Agenda and draft minutes

To approve as a correct record the Minutes of the meeting of the Board held on 5 December 2024.

The Minutes of the meeting held on 12 December 2024 were approved as a true and correct record and signed by the Chairman, subject to correction of the attendee list which included a duplication.

To consider outstanding actions from previous meeting(s).

Members reviewed the updates on actions from the previous meetings:

·       24-13 - Ch Supt Felicity Parker had requested that the police only attend HWB meetings when there were agenda items relevant to them. However, the Chairman had indicated that it was important for them to be represented at every meeting, since they may be required to respond to matters that arose in debate.

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 Patrick Clark – 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; and

·       Councillor Jo Stewart – spouse is Head of Contract Management at the Royal Berkshire NHS Foundation Trust.

No further declarations of interest were received beyond those standing declarations given in the agenda papers.

Members of the Health and Wellbeing Board to answer questions submitted by members of the public in accordance with the Meeting 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.

Councillors or Members of the public may present any petition which they have received.

There were no petitions presented to the Board.

Purpose: To agree any changes to Health and Wellbeing Board membership.

The Board welcomed Dr Ben Riley as the BOB Integrated Care Board’s representative. It was noted that there was now only one ICB Member, which created a risk of the meeting not being quorate if he was delayed.

Action: HWB Chairman and Vice-Chairman to review ICB representation in consultation with the Council’s monitoring officer.

It was noted that Ch Supt Felicity Parker had replaced Supt Andy Penrith. Discussions were ongoing about Thames Valley Police attendance at future meetings.

Purpose: To provide an update on behalf of the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board.

Dr Ben Riley (Chief Medical Officer, BOB ICB) provided the ICB Update (Agenda Item 8).

The following points were raised in the debate:

·       It was highlighted that there had been a long-standing discrepancy in Continuing Health Care (CHC) decisions for patients in Berkshire West vs those in the rest of BOB and elsewhere. This had been referred to in the operating model paper, and appointments to key posts were welcomed. However, it was hoped that the ICB was serious about addressing this and delivering changes in outcomes affecting CHC decisions.

·       The Board noted that NHS England had provided guidance about Neighbourhood Health Development Plans (NHDPs), which would seek to shift care out of hospitals and into neighbourhoods, with an increased focus on prevention and health inequalities. There were six areas of focus, including Integrated Neighbourhood Teams to wrap around patients, particularly those with complex needs, so they had a better experience of care. It was noted that NHDPs also had a population health aspect, which would require better use of data and digital services. NHDPs were seen as a key tool for addressing the health needs of an ageing population. The ICB was still working out how best to deliver this, but elements had already been set out in the Primary Care Strategy.

·       It was highlighted that the Council’s leisure provider was doing preventative outreach work, which was helping to reduce the need for acute care. The ICB was encouraged to work with the Council to help fund preventative measures like this.

·       It was suggested that conversations around Integrated Neighbourhood Working needed to take place at the lowest possible level, and the approach should not be developed at the System level.

·       The Board noted the financial challenges facing the ICB and the current focus on breaking even. However, it was stressed that prevention was important, and the HWB needed to be involved in conversations about what good prevention would look like.

·       The topic of Women’s Health Services was highlighted by Healthwatch. It was noted that while Buckinghamshire and Oxfordshire had specific services, there was very little in Berkshire West, and none in West Berkshire. Healthwatch considered that it was important to have specific women’s health services across the whole BOB footprint. It was confirmed that there had been correspondence on this matter, and it would be discussed at the next meeting of the Locality Integration Board. The matter would be brought back to HWB if the LIB was unable to resolve it.

RESOLVED to note the update.

Purpose: To provide an update on community pharmacy provision, including the implementation of the Pharmacy First initiative.

Sanjay Desai (Associate Director of Primary Care Operations, BOB ICB) and David Dean (Chief Executive Officer, Community Pharmacy Thames Valley) presented the update on Community Pharmacy Provision (Agenda Item 9).

The following points were raised in the debate:

·       It was noted that there were plans for pharmacists to become independent prescribers, which would open up additional opportunities.

·       In terms of vaccinations programmes, pharmacies were useful in accessing communities, that NHS Trusts or GP Surgeries struggled to reach.

·       It was confirmed that once a patient had been diagnosed with hypertension, the data was fed back to GPs and was added to the patient’s record. Pharmacists did not see the final diagnosis. People were then helped by referring them to available services.

·       The Board asked how they would know what community pharmacy services were available. It was confirmed that this information was available on the NHS Service Finder.  It was noted that pharmacies in West Berkshire were not currently commissioned to deliver weight management, smoking cessation services, or alcohol programmes, but these could be delivered through the Integrated Neighbourhood Teams.

·       It was acknowledged that there was more work to be done to help with signposting to local services. Some areas were using the Joy app for this.

·       It was recognised that Pharmacy First had marked a pivotal change for pharmacies, and there would be further opportunities through integrated neighbourhood teams.

·       Members highlighted anecdotal evidence of long queues at some pharmacies and asked if there was sufficient coverage. It was explained that there could be numerous reasons for queues, such as GP practices being behind on issuing prescriptions, or challenges with medication availability. The latter was recognised as a major, national issue, which would require government intervention.

·       It was noted that the Council’s Wellness Outreach Programme was separate to the hypertension case-finding programme being run in pharmacies. The Outreach Programme was more holistic, while the pharmacy programme was only looking at hypertension. However, both were considered to be important prevention interventions. There had been around 3,000 blood pressure consultations in West Berkshire pharmacies in the last 9 months.

·       It was highlighted that the number of GP referrals to pharmacies varied hugely. Those GP practices that had embraced Pharmacy First had eliminated the 8am phone rush for appointments. If pharmacies knew they were going to get increased referrals, then they could invest in consultation rooms and staff accordingly.

RESOLVED to note the update.

Purpose: To update the Board on the implications for the Council (Public Protection) arising from the Renters Rights Bill (2024) and the Supported Living (Regulatory Oversight) Act 2023.

Sean Murphy (Service Lead - Public Protection) presented the report on Implications for Housing Arising from Legislative Changes (Agenda Item 10).

The following points were highlighted in the debate:

·       In terms of enforcement, it was noted that residents were encouraged to report housing related issues. Housing was top of the Public Protection Partnership’s list of priorities and the service received a high volume of complaints, particularly related to damp and mould. While this used to be seasonal, complaints were now received throughout the year. Also, work was ongoing in relation to unlicensed houses in multiple occupation (HMOs), which had uncovered some serious issues. While the overall housing stock in West Berkshire was generally in a good condition, there were still some serious issues.

·       The Board noted that the appointment of a Public Health Analyst to the Public Health Team would support investigation of links between properties with damp and mould and patients with respiratory illness. It was suggested that there could be a referral scheme for housing assessments.

·       It was confirmed that SNG had undertaken a trial where 400 homes were fitted with devices to monitor damp and mould. They were also looking to install enhanced sensors as part of a retrofit programme. Data gained from the sensors would allow the housing provider to be more proactive in terms of identifying issues before they became a problem. Consideration was being given as to how this could be scaled up to cover all of SNG’s homes.

·       Members asked about SNG’s capacity to deliver the necessary improvements to tackle existing problems. It was confirmed that damp and mould issues were prioritised. While there was currently a backlog of issues, they were looking to get through these as quickly as possible. Resources were being increased in Property Services in advance of the introduction of Awaab’s Law.

RESOLVED to note the report.

Purpose: To provide an update on the impacts of the cost of living on local residents and the support being provided locally.

Sean Murphy (Service Lead - Public Protection) presented the Cost of Living Update Report (Agenda Item 11).

The following points were raised in the debate:

·       Disappointment was expressed that West Berkshire Council would receive a reduction in Household Support Fund Grant for the coming year, at a time when demand was still increasing.

·       It was noted that the Hungry Holidays scheme would be run again this summer, to help provide meals for children over the summer holidays who usually receive free meals at school. 

·       It was confirmed that the Council would continue to work with voluntary sector partners to address problems arising as a result of cost of living challenges.

·       There was recognition of potential inflationary pressures arising from national insurance increases. A sample of 16 local charities had indicated that they would incur additional costs of around £386,000 as a result of increases to NI contributions and the Living Wage. However, It was acknowledged that there was still a lot of uncertainty about costs. Competition for grant funding had also increased. Charities would need to reflect on what services they delivered, which of these were essential, and which could not be delivered or delivered in a different way.

·       It was suggested that more needed to be done to promote local holiday schemes for children and young people. However, it was noted that funding was sometimes not enough to cover the cost of providing them, and charities were having to subsidise the schemes. It was recognised that the voluntary sector was approaching breaking point.

RESOLVED:

·       To note the report, and

·       For the Service Lead for Public Protection provide an update to the Board at its next meeting.

Purpose: To provide an update on Health Protection activity over the previous year.

Dr Matt Pearce (Director of Public Health) presented the Health Protection Annual Report (Agenda Item 12).

The following points were raised in the debate:

·       It was confirmed that the planned pandemic exercise would be a desktop scenario involving national and regional agencies – details were yet to be confirmed.

·       It was noted that the media had picked up on positive news about sexual health in West Berkshire.

·       Officers were asked if future reports could draw out the links between what the HWB had/had not done and health outcomes. It was noted that while responsibility for vaccines sat primarily with the NHS, there was a role for the HWB around engagement of local communities.

·       It was also suggested that the HWB had a role to play in tackling misinformation in relation to vaccinations. Although vaccination levels were still good amongst children, levels were falling amongst adults, including amongst healthcare staff. This was thought to be related to a change in attitudes rather than a lack of access. Planning needed to start now in preparation for next winter. Experience gained during the Covid pandemic had shown that a tailored, localised approach was more effective in boosting vaccine take-up than national comms. The Making Every Contact Count approach was also highlighted as being effective – this would require partnership working with the voluntary sector, primary care, patient groups, etc. It was noted that during the Covid vaccine campaign, cultural and religious leaders had been engaged to help identify and address concerns about vaccines, and this had proved to be an effective approach.

Action: Public Health to review comms re vaccination messaging.

RESOLVED to note the report.

Purpose: To update on progress in implementing the actions set out in West Berkshire’s Joint Health and Wellbeing Strategy Delivery Plan.

Steven Bow (Consultant in Public Health) presented the Joint Local Health and Wellbeing Strategy Delivery Plan Progress Report – Q3 2024/25.

It was noted that work was underway to review the Early Help and Early Years offers in West Berkshire. This involved both Education and Children’s Services. The immediate attention was on the Family Hub offer, which was being broadened from 0-5 years to 0-19 years. The intention was that this would be delivered through a mix of virtual and face-to-face services. Officers indicated that the Council would be happy to work with partners on this project.

RESOLVED to note the report.

Purpose: For the Board to receive an update on progress with the LGA review of the Health and Wellbeing Board.

Dr Matt Pearce (Director of Public Health) provided an update on the LGA Review of the Health and Wellbeing Board (Agenda Item 14).

It was confirmed that the LGA had concluded its interviews, and a workshop had been organised for the morning of 3 April at Shaw House, where reflections would be fed back to the Board. All HWB members were encouraged to attend, since the discussions would shape what the Board would look like in future. The aim was to help the Board make a difference to residents. It was acknowledged that there would need to be a balance between the Board being told what it could do and owning/co-designing the solutions.

RESOLVED to note the update.

Purpose: To present the annual report from the Safeguarding Children Partnership.

The Board considered the Berkshire West Safeguarding Children Partnership’s Annual Report for 2023/24 (Agenda Item 15).

Given that the annual report referred to matters that were nearly a year old, it was felt that there would be limited value in discussing it in detail at the meeting. It was noted that the HWB Steering Group had suggested that the Board should be involved at an earlier stage in the process, so it had an idea of live issues and recent successes. It was suggested that the update could be given by AnnMarie Dodds rather than the Partnership’s Chairman.

Action: AnnMarie Dodds to give an update on the Safeguarding Children’s Partnership to a future meeting.

RESOLVED to note the report.

Purpose: To present the annual report from the Safeguarding Adults Board.

The Board considered the West of Berkshire Safeguarding Adults Board Annual Report for 2023/24 (Agenda Item 15).

As with the previous item, it was felt that there would be limited value in discussing the report in detail at the meeting due to the age of the information reported. It was suggested that an update be given to the future meeting so the Board could get an idea of live issues and priorities for the coming year.

It was highlighted that the graph on p107 of the agenda could lead readers to conclude that residents of West Berkshire were much safer than those in Reading and Wokingham. However, it was stressed that the difference was due down to how each local authority responded to requests for support, and in reality, the three local authorities were broadly comparable in terms of demand. Officers considered that the Safeguarding Adults Board was working well, and the safeguarding function was effective in West Berkshire, having been scrutinised externally and effectively.

It was suggested that there was a need to better connect with and have oversight of the Health and Wellbeing Board with the Adults Safeguarding Board, Children’s Safeguarding Partnership, Community Safety Partnership, Children and Young People Partnership. This was something that would be picked up at the workshop to consider the feedback from the LGA review of the Health and Wellbeing Board.

RESOLVED to note the report.

Purpose: To approve the Better Care Fund quarterly monitoring report for Q3 2024/25

Paul Coe (Executive Director – Adult Social Care) presented the Better care Fund Monitoring Report – Q3 2024/25.

Members had no comments on the report.

RESOLVED to note the report.

Purpose: To provide a summary of recent activities and future actions for each of the Health and Wellbeing Board Sub-Groups.

The Board considered the Sub-Group Updates (Agenda Item 18).

No comments were made in relation to the updates.

RESOLVED to note the updates.

Members of the Health and Wellbeing Board to answer questions submitted by Councillors in accordance with the Meeting Rules contained in the Council’s Constitution.

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

There were no Member questions submitted to the meeting.

An opportunity for Members of the Health and Wellbeing Board to suggest items to go on to the Forward Plan.

The Board considered the Health and Wellbeing Board Forward Plan (Agenda Item 20).

It was agreed that the Delivering Better Value report should be delayed to the July meeting to allow the Council to finalise its submission to the Department for Education before it was considered by the Board.

It was suggested than an item come to the May meeting on hot weather planning. However, it was noted that the LGA workshop on 3 April would consider the types of report that should come to HWB.

8 May 2025

10 July 2026

24 September 2025

11 December 2025

5 March 2026

7 May 2026

The dates of the future meetings were noted.

Transcription of questions and answers from the meeting.