, alcohol abuse, etc were outside of their control. However, it was noted that the Integrated Care System included all the organisations represented on the Integrated Care Partnership (ICP) as well as the Integrated Care Board. The Strategy was being written on behalf of everybody involved in supporting people to stay well across the entire BOB geography.

It was stressed that local authority services needed to be represented in relevant meetings, including those associated with wider determinants of health, such as planning and transport. The ICB acknowledged that wider determinants were included within the scope of the organisations included within the ICP, but some of these things would be developed at place rather than system. Also, there was a balance to be struck, since the Strategy could not cover everything, so it had to focus on the most important aspects to be provided at the System level.

It was highlighted that the next phase would be engagement with partners and the public, with the full document available from Monday 12 December, with consultation open until the end of January 2023. The Board was asked for suggestions for engaging with the local population to get the best possible input to the Strategy.

Action: Gordon Oliver to confirm that the Council’s Communications Team were aware of the consultation.

It was suggested that there may be an element of consultation fatigue and that the ICB should review the consultation outcomes for the recent Joint Local Integrated Health and Wellbeing Strategy. Also, it was noted that consultees may not be aware of the difference between the two strategies.

Before going onto the next item, the Chairman invited Professor Tracy Daszkiewicz to provide a brief update on the current situation regarding Strep A infections.

Purpose: To provide the West Berkshire Health and Wellbeing Board with an update on the Pan Berkshire Suicide Prevention Strategy and on changes, challenges and opportunities flowing from the national Suicide Prevention Agenda, and the regional and local works under way to address these.

Professor Tracy Daszkiewicz (Director of Public Health for Berkshire West) presented the report on the Berkshire Suicide Prevention Strategy (Agenda Item 9).

Garry Poulson (Voluntary Sector Representative) was invited to comment in his capacity as Chairman of West Berkshire Suicide Prevention Action Group (SPAG). He was pleased that the Pan Berkshire Group had been reformed. It was noted that the Volunteer Centre West Berkshire was a member of the National Suicide Prevention Alliance as representatives of SPAG. Concern was expressed about the capacity of Amparo to provide bereavement support. It was suggested that the summit should include practical actions, such as establishing a SPAG equivalent in each of the Berkshire local authorities. It was noted that SPAG would be delivering suicide prevention training to a different themed group each month from 2023 and would distributing resources to local businesses. It was highlighted that the SPAG outreach worker was only employed until April 2023, so additional funding would be required to maintain this role.

Members queried whether they had received an invitation to the Summit. It was noted that an initial place-holder email had been received, which had signposted the event, but the follow-up email with details of the Summit had not been received.

The Board welcomed the provision of a post-vention service, but a question was asked around how many West Berkshire families who had been affected by suicide had received support.

It was explained that a comprehensive needs assessment would be carried out to look at this. It was also highlighted that pathways for mental health and crisis support were being picked up by the Police because much of this activity happened out of hours. 

It was suggested that there needed to be a golden thread across the Integrated Care System and that suicide prevention could be a regular item for a number of different forums / boards.

It was highlighted that the Samaritans had recently launched a new telephone number 116 123, which was aimed at people in crisis. Also, it was noted that westberkshiresuicideprevention.org had details of immediate and non-immediate sources of support. It was suggested that Board Members could add this to their email signatures to promote the website.

RESOLVED to note the report and the actions being undertaken.

Purpose: To inform the Board of the proposed priorities for Children and Young People’s Mental Health across Reading, West Berkshire, and Wokingham and to seek sign off and/or suggestions to refine the priorities further.

Lajla Johansson (ICB Assistant Director of Joint Commissioning) presented the report on the Children and Young People’s Mental Health Local Transformation Plan (LTP) (Agenda Item 10).

Members highlighted the importance of prevention and also raising awareness. It was suggested that due to pressures of life, it could be difficult for parents to take the time to talk to children, and that it was important to support them in doing this. It was also suggested that problems had got worse due to isolation associated with the Covid pandemic.

The Transformation Plan was welcomed, but challenges around delivery were acknowledged.

It had been highlighted at the West Berkshire Corporate Parenting Panel that targets were not being achieved for delivering initial healthcare assessments for children in care (CIC). Members sought assurance that this would be prioritised. This was seen as important as these initial assessments could often highlight additional mental health needs. Also, a question was asked about what was meant by ‘mobilise the CIC offer’.

It was confirmed that the ICB was aware of the issue around initial healthcare assessments. This had been highlighted as a risk and steps were being taken to address this. It was noted that the CIC Service was a new, specialist service that had been co-funded by the ICB and West Berkshire Council. Recruitment was an issue and had slowed mobilisation of the service (i.e. staff on the ground delivering services). The ICB offered to give a further presentation to the Corporate Parenting Panel to provide an update on the service.

Action: ICB to give a presentation to the Corporate Parenting Panel on the CIC Service.

It was highlighted that at a recent Children and Young People’s Board meeting, a Member had highlighted that there was a lack of understanding amongst GPs, schools and parents about the support that was available to support children and young people’s mental health in West Berkshire. There was confusion about what was being provided by the statutory and voluntary sectors. It was suggested that there should be a meeting between the voluntary sector, and health / local authority partners to discuss pathways and clarify what services were available. The ICB was happy to support this.

Action: Hold a meeting between the voluntary sector, and health / local authority partners to discuss pathways and clarify what services were available.

It was noted that a Knowledge Event would be held on 20 March 2023 to allow professionals to meet local voluntary groups and learn about the services that they offered.

It was stressed that while social media could be an effective tool for engaging with communities, there were issues of security that affected vulnerable people and children in particular. This should be acknowledged whenever digital tools were discussed.

A point was made about the lack of reference to schools within the LTP. Reassurance was provided that schools were included within partners. It was recognised that children had better outcomes when engaged in education. Children spend a large proportion of their time in schools,  ...  view the full minutes text for item 56.

Purpose: To provide an update from the on Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board’s (BOB ICB) response to the recommendations made in the Survey Feedback report by Healthwatch West Berkshire on Child and Adolescent Mental Health Services (CAMHS) (February 2021).

Niki Cartwright presented the report on the BOB ICS Response to the Healthwatch CAMHS Report (Agenda Item 11).

It was stressed that achieving expected outcomes for parents and carers would be the main focus going forward.

Members wanted to understand why there were high numbers of young people who were self-harming in West Berkshire. It was confirmed that the ICB worked closely with Public Health around self-harm and the Suicide Prevention Strategy. It was noted that self-harm was not related to deprivation, but there was  strong link with loneliness and isolation. Also, there was anecdotal evidence of children seeing parents struggling, and children were not able to get the same level of support through schools and clubs during the pandemic. The ICB was looking to see what support could be put in place in schools through Mental Health Support Teams and targeted interventions were being put in place where there were clusters of self-harming incidents / suicide attempts.

The issue of staff shortages was highlighted as a concern and Members wanted to know how this would be addressed. Funding had been secured from the NHS Regional Team to pilot a CAMHS Academy. The ICB was also looking at ways to take people who had just finished their training and fast-track their professional development. It was noted that there had been investment in the Children and Young People’s Neuro-Diversity Service and it had taken 12 months to fully recruit.

Action: Niki Cartwright to provide further details of the scheme after the meeting.

Members highlighted that there were problems with CAMHS waiting times pre-Covid that had been exaggerated by the pandemic. The CAMHS Academy was welcomed as a positive step. It was acknowledged that there were national shortages with specialist staff and Members wanted to know how staffing issues would be addressed locally, given the higher costs of living in the South East of England.

The action to improve communications between CAMHS Teams and parents / guardians was noted. It was highlighted that parents did not understand that they did not have to wait for an assessment in order to access services and it was suggested that communications needed to be improved around this aspect in particular. It was explained that the autism diagnosis did not sit within CAMHS, but under Learning Disability. However, the two services worked closely together. It was accepted that communication with families and parents needed to improve. This would be part of the re-design of CAMHS and would involve co-production. Regarding autistic patients, there would be co-production with local authorities, with the emphasis on being needs-led rather than diagnostic led.

Members noted that the above was not set out in the report and it was suggested that the report should set out all the actions that would be progressed. However, it was also noted that Healthwatch had been supposed to provide a slide on communications as part of the presentation.

Action: Check that co-production work on communications is reflected in the LTP.

It was noted that in  ...  view the full minutes text for item 57.

Purpose: To present the Better Care Fund Plan for approval.

Paul Coe presented the report on the West Berkshire Better Care Fun Plan (Agenda Item 12).

The Board thanked Maria Shepherd for her work in preparing the Better Care Fund Plan submission for 2022-23, which the Board was asked to approve.

It was noted that an additional amount of £1.18 million would be allocated to West Berkshire through the Winter Discharge Fund. The bulk of this funding would be spent on domiciliary care. The submission deadline was extremely tight (16 December), and given that discussions were still ongoing with the acute hospital trusts and the Integrated Care Board, it was proposed that the Board delegate authority to the Chairman to approve the final Plan submission.

RESOLVED that the Health and Wellbeing Board:

·         Approve the Better Care Fund Plan for 2022-23.

·         Delegate authority to the Chairman of the Health and Wellbeing Board to sign off a second Better Care Fund Plan submission in relation to the Hospital Discharge funding.

Purpose: To provide an update on the work of the Cost of Living Sub-Group

Sean Murphy presented the Cost of Living Update (Agenda Item 13).

Members raised an issue with the delivery of leaflets to households, which resulted in some addresses receiving duplicates.

It was highlighted that the website did not give details of where public warm spaces were located and so people did not know about them. It was explained that the warm spaces had been mapped and were online, but officers offered to check whether this was sufficiently easy to find.

Action: Sean Murphy to review the information about warm spaces on the website.

Members observed that there had been articles in the media about people with pre-payment meters not receiving the vouchers they were entitled to and asked if this was an issue in West Berkshire. Officers had not received any questions from residents on this issue, but confirmed that the hub was receiving queries about energy prices. It was noted that take-up was only around 50% nationally, and with smart meters, there was some confusion amongst customers as to whether they were on a pre-payment plan and whether they were entitled to funding. It was suggested that there may be improved communications needed on this issue.

Action: Sean Murphy to discuss the issue of advice about vouchers for people on pre-payment meters with the hub manager.

It was noted that there was lots of communication on staying well during cold weather and the links between keeping warn and keeping long-term health conditions under control. The Public Health Team had sought to strike an appropriate balance between staying warm and the affordability challenges this presented.

RESOLVED that the report be noted.

Purpose: To provide an update on progress with the Health and Wellbeing Conference 2023.

The Chairman presented the item on the Health and Wellbeing Board Conference Update (Agenda Item 14).

Members were advised that the event would be on 31 January 2022 and it would be a hybrid event with the option to attend in person at the Council offices, or to join remotely via Zoom.

It was noted that the District Parish Conference would take place in the evening, which would allow town / parish councillors to attend both events.

It was also noted that there would be a marketplace with stalls before each event.

RESOLVED to note the report.

Purpose: To provide the performance dashboard for the delivery of the Health and Wellbeing Strategy Delivery Plan and to highlight any emerging issues.

Dr Zakyeya Atcha presented the report on the Health and Wellbeing Strategy Delivery Plan - Progress Report Q2 2022/23 (Agenda Item 15).

It was noted that the Delivery Plan had not yet been input to the Council’s programme management software, but this would be done at the earliest opportunity, and partners would be able to input their own data.

Also, it was suggested that the conference represented an opportunity to review the Delivery Plan priorities and actions.

RESOLVED that the report be noted.

Purpose: To provide an update on work relating to the management of Continuing Health Care in West Berkshire.

The report on Continuing Health Care (Agenda Item 16) was provided for information only and was not discussed at the meeting, except to note that things were moving in a positive direction.

RESOLVED that the Board note the report.

Purpose: To provide an interim report from the Mental Health Action Group as part of its work in addressing elements of the delivery plan for the West Berkshire Health and Wellbeing Strategy. This work involves the impact of personal financial problems on people’s mental health.

The report on Financial Problems and Mental Health (Agenda Item 16) was provided for information only.

Adrian Barker and Rachel Johnson were thanked for their contributions and approach. It was noted that a final report would be presented to the next meeting in February 2023.

Also, it was noted that the report had been well-received by local charities and other partner organisations.

It was stressed that support needed to be given to people as early as possible and that this would require additional resources. 

Purpose: To note the changes to the Council’s Constitution with respect to the Health and Wellbeing Board and Steering Group that were adopted at Council on 6 October 2022, including: the Meeting Rules, the Council Bodies Rules, and the Health and Wellbeing Board Appendix.

The item on Updates to the Council Constitution (Agenda Item 18) was provided for information only.

It was noted that work was ongoing to update the terms of reference for each of the sub-bodies of the Health and Wellbeing Board.

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

(Note: There were no questions submitted relating to items not included on this agenda.)

There were no questions submitted to the meeting.

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

Members were invited to comment on the Health and Wellbeing Board Forward Plan.

It was suggested that an item be added to the meeting on 23 February 2023 to provide feedback from the Health and Wellbeing Board Conference.

Action: Provide feedback on the Conference to the February meeting.

There was a query about who would be presenting the deferred item on the Healthwatch Report on Asylum Seekers. It was noted that Healthwatch was a statutory member of the Board and Fiona Worby had been appointed as Andrew Sharp’s replacement. It was suggested that the report be presented in conjunction with the voluntary sector partners. It was noted that the report would be considered by the Health and Wellbeing Steering Group before coming to the Board for consideration.

23 February 2023

20 April 2023

(All meetings to start at 09:30am)

The Board was invited to note the dates of future meetings.