Agenda and minutes

To approve as a correct record the Minutes of the meeting of the Board held on 19 May 2022.

The Minutes of the meeting held on 19 May 2022 were approved as a true and correct record and signed by the Chairman.

A question was asked about the proposed programme of first aid training in schools. It was confirmed that this would be brought back to the September meeting, since school holidays would make it difficult to progress the action.

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:

·         191 – Councillor Jo Stewart to discuss the reporting timetable with the Mental Health Action Group.

·         198 – It was noted that It has been agreed in principal that defibrillators could be installed in the water safety facilities – options and costs were being considered.

It was highlighted that with the warm weather, people were using rivers for recreational swimming. Emergency lifebelts were being misused, which could jeopardise water safety. Also, there was a risk of deaths due to people hitting submerged objects and due to shock from the cold water. It was suggested that a public awareness campaign was needed. It was noted that the Royal Berkshire Fire and Rescue Service was visiting key locations and was working with partner agencies. The Water Safety Partnership, Thames Valley Police, Environmental Health and the Countryside Team had been involved in discussions. It was agreed that a multi-agency response was needed across West Berkshire.

Action: Gordon Oliver to liaise with the Public Protection Partnership to arrange a coordinated response to water safety concerns.

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, and Governor of Berkshire Healthcare NHS Foundation Trust; and

·         Andrew Sharp – Chair of Trustees for West Berks Rapid Response Cars

There were no declarations of interest over and above the standing declarations of Councillor Graham Bridgman and Andrew Sharp.

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 the meeting.

Membership of the Councillors or Members of the public may present any petition which they have received. These will normally be referred to the appropriate Committee without discussion.

There were no petitions presented to the Board.

To agree any changes to Health and Wellbeing Board membership.

It was noted that on 1 July the Buckinghamshire Oxfordshire and Berkshire West Integrated Care Board (ICB) formally came into being and the Berkshire West Clinical Commissioning Group (CCG) was absorbed into the ICB. Legislation had transferred duties of the CCGs to the ICBs, including membership of Health and Wellbeing Boards.

The terms of reference for the West Berkshire Health and Wellbeing Board required an ICB representative and West Berkshire Council representative in order to be quorate.

Members were asked to note that until October 2022, Belinda Seston and Dr Heike Veldtman would be the ICB representatives with Jo Reeves as substitute.

In the longer term, the link with the ICB would be via the Place Based Partnership. Once appointed, the Berkshire West Place Director would join the Health and Wellbeing Board, and a clinical representative would be designated. At least one additional substitute would also be sought.

To provide an update on the formation of the new bodies at 'system' and 'place' level and associated strategy development.

Matthew Tait (BOB ICB Interim Chief Delivery Officer) presented the item on the BOB ICS update (Agenda Item 8).

He summarised his responsibilities, which included: planning and performance; lead on urgent care and elective care; and overseeing the place directors.

Over the last three months, there had been a focus on the technical establishment of the ICB, transfer of functions and staff from the CCGs. The ICB constitution had been signed off and the ICB had been formally established on 1 July 2022. A working group had been established to work up proposals for the Integrated Care Partnership (ICP).

It was explained that the ICP was a joint committee between local authorities and the ICB. The ICB was the NHS statutory body. PBPs would be created as sub-committees of the ICB. Work was ongoing to understand how these would relate to the Health and Wellbeing Boards, but it was acknowledged that there was a strong baseline of partnership working. The final element was Provider Collaboratives, with NHS providers, local authorities and the voluntary sector coming together to delivery joined up services.

The ICB Goals were highlighted, including: tackling inequalities, improving population health and healthcare, enhancing productivity and value for money, and helping the NHS to support broader social and economic development.

Key roles of the ICB were: setting system priorities; orchestrating system working along whole patient pathways; allocating funding in line with the strategy; and earning a seat at the table by focusing on where the ICB could add value.

The Board met on 1 July 2022 to agree governance arrangements and receive various system level plans.

The ICB website was in development, only core information provided at this stage.

The ICB Board membership was detailed – this included: executives employed by the ICB; partner members from NHS trusts, primary care and local authorities; and non-executive members .

A high level strategy had been prepared on working with people and communities, which outlined a set of principles.

Place Based Partnerships (PBPs) were being developed and the ICB was keen to decision making as far as possible, since this would allow effective delivery, integration and work on wider determinants of health. These would build on existing partnerships.

A timeline was presented which showed how the focus was moving from technical tasks to developmental activities.

It was explained that Amanda Lyons was leading on strategy development. Initial work had focused on engagement and pulling together data.

A key focus of the strategy would be reducing healthcare inequalities. This would involve targeting areas of deprivation. It was noted that four out of the five local authorities were in the highest ranks in England in the overall health index.

ICP Strategy Guidance was awaited, but strategies were expected to consider the Joint Strategic Needs Assessments, the Health and Wellbeing Strategies and the NHS Mandate. New areas included: integrated commissioning, budgets, data sets, and health and care records.

The Chairman noted that the local authority representative on the ICB would be the Interim Chief  ...  view the full minutes text for item 23.

To present the annual report on the health of the people of Berkshire for 2021/22.

Professor Tracy Daszkiewicz (Director of Public Health – Berkshire West) presented the item on the Annual Report from the Directors of Public Health (Agenda Item 9).

It was highlighted that for sustainability reasons, the document would only be made available online.

Directors of Public Health could present reports on the state of the population’s health in general terms or in a thematic way. The latest report focused on sustainability, climate change and food production and had been prepared as a pan-Berkshire report.

Members were encouraged to share the report with their networks. 

Since it was an online document, video case studies of local community groups had been included. These looked at where people could get sustainable food from as well as issues such as packaging and the impacts that farm-reared food had on the environment.

Members asked about how the report would be communicated to local residents and what the Council’s Communications Team could do to support this.

It was explained that there would be more targeted communications activities in September, once the report had been taken to each of the Health and Wellbeing Boards.

A question was also asked about the impacts on the Public Health Service as a result of Slough Borough Council being declared bankrupt. It was noted that for pan-Berkshire initiatives and the Ukraine Homes project, colleagues from Slough were still taking part. However, it was suggested that the Director of Public Health for Berkshire East would be better placed to comment on the impact on local public health initiatives.

A comment was made about food sustainability being a global issue with poorer countries / populations being most adversely impacted. Concern was expressed that that the report put the responsibility on individual action, but this was reliant on people having enough money to implement these actions. It was suggested that the benefits system needed to be changed.

Tracy Daszkiewicz acknowledged the points about global food production and distribution and stressed that food banks should not be the focus for supporting families in the UK. She recognised that there was a looming financial crisis which would implications for food poverty and child poverty, and agreed that a wider system changes was needed to support families in a meaningful way without judgement and stigma.

Members praised the report for being easy and enjoyable to read. It was recognised that the report gave practical advice to those who were able to act upon it, but there were many who would struggle to do so. It was also noted that a culture change was underway with many people already eating less meat. Praise was given to practical examples within the report where ‘people power’ could make a difference.

It was suggested that the advice within the report should be pulled out and communicated in bite-sized formats so people did not have to read the full report.

A question was asked about how the Directors of Public Health chose the theme for the annual report and whether it was tied into  ...  view the full minutes text for item 24.

To present the draft Pharmaceutical Needs Assessment and explain the consultation process.

Dr Joel Mulimba and Puja Patel presented the item on the West Berkshire Pharmaceutical Needs Assessment (Agenda Item 10).

It was explained that the Pharmaceutical Needs Assessment (PNA) was a statutory document that was produced every three years. A new version was due in October 2021, but this had been deferred by a year due to Covid.

The PNA was used to inform commissioning of pharmaceutical services and to support decisions about applications for new pharmacies or changes to  pharmacy premises.

Data had been gathered from various national and local datasets, a survey of pharmacy contractors and a survey of service users and the general public. Existing and anticipated population demographics had been taken into account, as well as population health issues prevalent in the area. Various strategies and plans had also been reviewed including the Joint Strategic Needs Assessment.

Development of the PNA was overseen by a Steering Group with representation from Public Health Berkshire, the Local Pharmaceutical Committee, the Integrated Care Board, NHS England Pharmacy Team, the Local Medical Committee, Healthwatch and a patient representative.

A public survey was carried out between 13 January and 4 March 2022 to capture views on: frequency of use; accessibility; reasons for using pharmacies and protected characteristics. This had been disseminated on a whole population basis and a targeted population basis, with support from the a variety of organisations including West Berkshire Council’s Communications Team, Healthwatch, the Volunteer Centre, Community United and Newbury College. Paper copies of the survey were offered in addition to the online survey and focus groups were offered to community groups.

256 residents were engaged. Overall, residents were happy with the services they received and most people chose their pharmacy on the basis of location. 98% of respondents took 20 minutes or less to reach their pharmacy. Most respondents visited their pharmacy once a month.

A contractor survey captured information about commissioned services that they delivered and services they would like to deliver. Responses were received from 19 out of 21 contractors.

The draft PNA went out for a 60 day public consultation on 10 June 2022. All statutory consultees had been invited to comment. The final draft would be taken to the Steering Group on 21 September 2022, before coming to the Health and Wellbeing Board for approval on 29 September 2022.

The Chairman noted that the document still had some references to West Berkshire as a borough rather than a district and asked for these to be corrected for the final version.

Members of the Health and Wellbeing Board were encouraged to provide feedback as part of the consultation rather than waiting until 29 September.

It was highlighted that in the Health Index, one of the aspects where West Berkshire scored most poorly was the distance to pharmacies. However, the draft PNA suggested that there was good access to pharmacies.

It was explained that a national survey had shown that 95% of people could reach a pharmacy within a 20 minute travel time. This was agreed  ...  view the full minutes text for item 25.

To provide the Health and Wellbeing Board with an update on the Suicide Prevention Strategy. In addition to gain the Board’s approval for the change in approach and endorsement for the timeframe to make the amendments to the existing strategy, and to agree the approach of putting in place a principles document to ensure work continues on this agenda and can be monitored whilst the amendments are made.

Professor Tracy Daszkiewicz (Director of Public Health – Berkshire West) presented the item on the Suicide Prevention Strategy Update (Agenda Item 11).

It was explained that there had been a policy shift, which had taken account of research and data related to the impact of Covid on the level of suicides. Also, a new system had been developed around real-time surveillance that it was hoped could be adopted locally.

As part of the update, the intention was to overlay Public Health Strategy, taking into account social, economic and environmental factors and root causes of suicide, the triggers and key transition points in people’s lives. The proposed review of the document would make it broader.

It was also proposed to hold a suicide prevention summit in the autumn to launch the consultation on the refreshed strategy and secure greater partner buy-in to deliver suicide prevention across a broader range of policy.

The final updated strategy would be presented for adoption in spring 2023.

The Board noted that the Suicide Prevention Action Group (SPAG) continued to do all the practical suicide prevention group in West Berkshire. SPAG had a one day per week outreach worker, supported by the Board, who provided training courses. Two courses would be provided in the coming six week period, one of which would be aimed at the racing industry.

Members asked if there was any data being collected on suicides related to long-Covid.

It was confirmed that data was being gathered on people with long-Covid, but it was not being linked directly to suicide prevention. However, closer working with the Coroner’s Office would help improve understanding the causes of deaths by suicide. Improved understanding about the factors that led to suicide would allow for more targeted interventions and support to be put in place.

It was noted that only 28% of people who died of suicide were known to services, which highlighted the importance of mental health first aid training so people were more aware of the signs and how to help. The Board had been unable to recruit a representative from local employers, but it was felt that a contact could be useful in communicating issues and potential interventions around mental health.

It was acknowledged that a challenge of home / hybrid working was that it made it harder for managers and colleagues to identify where individuals were affected by low mood. It was stressed that employers had a responsibility to check that staff were OK and had the opportunity to highlight any support that they might need. It was noted that death by suicide could appear to be very sudden. This was devastating for family members.

The work of SPAG was praised by the Board. However, it was suggested that there were still blocks in the system, such as GDPR issues preventing exchange of information. It was suggested that solutions be found for high-risk individuals so wrap-around care could be provided.

It was noted that some types of training were ubiquitous amongst employers (e.g. equality  ...  view the full minutes text for item 26.

To provide a briefing on current numbers of GPs per head of population in West Berkshire.

Jo Reeves (Newbury Locality Manager) presented the item on GP Numbers in West Berkshire (Agenda Item 12).

There had been a slight fall in GP numbers in Berkshire West and across the Buckinghamshire, Oxfordshire and Berkshire West Health System as a whole. However, the area still benchmarked well compared with neighbouring areas.

There was some optimism regarding the potential to retain the 25 GP trainees in Berkshire West.

Funding had been increased for the Additional Roles Reimbursement Scheme and this was being successfully used to increase numbers of staff in roles that offered direct patient care and relieve pressure on GPs and allow them to work at the top of their licence and work with those patients who had the most complex needs.

In summary, although there were still some recruitment and retention issues that affected GPs, overall workforce numbers were increasing.

Action: Questions relating to the GP Numbers report to be sent to Gordon Oliver.

To present the Berkshire West Clinical Commissioning Group’s Annual Report and Accounts for 2021/22.

The Board noted the Berkshire West Clinical Commissioning Group’s Annual Report for 2021/22. Members were invited to make comments directly to the Integrated Care Board, which had replaced the CCG.

Members of Health and Wellbeing Board 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.

Healthwatch West Berkshire highlighted that due to staffing issues, the Voice of Disability update would need to slip to the December meeting.

·         29 September 2022

·         8 December 2022

·         23 February 2023

·         25 May 2023*

(All meetings to start at 09:30)

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

The Chairman indicated that he would be unable to attend the next meeting on 29 September.