Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Sarah Deason, Nick Fellows, Councillor David Hare and Steve Moore.

To confirm the Minutes of the Meeting held on 1 September 2022.

The Minutes of the meeting of the Board held on 1 September 2022 were confirmed as a correct record and signed by the Chair.

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 Board.

Subject to meeting certain timescales, questions can relate to general issues concerned with the work of the Board 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 ICB and ICP update.

The Board received an update on the ICB and the ICP.

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

·       Sarah Webster indicated that she was the Executive Director for Berkshire West for the ICB, and that it was her second week in post.

·       The ICB had met at the end of September and received papers on a range of matters including the formation of the ICP, the ICS Strategy development and the Working with People and Communities Strategy.

·       With regards to the ICP formation, the statutory members, the ICB and the five local authorities, had agreed the wider membership.  The first meeting would be held on 27 October.  Locally, a Place Based Partnership would need to be developed for Berkshire West, with the aim being to devolve as much local decision making as possible from the ICB to the local partnership.  It was vital that this was jointly developed.  It would be an iterative process.

·       With regards to the development of the Strategy, the partnership was required to agree a strategy by the end of the year.  This timescale was based on national deadlines, which were very tight.  A number of working groups had been identifying key themes and issues which would benefit from collaborative work between the partners.  It was expected that the Strategy would be based on common themes from the Health and Wellbeing strategies.

·       There was an ongoing period of engagement.  The Chairs of the Health and Wellbeing Boards would be meeting the following week to discuss emerging themes and how best to engage the wider Boards.  Sarah Webster commented that she was aware that the Board did not have a meeting scheduled for November so was open to ideas on how best to engage.

·       The Board was informed of some changes in leadership.  Dr James Kent had left to take on a national role and in the very short term the Chief Medical Officer was acting up.  Steve McManus would be joining at the end of the month as the interim Chief Executive Officer.

·       Councillor Margetts welcomed Sarah to her new role.  He indicated that the Board had expressed concerns regarding the NHS reforms for some time.  The areas in BOB were very different to each other and faced different challenges.  When Chairman of the Board he had written to Dr Kent asking that these concerns be considered, but did not receive a reply.  He asked that these concerns be taken on board.  Sarah Webster stressed the need for partnership working and re-emphasised the importance of designing a local Place Based Partnership.  It was not the intention that everything be held centrally.

·       Matt Pope commented that given the complex footprint, many meetings were taking place, and it was difficult as a local authority to have a view of what these meetings were, to ensure the correct level of engagement.  He had been unaware of the forthcoming Chairs meeting.  Sarah Webster agreed that the structure required some clarification.

·       Matt Pope questioned whether the Strategy  ...  view the full minutes text for item 26.

To receive the Berkshire West Covid Vaccination Autumn Plan Sept - Dec 2022.

Jo Reeves, Newbury Locality Manager, BOB ICB, provided an update on the Berkshire West Covid Vaccination Autumn Plan Sept-Dec 2022.

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

·       The Plan had been adopted by the Berkshire West Vaccine Action Group.  The Plan had also been shared with the Health Overview and Scrutiny Committee.

·       There were two strands to the Covid vaccination programme this autumn; maintaining an evergreen offer of primary vaccinations, and delivering the autumn booster to the identified cohorts.

·       The Autumn booster programme had commenced on 5 September and had initially focused on the most vulnerable cohorts.  However, this had now been extended, and all those eligible had been called forwards. 

·       Vaccinations were available at the Broad Street Mall in Reading, community pharmacies, the PCNs, and at Shute End.  Access was via the national booking system on the NHS website or by calling NHS 111, or having received a direct invitation from the GPs. 

·       PCNs were also visiting house bound patients and care home residents.  The end of October was the target date for all care home residents to be vaccinated.  This target was on track.

·       The NHS had been sending letters and text messages to invite people to book their appointment, and a national communication campaign would be launched shortly to encourage people to top up their immunity for winter by taking up their flu jab and where appropriate their covid booster.  Where possible the PCN’s were co-administering the Covid and flu vaccines.

·       The primary vaccination was available at the Broad Street Mall mass vaccination centre.  Bringing it more locally to Wokingham was a key part of the inequalities approach.  The Health on the Move service would be used again.

·       Councillor Margetts welcomed the commitment to maintaining a Wokingham vaccination centre as Broad Street Mall in Reading was not convenient for all residents. 

·       Councillor Margetts commented that health care workers were able to be vaccinated at work but that social care workers had to book using the national system.  He questioned why this was and queried whether this had an impact on uptake.  Jo Reeves agreed to look into the matter. She indicated that staff were often dispersed amongst various providers, but the situation could be difficult where they were concentrated and trying to book around their shifts.  Sarah Webster added that she had recently raised this issue of equitable access with the Chief Nursing Officer.

·       Matt Pope questioned whether the target relating to care home residents being vaccinated only referred to residents in older person’s care homes or if those living in learning disability care homes were also included.  Jo Reeves believed that it related to any care home.

·       With regards to vaccinations for 12–17-year-olds, Councillor Bray questioned whether there was likely to be a more local provision than Broad Street Mall in Reading.  Jo Reeves responded that the new booster was coming online which was suitable for those 12 years old and above.  It was likely that vulnerable 12-17 years olds would have  ...  view the full minutes text for item 27.

To receive the Wokingham Integrated Partnership Update and End of Year Better Care Fund Reporting.

The Board received a presentation on the Wokingham Integrated Partnership update and end of year Better Care Fund reporting.

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

·       The end of year template had been submitted on time and signed off by the Chairman of the Wokingham Borough Wellbeing Board and the relevant officer for the ICB.

·       A section 75 was completed to appropriately share the funds between the CCG and the Council, and all of the conditions had been met.

·       Income and expenditure targets had been met.

·       Lewis Willing took the Board through the statements from NHS England that the WIP had to state whether it agreed or disagreed with.

·       Services delivered had performed well against the backdrop of Covid.

·       15 of 19 projects had been completed and 3 had been moved to business as usual or a secondary phase.  One project had not moved to completion.  This project was linked to getting service user feedback and understanding their journey through integration.  Feedback from the individual services was good but there was limited feedback on the linkages between the services.

·       Lewis Willing went on to highlight some successes.  For example, the BCF funded the purchase of software called Connected Care which was used by health and social care partners.  It had been identified that it had been less well used social care colleagues.  Further education around the system had been undertaken and usage had increased.  Another success had been the reablement programme and there was a slightly larger pilot this year as a result.

·       Challenges included Covid and the impact that it had had on staff.

·       Two of the five Better Care Fund targets had been achieved.  NHS England ensured that challenging targets were set  

o   Unplanned hospitalisation for chronic ambulatory care sensitive conditions (NHS Outcome Framework indicator  2.3i) – whilst this target had not been met, performance had been maintained at a similar level to the previous year.

o   Proportion of inpatients resident for: i) 14 days or more ii) 21 days or more – within 2% of the target had been achieved

o   Percentage of people who are discharged from acute hospital to their normal place of residence – target on track.

o   Rate of permanent admissions to residential care per 100,000 population (65+) – target on track.

o   Proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement / rehabilitation services – there were challenges in the way this target was measured, in that the BHFT team who delivered this also delivered end of life support.  Their inclusion in this reporting had resulted in the achievement of 84% against this target.  NHS England had advised that the way in which the target was measured would not be changed.

·       Dr Milligan praised what had been achieved. 

·       Councillor Bray was pleased to note that the Wokingham system did not at any stage use a residential nursing bed for lack of home care.

RESOLVED:  That the Wokingham  ...  view the full minutes text for item 28.

To receive the Wokingham Integrated Partnership Better Care Fund Annual Plan Submission 2022/23.

The Board considered the Wokingham Integrated Partnership Better Care Fund Annual Plan Submission 2022/23.

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

·       The planning submission did not always align with the financial year that it supported.  It was 6 months into the programme delivery.

·       During the development of the annual integration plan and this submission, the Integration Team had been in touch with colleagues from the ICB, BHFT, RBH and the other West of Berkshire Local Authorities.

·       The majority of the submission was noted as being good, with few areas of improvement.  These had subsequently been addressed with support from partners.

·       All the minimum contributions had been met, as had all of the national conditions.

·       The Board noted some of the services that were funded through the Better Care Fund.

·       Lewis Willing highlighted the programme overview.  The five key priorities for the year closely matched the work for the BCF.

·       With regards to targets, NHS England would not accept a target lower than the previous years performance.  Overall targets would be exceptionally challenging following Covid.

·       The demand and capacity template had been requested for the first year.  Currently, on paper demand looked like it would be closely met by capacity (in part down to few people leaving in longer than a month), but also as the information could be more accurate, there was still potential for delays in discharge.

·       There were 25 projects, and the majority were on track.

·       In response to a question from Councillor Bray, Lewis Willing explained how the funding was recorded.

·       Dr Milligan questioned whether the demand and capacity information could be backed up by people’s stories and experiences.

RESOLVED:  That the Wokingham Integrated Partnership Better Care Fund Annual Plan Submission 2022/23 be noted.

To consider the Board’s work programme for the remainder of the municipal year.

The Board discussed the forward programme for the remainder of the municipal year.

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

·       Sarah Webster suggested that an update on the ICB and ICP, an update on the ICP Strategy and a report around the development of the Place Based Partnership be added to the December meeting.

·       Councillor Margetts proposed that an update on Covid be brought to the February meeting.

·       It was noted that further consideration would need to be given as to how the Wellbeing Board would be engaged in the development of the ICP Strategy.

RESOLVED:  That the forward programme be noted.