Agenda and minutes

Purpose: To receive apologies for inability to attend the meeting (if any)

Purpose: To approve as a correct record the Minutes of the meetings of the Committee held on 5 April 2022 and 10 May 2022.

The Minutes of the meeting held on 5 April 2022 and 10 May 2022 were approved as a true and correct record and signed by the Chairman, subject to the following amendment:

It was noted that Councillor Graham Bridgman was in attendance at the meeting.

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.

Councillors Claire Rowles and Tony Linden declared an interest in Agenda Item 5 by virtue of the fact that Councillor Rowles’ partner has a tenant who works at Thornford Park Hospital and Councillor Linden works for a company deploying advertising at petrol stations for Elysium Healthcare, but reported that, as their interest was a personal or an other registrable interest, but not a disclosable pecuniary interest, they determined to remain to take part in the debate and vote on the matter.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received.

Purpose: To provide an update on the response to the Care Quality Commission report.

Jo Sherman, Hospital Director, Elysium Healthcare and Michele Paley, Elysium Healthcare, presented the report on Thornford Park Hospital (Agenda Item 5).

Ms Sherman gave an overview on Elysium Healthcare and Thornford Park Hospital. This included the Operational Board, background of Elysium Healthcare and geographical coverage. The Strategic Plan for 2022 was explained with a number of aims highlighted.

Councillor Tony Linden asked for clarification around how Thornford Park Hospital was regulated. It was confirmed that the regulatory requirements were not affected by Australian ownership and they were regulated by the Care Quality Commission (CQC).

Ms Sherman continued the presentation including an overview of the organisational structure of Thornford Park Hospital, how it had developed over recent years and the beds and wards that they had. They explained that had mostly male wards and two female wards. They clarified that PICU stood for Psychiatric Intensive Care Unit where high risk patients were for six to eight weeks. They were commissioned by NHS England and the Clinical Commissioning Group (CCG).

Jo Sherman then explained the action plan in response to the CQC report (slides 10 – 12). Ms Sherman advised an example of restrictive practices was stopping takeaways after 10pm. They ensured that they did not have blanket rules for everyone and that everything was individually risk assessed. There were risks and so they ensured that they evidenced their decision making process and that service users were part of that process. It was clarified that ‘leave’ was time outside of the hospital which was individually risk assessed. Data was submitted to Provider Collaborative and other stakeholders.

Ms Sherman explained the external audit and governance of Thornford Park Hospital. In addition to the CQC and internal governance, they were audited by NHS England, Provider Collaborative, NHS Wales, CCGs, Local Authorities and Advocacy. The Provider Collaborative was external NHS input involving specialised commissioning. This included independent sector and NHS groups. There was a lead Trust. These Provider Collaboratives helped to minimise out of area placements and also bring consistency of treatment, care and outcomes. They also came on site and reviewed their data. The Advocacy was a large presence in the hospital from two providers attending weekly to support patients with their voice.

Jo Sherman moved on to advise the Committee of areas of achievement which included enhanced access to leave into the community, grounds and home. Ongoing collaborative working with external stakeholders was another area of achievement highlighted. This had meant working with NHS England in developing services locally and the development of specialist services for autism and learning disability. Finally they explained that their management of Covid was very good and they had no deaths within the hospital. They also managed to increase levels of leave despite Covid. Finally Jo Sherman advised they were keen to reduce the length of stay for people at hospital.

Councillor Jeff Brooks commended the hospital for their management of Covid but noted concern in elements of the CQC report. Councillor Brooks highlighted the actions  ...  view the full minutes text for item 13.

Purpose: To provide an update on current performance re. waiting times and referrals, and the mitigation measures introduced.

Chris Lowrie, Directorate Manager Berkshire Cancer Centre, Nicola Costin-Davis, Royal Berkshire NHS Foundation Trust (RBFT) and Mark Foulkes, Macmillan Cancer Lead and nurse consultant RBFT, presented the report on Cancer Performance at RBFT (Agenda Item 6).

Mark Foulkes presented the report on cancer services at Royal Berkshire Hospital and the surrounding area. He started with an overview of cancer services at RBFT including the population served and the main sites for treatment. He gave a summary of the Cancer Access Standards including nine key targets of diagnosis and treatment, and the national ambitions. Mr Foulkes highlighted that to meet these targets they needed more patients referred in for assessment. Personalised care was a key ambition at RBFT. He noted the performance management in cancer care and that it would continue into the future. Mr Foulkes then gave an overview of the cancer pathway noting the challenges in diagnostics which would be detailed later in the presentation.

Andrew Sharp, West Berkshire Healthwatch, requested to ask a question. The Committee resolved to suspend standing orders to allow Andrew Sharp to speak and this remained for the rest of the committee meeting.

Andrew Sharp asked why diagnosis in the UK was a challenge compared to Europe. He asked if the 75% target was realistic. Mark Foulkes agreed that delayed diagnosis of cancer might in part be due to stoicism and groups of patients who tended to present later with cancer. This could be men and people who did not speak English as a first language. Those admitted into hospital tended to be older people and people who were more isolated. This was particularly the case during Covid as anecdotal evidence supported that people who were isolated tended to present later with symptoms. Dr Kajal Patel (Cancer Clinical Lead, Clinical Commissioning Group, CCG) added that it was quite complex. There were different factors leading to late presentation. These included deprivation, language barriers and cultural barriers. Screening uptake in different groups and awareness of red flags were also important but complicated. Any patient presenting with a red flag symptom was seen quickly but there were some cancers that had vague symptoms to start off with which were hard to pinpoint. These could go on for a long time before the cancer manifested. This led to a vague symptom pathway which GPs could refer patients on to. This was a suspected cancer of unknown pathway. There was work to improve awareness and increase screening. There were different layers and so many approaches were needed to have faster diagnoses. For every 100 people referred by GPs for a suspected cancer, on average less than seven had a cancer. Of course they wanted to refer all but that would subject more people to CT scans, high dose radiation and going through the pathway. It was those 7% that needed treatment on time.

Andrew Sharp highlighted that the communications across Berkshire West in terms of reaching out to the groups, screening and prostate cancer were impressive. He  ...  view the full minutes text for item 14.

Purpose: The Berkshire West Clinical Commissioning Group (CCG) to provide an update on activities and commissioning plans, including development of the Integrated Care System (ICS).

There was no Berkshire West Clinical Commissioning Group update given.

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

 Andrew Sharp, Chief Officer Healthwatch West Berkshire, was invited to report on current activities and feedback from local residents.

Andrew Sharp advised that they were currently surveying asylum seekers in hotels in West Berkshire. This was about their health needs and interactions. Their mental health requirements were possibly not being met. This was a challenge across the whole system but noted the incidents in Reading and Glasgow were mental health related. They were working with Reading refugees. Mr Sharp had written to all Chief Executives across Berkshire West highlighting this concern. There were also concerns around Rwanda for refugees. Andrew Sharp commended Thatcham Medical Centre and Theale Medical Centre.

Mr Sharp advised the Committee that the CCG had spoken to Healthwatch to create a maternity forum for West Berkshire that was not based around a Trust. 

Thinking Together 6, the mental health service user, public and professional event, was planned for October 2022. It would be based around children and young adults’ mental health.

Mr Sharp mentioned Continuing Health Care and the need for an update from the CCG.

Finally Mr Sharp raised the Huntercombe House CQC report and it requiring scrutiny.

Purpose: To present the final protocol for approval.

The Chairman explained that the Partners Protocol had been amended in response to questions raised at the Health Scrutiny Committee on 5 April 2022 and that this was not an agreement but a way of working that West Berkshire Council wished to adopt.

Councillor Brooks noted the partnership working in the protocol and highlighted that scrutiny, challenging questions and making recommendations were also part of the scrutiny committee.  Councillor Rowles advised of their role as a critical friend and allowing more time in future meetings for questions.

RESOLVED that:

1.    The final protocol and the process for dealing with proposed substantial developments of variations to health services be endorsed.

2.    The protocol be approved.

Purpose: To agree the Terms of Reference and Membership for any Task and Finish Group that the Health Scrutiny Committee might wish to appoint in-depth scrutiny reviews:

1) Provisions of healthcare serving new developments.

The Chairman asked Members to consider the proposed Terms of Reference for the Healthcare Provisions in New Developments Task Group. To agree membership, the Chairman and a timescale.

The Terms of Reference were agreed. The membership and timescales would be decided after the meeting.

Purpose: To receive updates from the Chairmen of Task and Finish Groups appointed by the Health Scrutiny Committee:

1) Continuing Health Care Task Group

Councillor Alan Macro advised the Committee that the Continuing Health Care task group had met and agreed the work programme. The task group would report back to the Health Scrutiny Committee on the 13 December 2022.

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

The Chairman invited Members to make suggestions on items to add to the Work Programme. The Chairman noted that all suggestions would go through the prioritisation process.

Councillor Tony Linden noted pharmacists as a possible item. The Chairman noted Huntercombe House. Councillor Alan Macro suggested blood tests and phlebotomy at West Berkshire Community Hospital.

The Chairman highlighted the form on the website for members of the public to nominate topics for the Health Scrutiny Committee to consider.