Agenda and minutes

Purpose: To approve as a correct record the Minutes of the meeting of the Committee held on 10 November 2021.

It was noted that Councillor Bridgman was in attendance at the meeting. Subject to this amendment, the Minutes of the meeting held on 10 November 2021 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.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received.

Purpose: To provide an update on Tier 4 services and an interim update on the local transformation plan.

The Committee considered a report on Children and Young People’s Mental Health Services (Agenda Item 5).

Louise Noble (Head of CAMHS and BEDS, Berkshire Healthcare NHS Foundation Trust) gave an update on the CAMHS Tier 4 Service which had moved from an inpatient facility based at Wokingham hospital to a community based model in 2021.

She stressed that the objective of the provider collaborative was to reduce the number of times children are sent out of area for treatment. It was noted that the new service was called the Phoenix Unit. The presentation covered what it offered, the staff team and the delivery timetable. The presentation covered: how the community model improved outcomes for young people; how it supported and involved families and carers; and what was involved in the Eating Disorder programme.

Examples were given of young people and their families who attended the unit and how they worked with staff to develop and practice skills which they could then put in place at home. Research had shown that this was more effective in providing better longer term outcomes whilst maintaining relationships and community links.

It was noted that this was a developing model. There had been a significant surge in demand for Eating Disorder treatment and so they had reviewed their staffing mix to include a therapeutic cook and had made a slight change to the layout at the unit. There had been significant interest in the new model and details were being shared nationally.

Councillor Andy Moore asked about the male / female balance of Eating Disorder treatment and what strategies that prompted. Louise Noble responded that there were more males presenting than previously, but the balance remained towards more females than males. She explained that one of the reasons for the community based model was that they needed to be very careful about the mix on site, especially at night. The new model had been helpful as it had resulted in less group-focussed self-harm behaviours.

Councillor Alan Macro asked how patients got to the Phoenix Unit. He suggested that it could be a challenge for some people travelling from West Berkshire. Louise Noble agreed that it could be a challenge and they also had patients who travelled from Oxfordshire and Buckinghamshire. In each case, staff would have a discussion with the young person and their family to look at options to help. They also had a social worker on the team who could work with local authority social services teams regarding entitlements. They also had some interventions which were delivered at home. There had been challenges but in each case solutions had been found. Councillor Macro asked if they had any transport. Louise Noble confirmed they did not, but they could help with accessing funding.

Councillor Moore noted the demands on parents and carers of this new model and how the new service supported them. He also asked if parents had any choice in the treatment. Louise Noble advised there were many considerations about the treatment  ...  view the full minutes text for item 26.

Purpose: To provide an update on the response to the recent CQC report.

The Chairman welcomed Alex Whitfield (Chief Executive) Julie Dawes (Chief Nurse) Elliot Nichols (Associate Director Comms and Engagement), Fay Corder (Associate Director Midwifery) and Wendy Landreth (Communications Team Coordinator) to the meeting. The Chairman invited them to present their report on the Maternity Services provision.

The Committee considered a report on Maternity Services at Basingstoke and North Hampshire Hospital (Agenda Item 6).

Alex Whitfield (Chief Executive) introduced the team. She gave apologies for Julie Dawes (Chief Nurse) and introduced Sarah Musset who was coordinating the Care Quality Commission) CQC response on behalf of the Trust. It was noted that the presentation had been requested off the back of the Healthwatch report from a couple of years ago and also on the recent CQC visit where they had made an unannounced visit as a result of which the rating for maternity service had been downgraded from ‘good’ to ‘requires improvement’.

Fay Corder (Associate Director Midwifery) gave the presentation. She advised the Committee of the current maternity service provision from Hampshire Hospitals to West Berkshire women. She then introduced the Healthwatch report, which had highlighted communication as a key concern. The Trust had put a number of measures in place to address this, including improvements to the website and social media, electronic patient information leaflets on Badgernet, and printed complex care plans for women giving birth at other NHS Trusts. She then highlighted the positive feedback from the CQC before covering the should-do’s and must-do’s from the inspection. She went through a series of slides on the progress made in responding to the key concerns raised in the CQC report, which related to: sepsis; security; emergency equipment; domestic abuse; red flag reporting and risk; learning from incidents, staffing levels; and leadership and culture. She noted that 51 out of 64 actions had been completed. Finally she advised the committee of the main challenges facing the service, progress in terms of Ockenden compliance, and the aspiration to build on changes introduced since the CQC inspection, with the development of QI Plans.

Councillor Alan Macro highlighted the theme of staffing in the CQC report in terms of number of staff, staffing at the appropriate levels and staff working above competency levels and asked for further information on whether the recruitment campaign would be sufficient. Alex Whitfield responded to advise that more midwives were needed for the same number of babies and so they had been chasing a moving target in terms of recruitment. The actual number of midwives had increased, but so had the number of vacancies. However in recent months they were closing the gap through recruitment and retention. The numbers coming in over the next few months would mean that by the autumn they should be where they needed to be.

Councillor Tony Linden noted the Ockenden report and the seriousness of it. He welcomed the progress that had been outlined and the importance of giving assurance to mothers and families associated with the birth experience. He highlighted the higher rates  ...  view the full minutes text for item 27.

Purpose: To present the final protocol for approval.

The Chairman advised that the protocol went to consultation. There was a joint response from Berkshire Healthcare NHS Foundation Trust and Royal Berkshire NHS Foundation Trust in support of the protocol and that there have been no objections or amendments. The recommendations were to endorse the final protocol and to recommend the protocol for approval by the Health Scrutiny Committee.

Councillor Moore raised concern that the protocol doesn’t have a list of the organisations with whom we are developing the protocol. The protocol should list the bodies and to give an indication of the response from those bodies. There was discussion confirming that we need to an engagement document about the joint requirement to work together and that changes are needed to the protocol.  It was agreed that the protocol will be revisited with further guidance from legal before it is voted on. The protocol will come back to the committee at a later stage.

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).

The Chairman welcomed Belinda Seston and Amanda Lyons from the CCG and asked they provide their update.

Belinda advised that she is the Interim Director of the Place Partnership in place of Katie Summers who is on a secondment. She made the following key updates:

·       Hampshire Hospitals are modernising their hospital programme. She is involved in that along with Nigel Lynn. They will consider any wave effects of the new build on West Berkshire residents. 

·       There has been an access fund to increase GP activity. Additional appointments were made. 

·       There are conversations around a hospital discharge service. Susan Parsonage, chief executive of Wokingham Borough Council, will be leading on that.

·       Dr Tracy Daszkiewicz, Public Health Director for Berkshire West, is taking the lead on the response to the Ukraine crisis.  She is being supported by Julian Emms. They are developing a task group.

·       Due to covid there has been a significant impact on elective care. The main initiative is to reduce number of patients waiting more than two years. Very soon there is will no patients waiting over 104 weeks and there will be further work to bring that down further.

Amanda Lyons gave an update on ICB and ICS development. The transition to the ICB as a statutory organisation is subject to royal ascent but they are still working toward 1^st July. They have a 12-18 month transition roadmap on both the technical set up of the ICB (the architecture) and are also looking at the developmental areas of the ICS and some of the key enablers.

The ICB architecture looks at the governance between the place-based partnerships and the ICB and the ICP. The ICP being the partnership organisation which includes Local Authority members and the ICB being the NHS statutory body. It also includes that technical and functional integration. It looks at the formation of the board and the how it will interact as the NHS with the region and also taking into account the February Integration White Paper. This is organised and under control for 1 July 2022.

The ICS development aspects are more forward looking. This includes the Provider Collaboratives and the place-based partnerships. They are starting to think through the ICS Strategy and how it fits with Health and Wellbeing Board strategies. What public engagement needs to take place. There are some key enablers which are different to how the CCG’s would have functioned. There is real focus on:

·       Digital and data – connectivity across the ICS footprint

·       Clinical and profession leadership – patient pathways (preventative through to leaving the care of the NHS).

·       Diversity and inclusivity of staff and culture. How they tackle inequalities and learning from each other.

·       Assurance to give that outcomes are achieved.

Councillor Bridgman welcomed Belinda to the Health Scrutiny Committee. He clarified that Julien Emms is the CEO of Berkshire Healthcare and that Councillor Linden is on the JHOSC for BOB. Councillor Bridgman will be the representative for West Berkshire on the ICP. They are waiting for  ...  view the full minutes text for item 29.

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

The Chairman noted the reports in the pack. No update was given.

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)    Continuing Health Care: To look at CHC assessments and awards locally compared to other areas and to consider the review made by the CCG.

The Chairman asked Members to consider the proposed Terms of Reference for the Continuing Health Care Task Group. To agree membership, the Chairman and a timescale.

Councillor Bridgman advised that this is on James Kent’s radar. Councillor Bridgman has made it clear that we are not happy with how West Berkshire comes out under CHC. We are not working the same as Oxford. There are different matrices which lead to different financial end points. There is a conversation to be had with the CCG and what will become the place-based partnership. Belinda Seston said that she will go back and look at it. Amanda advised that from a system level that James Kent is sighted on these conversations and she will take it back also.

It was agreed that the Task and Finish Group will begin with this in mind. The Chairman advised that membership has been discussed and Councillor Beck, Councillor Moore, Councillor Linden and Councillor Macro will be on the Task Group. Councillor Macro will be Chairman and Councillor Linden will be Vice-Chairman. The timescale can be agreed at the task group meeting.

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

The Chairman asked for any comments on the work programme.

Councillor Macro asked for the Facilities for New Developments to be moved forward because the Local Plan is being updated and it is an important factor for residents when new developments are proposed. The Chairman agreed we can look at moving it up the schedule. The motion regarding the re-development of RBH was raised by Councillor Moore and agreed it will be discussed at the next meeting.