Agenda item

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) have been invited to provide an update on All Age Continuing Care (AACC) and the AACC transformation programme since attending the Health Scrutiny Committee in December 2024.

Daphne Barnett (Interim Associate Director of Nursing, BOB ICB) gave an overview of the report on All Age Complex and Continuing Care. Sarah Flavell (Associate Director Nursing, BOB ICB) also answered questions on this item.

During the presentation the following points were highlighted:

·         It was a key objective of the BOB ICB to ensure that Berkshire West did not have unwarranted variation in referral and eligibility for CHC. Early indications showed that Berkshire West was moving closer to the national benchmark and the metrics were improving. However, Berkshire West did remain below the regional and national benchmark for number of people eligible for CHC. The aim was to ensure there was a one stop entry point for referrals across BOB and that there was an equity of approach.

·         Processes were in development for a joint funding approach for individuals who did not meet eligibility for CHC or CYPCC but had unmet health needs not provided through core NHS service provision. A healthcare contribution policy has been in development and Berkshire West were involved in the testing of this policy to gain learning.

·         It was confirmed that the disputes and health care contribution policy were in place. The Strategic Partnership Board had been influential in helping to develop and co-produce local neighbourhood services.

·         The Berkshire West Joint Funding panel for Children and Young People’s Continuing Care (CYPCC) had been in place since December 2024. The aim was to streamline the funding process for continuing health care. It was working in partnership with Wokingham, Reading and West Berkshire Councils.

·         It was advised that many changes had been made including improved collaboration, decision making, addressing back logs and taking a test and learn approach. This had led to improved support for individuals, positive feedback and an ongoing commitment for further improvements.

·         A summary was provided in the report which highlighted working closely with Adult Social Care and Local Authorities to continue to make improvements.

During the discussion the following points were noted:

·         Paul Coe, Executive Director for Adult Social Care and Public Health, advised the Committee that there had been a greater pace of improvements and tangible changes were being seen such as the disputes policy. However, there were still challenges. The referral rates and eligibility outcomes were still below benchmark, and this meant outcomes for people in West Berkshire.

·         It was noted that Local Authority data was not yet available. It was agreed this would assist the BOB ICB to understand where to address concerns.

Action: Sarah Flavell will progress the availability of Local Authority data. 

·         Members raised concern that this variation in eligibility was continuing after many years. Berkshire West remained very low nationally and this needed to be addressed more urgently. This was noted, and it was highlighted that recent developments by the BOB ICB had made some recent change that was welcome. However, whilst improvements had been made, a question was raised whether the reduction in inequity across BOB had been due to increased eligibility rates for Berkshire West or whether eligibility had decreased in other areas.

·         It was advised that there were challenges in delivering the national framework consistently across the BOB footprint and that the BOB ICB were working to do that at pace. NHS England were also challenging the BOB ICB to ensure consistency across the Southeast region. An example was shared regarding population demographics (an aging population) and nursing home numbers which can affect the statistics. In addition, referral rates affected the variation also. Changes to the NHS would ensure stronger collaboration between areas in the future.

·         It was highlighted that joint training with Adult Social Care colleagues would be taking place.

·         Members agreed that they would like this to return to the Health and Adult Social Care Scrutiny Committee in 6 months’ time.

Action: Vicky Phoenix to add this to the work programme for December 2025

RESOLVED that the report be noted.