Agenda and minutes

Health Overview and Scrutiny Committee - Wednesday, 15th November, 2017 7.00 pm

Venue: David Hicks 1 - Civic Offices, Shute End, Wokingham RG40 1BN. View directions

Contact: Madeleine Shopland  Democratic & Electoral Services Specialist

No. Item



To receive any apologies for absence


Apologies for absence were submitted from Councillors Parry Batth and Bill Soane.


Minutes of Previous Meeting pdf icon PDF 245 KB

To confirm the Minutes of the Meeting held on 10 July 2017.



The Minutes of the meeting of the Committee held on 10 July 2017 were confirmed as a correct record and signed by the Chairman.


Councillor Jones asked whether further clarification had been received regarding the Carr Hill formula and was informed that it had not.  Darrell Gale commented that he had been requested to ascertain where Wokingham ranked in terms of the CCG funding allocations.


Declaration of Interest

To receive any declarations of interest


There were no declarations of interest received.



Public Question Time

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


There were no public questions.


Member Question Time

To answer any member questions


There were no Member questions.


Ophthalmology services Wokingham Borough

To receive an update on Ophthalmology services provision. (20 mins)

Additional documents:


Dr Zylstra provided an update on ophthalmology services within the Wokingham Borough.


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


·         The contract for the community ophthalmology service in Berkshire West had been retendered at the end of last year through to the middle of this year.  Health Harmonie had been appointed the community providers following an extensive tender process.

·         Examples of conditions treated included:

Ø  Dry Eyes;

Ø  Cysts;

Ø  Common Eyelid abnormalities;

Ø  Conjunctivitis;

Ø  Pupil abnormalities;

Ø  Inflamed Eyelids;

Ø  Allergies;

Ø  Small dots, circles and specks in a person’s vision;

Ø  Eczema around the eye;

Ø  Inflammation of the middle  area of the eye;

Ø  Ocular  Refinement;

Ø  Repair of the eyelid.

Ø  Removal of foreign object from eye (as appropriate)

·         With regards to secondary care hospital services, patients could choose where they would be treated including independent providers, at the point of referral, via Choose and Book.  Members were informed that there were certain exclusion criteria which restricted when a patient could choose to be treated at an independent provider.  For example if a patient had other conditions such as severe diabetes, they may not be able to use an independent provider.  This would be considered by their GP at the point of referral.

·         Royal Berkshire Hospital provided the majority of the secondary care, hospital services for Berkshire West.

·         Services provided included:

Ø  Cataract Removal;

Ø  Management of Glaucoma;

Ø  Management of Age-Macular Disease;

Ø  Eye Injection Services; 

Ø  Children Eye Services;

Ø  Eye Surgery Services (More complex than those treated in the community service);

Ø  Management of conditions at the back of eyes.

·         Councillor Richards asked how procedures were funded.  Dr Zylstra commented that Payment by Result was used.  Each individual type of procedure had a given tariff.  Tariffs were centrally negotiated and updated each year.

·         Councillor Blumenthal asked whether any feedback had been received regarding Health Harmonie’s performance.  Dr Zylstra commented that feedback was provided after they had been in place for 6 months.  He personally had generally not received any negative feedback.

·         Councillor Jones asked about the severity of visual difficulties required for cataract surgery to be offered.  Dr Zylstra emphasised that this varied depending on the type of cataract.  The minimum eyesight standard for driving was having a visual acuity of at least decimal 0.5 (12/6) measured on the Snellen scale (with glasses or contact lenses, if necessary) using both eyes together or, if you have sight in one eye only, in that eye.  Individual funding requests could be considered, for example if the type of cataract caused dazzling at night, making night driving difficult.

·         Members were advised that there were risks associated should procedures such as cataract surgery be carried out earlier than required.


RESOLVED:  That Dr Zylstra be thanked for his presentation and that the update on ophthalmology services be noted.


Update on Optalis pdf icon PDF 1 MB

To receive an update on Optalis. (20 mins)


Angela Morris, Director of Operations and Martin Farrow, Chief Executive Officer, Optalis provided an update regarding Optalis following the Royal Borough of Windsor & Maidenhead Council (RBWM) joining with Wokingham Borough Council in April 2017 to jointly own the company.


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


·         Members were reminded that Optalis had been launched as a Local Authority Trading Company by Wokingham Borough Council on 6 June 2011 with the aim of efficiency, growth and excellence.

·         On 3 April 2017 RWBM Council had joined with the Council to jointly own the company, meaning that Optalis was the primary provider for both councils.

·         Angela Morris outlined Optalis’ vision and mission.

·         Approximately 700 people were employed by Optalis and support and care was provided to approximately 5000 people.

·         Services were provided at sites in Wokingham, Windsor, Maidenhead and also Oxfordshire.

·         Optalis worked closely with the voluntary sector and the health sector.

·         Feedback received from customers was generally positive.

·         A multi-disciplinary approach was taken in order to maintain people in their own homes if appropriate.

·         Members were informed that Optalis invested in training to ensure that staff had the necessary skills to adequately support customers.

·         The Committee was informed of the services that Optalis provided.  It was noted that Optalis delivered all adult social care services, including statutory services, for RBWM Council.

·         Key achievements included growing the business as one of the first Local Authority Trading Companies in the country with the delegated powers to provide statutory services and also customer led community initiatives such as Hug in a Mug.

·         With regards to staff recruitment, Councillor Blumenthal asked whether there were significant vacancies in any particular areas or challenges.  Angela Morris commented that Social Workers and Occupational Therapists had been difficult to recruit to but that this was improving.  The recruitment of non-qualified staff was a challenge across the South East of England.  Councillor Blumenthal questioned whether workers often gained experience and then moved elsewhere.  Angela Morris indicated that many staff had come from other areas such as London.

·         Councillor Kaiser commented that he had had feedback that the quality of service provided by Optalis was excellent.

·         Councillor Kaiser also asked whether the business was fully integrated and staff covered both Wokingham Borough and Windsor and Maidenhead.  Members were informed that it was important to have a local feel and that with regards to the direct delivery of services locally based workforces generally serviced the local need. 

·         A member of the public asked what proportion of staff were from the European Union and what impact Brexit might have.  Angela Morris commented that many businesses were looking at whether this may create a risk to service delivery.  She did not expect this to create a risk for Optalis.

·         In response to a question from Councillor Mike Haines regarding the possible effect of the roll out of Universal Credit in December, Angela Morris stated that staff were aware of the forthcoming changes and would be able to support individuals.

·         Councillor Miall  ...  view the full minutes text for item 27.


Local Account: Annual Report for Adult Social Care 2016/17 pdf icon PDF 68 KB

To receive the Local Account: Annual Report for Adult Social Care 2016/17. (20 mins)

Additional documents:


The Committee received the Local Account:  Annual Report for Adult Social Care 2016/17.


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


·         David Archibald took the Committee through the key points of the report including the progress made against the previous year’s priorities and the priorities for 2017-18.

·         The delivery of adult social care was a challenge nationally.

·         Councillor Jones asked whether the use of the Step Down facilities had increased.  David Archibald commented that it was slowly increasing but that there was scope for further improvement. 

·         Councillor Jones stated that it was good that only five formal complaints had been received and asked how this compared to other authorities.  David Archibald commented that there was a focus on early resolution but the figure for Wokingham was quite low.

·         In 2016-17, Wokingham scored 19.3 out of a maximum possible score of 24 (up from 19.0 in 2015-16) for the overall measure for enhancing the quality of life.  Councillor Blumenthal questioned how Wokingham performed in comparison to other local authorities.  David Archibald agreed to feed back to the Committee.

·         With regards to the measure that services made the service user feel safe and secure, Councillor Blumenthal asked how Wokingham performed in comparison to other local authorities and what was meant by ‘safe and secure.’  She also questioned what reasons people might give for feeling unsafe.  David Archibald agreed to look into the queries and feed back to the Committee.

·         It was noted that two extra care units would be opening in the Borough in 2017-18.

·         Councillor Kaiser commented that overall there was a lot of positives within the report and a good base on which to build.

·         Overall 37.5% of carers had reported that they were extremely or very satisfied with the support services they had received in 2016-17.  This was down from 39.7% in 2015-16 and lower than the South East region average of 41.2%.  Councillor Miall asked what measures, in addition to the review of the Carers Strategy, were in place to improve on this.  David Archibald stated that the reason for this decrease and the action which could be taken to improve was being explored.


RESOLVED:  That David Archibald be thanked for his presentation and that the Local Account: Annual report for Adult Social Care 2016/17 be noted.


Update on Wokingham Borough Pharmaceutical Needs Assessment 2018-2021 pdf icon PDF 112 KB

To be updated on the Pharmaceutical Needs Assessment. (20 mins)

Additional documents:


Darrell Gale, Consultant in Public Health, provided a presentation on the Wokingham Pharmaceutical Needs Assessment (PNA) 2018-2021.


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


·         The draft Pharmaceutical Needs Assessment was subject to a full public consultation from 1 November to 31 December 2017.

·         The Committee was invited to respond to the consultation.  All councillors had been sent details of the consultation.

·         Health and Wellbeing Boards was required to assess and publish a document outlining the local needs for community pharmacy services.  The previous assessment ran from 2014 to March 2018.

·         All applications for new or altered pharmacy provision were tested against the PNA by NHS England.  Previously a couple of applications had been rejected as they could not be supported under the existing PNA.

·         The Health and Wellbeing Board was informed of all applications.

·         There were 22 pharmacies in the Borough which equated to 15 per 100,000 people.  This was lower than the average for England of 22 per 100,000 and the South East average which was 19 per 100,000.  Darrell Gale commented that there were also a number of pharmacies close to the local authority boundary, for example in Reading.

·         The Committee noted that the pharmacies were generally well distributed for the current population.

·         Members were informed that Sunday access could be improved.

·         Whilst most areas were within a 10 minute drive of a pharmacy, Hurst, Arborfield and Barkham were less well served than other areas.

·         Services for over 65s in the north of the Borough were supplemented by Henley-on-Thames provision.  

·         Darrell Gale commented that the growing population in the Arborfield SDL may require additional or relocated provision during the 3-year period of the 2018-2021 assessment.

·         Feedback suggested that there were high levels of satisfaction with the current provision.  Many pharmacies offered enhanced services but locally-enhanced services could be expanded further.

·         There were no definite gaps in pharmacy provision identified. 

·         Councillor Jarvis enquired what impact online pharmacies might have on pharmacy provision within the Borough.  Darrell Gale commented that patient choice was important and that some may prefer to use online pharmacies.  There were three surgeries within the Borough that dispensed to their patients and also a number of 100 hour pharmacies.

·         The Committee discussed potential national funding cuts to pharmacy and the impact that this may have on pharmacy provision within the Borough.  Councillor Jones asked how many pharmacies might be at risk should funding be cut.  Darrell Gale commented that it was not possible to know at this stage. 

·         Councillor Kaiser commented that there were pharmacy collection points, such as at Henry Street Garden Centre, in more rural areas, which suggested that these areas was less well served for pharmacy provision.

·         In response to a Member question Darrell Gale clarified that pharmacy was commissioned by NHS England and that primary care services were commissioned by the Clinical Commissioning Group.  Members felt that it would be helpful to request a further update on primary care facilities and estates at the Committee’s January meeting. 


RESOLVED:  ...  view the full minutes text for item 29.


Healthwatch update pdf icon PDF 539 KB

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


Members received an update on the work of Healthwatch Wokingham Borough.


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


·         The Committee considered a report which outlined work undertaken between July and September.

·         A visit to Suffolk Lodge had been undertaken and a positive response had been received to Healthwatch’s report.

·         Jim Stockley informed the Committee that six Healthwatches had visited Prospect Park and had spoken to 40 people over 7 days about the services that they received.  He commended Prospect Park for their support during the process.  It was noted that 81% of participants felt that they were treated with dignity.  The report on the visit would be sent to the Committee once finalised. 

·         Four Community Research projects had been improved including LINKS Sunday Kitchen, Brighter Berkshire events and Deaf Positives accessible information.

·         Councillor Blumenthal asked whether one of the five summer fetes visited was the Earley Green Fayre and encouraged Healthwatch to attend the next fayre.

·         Councillor Miall questioned whether Healthwatch Wokingham Borough had been involved in engagement around the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan and the Berkshire West Accountable Care System.  Jim Stockley commented that they had received feedback from other Berkshire West Healthwatches,


RESOLVED:  That Jim Stockley be thanked for his presentation and that the update on the work of Healthwatch Wokingham Borough be noted.



Forward Programme 2017-18 pdf icon PDF 160 KB

To receive the forward programme for the remainder of the municipal year. (5 mins)

Additional documents:


The Committee considered the Forward Programme for the remainder of the municipal year. 


Members requested a further update on primary care facilities and estates at the Committee’s January meeting. 


RESOLVED: That the forward programme for the remainder of the municipal year be noted.