Agenda and draft minutes

Purpose: To approve as a correct record the Minutes of the meetings of the Health and Adult Social Care Scrutiny Committee held on 10 March 2026 and 14 May 2026.

The Minutes of the meetings held on 10 March 2026 and 14 May 2026 were approved as true and correct records and signed by the Chairman.

A Committee Member raised a matter arising from the 10 March 2026 minutes (Item 7: South Central Ambulance Service update), reporting a recent first-hand account of unacceptable response times for an elderly resident following a fall. It was noted that a complaint had been made to the Council. The Chair stated that further information would be received once the follow-up had been completed

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

The Committee noted the progress report on the recommendations and actions tracker. The Chair highlighted that the Children’s Mental Health and Emotional Wellbeing Task Group response reports had gone to the Executive on 28 May 2026 (with responses to recommendations to be added to the tracker in due course). The Chair also corrected the recorded receipt date of an ICB response (amended from September 2026 to September 2025). No further comments were raised.

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. In addition her spouse is Head of Contract Management at the Royal Berkshire NHS Foundation Trust.

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: To review the system approach to palliative care and hospice provision in West Berkshire.

Zoe Woods (Head of Palliative and End of Life Care (all age), Community Services and Section 117 (Berkshire West), Thames Valley Integrated Care Board (TV ICB)) presented the report on palliative care and hospice provision. The report provided assurance on the current system approach to end-of-life care; described progress to date and continuing areas for improvement; and set out the direction of travel towards a more integrated, community-focused model aligned to people’s preferences for place of care and death. It reported West Berkshire deaths (2023) and described the system’s expectation that a significant proportion of those approaching end of life would require specialist palliative care. It outlined recent service developments and partnership arrangements across the ICB, Berkshire Healthcare NHS Foundation Trust (BHFT) and Sue Ryder, including commissioning changes and expansions in community provision (including hospice at home), a 24/7 clinical advice line, virtual wards, rapid response, and inpatient bed capacity across local hospice and community hospital settings. It also identified ongoing challenges including coordination, digital infrastructure and consistent access/experience, and linked the work to wider strategic priorities (including a “Dying Well” approach across the Thames Valley).

During the debate the following points were discussed:

·         It was raised that the table on page 21 was labelled “Preferred Place of Death” and clarification was sought as it appeared to reflect where people died. Zoe Woods advised the data was sourced from ONS. It was subsequently clarified in discussion that the table on page 3 was actual deaths rather than preferred place of death, and that the meeting should distinguish between preference and actual place of death.

·         A question was asked about the reported figure that 56% of people would prefer to die at home, and whether this was a national figure or specific to the local area, as it did not appear to align with the table presented. Dr Jane Bywater explained that people do not always achieve their stated preferences due to service access, illness progression, unexpected events, and that preferences can change over time (often influenced by family support and carers’ capacity).

·         It was discussed that the key service question was the gap between what people say they want (e.g. dying at home) and what actually happens, and what “added value” the system can deliver. Dr Hannah Western (Palliative Care Consultant, Sue Ryder) noted that data can be difficult to interpret because it depends on when preferences are recorded; a preference expressed by the “well population” may change near end of life as care needs increase, symptoms become complex, or carers struggle. She also noted that changes in preference may reflect constraints in the level and responsiveness of home support, and that service developments aimed to make community provision more responsive across settings.

·         Concern was raised about national reporting (a Marie Curie report) describing end of life care as “broken”, with significant unmet need and out-of-hours gaps, especially in rural areas. It was also raised that a high proportion of deaths in West Berkshire occur in hospital compared with England,  ...  view the full minutes text for item 5.

Purpose: To review the implementation and progress of Health in all Policies across West Berkshire Council.

Steven Bow (Public Health Consultant, West Berkshire Council) presented the report on the Council’s Health and Wellbeing in All Policies (HiAP) approach and programme update, supported by a short slide presentation. The report set out a shared understanding of HiAP as an organisational approach (rather than a discrete service), explained why it was needed, summarised progress in phases one and two (foundations, tools, skills and processes), described the projects funded to date, and outlined phase three priorities focused on embedding HiAP as business-as-usual, strengthening governance and decision-making, and improving measurement of impact and sustainability.

During the debate the following points were discussed:

·         It was raised that embedding HiAP required a training and education approach for both officers and elected members, as people can be focussed in their own workstreams and may find it difficult to apply a health lens to routine decisions; Steven Bow confirmed training and workshops had been delivered (including LGA leadership workshops and systems thinking workshops) and that phase three would focus on embedding the approach through organisational change.

·         It was raised that planning policy and the built environment are critical levers for health, and that historically it had been difficult to influence the local food environment (e.g., fast food outlets) because of planning constraints; Steven Bow responded that progress had been made by including health and wellbeing requirements in the Local Plan, and that further work was underway to provide clearer guidance to developers and strengthen implementation.

·         A question was asked whether a tracker could be provided for HiAP-funded projects, including timelines and how the committee would know whether individual initiatives are progressing and whether they are successful; Steven Bow stated that tracking projects was an aim for the year and that a performance workstream had been established to balance local ownership of projects with central oversight and reporting.

·         It was discussed that measuring public health success was inherently difficult because prevention benefits may not be visible for years and because it is hard to demonstrate “what was prevented”. Steven Bow acknowledged the challenge and confirmed phase three included a focus on measuring performance/impact of funded projects and building a stronger approach to evidencing outcomes.

·         It was raised that the “health in all policies” approach should not become purely theoretical and needed to translate into tangible benefit for residents; Matt Pearce (Director of Public Health, West Berkshire Council) acknowledged the recurring challenge of “bringing it to life”, noted that some impacts were “soft influence” (e.g., health inequalities being actively discussed in decision-making), and stated that further work was needed on an outcomes framework.

·         It was raised that the report referenced environmental interventions in homes with damp and mould and that there had previously been issues with outdated measurement equipment compared to private providers; Steven Bow stated the project was led by Environmental Health and he could seek further information on the technology/equipment being procured, as he did not have the detail to hand.

·         A question was asked about the new Public Health Planning Liaison Officer post  ...  view the full minutes text for item 6.

Purpose: To receive an update on All Age Complex and Continuing Care since attending the HASC in December 2025.

Daphne Barnett (Interim Head of Neuro Transformation and Complex Cases, Thames Valley Integrated Care Board (TV ICB)) presented the report on all-age continuing care and complex care. The presentation set out: the establishment of the new Thames Valley ICB (from 1 April 2026) and its governance arrangements across “places”; work to improve joint working between health and social care (including disputes processes and joint reviews); policy alignment across the new ICB footprint (including further work on a draft healthcare contribution policy); performance and activity data for Continuing Healthcare (CHC) and Fast Track CHC; and key priorities for future delivery including a more centralised operational model, improved consistency and timeliness, and performance reporting to NHS England.

During the debate the following points were discussed:

·         It was discussed that the data being presented had only recently become available at the requested granularity; a caveat was raised by Daphne Barnett that reliability was still improving due to system merging and inconsistent historic recording, and that a new process was being introduced to ensure consistent recording going forward.

·         It was raised by Paul Coe (Executive Director, Adult Social Care and Public Health, West Berkshire Council) that the committee valued receiving local authority-level data and noted that ICB colleagues had done extra work to provide this. It was suggested that embedding this granularity into routine reporting would be beneficial going forward.

·         It was discussed that commentary within the slides about proportionality across Buckinghamshire, Oxfordshire, Berkshire West and the newly-added East Berkshire needed careful interpretation; It was noted that some comparisons were expressed “per 50,000 population” and that would slightly challenge the proportionality point as expressed.

·         It was discussed that, on formation of the new larger Thames Valley ICB, CHC was understood to be an area “protected” within the new organisation, giving some confidence about continuity and focus.

·         It was discussed that quarter-to-quarter data could fluctuate; Paul Coe advised that, for scrutiny purposes, a longer time period (e.g., a full year / four quarters) would provide a more reliable sense of trend and direction of travel than isolated quarterly snapshots.

·         A question was asked about the clarity and internal consistency of the data visualisations and narrative on “slide 3” (standard CHC referrals per 50,000 and eligibility metrics). It was raised that:

·         The narrative referred to specific figures (e.g., 13.6, 16.75, and 9.7 rising to 12.8) that were difficult to reconcile with the charts shown.

·         Some lines/bars appeared not to clearly correspond to the narrative values, making it hard to interpret without confusion.

·         It was suggested that the presentation might be improved by showing data over a longer run (e.g., four quarters), with clearer “before/after” comparisons and/or clearer depiction of means/trends, rather than complex multi-line charts that were hard to map to stated figures.

·         Daphne Barnett responded that she had noted the feedback and would take it back to the data team who produce the figures and slides, with the intention of improving representation and clarity next time. It was also offered that a councillor was willing  ...  view the full minutes text for item 7.

Purpose: Paul Coe, Executive Director for Adult Social Care and Public Health, will provide an update on the Adult Social Care strategy consultation.

Paul Coe (Executive Director, Adult Social Care and Public Health, West Berkshire Council) presented the report on the draft Adult Social Care Strategy consultation. He explained that the strategy was in draft form and had been published for consultation, with active engagement under way to gather views before finalising. He outlined that officers had been engaging adult social care staff, partner agencies (including health partners and other statutory services), the independent provider market, and representative forums including the Learning Disability Partnership Board and carers’ groups. The consultation closing date was confirmed as 22 June 2026. It was stated that feedback was ideally submitted via the formal online consultation route to support collation, although comments made in the meeting would be noted.

The following points were discussed:

·         It was raised that the strategy included an easy read option, and a question was asked how people with learning disabilities and others who need accessible formats were being supported to provide feedback, particularly if responses were expected to be submitted online; it was explained that the Learning Disability Partnership Board had received a presentation (delivered by the strategy lead, Melanie O’Rourke), an easy read version was available, and printed copies had also been circulated so engagement was not solely dependent on online access.

·         It was discussed that some service users may not be able to respond directly even with accessible formats, and a question was asked whether the council would place weight on feedback provided by representatives; Paul Coe stated that the council intended to gather views through valid proxies, including family members and informal carers (as “experts” in the lived experience of their loved ones), advocacy organisations and voluntary sector partners, and that such representative input was considered legitimate and important.

·         It was raised that one of the “areas to improve” in the draft strategy was to increase uptake of direct payments, and a question was asked why West Berkshire was at around 12% when the England average was more than double, and whether this reflected a lack of trust in residents; Paul Coe responded that it was not a trust issue, but an area where the council had tried repeatedly to increase uptake without successfully shifting the position.

·         It was discussed what direct payments were intended to achieve and why people might not choose them; Paul Coe explained that direct payments provide people with funding to arrange their own care rather than having the council arrange provision, aiming to increase autonomy and flexibility, but there were practical trade-offs that may deter uptake.

·         It was discussed that council processes could influence direct payment take-up, and it was raised that the current process may be too “sticky” or complicated; Paul Coe stated that this was likely a contributing factor and that the council had a small specialist direct payments team, while social workers and care management teams were expected to make the initial offer, and the council had been working to shift resources so the specialist team could engage faster when someone expressed  ...  view the full minutes text for item 8.

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) presented the report on Healthwatch West Berkshire’s current activities. She explained Healthwatch’s statutory role in relation to health and social care and how it gathered and represented the public voice through outreach, visits and events. She also reported that the team was preparing its statutory annual report (due by 30 June) and outlined key ongoing and planned projects (patient transport experiences; experiences of young people after turning 18; and women’s health), along with emerging themes from resident contacts (including access, communication, and public understanding of adult social care). She additionally updated the committee on the national proposal to abolish Healthwatch and the lack of formal communication received from Government on that issue.

The following points were discussed:

·         It was advised that Healthwatch was facing a proposed abolition progressing through Parliament (reported as being in the House of Lords, with a second reading occurring that week), and it was noted that Healthwatch had received no direct update from Government and was learning developments at the same time as the public; Fiona Worby advised that, if the abolition proceeded, implementation would likely take time and she anticipated Healthwatch could remain in place until around mid?2027 due to the legislative process and Parliamentary timings.

·         It was raised that the committee and wider scrutiny structures had significant concerns about the proposal to abolish Healthwatch, particularly regarding the loss of an independent voice for service users; the Chair stated that concerns had been raised at the Joint Health Overview and Scrutiny Committee and that senior health leaders had been present to hear those concerns.

·         A point was made challenging the Government’s stated rationale for abolition (that fewer organisations would create a clearer path for feedback), and it was argued that removing Healthwatch would reduce, rather than improve, routes for people to share views.

·         Fiona Worby reported that she had supported a mapping exercise requested by MP Lee Dillon’s team because they were receiving high volumes of constituent contacts and were uncertain where to signpost people; Healthwatch identified more than 157 pathways for feedback in health and social care in West Berkshire (including some national routes) and fed this back to the ICB, suggesting that streamlining may be needed.

·         It was noted that Healthwatch’s statutory powers to hold services to account were important, though Fiona Worby indicated she did not consider formal escalation was often necessary because issues could frequently be progressed through constructive discussion; she reiterated that the key concern was the removal of an independent public voice if Healthwatch were abolished.

·         Fiona Worby outlined a live project on patient transport following receipt of multiple resident contacts; it was discussed that dissemination was challenging, so Healthwatch had used its website and social media, asked partners (including carers’ networks) to share the survey, and planned press coverage in the Newbury Weekly News to reach residents who are not online.

·         In relation to patient transport, it was discussed that feedback included both positive and negative experiences; concerns reported by  ...  view the full minutes text for item 9.

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

The Chair (Cllr Martha Vickers) introduced the draft work programme for 2026/27 and reminded members that proposals for scrutiny items are submitted through a prioritisation tool and then considered by the Chair and Vice-Chair ahead of the next meeting. She noted that the September agenda was already full (including women’s health strategy, carers strategy and the Better Care Fund), and that women’s health had been delayed from the current meeting due to timing of reports.

It was discussed that the committee should consider scheduling a future update on the new integrated palliative care and hospice provision model, once the partnership arrangements have had time to embed; Cllr Stevenson suggested March 2027 as an appropriate point for an update (after approximately a year of operation), and the Chair indicated this could potentially be strengthened by also including an update on children and young people’s palliative care.

It was discussed that there was now a meeting end time extension to 4:30pm, which may provide slightly more capacity to accommodate additional agenda items, though the forward plan is already busy.

Cllr Stewart proposed that the committee should consider scrutiny of the vaccination programme, prompted by recent local concerns about meningitis and wider issues relating to immunisation uptake (including the observation that second-dose uptake can be lower than first-dose uptake, e.g., measles); the Chair advised the suggestion should be put through the prioritisation tool to assess how and when it could be scheduled.

Action: Vicky Phoenix to put the proposed scrutiny item on the vaccination programme (including meningitis and wider immunisation uptake issues) through the committee’s prioritisation tool for scheduling consideration.