Agenda and draft minutes

Purpose: To approve as a correct record the Minutes of the meeting of the Health and Adult Social Care Scrutiny Committee held on 16 December 2025.

The Minutes of the meetings held on 16 December 2025 were approved as true and correct records and signed by the Chairman.

Purpose: To receive an update on recommendations and actions following the previous Committee meeting.

Members reviewed the updates on actions and recommendations from the previous meetings.

It was highlighted that the response report to the Children’s Mental Health and Emotional Wellbeing Task Group report was due to be on the agenda at today’s meeting. It was confirmed there had been a delay and the report was now expected at Executive on 19 March 2026 and then at the Health and Adult Social Care Scrutiny Committee in June 2026.

It was noted the Care Quality Commission were due to revisit West Berkshire Council Adult Social Care (ASC) in spring 2026 and that there would be work completed in readiness of this. Melanie O’Rourke (Service Director for Adult Social Care) advised that this work was being completed and preparedness was nearly complete. This included strategy work and providing evidence.

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.

The following are considered to be standing declarations applicable to all Health and Adult Social Care Scrutiny Committees:

·         Councillor Patrick Clark – Governor of Royal Berkshire Hospital NHS Foundation Trust, Governor of Berkshire Healthcare NHS Foundation Trust, and West Berkshire Council representative on the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Partnership; and

·         Councillor Jo Stewart – Employed by the Royal Berks Charity as a Fundraising Manager. Although the charity is a separate entity from the Royal Berkshire NHS Foundation Trust, there may be occasions where it would be inappropriate to take part in discussions for certain topics. Her spouse is Head of Contract Management at the Royal Berkshire NHS Foundation Trust.

Councillor Alan Macro declared a personal interest in relation to item 6 (Provision of Community Equipment) by virtue of the fact that he had an item of community equipment in his home. Councillor Macro remained in the meeting and took part in the discussion.

Councillor Joanne Stewart declared a personal interest in relation to item 8 (South Central Ambulance Service (SCAS)) by virtue the fact that family members worked for SCAS in operational roles. Councillor Stewart remained in the meeting and took part in the discussion.

Purpose: To consider any petitions requiring an Officer response.

There were no petitions received at the meeting.

Purpose: To review the organisational response to the changes in the provision of social care and community equipment implemented in July 2025, and to consider the measures being put in place to ensure the effective and sustainable delivery of equipment services going forward.

Melanie O’Rourke (Service Director, Adult Social Care) presented the report on the provision of community equipment, focusing on the challenges faced following the insolvency of the previous provider, NRS, and the transition to a new provider, Millbrook. The presentation highlighted the challenges faced, the measures taken to ensure continuity of service, and the lessons learned to improve future resilience. The council’s priority during the crisis was to ensure the delivery of critical equipment to support hospital discharges, avoid hospital admissions, and provide end-of-life care.

During the debate the following points were discussed:

·         It was raised that the council should regularly review the credit status of contractors to prevent similar issues in the future. Melanie O’Rourke confirmed that this would be incorporated into future commissioning practices to ensure early identification of financial risks.

·         A question was asked about the maintenance of equipment and whether the new provider, Millbrook, was in a position to handle this responsibility. Melanie O’Rourke explained that Millbrook was prioritising high-risk equipment maintenance in compliance with regulations. She added that all servicing was expected to be completed by June 2026, with regular monitoring in place to ensure safety.

·         Concern was expressed about the lack of support from the Department of Health and Social Care (DHSC) during the crisis. It was noted that the DHSC did not intervene to provide financial assistance or extend the operational period of NRS, which could have allowed for a smoother transition. Melanie O’Rourke confirmed that feedback on this issue was being provided through national resilience debrief sessions.

·         It was discussed how NRS accumulated a £20 million funding gap and whether government intervention was needed to prevent such failures in essential services. Melanie O’Rourke highlighted that the limited number of providers nationally posed significant risks, with only two major providers now operating in the market. She noted that this issue was being reviewed by the Association of Directors of Adult Social Services (ADASS) to explore future commissioning strategies.

·         A question was raised about ownership and timelines for the action plan to address the lessons learned from the crisis. Melanie O’Rourke explained that Paul Coe, as Executive Director, is leading the commissioning work. She added that regular meetings with key stakeholders are transitioning into a business-as-usual model, with clear actions and timelines being incorporated into the commissioning arrangements.

·         It was queried whether Millbrook’s pricing was significantly different from NRS and whether the overall cost of the service is expected to rise. Melanie O’Rourke explained that Millbrook’s pricing reflects the true cost of providing a sustainable service. She noted that prescribing practices have changed, with a focus on avoiding over-prescription of equipment while ensuring that individuals’ needs are met. This approach is expected to balance costs over time.

·         A question was asked about how the council managed communication with clients during the crisis and whether the delays had any severe health impacts. Melanie O’Rourke acknowledged that communication was challenging due to the sensitivity of the situation. She emphasised that the council prioritised critical cases, such as  ...  view the full minutes text for item 5.

Purpose: To receive the annual report of the Inquest Review Panel and to consider any findings or recommendations arising.

Melanie O’Rourke (Service Director, Adult Social Care, West Berkshire Council) presented the report on the Inquest Review Panel, which was established in 2022 in response to an increased number of cases where Adult Social Care was approached by the coroner’s office for information or as an interested party. The panel ensures governance, oversight, and learning from such cases to improve services and prevent future deaths where possible. It was explained that the panel met quarterly and was chaired by Melanie O’Rourke. It includes representatives from operational teams, safeguarding, legal, and insurance services. The focus is on identifying learning opportunities and improving practices.

During the debate the following points were discussed:

·         It was noted that the majority of cases reviewed by the panel involved themes such as substance misuse, homelessness, and mental health, often with interrelated factors.

·         It was confirmed that no discernible patterns have been identified in terms of specific wards or areas but monitoring continued.

·         A question was asked about the training provided to staff. It was explained that training focused on improving awareness of risks, recognising signs of substance misuse, and ensuring collaborative working across teams.

·         It was highlighted that a partnership learning event was planned to bring together mental health services, community mental health teams, and locality teams to improve joint working.

·         It was raised that Public Health, as commissioners of drug and alcohol services, had been invited to participate in panel meetings to ensure effective collaboration and contract monitoring.

·         It was reported that a new role, the Co-occurring Mental Health, Alcohol, and Drug (COMAD) worker, had been created to support individuals with complex needs. This role was jointly funded by Berkshire Health Foundation Trust, Public Health, and Housing. The postholder had recently started and was undergoing induction.

·         It was confirmed that of the five cases that went to inquest in the last year, the coroner provided advice in one case, recommending an upgrade to the recording system in a care home. This recommendation had been implemented.

·         A question was asked about whether staff were trained to administer emergency interventions, such as naloxone, in cases of drug overdose. It was clarified that this was the responsibility of the commissioned drug and alcohol service, VIA, which provided specialist training and support. Adult Social Care staff focussed on awareness and signposting individuals to appropriate services.

·         It was asked whether the panel also reviewed cases involving children and young people. It was explained that there was a separate mechanism for children’s deaths, chaired by the Service Director for Children’s Services. Both panels followed the same framework and guidance.

·         It was clarified that the panel reviewed cases involving any vulnerable individual, regardless of whether they were known to Adult Social Care. In some cases, the panel may not have prior knowledge of the individual.

·         It was noted that the panel’s increased activity reflected a proactive approach to learning and prevention. The aim was to prevent deaths wherever possible, even though the numbers were relatively small.

·         It was highlighted that the panel’s  ...  view the full minutes text for item 6.

Purpose: To receive an update from South Central Ambulance Service on the key priorities and progress on their improvement journey since the CQC inspection in 2023.

Rebecca Murray (Chief Governance Officer, South Central Ambulance Service (SCAS)) and Kirsten Wills-Drewitt (Assistant Director of Operations, SCAS) presented the report on the performance, challenges, and ongoing improvements within SCAS, including updates on the group model with Southeast Coast Ambulance Service (SECAM) and the organisation’s Fit for the Future improvement plan. The report also covered operational performance, the recent business continuity incident, and progress with the Care Quality Commission (CQC) ratings.

It was explained that the report covered operational performance data for West Berkshire from April 2025 to February 2026, including response times for Category 1 and Category 2 calls. Category 1 mean response times were reported as 8 minutes 51 seconds, exceeding the national target of 7 minutes. Category 2 response times were 31 minutes 32 seconds, slightly above the target of 30 minutes. It was noted that hear and treat rates had increased to 17.2%, and see and treat rates had risen to 32.1%, reflecting efforts to manage more patients in the community and reduce hospital conveyances.

During the debate the following points were discussed:

·         It was clarified that Category 1 calls involved life-threatening emergencies, such as cardiac arrests, while Category 2 calls included conditions like strokes and chest pains. Categories 3 and 4, which were not detailed in the report, involved less urgent cases. It was suggested that future reports include clearer explanations of the categories and their associated targets for comparison.

·         A question was raised about the clarity of the graphs in the report, particularly the trend lines and axes. It was explained that the trend lines represented response times, while the bars showed the number of incidents. It was suggested that future reports include clearer explanations and annotations to improve accessibility for readers unfamiliar with the data.

·         It was reported that SCAS experienced a business continuity incident from 16 January to 2 February 2026 due to resource pressures and fleet availability issues. This was declared during a period of sustained disruption and included reports of patient harm. The incident was managed through a command structure, daily calls, and a focus on recovery. Borrowing crews and vehicles from other areas was a key part of the response.

·         It was asked whether the same issues could arise next winter. It was explained that steps had been taken to minimise the risk, including the introduction of a third workshop for vehicle maintenance, the procurement of new ambulances (including electric vehicles), and changes to rostering practices. However, it was acknowledged that winter pressures would always present challenges.

·         It was discussed that the age of SCAS’s ambulance fleet was a significant factor in the business continuity incident. It was noted that SECAM had received more investment in fleet, and SCAS was now working to address this disparity. The introduction of new vehicles was expected to improve resilience.

·         It was confirmed that the group model with SECAM was not a merger but a collaborative approach to improve resilience, reduce health inequalities, and align commissioning specifications. A single chief executive and  ...  view the full minutes text for item 7.

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

Fiona Worby (Lead Officer, Healthwatch West Berkshire) was unable to attend the meeting, but the committee reviewed the Healthwatch update report, which outlined the organisation’s activities, ongoing projects, and future challenges. The report highlighted Healthwatch’s contributions to gathering public feedback on health and social care services and advocating for improvements, despite operating with limited resources and under the shadow of closure.

During the debate the following points were discussed:

·         The committee reviewed Healthwatch’s ongoing projects, including work on mental health services, GP access, and hospital discharge processes, recognising these as critical to addressing service gaps and ensuring patient voices are heard. It was noted that Healthwatch continued to operate effectively despite having a small team and limited resources.

·         Concerns were raised about the planned closure of Healthwatch organisations nationally, with members expressing apprehension about the potential loss of independent oversight and advocacy for health and social care services. Members also discussed the unclear future replacement structure for Healthwatch and questioned whether it would maintain the same level of independence and effectiveness.

·         Healthwatch’s list of next steps and open projects aligned with local health and social care priorities, and members expressed strong support for these initiatives.

·         A comment was made that Healthwatch’s work was highly valued, with its role in advocating for patients and ensuring public feedback informs service improvements deemed essential. The committee acknowledged the vital nature of Healthwatch’s work and expressed gratitude for their contributions to improving health and social care services.

·         It was noted that the future of Healthwatch and its replacement structures was a concern across local authorities and would likely be discussed further at the Buckinghamshire, Oxfordshire and Berkshire West Joint Health Overview and Scrutiny Committee (BOB JHOSC).

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

The committee reviewed the work programme, which outlined the topics and issues to be addressed at future meetings. Members were encouraged to provide input on additional topics they felt should be included. Any new suggestions for the work programme would be assessed using the prioritisation tool to determine their inclusion in future meetings.

It was suggested that the patient transport services provided by EMED, be considered for the work programme. It was advised that this was currently being reviewed for prioritisation on the work programme. As part of that the BOB ICB had provided a report which would shortly be shared with Members.

It was suggested that dentistry return as a future item, including attendance by the dentist who attended a previous meeting. It was noted there was a new contract for dentists, the impact of which could be reviewed.  It was advised that an oral health needs assessment was an outstanding recommendation of the committee which was going to Executive next week for consideration. This would therefore be reviewed for future consideration of the committee.

A review of the use of Resource Centres was also suggested. This was noted and would be included in the review for the work programme.

It was noted that Members of the public could also suggest items for consideration and that it would be helpful if a request was shared in the WBC newsletter.

Action: Vicky Phoenix to ensure an article on the health and adult social care scrutiny committee, and a request for participation from the public, be included in a future WBC weekly newsletter.