Agenda and draft minutes

To approve as a correct record the Minutes of the meeting of the Board held on 22 February 2024.

The Minutes of the meeting held on 22 February 2024 were approved as a true and correct record subject to the following amendments and were signed by the Vice Chairman:

·       Members had requested that the SEND Review be added to the Forward Plan for the September meeting.

It was noted that Paula Saunderson’s question about Dementia Admiral Nurses had not been fully answered at the meeting. Members asked whether responses provided after the meeting were recorded.

Action: Gordon Oliver to confirm the process for recording written responses provided after the meeting and whether Paula Saunderson had received those written responses.

To consider outstanding actions from previous meeting(s).

Progress on actions from the previous meetings was noted.

Further updates were provided as follows:

·       218 – It was confirmed that this action had been dealt with at the time and could therefore be closed.

·       244 & 253 - The Board noted that updates on these actions would be addressed as part of the Cost of Living Update later on the agenda.

·       258 – a report template had been shared with the Volunteer Centre and would be used for future voluntary sector updates, so this action could be closed.

·       259 – it was confirmed that an information leaflet on vaping had been produced and had been shared with schools.

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 Alan Macro – Governor of Royal Berkshire Hospital NHS Foundation Trust, and West Berkshire Council representative on the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Partnership;

·       Councillor Janine Lewis – Governor of Berkshire Healthcare NHS Foundation Trust; and

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

There were no declarations of interest received other than the standing declarations set out in the agenda.

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.

It was noted that Andy Penrith had replaced Helen Kenny as the Thames Valley Police representative and Rachel Peters had replaced Garry Poulson as the voluntary sector representative.

Purpose: To endorse the establishment of a Berkshire West Health Protection and Resilience Partnership Board to provide assurance that robust arrangements are in place to protect the health of residents across Berkshire West (West Berkshire, Wokingham, Reading).

April Peberdy (Interim Service Director – Communities and Wellbeing) presented the Berkshire West Health Protection Board report (Agenda Item 8).

It was noted that that lessons learned from the pandemic would be applied via the Health Protection Board. The proposed terms of reference were considered to cover all the relevant points and the proposed membership was considered appropriate.

In addition to the resolutions set out in the report, Councillor Jeff Brooks proposed that the Board should prepare an annual report to describe what it had considered, delivered, and achieved. This was seconded by Councillor Heather Codling.

RESOLVED that:

a)    Establishment of a Berkshire West Health Protection and Resilience Partnership Board (HPRPB) be endorsed to provide assurance that robust arrangements are in place to protect the health of residents across Berkshire West (West Berkshire, Wokingham, Reading);

b)    The draft Health Protection Board terms of reference be approved; and

c)    The Health Protection Board be required to prepare an annual report.

ACTION: The Health Protection Board Annual Report be added to the Forward Plan

Purpose: To provide an update on the Berkshire Suicide Prevention Strategy.

Zoe Campbell (Interim Service Lead Public Health and Wellbeing) and Professor John Ashton (Interim Director of Public Health) presented the report on the Berkshire Suicide Prevention Strategy (Agenda Item 9).

The following points were raised in the debate:

·       Members asked if the West Berkshire Suicide Prevention Action Group (SPAG) had been consulted on the report. It was confirmed that the previous Consultant in Public Health had liaised with the SPAG Chairman, but it was not known if he had been consulted on this report.

ACTION: Zoe Campbell to confirm if SPAG had been consulted and to ensure that SPAG and the Volunteer Centre were involved in future.

·       The importance of bereavement counselling was highlighted in terms of providing short and long-term support to those affected by suicide. It was also noted that other areas had established Survivors of Bereavement by Suicide (SoBS) groups to provide mutual support. It was confirmed that both options would be explored by the new Director of Public Health and that SPAG was already looking at establishing a SoBS group.

·       Members asked why female suicides were a priority when the rate of male suicides was three times higher. It was highlighted that female suicides were often victims of domestic abuse. Different factors affected different groups of people, so interventions had to be targeted. Suicide levels were highest amongst men in their 40s and this was often linked to a crisis in male identity.

·       It was suggested that farmers may need particular support, since they had higher than average levels of suicide and poor mental health. There were also issues with deaths from farm accidents. It was suggested that a strategy for rural health may be appropriate in West Berkshire. Data analysis was underway to consider issues across West Berkshire. It was noted that Sweden had an ambition of zero farm deaths and had adopted a system of peer inspections, which had proved effective. Provision of support to gay men in rural communities was also flagged as being more difficult than in urban areas. It was suggested that all HWB sub-groups could consider rural aspects as part of their work.

ACTION: April Peberdy to consider how rural issues could be addressed.

·       Members stressed the importance of marketing of services so people were familiar with the support that was available, as well as being able to provide that support within a reasonable timeframe. However, the strategy did not mention support or timelines for providing that support.

·       Also, it was noted that the report focused on adults and did not mention children and young people. Voluntary sector organisations providing mental health support to young people had waiting lists of up to 18 months.

·       It was suggested that a person taking their own life was a sign of system failure, and so the strategy needed to be more pro-active and focused on engagement.

·       Officers acknowledged that there was more work to be done on the Strategy, but highlighted that there was lots of information on the Council’s website and social  ...  view the full minutes text for item 80.

Purpose: To provide an update on plans for the redevelopment of the Royal Berkshire Hospital.

Alison Foster (Programme Director) provided the Building Berkshire Together Update (Agenda Item 10).

The following points were raised in the debate:

·       Site tours of the existing hospital helped Members to understand the issues and helped the Trust to learn how best to engage and link with local communities.

·       The Trust was keen to engage with local groups and attend events. Members were encouraged to email Alison Foster directly with details of any local community events (alison.foster@royalberkshire.nhs.uk).

·       Transport and parking issues were highlighted as key concerns. It was suggested that patients would use public transport if it was convenient (e.g., a direct service from Newbury Bus Station). The Trust welcomed all feedback and confirmed that as part of the impact assessment process, it was considering how to mitigate the impacts of relocating the acute hospital on local communities within its catchment. This included making better use of local facilities such as the West Berkshire Community Hospital.

·       Concern was expressed about the way in which the project was being approached, i.e., considering a replacement for the existing hospital rather than considering the sort of health system that would be needed in 30-40 years. It was noted that West Berkshire had an ageing population, which would lead to an increased demand for services. More people at end-of-life were choosing to die at home, and a better community health system would be needed to support this. The Trust was urged to consider multiple scenarios and be open to changes in working practices (e.g., consider what size hospital would be needed if there was significant investment in prevention; look at health spaces within communities; or consider the impact of a shift from surgical to medical interventions). The Trust confirmed that the hospital would come after a significant, multi-year transformation programme. The Trust had engaged with the wider health system in order to work out the right size of hospital for the future. They offered to provide a further update on this process to a future meeting. It was stressed that there would always be a need for an acute hospital, but there was a clear commitment to move to a more preventative model of care, as set out in the Primary Care Strategy. Much was dependent on the funding envelope. It was stressed that the bricks and mortar development was just one part of the set of system-wide solutions being considered.

·       It was noted that the Berkshire West Place was engaged in a major programme to move services closer to patients. The hospital redevelopment project aimed to secure funds to replace current infrastructure on the existing site, which was not fit for purpose. It was accepted that the Trust needed to do more to explain its clinical strategy.

·       Members welcomed the level of engagement experienced at Stratfield Mortimer Parish Council and expressed a desire to engage other communities across West Berkshire in a similar way.

·       The Trust confirmed that details of all engagement events were available on the Building Berkshire Together website and  ...  view the full minutes text for item 81.

Purpose: To update the Health and Wellbeing Board on the collective response to the impact on residents in West Berkshire of the rise in the cost of living and consider how we build upon the response so far.

Sean Murphy (Public Protection Manager) presented the report on the Local Response to the Cost of Living Crisis (Agenda Item 11).

The following points were raised in the debate:

·       It was noted that the proposals for the latest round of the Household Support Fund had been signed off by the Executive Portfolio Holder. These included: assistance for food and energy costs; the goods scheme (replacement of beds, cookers, white goods, etc); food support for those in emergency accommodation; discretionary assistance for school holiday meals to 4,200 young people; and targeted support for pensioners, young carers and those leaving care. Also, £200,000 was being set aside to allow people to make applications directly to the Council for immediate support.

·       A sum of £50,000 had been allocated to the joint fund with Greenham Trust. This had already issued grants to the value of £209,000 to local organisations.

·       In terms of outstanding actions:

o   244 - It was confirmed that Sovereign Network Group was represented on the local coordinating group.

o   246 - Work on tackling the rising cost of living was now embedded in the work of the Public Protection Partnership and the impacts on health were well-recognised.

o   253 - Further work was needed on promotion of where people could donate items with voluntary sector partners.

·       It was felt that there were still people who were really struggling with the cost of living, but support mechanisms were well-established.

·       The voluntary sector had welcomed the opportunity to engage and move forward with key deliverables.

·       A request was made for the Public Health Team to have more involvement.

ACTION: Sean Murphy and John Ashton to discuss how the Public Health Team could be involved.

·       Board Members were invited to provide input to the support that was being provided in West Berkshire. An invitation was also extended to Board Members to attend the coordination group.

·       Thanks were expressed to Rachel Peters and Garry Poulson for their ongoing support.

RESOLVED to:

·       Note the report

·       Receive a further update to the next meeting.

Purpose: To note the contents of the new Health and Wellbeing Board Dashboard.

Gaya Perera (Interim Intelligence Manager) presented the item on the Health and Wellbeing Board Dashboard (Agenda Item 12).

The following points were raised in the debate:

·       It was noted that the presentation was different to that in the agenda pack.

·       Concern was expressed that some of the data was several years out of date. It was noted that more recent data was available locally, however, this did not allow for comparisons with national averages.

·       Members indicated that they would like to see more granular data, particularly in relation to deprived areas, since this would guide the work of the Board and its Sub-Groups. It was confirmed that work was already being effectively targeted, but the need for high quality data was recognised.

ACTION: Gayan Perera to review data sources.

·       Concern was expressed about data sources that referenced different timeframes. It was noted that pre- and post-pandemic situations were markedly different, so it was important to use current data.

·       Members queried why Frimley data sources were being quoted.

·       Members highlighted that data sets taken in isolation might lead to one conclusion, but when taken in the context of other factors, this might lead to a different conclusion.

·       The public health intelligence function was currently shared with Reading, but it was confirmed that it was a priority for West Berkshire to develop its own intelligence function. This would allow for better integration of public health and corporate intelligence.

·       During the pandemic, Directors of Public Health had been critical of the way in which data had been hoarded by local authorities.

·       It was hoped that data captured through Primary Care Networks would become a rich source of intelligence.

·       It was suggested that the Council should invest in intelligence capacity.

RESOLVED to note the report.

Purpose: To update on progress in implementing the actions set out in West Berkshire’s Delivery Plan, focusing on the fourth and fifth priorities to: 'Promote good mental health and wellbeing for all children and young people', and 'Promote good mental health and wellbeing for all adults'.

Dr Heather Howells (BOB ICP Clinical Lead for Mental Health) presented the Delivery Plan Progress Report: Priorities 4 and 5 (Agenda Item 13).

It was agreed that actions referred upwards to ‘Place’ and ‘System’ levels should be discussed at the Berkshire West Mental Health Board.

ACTION: Sarah Webster to discuss actions referred upwards to ‘Place’ and ‘System’ levels at the Berkshire West Mental Health Board.

RESOLVED to:

·       note the report and the progress made to date;

·       agree that the actions were still appropriate;

·       agree the actions to be referred upwards to the ‘Place’ or ‘System’ levels;

·       commit their respective organisations to delivering the agreed actions.

Purpose: To note the BCF quarterly monitoring report for Q3 2023/24.

The Better Care Fund Monitoring Report: Q3 2023/24 (Agenda Item 14) was provided for information only.

RESOLVED to note the report.

Purpose: To provide details of recent and planned changes to pharmaceutical services in West Berkshire and advise the Health and Wellbeing Board on the implications for the West Berkshire Pharmaceutical Needs Assessment.

The Chairman presented the Changes to Pharmaceutical Services Report (Agenda Item 15).

The following points were raised in the debate:

·       Although it had been intended to include the report for information only, Primary Care Support England had recently provided details of third party responses to the unforeseen benefits applications for new pharmacies at Gaywood Drive, Newbury and the Kingsland Centre, Thatcham.

·       Members welcomed both applications. While there was official capacity at existing pharmacies, there was anecdotal evidence of additional need from residents.

·       It was noted that Councillor Alan Macro had requested that the Board respond to the comments made in relation to the Gaywood Drive application, particularly in relation to parking.

·       It was noted that previous pharmacies had failed in West Berkshire and it was highlighted that online pharmacies could offer significant benefits for some patients. Although it was recognised that these were not accessible to all patients, it was suggested that a more long-term approach was needed.

·       Members were reminded of the presentation to the last Health and Wellbeing Board, which gave an assessment of the sustainability of pharmacies and the long-term strategic direction as set out in the Primary Care Strategy.

·       It was noted that the large chains had bought numerous local pharmacies, but could no longer make their operations stack up financially, so they were closing stores. However, Pharmacy First meant that pharmacies were starting to pick up work previously undertaken by GPs. Pharmacists had previously played significant roles in harm reduction in relation to HIV and it was felt that pharmacists could play a more significant public health role in future.

·       It was noted that there were challenges for rural residents accessing pharmacies, particularly where they were not digitally enabled and/or lacked transport.

·       Healthwatch confirmed that they would be undertaking a study of the local pharmacy sector in the coming month, which would pick up aspects such as wait times and the impact of the Pharmacy First initiative.

RESOLVED to respond to Primary Care Support England on comments made in relation to the recent unforeseen benefits applications at Gaywood Drive and the Kingsland Centre, and to delegate the wording to the Director of Public Health in consultation with the Chairman of the Health and Wellbeing Board.

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

The Health and Wellbeing Board Sub-Group Updates (Agenda Item 16) were provided for information only.

RESOLVED to note the report.

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.

A full transcription of the public and Member question and answer sessions is available from the following link: Transcription of Q&As.

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

The Board reviewed the Forward Plan (Agenda Item 18).

It was agreed that the following items should come to the next meeting:

·       Hampshire Together Update

·       Results of the Care Quality Commission review of West Berkshire Council’s Adult Social Care Services.

·       Director of Public Health Annual Report.

It was noted that the Women’s Hub Project had not been implemented in Berkshire West and funding had been absorbed into the BOB ICB’s deficit. NHS England had written to all ICBs to ask how funds had been spent – unspent funds would be clawed back. Healthwatch was interested to know what would happen in the second year of the project.

ACTION: Sarah Webster to ask ICB colleagues about plans for the Women’s Hub and consider whether this could be picked up in the ICB Annual report.

It was suggested that a report be brought to a future meeting on how Tobacco Control and Vaping Legislation was being implemented at a local level, including awareness and education initiatives.

11 July 2024

12 September 2024

5 December 2024

6 March 2025

8 May 2025

(All meetings to start at 9:30am)

The dates of the future meetings were noted.