Agenda and minutes

Purpose: To elect a Chairman of the Health Scrutiny Committee for the remainder of the 2022/23 Municipal Year. 

RESOLVED that Councillor Graham Pask be elected Chairman of the Health Scrutiny Committee for the rest of the 2022/2023 Municipal Year.

Purpose: To approve as a correct record the Minutes of the meeting of the Committee held on 20 September 2022.

The Minutes of the meeting held on 20 September 2022 were approved as a true and correct record and signed by the Chairman.

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.

There were no declarations of interest received.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received.

Purpose: To consider the stammer service provisions for children in West Berkshire.

Catherine Woolley from STAMMA gave an overview of the report on the need for and benefit of specialist stammering services. It was noted that they used the terminology of a ‘stammering service’ rather than a ‘fluency service’. Catherine Woolley explained that they were contacted earlier this year by members of Berkshire Healthcare Foundation Trust (BHFT) who had raised concerns that staff were leaving the service and were not being replaced. They were concerned about the service and the impact on children. Catherine Woolley advised that they were interested to learn more about the BHFT service review and how the options might be implemented. Catherine Woolley noted that she was concerned that option 1 relied heavily on the Michael Palin Centre which might not have provided therapy and it would have been a challenge for local families to travel to London.

Catherine Woolley highlighted a further concern about the reduction in staffing levels leading to a significant change in service provision over the last 6 – 12 months and the resultant impact on children and young people in West Berkshire. The Chairman noted that resources were a national issue in speech and language therapy and asked what could be done in relation to retention and recruitment. Catherine Woolley advised that there was a significant impact from Covid on speech and language therapy. She noted that many Trusts had a specialist clinical pathway for speech and language therapy and that stammering was the third core pathway of speech and language therapy that required specialist support. Catherine Woolley advised that there was a psychological risk associated with stammering particularly with stigma and attitudes towards people who stammered. The care pathway was holistic in providing support, resilience and social communication skills. She advised that generalist speech and language therapists might not have had the time and experience to provide that. Catherine Woolley agreed that recruitment and staff retention was an issue. She noted that staff needed to be encouraged to stay longer. Staff needed time to share learning and skills, and that clinical supervision and training was needed to retain and recruit staff.

Councillor Tony Linden asked what the implications were for residents of West Berkshire.  He noted that it was a rural area which was a challenge for service provision and that there were areas of deprivation. Catherine Woolley advised that it was difficult to assess the impact of stammering on someone. She highlighted that it had a big impact on someone’s life, such as the negative stereotyping and resultant behaviours towards people who stammered. She gave an example of employment tribunals and the impact on education. There could have been teasing and bullying. Young people who stammered were more likely not to attend school and had higher levels of anxiety and depression which impacted on their mental health in the future as adults. It was not the case for every individual but these were potential impacts if not given specialist support. Catherine Woolley explained that for some, speaking more fluently was the  ...  view the full minutes text for item 33.

Purpose: To receive a presentation on the provisions of dental services in West Berkshire.

Hugh O’Keeffe, Senior Commissioning Manager, Dental NHS England (BOB and Frimley) gave an overview of the report on Dental Services. He advised the report included an overview of the systems and services, primary and secondary dental care, patients’ access to services and information on practices and referrals in West Berkshire. Hugh O’Keeffe explained that it also included information on the impact of Covid which had hit dental services hard and they had been running services at below 100% capacity for about two years. They had only been working at full capacity since July 2022. Hugh O’Keeffe highlighted that the number of patients accessing dental services was improving but it was still below pre-pandemic levels. Practices had called people back in, but it was challenging with those who had not been attending regularly, some of whom used private dental services and others only went to the dentist when necessary. Additional access sessions had been provided. They were also looking to bring down the numbers of long waiters so that no one was waiting for secondary care for more than two years.

Hugh O’Keeffe highlighted that recovery was still at an early stage. Treatment needs were higher due to gaps in treatment and there were workforce issues including morale, recruitment and retention. Across the South East NHS dentists were handing back NHS contracts and going fully private, although this was not a significant issue in the West Berkshire area yet. There were national contract changes as well as a flexing of local contracts to increase capacity. Hugh O’Keefe summarised that the overall picture was very difficult over the last few years but it was improving and they were working on a number of schemes to address it.

David Chapman, System Clinical Lead for Pharmacy, Optometry and Dental Services, added that there was a new way of commissioning for dentistry. It was now the BOB ICB and it was in its first year phase. There were slight difficulties in how quickly things could be changed at the time. They were looking to address health inequalities and highlighted that some of the most deprived areas suffered the most. Some of the schemes might address some aspects of that.

The Chairman noted awareness of difficulties in the waiting times for orthodontic work. Hugh O’Keefe advised that there was a backlog built up for orthodontics but they were not concerned about the delays in terms of risk to patients. They wanted though to look at the variations in waiting lists between practices and for there to be more joint working as some had shorter waiting lists that others.

Councillor Alan Macro asked for further detail on the national contract changes of November 2022. Hugh O’Keefe advised that they would allow dentists to perform more activity under their contracts. It would require practices to provide up to date information on NHS Find a Dentist webpage. There were also contractual powers to redistribute the resources allocated to the practices in relation to the level of activity. There were  ...  view the full minutes text for item 34.

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

Sarah Webster, Executive Place Director Berkshire West ‘Place’ BOB ICB, gave an overview of the new landscape and her role within it. Sarah Webster explained that there was an Integrated Care Partnership across Buckinghamshire, Oxfordshire and Berkshire West (BOB ICP) made up of 5 lead Local Authorities and the NHS. The NHS body within the ICP was called the Integrated Care Board (ICB). Sarah’s role was as the lead director for Berkshire West within the ICB.

Sarah Webster highlighted some key items. The first was the Strep A news and the impact on the relevant services. There was a significant demand for urgent care services. Over the weekend there was five times the usual demand for out of hours services and 111 services had 150% of their normal activity. Primary Care colleagues also had a significant demand for urgent appointments. The ICB had been monitoring the situation and had contacted primary care providers seeking available additional capacity and there was funding associated with that. Sarah Webster advised they were sending a reassuring message at all opportunities that whilst Strep A is an illness impacting particularly young children, it was only in very rare cases where that could be serious. Regarding antibiotics, the message from NHS England was that there was enough supply but it needed to be appropriately distributed. A lot of information was being shared with services and the prescribing demand was being managed.

Secondly Sarah Webster advised they were anticipating nursing strikes on the 15^th and 20^th of December. She advised the Royal Berkshire Foundation Trust (RBFT) met the threshold for the strike. Plans were being put in place to mitigate the impacts. Emergency care would still be provided. There was a significant administrative resource being used to communicate with patients whose plans were being affected. The RBFT had reassured the ICB that they were confident that safety would not be compromised.

Thirdly Sarah Webster advised that the Urgent Care Centre opened last week at the Broad Street Mall Reading. It was designed to take in 50 on the day self-presentations and 50 referrals from the emergency department and from primary care colleagues. This capacity plus additional GP capacity would really help relieve some of the urgent care demands expected over coming weeks. The Urgent Care Centre was an 18 month pilot.

Sarah Webster advised the Committee that there was a recent announcement regarding Adult Social Care discharge funding. For West Berkshire it was £1,200,000 within a £3,400,000 envelope for Berkshire West. Discussions had been held around how the money would be used to support the continuation of service provision noting the high demand being experienced at the time. Councillor Graham Bridgman explained that he was involved because the money went through the Better Care Fund which was owned by the Health and Wellbeing Board. It was agreed at last week’s Health and Wellbeing Board to give Councillor Bridgman sign off so that the timescales would be met. He advised that roughly £700,000 would be coming  ...  view the full minutes text for item 35.

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

Sarah Deason from The Advocacy People explained that they were the host organisation for Healthwatch Berkshire West. She advised that Andrew Sharp had left West Berkshire Healthwatch.

Sarah Deason advised that a theme across Berkshire West was around self-care and prevention. They had been talking to people about using the right services at the right time and sharing communications around that. They had just closed a Healthwatch survey on maternal mental health and were looking around what was needed locally around maternal mental health. She noted that dentistry also continued to be a theme.

Councillor Tony Linden added that Members had been notified of a new number 116 123 for support in a mental health crisis. There was discussion around Healthwatch and Members communicating that to the public.

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

Councillor Alan Macro advised the Committee that the Continuing Health Care (CHC) task group met on 29 November 2022. They discussed the Peer Review report which confirmed that CHC provision was significantly lower than other areas of the country and fared poorly compared to other areas of the ICB (Integrated Care Board). The review was ongoing and they needed to keep an eye on it. Paul Coe, Service Director of Adult Social Care, was thanked for his input for the task group.  

Sarah Webster (Executive Place Director Berkshire West BOB ICB) advised that the Transformation Programme across BOB (Buckinghamshire, Oxfordshire and Berkshire West) was to address imbalances. There were also local conversations about what could be done now and they were expecting updates in January.

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

The Chairman invited Members to make suggestions on items to add to the Work Programme.

Councillor Alan Macro requested that blood tests and phlebotomy shortages be reviewed as he was aware of some delays.

Councillor Tony Linden highlighted GP numbers, pharmacist provisions and refugees and asylum seekers as important items. It was noted that pharmacy provision had been a problem in Thatcham recently. Councillor Graham Bridgman advised that pharmacy provision was discussed at Locality Integration Board recently with a useful presentation from Pharmacy Thames Valley. 

Councillor Macro noted that Members of the Committee recently visited the Royal Berkshire Hospital. He thanked the hospital for a very useful visit and noted concerns in Cancer Care building and the pharmacy workplace. He asked for Councillor Bridgman to pass on thanks from the Health Scrutiny Committee.