Agenda and minutes

To approve as a correct record the Minutes of the meeting of the Board held on 23 February 2023.

The Minutes of the meeting held on 23 February 2023 were approved as a true and correct record and signed by the Chairman.

To consider outstanding actions from previous meeting(s).

Progress on actions from the previous meetings was noted.

In relation to Action 211, it was agreed that the presentation to the Corporate Parenting Panel would be promoted to all Councillors.

In relation to Action 218, it was noted that several meetings had taken to consider support for asylum seekers, which had included partner organisations. Reassurance was provided that responses to the Healthwatch recommendations were being discussed and reviewed.

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, Governor of Berkshire Healthcare NHS Foundation Trust, and West Berkshire Council representative on the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Partnership.

Councillor Jo Stewart and Dr Heike Veldtman declared an interest in Agenda Item 11, but reported that, as their interest was a personal or an other registrable interest, but not a disclosable pecuniary interest, they determined to remain to take part in the debate and vote on the matter.

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.

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

There were no public questions submitted to this meeting.

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:

·         April Peberdy had replaced Steve Welch as Interim Service Director - Communities and Wellbeing, and Zoe Campbell had been nominated as her substitute.

·         Professor John Ashton had replaced Professor Tracy Daszkiewicz as Director of Public Health for Reading and West Berkshire.

·         Kate Rees had replaced Lorraine Adams as Matthew Hensby’s nominated substitute.

RESOLVED: to note the changes.

Purpose: To update the Health and Wellbeing Board on the progress with the Joint Forward Plan. To introduce the key areas of focus, summarise key areas of feedback received and remind the Health and Wellbeing Board of the formal opportunity to provide an opinion ‘on whether the draft takes proper account of local health and wellbeing strategy’.

Rob Bowen, Integrated Care Board (ICB) Acting Director of Strategy and Partnerships, presented the report on the Joint Forward Plan (Agenda Item 8).

Members of the Health and Wellbeing Board were invited to provide feedback on the draft Joint Forward Plan and it was confirmed that there would be a formal request from the ICB in June for the Health and Wellbeing Board to confirm how well the Plan aligned to / supported the Joint Local Health and Wellbeing Strategy (JLHWS) for Berkshire West.

It was acknowledged that the recent workshop to discuss the Plan had been a very useful and positive event with good levels of engagement. It was felt that the right messages had been communicated to the ICB, but there was some cynicism about how the vision could be achieved given the current pressures and the fact that the health system was starting from a deficit position.

Rob Bowen was thanked for his work in developing the Plan.

The Board welcomed the commitment to an increased focus on prevention activity and asked what the Council could do to support this. It was acknowledged that there was a challenge to balance short and long-term priorities, but the ICB was seeking to lay the foundations for long-term change.

It was noted that housing was a critical area and there was a need for more and better quality housing. It was suggested that the Council needed to have more influence, particularly in relation to smaller social / private landlords, since tenants often struggled to engage with them. The ICB acknowledged that wider determinants of health (such as housing) were important.

It was highlighted that GP surgeries were key points of contact for residents, but they had become less accessible since Covid and had been overwhelmed with enquiries. It was suggested that expanded health centres could provide one-stop shops. The ICB acknowledged the critical role of GP practices in providing support to patients and in supporting the shift in care from acute to community settings. It was confirmed that a five year strategy would be developed over the coming 12 months which would ensure that any models put in place were sustainable.

The Board recognised that there were lots of layers and strategies within the health system, and stressed the need for efficient working practices to avoid greatly increasing the number of meetings.

It was suggested that self-care was a critical aspect, since there were increasing numbers of older people with multiple conditions who were exerting huge pressures on the NHS. It was stressed that the NHS only accounted for 10% of care and there was a need to build resilience and develop knowledge of how to manage common conditions (e.g. through peer support). Also, it was suggested that patients should be encouraged to plan for the rest of their lives once they got to their 60s.

Discharge from hospital was highlighted as another important issue and it was suggested that the housing sector should be represented on hospital boards. It  ...  view the full minutes text for item 93.

Purpose: to present the terms of reference for the Health and Wellbeing Board Steering Group for approval.

(Note: Health and Wellbeing Board Terms of Reference were approved by Council on 16 March 2023 and have been included for information only.)

The Chairman presented the draft Health and Wellbeing Steering Group Terms of Reference (Agenda Item 9).

It was noted that terms of reference would be prepared for each of the Board’s sub-bodies and that each would be approved by the body above. The Board’s terms of reference had been approved by Council and the Board was asked to approve the terms of reference for the Steering Group.

It was agreed that the representative from the Voluntary and Community Sector should be amended to ‘a representative of the Council for Voluntary Service’.

It was highlighted that substitutes should be allocated. It was confirmed that the voluntary sector had a process for allocating substitutes.

RESOLVED to approve the terms of reference subject to the amended wording from ‘Voluntary and Community Sector’ to ‘Council for Voluntary Service’.

Purpose: To set out a proposed process for assessing the impacts of notified changes to pharmaceutical services in West Berkshire and for keeping the Pharmaceutical Needs Assessment under review.

April Peberdy (Interim Service Director – Communities and Wellbeing) presented the item on the Pharmaceutical Needs Assessment (PNA) Decision Making Process (Agenda Item 10).

It was noted that the recent notifications of proposed closures in the Sainsbury’s superstores at Calcot and Newbury had been a trigger for the Board to review its processes. It was recognised that the Board needed to respond in an agile manner between meetings.

Members noted that updating the PNA or publishing a supplementary statement would not address issues created by pharmacies closing and asked how concerns could be escalated. It was explained that the Board merely had a duty to assess the implication of any proposed changes to provision and had no powers beyond this. An updated PNA or supplementary statement was useful in highlighting gaps, but it was up to providers if they wanted to enter the market. It was confirmed that the PNA and any supplementary statements would be published on the West Berkshire Observatory website.

It was noted that the Health Scrutiny Committee had a role in questioning the NHS about the operation of pharmacies and had done so at the last meeting. Also, it was acknowledged that pharmacies were mostly private businesses and an appropriate response needed to be agreed by the NHS system.

It was proposed that all Board members should be notified of proposed changes to pharmacy services.

It was highlighted that recent temporary closures had resulted in long queues at other pharmacies in the areas, and that there was a need to communicate with patients and GPs.

It was recognised that pharmacies played a key role in the preventative approach to health care.

One of the proposed closured was in an area of relative deprivation where it was considered important to have a pharmacy present within the community in order to make access as easy as possible.

A question was asked about provision of pharmacies in new developments.

Concern was expressed that other pharmacies may be on the verge of closing.

Members were reminded that this item was related to the process for assessing the impact of changes rather than the planned closures, which would be discussed as part of Item 11.

There was a query about whether the PNA process took account of online pharmacies. It was recognised that while these offered benefits in terms of reliable supply of medicines and avoiding the need to queue, community pharmacists did much more than dispense medicines. Also, they were unable to provide same day supply of medicines.

Action: April Peberdy to confirm if the PNA took account of online pharmacy options.

It was noted that the proposal was for local ward councillors only to be consulted if a gap was identified. However, it was suggested that they should be consulted on all changes, since they had the local intelligence to help identify issues that may contribute to gaps in provision being declared. They could also disseminate messages to local residents.

It was suggested that a review was needed to  ...  view the full minutes text for item 95.

Purpose: To provide an analysis of the impacts of the notified closures of the Lloyds pharmacies at the Sainsbury’s superstores in Calcot and Newbury and to advise the Health and Wellbeing Board on the implications for the West Berkshire Pharmaceutical Needs Assessment.

(Councillor Jo Stewart declared a personal interest in Agenda Item 11 by virtue of the fact that the Calcot Sainsbury’s superstore was in her ward. As her interest was personal and not prejudicial she was permitted to take part in the debate and vote on the matter.)

(Dr Heike Veldtman declared a personal interest in Agenda Item 11 by virtue of the fact that the Newbury Sainsbury’s superstore was in the catchment for her GP practice. As her interest was personal and not prejudicial she was permitted to take part in the debate and vote on the matter.)

April Peberdy (Interim Service Director – Communities and Wellbeing) presented the item on Pharmacy Closures (Agenda Item 11).

Although Thames Valley Pharmacy had indicated that there was spare capacity at other pharmacies, Members observed that there had been significant queues at local pharmacies in recent weeks. It was highlighted that pharmacies offered other essential services, which may be compromised if they were struggling to cope with demand for prescriptions.

Members observed that new development would further increase the pressure on pharmacies.

Concern was expressed that the closure of the pharmacy at the Newbury Sainsbury’s superstore would require some people to walk further to other pharmacies in the town centre and the quoted walking times were felt to be optimistic. Officers recognised that any closure would have an impact on residents, but the analysis had shown that a significant gap would not be created in Newbury. Officers confirmed that walking times were averages and used standard values

Members thanked the staff at the Lloyds pharmacy in Calcot who had suffered abuse from customers who were frustrated at having to queue. It was noted that there were two wards affected by this closure, including one of the more deprived wards in the District.

It was noted that while Sainsbury’s was easy to access by bus, patients may struggle to access other pharmacies in the area that were not as well served by local bus routes. Some customers had already started to make alternative plans, including switching to online pharmacies.

The importance of the role of pharmacies in primary care provision was highlighted. Concern was expressed that several pharmacies had closed in West Berkshire, which would affect patient access and would impact on remaining pharmacies. Concern was also expressed that West Berkshire had a lower ratio of pharmacies to resident population than the national average. Members asked what could be done to address the issue. Officers recognised these concerns, but indicated that decisions about pharmacies opening and closing in West Berkshire were up to providers.

Members suggested that the Local Pharmaceutical Committee and Health Scrutiny Committee may have a role to play in stimulating the market and investigating the causes of pharmacies closing. It was confirmed that Pharmacy Thames Valley had been consulted in relation to the planned closures.

Concern was expressed that parts of Calcot were amongst the most deprived in the country. However, it was confirmed these areas were only within the fourth  ...  view the full minutes text for item 96.

Purpose: To provide an update to the Board on the progress of the outstanding actions for Young Carers contained in the Health and Wellbeing Strategy Delivery Plan.

The report on Young Carers (Agenda Item 12) was provided for information only and was not discussed at the meeting.

RESOLVED to note the report.

There were no questions submitted to the meeting.

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

Members reviewed the Health and Wellbeing Board Forward Plan.

RESOLVED that the Forward Plan be noted.

13 July 2023

28 September 2023

7 December 2023

22 February 2024

2 May 2024

(All meetings to start at 9:30am)

The dates of the future meetings were noted.