Agenda and minutes

Purpose: To approve as a correct record the Minutes of the meeting of the Committee held on 23 September 2024.

The Minutes of the meeting held on 23 September 2024 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 at the meeting.

Purpose: For the Chairman to provide an update on health scrutiny activities since the last meeting.

The Chairman provide an update on health scrutiny activities since the last meeting.

The Chairman and Councillor Steevenson attended the Buckinghamshire, Oxfordshire and Berkshire West Joint Health Scrutiny Committee (BOB JHOSC) in November 2024. On the agenda was an Integrated Care Board (ICB) overview from the BOB Integrated Care Board (BOB ICB), an update on the primary care strategy, and feedback from a working group on the BOB Integrated Care Board digital and data strategy. The Chairman and Councillor Steevenson raised a number of issues including the dental contract and the need for a flexible approach in West Berkshire to support areas of deprivation, the adequacy of services for people with learning disabilities and support for GP services in terms of digital services.

Members of the Health Scrutiny Committee also visited Eastfield House Surgery in October to meet with GP’s and the Practice Manager and to understand the challenges faced by the surgery at their current location. 

Purpose: Eastfield House Surgery have been invited to present a report on their proposed relocation to a new purpose-build GP practice on land south of Newbury College.

Dr Emma Featherstone (GP Partner) provided a short overview of the report on the proposed relocation of Eastfield House Surgery to a new purpose-built GP practice on land south of Newbury College. Dr Mark Galliver (GP Partner) and Liz Pope (Practice Manager) were also in attendance to answer questions.

During Dr Emma Featherstone’s presentation, it was highlighted that the current building was fully utilised. The lack of space meant that facilities were limited for both patients and for staff. It made it challenging to retain and recruit staff, and they were unable to recruit additional clinical staff. Patients often needed to stand whilst waiting for appointments and there was one disabled parking spaced.

During the discussion it was agreed by Members that the current building was no longer fit for purpose as it had been outgrown. Members had visited the surgery and seen how well the practice had adapted to and utilised the limited space whilst maintaining patient services. Members agreed that a move was necessary.  

It was noted that a key concern was how patients would travel to the proposed new facility in Sandleford and especially patients who did not drive or have access to a car. Dr Featherstone advised that as the new facility was part of a larger development including other facilities, that public transport links would be available. It was advised that most patients currently drove to Eastfield House and so the ample parking available at the new facility would benefit patients. This was discussed in more detail as it was highlighted that many patients currently walked and would be disadvantaged by this move. In addition, the timing of any new development may leave patients without the necessary transport links to attend. It was also noted that patients currently living near to the proposed new facility had Falkland surgery nearby. The focus needed to be on the impact of people living near to the town centre who would be disadvantaged by the move.

Dr Featherstone advised that people who currently walked did so because they could not drive due to limited parking available. It was highlighted that there was no available land in the town centre to develop and so there was no option but for the practice to move out of town. The climate impact was noted during the discussion of more vehicles needing to travel to the new surgery. It was confirmed that the Eastfield House surgery catchment area was Newbury south of the canal and out to the racecourse, Burghclere, Enborne and Wash Water. There was a volunteer service that could help with transport and the GP surgery provided a home visiting service for patients who were house bound.  It was reiterated that the key concern was around the location of the new surgery and providing sustainable travel for patients from the town centre. Dr Featherstone noted this and advised they would consider this further. This could include working with West Berkshire Council and Greenham Trust.

It was confirmed that the surgery was  ...  view the full minutes text for item 15.

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) have been invited to present a report on All Age Continuing Care (AACC) and the AACC transformation programme.

Daphne Barnett (Interim Associate Director Complex and All Age Continuing Health Care, BOB ICB) gave an overview of the report on All Age Continuing Care. It was highlighted that Berkshire West continued to be an outlier in relation to Continuing Healthcare (CHC) eligibility despite many audits commissioned to understand the variation.  It was advised that the BOB ICB were committed to ensuring a good, consistent service and that a number of actions were in progress to do so. This included working in partnership with the Council.

Paul Coe (Executive Director – Adult Social Care and Public Health) noted that this inconsistency had been occurring for a very long time. There were reassurances from the BOB ICB that it would be addressed and that there needed to be fair decisions for eligibility in West Berkshire. AnnMarie Dodds (Executive Director - Children's Services) agreed noting the importance of clarity and transparency around decision making. It was highlighted that changes needed to be made swiftly.

It was advised by Daphne Barnett that a change would start to be seen by the end of Quarter 1 in 2025/26. The biggest constraint they had was with recruitment, establishing teams and consistency. It was noted that there was best practice in Buckinghamshire that could be used and that more reviews and deep dives were not solving the problem.

It was confirmed that disputes policy was in the process of being implemented along the NHSE national policy. It was drafted and soon to be signed off.

Members asked for clarification around joint training to address inconsistencies. It was advised there was a new structure and dates for training were being confirmed, however it was not certain whether the training would be joint due to the resource constraints.

It was asked whether previous applications would be reviewed or reconsidered. It was advised that this was not yet determined. AnnMarie Dodds advised that there would be a review of applications and fresh applications may be made. It was confirmed that this was why a disputes policy was needed.

It was noted that the data provided was regarding Berkshire West rather than West Berkshire. It was clarified that the Management Oversight Group were looking at different presentations of data. The BOB ICB were receiving support from NHS England, and they aimed to provide a suite of consistent reports across BOB. It was confirmed that the Council would like to see visibility of local authority figures within the data.

Paul Coe advised the Committee that the Council would continue to gather feedback and understand the outcomes of individual cases. They worked with families to understand their experiences as well as the outcomes. It was important to keep this in view of the Health Scrutiny Committee to review how it progressed. It was confirmed that this should return to the Health Scrutiny Committee in 6 months.

Action: All Age Continuing Care to be added to the work programme for the Health Scrutiny Committee in June 2025.

Action: The BOB ICB to update  ...  view the full minutes text for item 16.

Purpose:  Healthwatch West Berkshire have been invited to present their report on GP Access. The BOB ICB will present a report on access to GP services in West Berkshire and will give an overview of the introduction of Integrated Neighbourhood Teams in West Berkshire.

Sanjay Desai, Associate Director of Primary Care Operations (BOB ICB) provided an overview of the report on primary care access and Integrated Neighbourhood Teams. Also present for this item were Sarah Wise and Will Gordon from the BOB ICB.

During the discussion the following points were noted:

·       There was variation in satisfaction in West Berkshire GP Surgeries. It was advised that there was a Primary Care Quality Framework that considered all data including soft intelligence. This was used to talk to Practices about challenges and pressures they faced and what support the ICB could offer. It was noted there had been changes to the appointment process with the introduction of Anima and queried how this may have impacted satisfaction rates. It was confirmed that the Quality Framework allowed a more detailed understanding. The national patient survey was soon to be carried out and would provide further data.

·       It was advised that there was no one way to run a Practice. The ICB supported the implementation of best practice to meet patients’ needs and each practice offered different services and access for patients.

·       It was clarified at the Additional Roles Reimbursement Scheme (ARRS) enabled Doctors to work at the top of their licence while other staff members could support patients with less acuity. The triage process allowed patients to be seen by the right professional for their needs. This was part of the BOB ICB Primary Care Strategy.

·       It was noted that the BOB ICB were working with Healthwatch around the communications relating to ARRS and the use of care navigators to triage patients. The Healthwatch report noted that patients were confused and clearer communications were needed. It was noted that the BOB ICB had a health inequalities team that supported this work to ensure the communications were inclusive and that vulnerable patients were considered. It was highlighted that each GP Practice was independent and the services provided varied which made the communications more challenging with each practice doing things differently. It was noted that Healthwatch were supporting this work in communicating with the public. An infographic was available that helped, and West Berkshire Council could assist in sharing it for the BOB ICB.

·       An overview was shared on Integrated Neighbourhood Teams (INT). It was confirmed that they would initially target specific cohorts. There would be a mapping exercise to bring the right people together. The aim was to bring services together to improve partnerships. This would build on what was already in place. The long term vision was to enable more proactive working for patients with complex needs to help them to stay well in the community. This would be a more upstream approach of prevention.

·       It was highlighted that there was a strong history of partnership working in West Berkshire particularly with the voluntary sector and by lining up services there would be anticipatory care planning. The INT was in development and would build on the structures that currently existed.

·       It was suggested that wellness or health hubs would  ...  view the full minutes text for item 17.

Purpose: Healthwatch West Berkshire to report on their activities since the last meeting. 

Fiona Worby, Lead Officer Healthwatch West Berkshire sent her apologies. The Chairman noted the Healthwatch report and the work being undertaken by Healthwatch West Berkshire.

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

The Chairman advised the Committee that the Task Group looking at Children’s Mental Health and Emotional Wellbeing met on 26 November to agree the work programme and session plan. Three sessions would be held in the new year looking at the 3 key areas agreed in the Terms of Reference.

A report with recommendations would follow and be presented at the Health Scrutiny Committee in 2025.

Purpose: To receive new items and agree and prioritise the work programme for the remainder of the municipal year.

The Chairman invited Members to review the work programme. It was noted that Dentistry, Dementia and the South Central Ambulance Service were on the agenda for the Health Scrutiny Committee in March 2025.

RESOLVED to note the work programme.