Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Councillors Sam Akhtar and Carl Doran.

To confirm the Minutes of the Meeting held on 12 July 2021.

The Minutes of the meeting of the Committee held on 12 July 2021 were confirmed as a correct record and signed by the Chairman.

Councillor Jones questioned whether the individual councillor who had asked a question could be referenced.  The Chairman indicated that the current approach had been agreed by the Overview and Scrutiny Management Committee.  Councillor Jones suggested that other councillors such as Executive Members be referenced by their title.  The matter was referred to the Overview and Scrutiny Management Committee.

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 from NHS England (dental services commissoners) on dental services in the Borough.

The Committee received an update on access to NHS Dental Services in Wokingham Borough from Hugh O’Keeffe, Senior Commissioning Manager Dental, NHS England and NHS Improvement – South East.

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

·       Access remained a challenge and services had been operating at below full capacity because of the pandemic.  This related largely to the safety issues involved in the provision of dental services, which slowed down the rate at which patients could be treated.

·       Practices were continuing to prioritise patients within the existing available capacity.  The key criteria used was urgency (pain, swelling and breathing), incomplete care plans and those with more frequent recall requirements, such as children, high oral disease risk and wider health issues.  Practices were working within a national standard operating procedure

·       Worse oral health was starting to be seen with more people requiring longer treatment plans or admittance into hospital.

·       Net capacity was increasing, and it was hoped that it would increase further from October.

·       Members were reminded that people were not registered with a dental practice.  It was often those who did not have an established relationship with a practice who had found accessing dental services more difficult during the pandemic.

·       Hugh O’Keeffe outlined some of the schemes in place to support those who were having difficulties accessing services.  Additional access sessions were commissioned from several practices on a voluntary basis – 13 in BOB, 3 of which were in the Borough.  Further provision was always being sought.  There was also advice about accessing services, available via NHS 111 and the NHS.UK website.

·       A decision had been taken to invest significantly in referral services, particularly non hospital specialised dental services based in the community such as special care and paediatrics and out of hospital oral surgery.  This was to help reduce the waitlists for these services.

·       There had been a 3 month reduction in patients waiting more than 52 weeks for hospital services, although this area was likely to remain a challenge going forwards.

·       A pilot scheme was being run to support access for Looked After Children.

·       There was a backlog in the dental system, which was likely to remain for some time, but it was hoped that the aforementioned schemes would help to make significant inroads over the next 12-18 months.

·       A Member asked what percentage of Wokingham Borough residents regularly attended a dentist, and also how many practices there were in the Borough.  Hugh O’Keeffe agreed to circulate this information following the meeting.

·       In response to a Member question regarding decreasing waitlists at the Royal Berkshire Hospital, Hugh O’Keeffe commented that the focus had been on those waiting the longest for services, and additional sessions had been run.  In addition, the Royal Berkshire Hospital did not admit oral and maxillofacial surgery patients, so the service did not face the same pressure on hospital beds as those that did admit.

·       Dentists were paid on the activity delivered.  60% was the minimum threshold applied for the  ...  view the full minutes text for item 30.

To receive an update on the performance of Optalis.

David Birch, Chief Executive Officer Optalis and Matt Pope, Director Adult Services, provided a presentation on the performance of Optalis.

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

·       David Birch outlined the services provided by Optalis.

·       With regards to operational performance, maintaining operational standards through the pandemic had been a challenge, which staff had met well.  A good review of the START service had recently been received from the CQC.

·       Members were informed that Optalis were now halfway through a two-year programme designed to deliver efficiency savings for the Council, in line with the Council’s Adult Social Care strategy.  Optalis had been able to return £578k to the Council in 2020/21 and despite the impact of the pandemic, the programme remained on track to deliver a further £400k of savings in 2021/22.

·       Optalis was starting to grow its services in Wokingham Borough, including launching a new independent living service at Gorrick Square in Wokingham.

·       David Birch highlighted the success of the Supported Employment service.

·       Members were pleased to note that over the last 18 months, Optalis had not lost a single customer or member of staff to a Covid infection picked up in its services.

·       Optalis had supported the surge testing efforts in June, helping to deliver test kits in target areas, and providing the Trinity Court offices to the testing team.

·       As a result of the pandemic, day services offered had had to be restricted.  Wherever possible, alternative support had been provided.

·       David Birch went on to highlight lessons learnt from the pandemic.  Staff had coped well with new ways of working and had been flexible.  The pandemic highlighted opportunities to do things differently.  In addition, the pandemic had emphasised the importance of organisations working together for the benefit of residents.

·       The Committee was informed that in line with the Council’s Market Management approach, planning was well-advanced for Optalis to take on at least 10 new and existing services in the Borough, covering a wide variety of different care needs.  This expansion was underpinned by investment in a new Peripatetic Team, which gave Optalis the capacity to transfer and initiate new services successfully when required by the Council.

·        Members were informed of the Ability Travel service, which helped customers to gain higher levels of independence and confidence on public transport through skills training.  Projected savings over the next 5 years for adult social care transportation costs, were estimated at between £400k and £500k.  A Member questioned whether the voluntary sector played a partnership role in this service and was informed that this would be welcome, as public transport did not go to all areas.  Nick Durman indicated that Healthwatch Wokingham Borough had received positive feedback about the service.

·       Capacity and productivity enhancements were planned for the START reablement team.

·       The Out & About service was consistently oversubscribed.  Optalis was now investing to expand this service.  A reduced service had been maintained during the pandemic.

·       Optalis was working with the Council’s commercial advisers to develop a range of  ...  view the full minutes text for item 31.

To consider the Key Performance Indicators Q1 2021/22

Matt Pope, Director Adult Services, took the Committee through the relevant Key Performance Indicators for Q1 2021/22.

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

·       In response to a question as whether the stretch targets were realistic and achievable, Matt Pope responded that it was his ambition for the department to a top performer, so targets were set deliberately as stretch targets.  Benchmarking data and direction of performance were considered.  Achievability had been affected by Covid and demand had increased.  There had also had to be a focus on safety and infection control.  He was confident that targets were difficult but achievable.

·       AS4 – Safeguarding timelines – how had this target been achieved and was it sustainable?  Matt Pope commented this had been an area of focus when he had become Director and some immediate changes had been made.  A dedicated Safeguarding team had been put in place and significant progress had been made on addressing concerns.

·       ASC 9 – Permanent admissions to residential and nursing care homes per 100k population – how was this target achieved?  National and local policy was that people be looked after in their own homes where possible.  This target fluctuated due to the differing needs of residents.  A Member questioned whether there was an element of seasonality and was informed that there was, but that Covid was the main reason for fluctuations.  There had been a change in national policy regarding hospital discharge and there had been periods where there had been some double counting, which had now been evened out.

·       The Chairman reminded the Committee that the Key Performance Indicators would be presented at each meeting, and asked that should Members have any technical questions on the reports, that they send them to the clerk prior to the meeting, so that these could be provided to Officers.

RESOLVED:  That the KPI’s for Q1 2021/22 be noted.

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

The Committee considered an update on the work of Healthwatch Wokingham Borough.

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

·       Members questioned whether Healthwatch had seen an improvement in health services in the last quarter or whether they felt that some were still facing issues.  Nick Durman stated that many were still having difficulties.  Access to dental care and increasingly access to GP services, were some of the main issues of concern to residents that Healthwatch had heard about via various means.  Healthwatch were aware that the GP surgeries were under severe pressure.  Many people who had had medical issues at the peak of the pandemic had put off contacting GPs.  Demand and call levels had increased.  Nick Durman went on to express concern regarding those who were extremely vulnerable or who were not proficient with technology.  He was concerned that if they found it difficult to contact their surgery they may give up, and potentially become sicker.  He questioned what short term measures would be put in place to relieve this.

·       Nick Durman referred to the most recent GP Patient Survey.  In terms of satisfaction several local GP surgeries were at the top and some were at the bottom for the Berkshire West practices.  He had contacted the CCG asking what they would do with the results and what had been learned from the best performing practices which could help those performing less well, to improve, but had not yet received a response.  The Executive Member added that he had written to James Kent, Head of the CCG asking for the improvement plans for the four GP surgeries in the bottom quartile.  The CCG were planning to commission additional GP practice appointments to increase capacity to March 2022, a pilot of hospital emergency departments booking patients into GP appointments who attended with problems would be carried out, in person booking of appointments enabled, more face to face appointments made available, a community pharmacy consultation service made available and an audit of GP practice phone messages carried out.  It was not clear how and when this would be undertaken and when residents would see a difference.

·       One of the practices had put in a dedicated carers phone line.  Nick Durman questioned why other practices could not do something similar.

·       The Committee referred to the pie charts within the What Matters Most report, which related to responders’ views on particular health services that they had used during the pandemic.  Members asked who the results were shared with and were informed that they were shared with the relevant service providers.  Key issues which had come out of the What Matters Most survey closely matched the five priorities of the Health and Wellbeing Strategy.

·       From next month Healthwatch would be running a GP access survey.  GP practice staff would also be invited to give their views on the issues that they faced and what solutions they could possibly see.  There was a possible communication piece as not all residents might  ...  view the full minutes text for item 33.

To receive an update on public toilet provision within the Borough.

This item was deferred.

To consider the forward programme for the remainder of the municipal year.

The Committee considered the forward programme.

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

·       It was agreed that the further update from Optalis be deferred to the Committee’s January meeting.

·       It was suggested that the item on mental health be moved to the Committee’s March meeting to allow the update to also include the Mind service.  Members of the Children’s Services Overview and Scrutiny Committee would also be invited to participate in this item. 

·       The Committee would request an update on maternity services for the January meeting.

·       Members agreed to defer the report on public toilet provision to the January meeting.  Members asked that representatives from the Chron’s and Colitis Society also be invited for this item.

·       The Committee would request an update on the continence service provided by Berkshire Healthcare Foundation Trust, for its January meeting.  Nick Durman commented that it would be good to see whether the rapid response that was being put in place would reduce the current 8 week wait list.

·       The Key Performance Indicators would be considered at each meeting.

RESOLVED:  That the forward programme be noted.