Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Councillors John Jarvis and Rachelle Shepherd-DuBey.

To confirm the Minutes of the Meeting held on 17 September 2018.

The Minutes of the meeting of the Committee held on 17 September 2018 were confirmed as a correct record and signed by the Chairman.

Councillor Haines questioned whether a long term plan for the NHS was still on track to be published prior to Christmas.

Councillor Jones asked for information regarding the hours a GP was situated in A&E each day.

Councillor Jones proposed that the Committee write to Reading Borough Council regarding whether it would be possible for there to be some free use of on street parking around the Royal Berkshire Hospital for patients and visitors.

To receive any declarations of interest

There were no declarations of interest.

To answer any public questions

A period of 30 minutes will be allowed for members of the public to ask questions submitted under notice.

The Council welcomes questions from members of the public about the work of this committee.

Subject to meeting certain timescales, questions can relate to general issues concerned with the work of the Committee or an item which is on the Agenda for this meeting.  For full details of the procedure for submitting questions please contact the Democratic Services Section on the numbers given below or go to www.wokingham.gov.uk/publicquestions

There were no public questions.

To answer any member questions

There were no Member questions.

To receive an update on the work of South Central Ambulance Service (30 mins)

Kirsten Willis, Head of Operations (Berkshire West), South Central Ambulance Service and Mark Ainsworth, Director of Operations, South Central Ambulance Service presented an update on the work of South Central Ambulance Service (SCAS).

During the discussion of this item the following points were made:

·         Kirsten Willis outlined the principles of the Ambulance Response Programme (ARP).  What the patient needed had to be considered and what was the right vehicle to be deployed and the right skill set.  Members were informed that this helped to reduce multi vehicle deployments and diverts and meant less time on scene for rapid response vehicles.

·         The way in which call response times was measured had changed nationally.  Kirsten Willis explained the different standards; Category 1 to Category 4.  Category 1 calls were those patients in a time critical life-threatening event who needed immediate intervention and/or resuscitation e.g. cardiac or respiratory arrest.  Nationally the mean response time was 7 minutes with 15 minutes 90^th centile response time.  The national standard for Category 4 calls – non urgent situations, was 180 minutes 90^th centile response time. 

·         Ambulances were primarily sent to Category 1 and 2 calls, with cars being sent to calls categorised as 3 or 4.

·         In response to a question from Councillor Loyes, Mark Ainsworth explained how calls were triaged.

·         Councillor Soane asked what difference Community First Responders made to Category 1 and 2 response times.   Mark Ainsworth stated that Fire Officers and First Responders contributed to responding to Category 1 calls.  If they arrived first on the scene, the response clock was stopped.  There was a focus on recruiting more Community First Responders.  Fire Officers could not respond to heart attacks.

·         Councillor Richards asked how the call response time standards were set.  Mark Ainsworth indicated that they were set by the Department of Health. 

·         Councillor Richards went on to ask whether the call response time standards were becoming more difficult to achieve.  Mark Ainsworth indicated that because the most appropriate vehicle rather than necessarily the closest was dispatched this made the achievement of the Category 1 and 2 standards, tighter.

·         Kirsten Willis highlighted some of the key benefits of the ARP including the most appropriate clinical resource to meet the needs of patients based on presenting conditions being provided and not simply the nearest; and improved patient experience.

·         The Committee considered information regarding the ARP performance for the Wokingham CCG area between April 2018, when the ARP had been introduced, and October 2018.  Members also received a comparison to the pre ARP year (April to October 2017) which suggested that performance had improved. 

·         Members received information regarding the ARP Category 1 response times for the Wokingham area and the SCAS area as a whole April to October 2018.  The very long response time identified for the week commencing 3 September had been driven by a single incident which had been process related and had been due to the arrive time of the crew not being processed.  Members were advised that the number  ...  view the full minutes text for item 26.

To receive an update on diabetes prevention. (25 mins)

Julie Hotchkiss, Interim Consultant in Public Health and Jenny Wilson, Diabetes Prevention Programme Coordinator, West Berkshire Council, provided an update on diabetes prevention.

During the discussion of this item the following points were made:

·         Julie Hotchkiss explained the difference between Type 1 and Type 2 diabetes.  In England there were currently 3.8million people with Type 2 diabetes with a round 200,000 new diagnoses each year.

·         Obesity was fuelling a rise in Type Diabetes.  Members were advised that if trends persisted 1 in 3 people would be obese by 2034 and 1 in 10 would develop Type 2 diabetes.

·         Members were informed that an individual’s ethnicity could have an impact on their Type 2 diabetes risk.  For example, the South Asian population living in the UK were up to six times more likely to develop Type 2 diabetes than that of the white population.

·         Members were informed of the Public Health England programme, Healthier You, an NHS Diabetes Prevention Programme.  Weight loss, healthier eating and exercise could help to reverse the diabetic trend.  On average participants lost half a stone.

·         Julie Hotchkiss highlighted some of the reasons why many people were becoming fatter.

·         Jenny Wilson explained that the Healthier You Programme was a joint ambition of the NHS Five Year Programme and Public Health’s Evidence into Action.  It identified those at high risk of Type 2 diabetes and referred them to a behaviour change programme.  100,000 places would be made available across the country by 2020.  In 2016 Berkshire had been identified as a ‘Wave 1’ site.

·         The long term aims of the programme were: to reduce the incidence of Type 2 diabetes; to reduce the incidence of complications associated with diabetes (heart, stroke, kidney, eye and foot problems); and over the longer term, to reduce health inequalities associated with incidence of diabetes.

·         Step 1 of the programme was to identify eligible patients.  Patients had to be over 18, registered with a GP in Berkshire and have a HbA1c between 42-47 mmol/mol (6.0%-6.4%) or Fasting Plasma Glucose between 5.5-6.9 mmols/l within the last 12 months.  Patients could not be pregnant, housebound or have had a previous diabetes diagnosis.

·         Step 2 was to invite patients to join the programme.  GP practices were paid £1.50 per invitation letter sent.

·         Patients were required to make a commitment to a 9 month 4 stage programme.

·         Jenny Wilson outlined the different stages of the programme. 

·         Members noted information regarding the number of referrals by practice.  All GP practices in Wokingham had engaged except Loddon Vale.  Jenny Wilson explained that there had been less referrals in May and June as the provider had changed in May and this had been a period of transition. 

·         Jenny Wilson highlighted progress made to date both nationally and locally.  There had been 4092 referrals across Berkshire and 1900 Initial Assessments had taken place.  Of this there had been 1750 referrals in Berkshire West with 956 Initial Assessments.  422 referrals had been made in Wokingham and 218 Initial Assessments  ...  view the full minutes text for item 27.

To receive an update on the work of Healthwatch Wokingham Borough. (15 mins)

The Committee were updated on the work of Healtwatch Wokingham Borough.

During the discussion of this item the following points were made:

·         Nicola Strudley advised Members that they had been awarded the new three year Healthwatch Wokingham contract.  They were undertaking a 2 week long relaunch and had that day visited Wokingham Community Hospital and Alexandra Grange.

·         Healthwatch Wokingham’s new website would be launching soon.

·         In response to a question from Councillor Jones it was clarified that Healthwatch Wokingham’s budget had been cut by 10%.  This would have an impact on staff capacity to undertake projects.  Jim Stockley commented that they were required to report back to the commissioners on a more regular basis and work towards 24 KPI’s, which also took some time.  Councillor Jones asked that the Committee be updated at future meetings on any impact that this budget reduction may have on Healthwatch’s work.

·         During the forthcoming year Healthwatch Wokingham would be focusing in particular on one specific priority; adult mental health.

·         Three applications had been approved so far for the Community Investment Fund.  ARC would be running three workshops on anxiety, Relax Kids would be running a scheme for teenagers and the Wellbeing in Wokingham Action Group would be running evening and weekend events on wellbeing matters such as sleep.

·         The Recovery College was being recommissioned and Healthwatch Wokingham wanted service users to be involved in the redesign process. 

·         Nicola Strudley highlighted an individual case study where an individual had, had an unsatisfactory experience with social care.  She advised that responses had been sought from the START team and the social workers.  Councillor Miall suggested that the Committee ask Officers how the individual case had been resolved.

·         It was noted that Healthwatch Wokingham would be involved in the redesign of the outpatients’ pathway.

·         Nicola Strudley stated that a number of strategies such as the Carers Strategy and the Emotional Wellbeing Strategy had recently been reviewed or were in the process of being reviewed.  Healthwatch Wokingham would like for key stakeholders and themselves to be more involved in the process.

RESOLVED:  That

1)         the update on the work of Healthwatch Wokingham Borough be noted;

2)         Nicola Strudley and Jim Stockley be thanked for their presentation.

To receive the Forward Programme for the remainder of the municipal year. (5 mins)

The Committee considered the forward programme for the remainder of the municipal year.

During the discussion of this item the following points were made:

·         Councillor Miall asked that an Officer response to the Healthwatch Wokingham case study be provided by the January Committee meeting.

• Members requested an update on the Suicide Prevention Strategy implementation, including progress of the Wokingham action plan, at the January Committee meeting.

·         Councillor Haines requested that the update on the pressure on GP resources scheduled for the January meeting also make reference to the usage of Community Navigators.

·         Councillor Richards requested that the briefing on discharge from hospital scheduled for the Committee’s March meeting refer to the issue of ‘bed blocking’ at weekends.

RESOLVED:  That the forward programme be noted.