Agenda and minutes

Health Overview and Scrutiny Committee - Monday, 17th September, 2018 7.00 pm

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

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 Kate Haines, Jim Stockley and Nicola Strudley.


Minutes of Previous Meeting pdf icon PDF 112 KB

To confirm the Minutes of the Meeting held on 16 July 2018.



The Minutes of the meeting of the Committee held on 16 July 2018 were confirmed as a correct record and signed by the Chairman.


Declaration of Interest

To receive any declarations of interest


There were no declarations of interest.



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.



Berkshire West Integrated Care System pdf icon PDF 740 KB

To receive an update on the Berkshire West Integrated Care System.


Dr Cathy Winfield updated the Committee on the Berkshire West Integrated Care System.


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


·         An Integrated Care System (ICS) was one in which local NHS organisations (both commissioners and providers), often in partnership with local authorities, chose to take on clear collective responsibility for resources and population health, providing joined up, better coordinated care.

·         Members were informed of the membership of the Berkshire West Integrated Care System (ICS), including the Berkshire West 10.

·         In response to a Member question regarding surgery size and the geography of the ICS, Dr Winfield commented that there were a number of smaller practices within the Reading area.  However, national policy was now predicated on the principle of larger practices with larger premises, with a minimum of approximately 10,000 patients.

·         The Committee noted the founding principles, including ensuring a high quality, fit for purpose acute specialist hospital service.

·         When developing the system, integration systems around the world had been considered.  The New Zealand Canterbury model had been considered a good approach.

·         Dr Winfield informed the Committee that it was anticipated that a long term plan for the NHS would be published prior to Christmas. 

·         Some of the achievements one year on were outlined.  Local Authority partners were identifying greater opportunities for joint working that improve efficiency of the whole system e.g. single social worker team at Royal Berkshire Hospital.

·         From 1 October pre bookable GP appointments would be available 7 days a week.  In response to a question from Councillor Jones, it was clarified that cluster arrangements would be in operation under which a practice within a cluster would offer pre bookable appointments outside of normal GP appointment hours.  On Sundays and Bank Holidays the service would be provided by Westcall.  Evidence suggested that demand for a pre bookable GP appointment on Sundays was low.  Demand for pre bookable appointments outside of normal opening hours would be monitored.

·         Councillor Soane questioned whether information was available regarding the number of patients who had attended A&E who should have gone elsewhere.  Dr Winfield indicated that the proximity that an individual lived to the hospital sometimes made a difference as to whether they visited A&E if they were unable to make alternative arrangements. 

·         Dr Winfield highlighted that a GP was now situated in A&E. The nurse screener who triaged patients could direct those who needed to see a GP but did not need to attend A&E, to this GP.  Councillor Miall asked how many patients who were referred to the GP were then referred back to A&E.  Members were assured that it was a small number and work was being carried out to further improve the triage process.

·         Councillor Jones asked how often a GP was situated in A&E and was informed that it was every day but that hours varied.  Dr Winfield indicated that she would provide information regarding specific hours.

·         104 patients had visited A&E over 50 times in  ...  view the full minutes text for item 17.


Hip and Knee surgery policy pdf icon PDF 353 KB

To be updated on Berkshire West’s hip and knee surgery policy.


Dr Winfield updated the Committee on the CCG Policy for patients with osteoarthritis; primary hip and knee replacement. 


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


·         The four CCGs in Berkshire West had reviewed and updated their policy for patients with osteoarthritis; primary hip and knee replacement, in June 2018.  An evidence based criteria had been established to identify those patients most likely to benefit from surgery.  GPs referring patients to hospital must ensure that the patient met the criteria in order for the hospital to accept them. 

·         Members were informed that there had been significant success locally for patients with the opportunity to discuss the full range of options available away from the GP Surgery.  The CCG commissioned this service from Arthritis Care.  Patients had the opportunity to participate in a shared decision making where they considered all options available.  GPs could still refer a patient for surgery if there was a clinical need.

·         The Committee was informed that when comparing nationally Berkshire West spent more on hip and knee surgery than would be expected.  Councillor Croy asked how this spend could be reduced.  Dr Winfield commented that the policy gave GPs the opportunity to set out alternative options to surgery, where appropriate.

·         The Committee was pleased to note that approximately 75% of patients chose conservative methods to manage their condition such as exercise or weight loss as opposed to surgery.

·         Patients within Berkshire West were treated within the 18 week referral to treatment standard.  Some patients felt that they were moved along the pathway too quickly.


RESOLVED:  That the update on the CCG Policy for patients with osteoarthritis; primary hip and knee replacement be noted.


Healthwatch Update pdf icon PDF 70 KB

To receive an update on the work of Healthwatch Wokingham Borough.


The Committee considered the update from Healthwatch Wokingham Borough.  Councillor Jarvis informed the Committee of the Healthwatch Fun Day at Twyford.


RESOLVED:  That the update from Healthwatch Wokingham Borough be noted.


Forward Programme 2018-19 pdf icon PDF 84 KB

To consider the Forward Programme for the remainder of the muncipal year.


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 Jones suggested that the Committee receive an update on diabetes prevention at the November meeting.

·         Members requested an update from South Central Ambulance Service at the Committee’s November meeting.  Councillor Shepherd-DuBey questioned how the Ambulance Service, Police and Fire Service were working together.

·         An update on the pressure on GP resources would be provided at the Committee’s January meeting.

·         Councillor Shepherd-DuBey requested an update about the possible impact of Brexit on the local health service for the Committee’s March meeting. 

·         Councillor Jones requested an update on the discharge of patients from the Royal Berkshire Hospital and the impact of the Better Care Fund on this, at the March Committee meeting.

·         Tony Lloyd informed the Committee that the Royal Berkshire Hospital NHS Trust would, from the next week, be going paperless.


RESOLVED:  That the forward programme be noted.