Agenda item

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board to provide an update on All Age Complex and Continuing Care since attending the Committee in June 2025.

Diane Utley (Clinical Service Lead, Berkshire West Place, BOB ICB) and Daphne Barnett (Interim Associate Director, Complex and All Age Continuing Healthcare, BOB ICB) presented the report on All Age Continuing and Complex Care. The report provided an update on referral activity, eligibility rates, fast track referrals, and collaborative working with local authorities. Key developments included the establishment of a central referral hub to improve consistency, alignment with Berkshire East in preparation for the Thames Valley ICB, and progress in healthcare contributions and dispute resolution policies.

·         During the debate, it was raised that the data presented was consolidated for Berkshire West, with West Berkshire, Reading, and Wokingham shown as separate grey bars. A question was asked about the lack of detailed data specific to West Berkshire. It was clarified that the consolidated data represented Berkshire West as a whole, while the grey bars showed individual areas. Officers committed to providing more detailed data specific to West Berkshire in future updates.

·         A question was asked about why West Berkshire’s positive referral rate appeared significantly lower than Reading and Wokingham. It was explained that the data showed referrals were appropriate and that the conversion rate was improving. Further analysis would be conducted to understand the variation. It was also discussed that West Berkshire has historically had low CHC eligibility rates. Paul Coe (Executive Director, Adult Social Care and Public Health) expressed cautious optimism, noting that the centralised team and joint training initiatives were positive steps towards addressing this issue.

·         It was queried whether socio-economic and demographic factors could explain the variation in referral and eligibility rates between the three local authorities. It was confirmed that they were working with population health colleagues to analyse these factors in more detail.

·         A question was asked about progress on the pilot to consider unmet health needs for children and young people who do not meet the threshold for CHC. It was explained that the children’s and young people’s guidance differed from the adult framework. A Berkshire West children’s and young people’s panel had been established to review cases and ensure consistency.

·         It was discussed that the disputes policy and healthcare contributions policy had been developed and published. The disputes policy had supported close partnership working with the three local authorities, enabling timely resolution of disputes. It was noted that 33 disputes had been completed, with 75% resulting in the not eligible decision being upheld. This aligned with the national benchmark, providing reassurance that decisions are appropriate. Officers emphasised the importance of operationalising these policies and rolling out joint training to improve referral processes and consistency. Collaborative working with local authorities had strengthened relationships and improved processes.

·         A question was raised about the high number of cases that were referred but found not eligible. Officers clarified that the checklist for NHS continuing healthcare consideration is deliberately set at a low bar, meaning more people are referred than are ultimately eligible. The expected conversion rate is around 22%, and Berkshire West was now moving closer to this figure. It was noted that referrals were appropriate, and the direction of travel is positive.

·         The creation of a central referral hub had allowed for greater consistency in processes and a deeper understanding of referral activity. Referrals were mainly coming from local authorities and community providers, with those from the community often involving self-funding individuals or those without social work involvement. Fast track referrals had increased to 21.4 per 50,000 population, aligning with the average referral rates across the region. The number of people eligible for fast track in quarter two is also aligned with expected eligibility per 50,000 population.

As part of the six-month update, the BOB ICB were requested to provide more detailed local data specific to West Berkshire, including a breakdown of referral and eligibility rates, to enable a clearer understanding of local performance and variations. This data should be presented in a format that allowed for direct comparison with Reading and Wokingham to identify trends and areas for improvement.

The Chair thanked the presenters for their update, and the committee noted the progress made. Further updates were anticipated in due course.

Action: Vicky Phoenix to add to the work programme for the agenda in June 2026.