Agenda and minutes

To approve as a correct record the Minutes of the meeting of the Committee held on 4 May 2021.

The minutes of the meeting on 4 May 2021 were accepted as a true and correct record.

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 Andy Moore declared that he was an NHS volunteer, and asked that this be noted as a standing declaration for this Committee.

Andrew Sharp declared that he was Chair of Trustees of the West Berks Rapid Response Cars (WBRRC), and asked that this be noted as a standing declaration for this Committee.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received.

Purpose: To present the Terms of Reference for the Health Scrutiny Committee as agreed at Full Council on 4 May 2021

Councillor Claire Rowles (Chairman) presented the current Terms of Reference (Agenda Item 5). She explained that these had been agreed when the Committee had been established by Council on 4 May 2021. 

Councillor Graham Bridgman indicated that the Constitutional Task Group was reviewing the Council’s Constitution and the Terms of Reference for this Committee would become an appendix of the Constitution. He noted that some aspects were already covered by the Constitution, such as the process for calling extraordinary meetings.

Councillor Tony Linden suggested that for a Committee of five Members, a quorum of three would be better than four, since some Members may not be able to attend all meetings or may need to attend remotely. He also suggested that the Committee should be increased to seven Members due to the volume of work involved. Councillor Bridgman explained that the Constitution was clear on the quorum, which was one third of the Committee or four Members, whichever the lesser in terms of membership.

Councillor Andy Moore noted that paragraph 1 of the Terms of Reference stated…. “to ensure that services are safe and effective in improving health and wellbeing of local citizens and reducing health inequalities”.  He stated that a regulator or scrutiny Committee did not have the power to ensure something, but that its function was to assure as a result of its scrutinisation. As such, he suggested the Terms of Reference be amended to reflect this. The Chairman advised that any amendment to the Terms of Reference would need to be agreed at Full Council. The Chairman reminded Members that any changes to the Terms of Reference would need to be agreed by full Council.

Andrew Sharpe noted that scrutiny of Social Care services would remain with the Overview and Scrutiny Management Commission (OSMC) and asked how scrutiny of services jointly commission by the Clinical Commissioning Group (CCG) and Social Care would be considered  (e.g. hospital discharges). Gordon Oliver advised that this issue had been raised in relation to the current review of Continuing Healthcare. He confirmed that where issues such as this arose, consideration would be given to who was taking the lead, and this would determine the most appropriate route for scrutiny. Councillor Bridgman added that the Health Scrutiny Committee and OSMC could appoint a joint committee to deal with such matters.

Purpose: For Health Scrutiny Committee to review the draft Joint Health and Wellbeing Strategy and associated Delivery Plan, and the initial findings from the formal public consultation exercise.

Sarah Rayfield, Acting Consultant in Public Heath, gave a presentation on the Joint Health and Wellbeing Strategy (Agenda Item 6). The presentation went through the process of how the Strategy was developed.

In April 2019, the Health and Wellbeing Board Chairmen from West Berkshire, Reading and Wokingham had agreed to develop a Joint Health and Wellbeing Strategy. Work started in March 2020 by evaluating the current strategies and looking at their impacts. Identification of residents’ needs was informed by data and discussion with stakeholders, partners and organisations working in the area. An initial long-list of 30 priorities had been developed, which was refined to a list of 11 through a series of workshops. In November 2020, a public engagement exercise was used to further refine the priorities to a total of five.

The presentation included a number of key Statistics relating to the population, demographics and health needs of West Berkshire residents.

It was explained that the Strategy had been co-produced and delivered through a Consultation and Engagement Task and Finish Group. An online survey had attracted 3,967 responses, 1,201 of which were from West Berkshire. In addition, 18 focus groups had been held with under-represented groups.

Comments from West Berkshire residents were around the following themes:

·         Better communication and support for parents of children with mental health difficulties.

·         Bring together the educational needs and long-term wellbeing of young people.

·         More financial support for people and families who work but still struggle to pay household bills.

·         Better coordination between Social Services and the NHS for elderly / vulnerable people.

·         Minority groups were less likely to use and trust public services.

·         The impact of dementia on people, and their families, required input from many agencies.

The final agreed priorities were:

1.    Reduce the differences in health between different groups of people.

2.    Support individuals at high risk of bad health outcomes to live healthy lives.

3.    Help families and children in early years.

4.    Promote good mental health and wellbeing for all children and young people.

5.    Promote good mental health and wellbeing for all adults.

The Strategy was underpinned by the following eight principles:

1.    Recovery from Covid-19

2.    Engagement

3.    Prevention and Early Intervention

4.    Empowerment and Self Care

5.    Digital Enablement

6.    Social Cohesion

7.    Integration

8.    Continuous learning

It was confirmed that the Strategy would be in place for the next 10 years, but it would be adjusted as needed to reflect new learning and data.

An online public consultation on the draft strategy had taken place in West Berkshire and Reading from 24 June to 4 August 2021. Of the 162 responses received, 67% were from West Berkshire, 26% from Reading and 7% from other areas. 80% of responses were from individuals and 12% were on behalf of organisations. The responses showed strong support for each of the priorities and supporting strategic objectives.

Themes in the ‘free text’ comments included:

·         A general acknowledgement that the priorities were sensible and important issues.

·         Interlinking / overlapping nature of  ...  view the full minutes text for item 7.

Purpose: Healthwatch West Berkshire to report on views gathered on healthcare services in the district and to present its annual report.

Andrew Sharp presented the Heathwatch West Berkshire Annual Report 2020/21 (Agenda Item 7).

He began the presentation by providing an overview of the Healthwatch service and explained that Healthwatch came into existence in 2013 under the Health and Social Care Act with a Healthwatch in every local authority area to champion local communities and to take people’s views and experiences back to those who commission and deliver services, with the aim that good practice would be recognised and repeated and to encourage reflection when things didn't go well.

Healthwatch had statutory powers to ‘enter and view’ healthcare facilities. Despite the pandemic, West Berkshire Healthwatch had been able to visit a number of care homes in December 2020 to talk to residents and their families. They also had a statutory power of response. Because it had not been possible to visit establishments during lockdown, they had focused on providing information to residents. They had produced 116 newsletters to disseminate the large amount of information related to the Covid pandemic. A key functions of HWWB was to let the public know what was happening with services and how they were changing, as well as letting the service providers know what the public were experiencing as a result of those changes.

Healthwatch England had shown that only one person in 100 formally complained about health services. As a result, service providers were often unaware when services failed to meet patient’s needs and consequently they were not in a position to put things right. 

A key function of Healthwatch within Health and Wellbeing Boards, Primary Commissioning Boards or Planned Care Boards, was to relay ‘lived experiences’. An example was cited of people who had experienced problems getting emergency blood tests during the pandemic. When patient experiences were communicated, it enabled providers to recognise problems and put in place solutions.

It was acknowledged that statutory bodies wanted to provide the best service they could for local residents, so it was important to get feedback from the public, both good and bad. It was stressed that even minor issues should be captured to avoid major problems from developing.

Another key function of Healthwatch was to capture feedback from West Berkshire's residents and deliver this to service commissioners and providers in a constructive, useful and helpful way.

Healthwatch was one of the few services that covered both Social Care and Health and it went to great lengths to ensure there was a genuine issue before referring up to the statutory bodies. Recent examples had included issues with maternity, dentistry and phlebotomy services.

Where it had not been difficult to engage with the public during the Covid pandemic, Healthwatch had created vehicles in order to make it easier to do so, e.g. the West Berkshire Diversity Forum, the West Berkshire Maternity Forum and the forthcoming CAMHS survey. 

The pandemic had highlighted health inequities, which had been made worse by the pandemic and it was stressed that the health system must be open to learning from the pandemic and  ...  view the full minutes text for item 8.

Purpose: To confirm the dates of future meetings, receive new items and agree and prioritise the work programme of the Health Scrutiny Committee.

The Chairman updated the Committee on the Work Programme (Agenda Item 8).

She highlighted that informal briefing sessions would be arranged with health bodies in between formal meetings to get the Committee up to speed. She asked if there were any further comments or suggestions around the Work Programme.

Councillor Linden noted that Royal Berkshire NHS Foundation Trust was included in the informal briefings item list and that they tended to deal with Reading Borough Council as that was where they were based, but he felt they should also deal with services in West Berkshire and Wokingham.  Councillor Linden also advised the Committee that he had been accepted as a vaccine volunteer based at Calcot. 

Councillor Moore asked how many protocols the Committee would be dealing with on the forward plan.  Gordon Oliver said there would be one protocol, which would set out a way of working between the HSC and other health partners in terms of responsibilities and managing disagreements.

Councillor Macro suggested that Mental Health for Young People should be added to the Work Programme as highlighted in the Healthwatch report.  He also suggested that Continuing Healthcare funding should be added to the Work Programme.

Andrew Sharp indicated that the Chief Executive of North Hampshire Hospital was keen to have a much closer relationship with West Berkshire, as well as Great Western Hospital and that representatives of both should be invited to talk to the Committee. In terms of the forward plan, he also suggested the Committee be mindful of the HIP2 projects for both Royal Berkshire and Basingstoke hospitals and the Ambulance Service and GP out of hours service.  

Councillor Bridgman said the HIP2 projects did not lie with this Committee because they were cross-border, so should be considered by the relevant Joint Health Overview and Scrutiny Committees.  Councillor Bridgman said there would be representation from the Royal Berkshire NHS Foundation Trust on the Health and Wellbeing Board and there would be a presentation by Dom Hardy on certain aspects of the ICP. Councillor Bridgman noted there was a standing item on the forward plan for updates from the CCG and strongly felt that Continuing Healthcare should form part of that regular update. Andrew Sharp advised that Berkshire West was at the bottom of the country in terms of awarding CHC funding with only 13 cases per 100,000 receiving funded, compared to 56 cases per 100,000 in Buckinghamshire and 108 cases per 100,000 in Cumbria. 

Andrew Sharp referred to the closure of the Duchess of Kent Hospice and suggested hospice services should be added to the forward plan to recognise the closure’s likely impact and discuss how future demand could be met in West Berkshire.