To receive any apologies for absence

Apologies for absence were submitted from Councillor Parry Batth, Martin Sloan, Head of Service Wokingham Integrated Social Care & Health Team and Jim Stockley, Healthwatch Wokingham Borough.

To confirm the Minutes of the Meeting held on 11 July 2016.

The Minutes of the meeting of the Committee held on 11 July 2016 were confirmed as a correct record and signed by the Chairman.

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 Step Up, Step Down project. (20 mins)

James Burgess, Better Care Fund Programme Manager provided an update on the Step Up, Step Down (SUSD) scheme.

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

·         Members were reminded that the Better Care Fund had created a local single pooled budget to incentivise local government and the NHS to work more closely together around people, placing their wellbeing as the focus of health and care services.  The Council and the Clinical Commissioning Group (CCG) had to jointly agree how the money would be spent.

·         The SUSD scheme was one of the eight Better Care Fund projects. 

·         James Burgess explained what was meant by SUSD.  Step Down was for those who were medically well in hospital but were not ready to return to their former home or level of independence.  Step Up was for people experiencing a sudden and severe change in need, and who required a period of intensive support and rehabilitation to avoid the need for a hospital admission or permanent placement in a residential or nursing home.

·         SUSD was based at the Alexandra Place Extra Care scheme with 24 hour 7 day a week staffing and one dedicated additional day staff.  There were one 2 bedroom and two one bedroom fully equipped and furnished flats with walk in showers and adapted bathrooms.

·         It was noted that the flats were intended for a maximum stay of 21 days in order to complete reablement required and to avoid bed blocking.  However, the 21 day period could be exceeded if the individual circumstances necessitated this.  Although the flats were rent free residents had to provide their own food, with the support of staff if needed.

·         Councillor Soane asked whether anyone who had gone into Step Up had then been admitted to hospital.  James Burgess commented that they had not and that there had not been that many admitted as a Step Up.  Some admitted to Step Down had been admitted to hospital for a short period before being discharged back to Step Down.

·         Councillor Blumenthal questioned whether 3 units were enough and if it were likely that more would be required as the Borough’s population aged.  James Burgess stated that when the scheme was initially piloted it had been thought that 8 units would be needed.  However, performance was kept under review.

·         Members enquired whether the units were as busy as they could be.  James Burgess stated that there were peaks and troughs in their usage.  Nevertheless, there was an increased focus on getting people back into their own home where possible. 

·         A ‘deep dive’ review would be undertaken 2016-17 to ascertain whether there were more cost effective ways of delivering SUSD units and the optimum staffing levels for SUSD.

·         Members were updated on performance of SUSD from July 2015.  It was noted that 37 people had used the service for a total of 698 days.  The total cost of the service had been £109,706; rent, staffing and utilities.  339 days in hospital had been saved and  ...  view the full minutes text for item 25.

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

Members were updated on the work of Healthwatch Wokingham Borough.

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

·         Healthwatch Wokingham Borough had attended a number of events over the summer, including Fun Days.  They had received some comments regarding the lack of seating which would be fed back to organisers.  Councillor Blumenthal suggested that Healthwatch Wokingham Borough attend the Earley Green Fun Day in future.

·         Members were informed that a report about Healthwatch’s Deaf Champion visits to a number of dental surgeries within the Borough would be published shortly.

·         The Healthwatch Wokingham Borough health and social care directories were being distributed.  In response to a question from Councillor Dolinski, Nicola Strudley commented that these could be made available in different formats if requested.

·         Healthwatch Wokingham Borough would be producing a piece for BBC South Today regarding its work with St Crispin’s School and the ‘Appyness’ App.

·         Members noted a summary of queries received.  Councillor Blumenthal asked whether the number of enquiries regarding difficulty in contacting a GP had increased.  Nicola Strudley indicated that it had.  However, the NHS 111 service had been recommissioned recently and as part of the new service NHS 111 phone operators would be able to book GP appointments online when recommended. 

·         Councillor Soane commented that Loddon Vale Practice had installed a blood pressure monitor within the waiting room.  Nicola Strudley stated that there was an increased focus on encouraging and enabling patients to self-care, and telecare.

·         Councillor Miall asked for further information regarding the query relating to an elderly lady with cancer seeking assistance with adaptive aids.  Nicola Strudley agreed to feed back to the Committee.

·         Councillor Dolinski asked whether the Healthwatch Intelligence Report was compared with those of other Healthwatches and if there were common themes in the enquiries received.  Nicola Strudley commented that there were 152 Healthwatches nationally and all produced their intelligence reports slightly differently which made benchmarking more difficult.  However, work was fed back to Healthwatch England which identified common themes, including issues with CAMHS and accessing GP appointments.

RESOLVED:  That Nicola Strudley be thanked for her presentation.

To discuss the registration of care home residents with GPs. (10 mins)

Councillor Houldsworth commented that he had visited Abbeyfield Homes, a new dementia care home in Winnersh and had been informed that there had been some difficulties registering residents with local GPs.  He had raised the matter at a meeting of the NHS Wokingham Clinical Commissioning Group.

Nicola Strudley indicated that NICE Guidelines recommended that all residents in care homes be registered with one GP.  However, Healthwatch had heard that residents in a number of homes were registered to different GPs, which could be confusing.

Members agreed to invite officers from the NHS Wokingham Clinical Commissioning Group to the Committee’s November meeting to provide an update on how the health and care economy was meeting the needs of the growing care home population in the context of the challenges faced by General Practice.

RESOLVED:  That officers from the NHS Wokingham Clinical Commissioning Group be invited to the Committee’s November meeting to provide an update on how the health and care economy was meeting the needs of the growing care home population in the context of the challenges faced by General Practice.

To consider a report regarding ideas for improvement for the Health Overview and Scrutiny Committee. (15 mins)

The Committee considered the proposed ideas for improving the Health Overview and Scrutiny process as set out in the report.

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

·         Members were informed that when preparing their work programmes for the new municipal year some councils made use of ‘scrutiny cafes.’  Under this approach Committee members would meet with partner organisations and service providers such as Healthwatch and local NHS Trusts in mixed groups.  The partner organisations would highlight their upcoming work, challenges, priorities and any anticipated risks.  Members could then explore the contribution that the Committee could make.  The Committee agreed that this approach should be explored and that consideration should be given to widening it to the other scrutiny committees.  The Chairman agreed to raise the matter at the next meeting of the Overview and Scrutiny Management Committee.

·         When producing its work programme in the new municipal year the Committee would liaise with the relevant Executive Members and Chairmen of the other overview and scrutiny committees to ascertain their likely priorities for the forthcoming year and consider where the Committee may be able to add value.  

·         The Health Overview and Scrutiny Committee was the committee with responsibility for health scrutiny and as such was the primary scrutiniser of the Health and Wellbeing Board.  Members agreed that it would be useful for the Committee to receive the agenda, minutes and forward programme of the Board to ensure that the committee’s work programmes were complementary.

·         With regards to presentations from the NHS and other health and social care partners, Members agreed to, so far as possible, send Members’ questions prior to the meeting to best target the presentation.

RESOLVED:  That the proposed actions for the improvement of the Health Overview and Scrutiny Committee detailed in the report be approved.

To consider a current ‘live’ health consultation. (5 mins)

It was noted that there was currently a live health consultation regarding expanding CQC ratings to include independent healthcare providers.

RESOLVED:  That the live health consultation be noted.

To consider 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 the item the following points were made:

·         It was agreed to defer the item regarding Community mental health services and accessing mental health services from November’s meeting to March’s meeting.

·         Members agreed to invite the CCG to the November Committee meeting to discuss how the health and care economy meets the needs of the growing care home population, in the context of the challenges faced by general practice.

·         Several Members questioned whether the item relating to Primary Care facilities at the Arborfield Strategic Development Location (SDL) should be expanded to include all SDLs.

·         Councillor Dolinski suggested that the Committee invite the Chief Executive Officer of the Royal Berkshire Hospital to discuss their vision for the future of the Trust.  Members suggested that other Councils including Reading and West Berkshire also be invited to this discussion. 

RESOLVED:  That the Forward Programme 2016/17 be noted.