Agenda and minutes

Purpose: To approve as a correct record the Minutes of the meeting of the Committee held on 13 June 2023.

The Minutes of the meeting held on 13 June 2023 were approved as a true and correct record and signed by the Chairman.

Purpose: To receive an update on actions following the previous Health Scrutiny Committees.

For Action 10, Sarah Webster advised that a written update would be sent. For Actions 8 and 9, it was agreed that annual updates would be sufficient.

Purpose: 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.

Councillor Martha Vickers declared an interest by virtue of the fact that she was on the Healthwatch Board.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received at the meeting.

Purpose: To consider a report on access to Primary Care in West Berkshire.

Dr Heike Veldtman (Clinical lead for Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) presented the report on access to primary care.

During the presentation the following key points were raised:

·       There was variation between practices in the patient survey.

·       It was important to ensure the most appropriate consultation type was offered and there would be consideration for how ongoing care would be delivered.

·       Berkshire West was fairing fairly well with 81% of appointments within two weeks, given the short period of time this measure had been in place. It was noted that if routine appointments were managed right, they would get fewer urgent appointment requests.

·       It was highlighted that appointment data was triangulated with patient feedback and what was heard on the ground, taking into account changes within the practice.

·       It was important to align national campaigns with local communications and engagement.

·       The ICB and Primary Care were in discussions around new developments and planning policies.

·       Learning how to live well with long term conditions was a key message. Local authorities and the voluntary sector were working on prevention and addressing inequalities to ensure health and the NHS were sustainable in the future.

The following points were noted during the Committee’s discussion:

·       It was confirmed that the friends and family feedback had a low response rate, and they were working to increase the response rate in future. The national patient survey had a larger response rate and was targeted at people who had recently attended the surgery.

·       It was advised that the variations in feedback between practices was multifactorial. It included differences between rural and town practices, deprivation levels, and demographics which affected health and access to support.

·       It was highlighted that Covid brought about change regarding telephone triage and online consultations. Some surgeries embraced this, and others were slower to embed it. There was good feedback on the new telephony system as patients became used to it.

·       It was confirmed that there was ICB-level support for primary care networks to work together and to share best practice particularly with methods of contact.

·       In the discussion regarding empowering patients, concern was raised regarding the role of community pharmacy, increased demand and how practices worked together with pharmacies. It was noted the Health and Wellbeing Board was responsible for the Pharmaceutical Needs Assessment. The benefits of online pharmacy were highlighted to enable pharmacies to deliver health checks and health promotion.

·       Pharmacies were commissioned by the ICB and they were working with colleagues to support and build resilience in community pharmacy. Concerns regarding a recent closure of a Newbury pharmacy were noted.

·       The advantages of the NHS App were promoted but concern was raised regarding access and digital exclusion. It was confirmed that digital inclusion and exclusion were always considered. Patient Participation Groups were involved and there were courses to help people to use the NHS App. The overall benefit of the NHS App helped all to have better access.

·       It was noted that they wanted to increase  ...  view the full minutes text for item 17.

Purpose: Following a Peer Review in 2022, the Buckinghamshire, Oxfordshire and Berkshire West  Integrated Care Board will present a report on Continuing Healthcare, the Continuing Healthcare transformation programme and progress in West Berkshire.

Niki Cartwright (Director of Vulnerable People’s Services, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) presented the report on the All Age Continuing Care (AACC) Transformation Plan.

During the presentation the following key points were made:

·       The Peer Review at a System level (Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System) illustrated the need for better joint working. An external consultant was commissioned to review how AACC could be improved. That was coming to an end and the Transformation Board had been set up. This was a Partnership Board including local authorities and West Berkshire Council.

·       A set of recommendations were made. The report noted that a lot of new elements had not been properly resourced over the last five years which made the functions fragile. Berkshire West and Buckinghamshire delivery teams would be merging to help with resilience. Assessments and case management would remain with local teams.

·       This would be an eighteen month to two year programme. It would be 2025 before the benefits were seen and afterwards improvements would continue.

·       It was noted that Berkshire West was one of the lowest areas in the UK for eligibility. This had been reviewed a number of times. They had recently requested the NHS South East regional team come in and have another review. They would be continually looking at it.

·       It was highlighted that the impact of the Transformation Plan would be to reduce variation and ensure equity in eligibility across the ICB.

·       The Implementation of the Transformation Plan would provide many benefits including a locally focussed team with more staffing resilience, more flexibility in managing the AACC service and improved relationships.

·       Next, they would be implementing a patient survey which would become regular business as usual.

The following points were noted during the Committee’s discussion:

·       It was noted that there was no strict definition of Continuing Health Care (CHC) or AACC. There was a long and detailed framework and it relied upon professional opinion. CHC was for adults and AACC was an umbrella term which included children and young people.

·       Paul Coe (Interim Executive Director - People) stated that it was agreed that the merging of Berkshire West and Buckinghamshire provided a good opportunity to import good practice. However, Paul Coe noted that the 2025 timescale did not feel urgent, and change was not being recognised on the ground yet. It was suggested that improvements would be needed before the end of the Transformation Plan and that the Health Scrutiny Committee keep the programme in sight.

·       It was noted that the Peer Review was concerning in a number of areas. It was confirmed that the recommendations had been agreed as part of the future delivery of the service.

Action: Niki Cartwright to provide the Committee with the detailed project plan.

·       It was confirmed that Buckinghamshire and Berkshire West were merging due to the size of the teams. They would be continuing to review the new team structure.

·       It was confirmed that Berkshire West was doing very well  ...  view the full minutes text for item 18.

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB) to provide an update on activities and commissioning plans.

Sarah Webster (Executive Place Director Berkshire West, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) provided an update.

During the presentation the following points were raised:

·       Nick Broughton was now the interim Chief Executive of the BOB ICB.

·       The Integrated Care Partnership (ICP) was the non-executive committee which included representatives from all local authorities and the ICB.  The ICP had confirmed the ICP Strategy and the five year Joint Forward Plan.

·       The ICB were continuing to develop Provider Collaboratives. Three acute hospitals were coming together to share best practice and deliver services. The were also two mental health Provider Collaboratives. This was to use the benefits of scale whilst keeping the local focus.

·       They were developing local / geographical partnerships to build strong and collaborative Places. In Berkshire West this was working well as they focused on priority areas and shared opportunities. For example, the community wellness outreach model which would be teams going out to public spaces to engage with communities and have wellbeing conversations. They would also book in for follow up appointments if needed.

Action: Sarah Webster to provide a written report to the next Health Scrutiny Committee on an overview of the work of the ICB in Berkshire West.

·       They were planning for winter pressures and would bring an update to the next meeting.

Action: Sarah Webster to bring a winter plan update to the next Health Scrutiny Committee.

·       Operationally they were progressing the covid and flu vaccination programme.

·       The ICB were continuing to support providers with the impacts of the ongoing industrial action. There was quality scrutiny to ensure services were safe.

The following points were noted during the Committee’s discussion:

·       The West Berkshire Community Hospital was highlighted as a friendly and accessible service for West Berkshire residents. Berkshire Healthcare NHS Foundation Trust and Royal Berkshire NHS Foundation Trust were looking regularly to use the hospital for outreach. A key consideration of the Building Berkshire Together programme was what services needed to be on site and what could be delivered in communities.

·       Cross-collaboration between West Berkshire Council and the NHS was discussed regarding health outreach in the community and the use of space / facilities. It was confirmed that discussions were had regarding looking at what was available in public-ownership or in the voluntary sector, and appropriate re-imbursement.

Purpose: Healthwatch West Berkshire to provide an update on Healthwatch’s current activities and feedback from residents.

Fiona Worby (Lead Officer from Healthwatch West Berkshire) presented the report on the current activities of Healthwatch West Berkshire.

·       Healthwatch West Berkshire were undertaking a joint project with Reading and Wokingham called GP Access. They would be running focus groups in each area, speaking with Patient Participation Groups from each Primary Care Network and meeting with vulnerable groups. This was in collaboration with GP’s and the ICB. They would be looking at new ways of working, the role of reception and communications around the changes. They would be gathering this information over the next few months, analysing the data in February with a report in March next year.

·       There was concern around pharmacies and phlebotomy services due to staff shortages.

·       They were monitoring the Building Berkshire Together work and accident and emergency waits.

·       Healthwatch were taking into account the impacts of increased costs of living in all the work they were doing. There was concern regarding patients not being able to pay for prescriptions or being unable to make calls to GP Practices due to call charges when on hold.

·       The ICB were supporting the GP Access project and were working closely with Healthwatch to understand the patient perspective to access and communications.

Purpose: To receive updates on Task and Finish Groups appointed by the Health Scrutiny Committee.

The Chairman advised the Committee that the task group looking into healthcare provisions in new developments had not met since the previous Health Scrutiny Committee.

Purpose: To receive new items, and agree and prioritise the work programme of the Committee.

The Chairman advised the Committee that the emotional wellbeing of children and maternal mental health were on the work programme for the next Health Scrutiny Committee in December.  

Members could propose items for the work programme. There was a form on the website for members of public to nominate topics for Health Scrutiny.

Action: Members of the Health Scrutiny Committee to review the Inquest Review Report from March 2023.