Agenda and minutes

To receive any apologies for absence

There were no apologies for absence.

To confirm the Minutes of the Meeting held on 26 September 2022.

The Minutes of the meeting of the Committee held on 26 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 received.

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 Primary Care Networks.

The Committee received an update on a number of the Wokingham Primary Care Networks from the following Clinical Directors – Dr Rachel Thomas (Twyford Surgery, Phoenix PCN), Dr Rupa Joshi (Woodley Surgery, Wokingham North PCN), Dr Jim Kennedy (Wargrave Surgery, Wokingham North PCN) and Dr Amit Sharma (Brookside Surgery, Earley + PCN).

The Committee had requested information on the challenges that the different surgeries and areas were facing.

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

Dr Thomas:

·       Dr Thomas indicated that she was a GP and partner for Twyford Surgery and one of the Clinical Directors for the Phoenix PCN which included Twyford and Loddon Vale surgeries.

·       It was a difficult time for General Practice and there was a lot of dissatisfaction in the press.  Dr Thomas emphasised that GPs were working harder than ever, and offering more appointments, with reducing workforces.

·       Dr Thomas indicated that there had been difficulties in retaining and recruiting staff.  Work was being undertaken creatively.  Through the PCN and ICB new Additional Roles Reimbursement Scheme roles had been created such as First Contact Physio and Pharmacists.  It was important to get the message out to patients around these roles.

·       With regards to the Phoenix PCN, one of the surgeries had lost a long term partner, who had not yet been replaced.  The other surgery had lost their Pharmacy Technician. 

·       A new telephone system had been implemented to make the process more user friendly for patients and to improve the patient journey.  Feedback so far had been positive.

Dr Joshi:

·       Dr Joshi indicated that she was a Managing Partner at Woodley Surgery and joint Clinical Director of Wokingham North Primary Care Network.  She also worked at NHS England helping and supporting practices with access issues.  In addition, she was chairing a Workforce and Estates Group for NHS Confederation, focusing on GP retention, and burnout mid-career for GPs.

·       Dr Joshi highlighted several current projects in the Wokingham North PCN around preventative measures, long term conditions and acute care.  The Council was offering its support on many of these projects. Using Population Health Management, information was being sought on the prevalence of certain illnesses and the population make up, in order to tailor resources accordingly, specifically for those in real need.

·       Demand and complexity of conditions was increasing.

·       Members received information regarding the three surgeries in the PCN, including the number of incoming telephone calls on a sample Monday/per week, and the average number of GP consults per session (half day). 

·       More phone calls than ever were being received.  At Parkside, the largest practice, 1,277 calls were received on a Monday and over the week 2,950.  The new Telephony System showed how many patients were waiting and for how long and how many calls were dropped.  At Woodley 931 calls were received on a Monday with 2,598 across the week.  There were four receptionists at Woodley taking calls.  Patients who did not require urgent on the day appointments were encouraged to use the online  ...  view the full minutes text for item 28.

To receive a presentation on developing the Integrated Care Strategy.

The Committee were updated on the development of the Integrated Care Partnership Strategy by Sarah Webster, Executive Director for Berkshire West, BOB ICB, and Rob Bowen, Deputy Director of Strategy, BOB ICB.

·       With regards to the change in structure of the health service, Sarah Webster reminded Members that the front line services such as the Royal Berkshire Hospital and Berkshire Healthcare Foundation Trust remained unchanged.  The change primarily related to the strategy and commissioning areas.  The three Clinical Commissioning Groups across Berkshire West, Oxfordshire and Buckinghamshire, were now one Integrated Care Board.

·       Within the Integrated Care System there sat the Integrated Care Board which was the largely NHS statutory entity, and the Integrated Care Partnership, a statutory Board bringing together the Integrated Care Board and representatives from the five local authorities.

·       Berkshire West was a Place, the local focus within the Integrated Care System.  Berkshire West had a strong history of health and social care working together.

·       Rob Bowen indicated that in July existing strategies and ambitions across the system, such as the Health and Wellbeing Strategies had been examined.  Consideration had been given to common themes. 

·       Six working groups had been established from September which were mostly led by local authority officers.  Membership was as diverse as possible to represent the partnership, for example there were representatives from the NHS, primary care, local authorities, Healthwatch, and the voluntary sector. 

·       Through conversations in the working groups several different priorities had started to be identified and worked up.

·       Some of the themes that were starting to be developed included:

Ø  Prevention - the need collectively across the system for a greater prevention focus;

Ø  Addressing health and wellbeing disparities in communities;

Ø  Taking a local approach where possible in the design and delivery of services – work at Place level and by Health and Wellbeing Boards would continue to be very important.

·       It had initially been expected that the Strategy would be published at the end of December.  However, this deadline would not have enabled meaningful engagement with partner organisations and the public.  It had since been agreed that an 8-10 week period of formal engagement would be built into the timeframe, beginning at the end of November.  Formal feedback on the emerging priorities would be sought.

·       It was likely that the Strategy would be published at the end of February.

·       A Member commented that a lot of the issues identified such as obesity, alcohol and smoking were not new.  She asked what new initiatives were being considered to address these.  Rob Bowen commented that this question highlighted why prevention continued to need to be prioritised through the Strategy.  Ingrid Slade added that she was the Chair of one of the Working Groups.  There would not be any surprises in terms of the priorities and existing priorities across the broader geography were being drawn together.  Consideration was being given to what could be tackled at scale and what would be better addressed at a more local level, and what new initiatives  ...  view the full minutes text for item 29.

To receive an overview of Community Mental Health Services in Wokingham.

The Committee received an overview of the Community Mental Health Services in Wokingham from Christine Dale, Assistant Director Integrated Mental Health, WBC, and Head of Mental Health, BHFT, and Helen Williamson, Operational Director Mental Health, BHFT.

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

·       Christine Dale explained that she managed the following services –

Ø  Community Mental Health Team (adults)

Ø  Memory Clinic

Ø  Community Mental Health Team (Older Adults)

Ø  Home Treatment Team (Older Adults)

Ø  Recovery College

·       Berkshire Healthcare NHS Foundation provided 40 Mental Health Services.  These included local community-based services, specialist services, hospital based service, and Berkshire wide services.

·       Christine Dale provided more information on the Community Mental Health Team (Adults).  The service was fully integrated between health and social care.  Staff included medical staff, social workers, nurses, Occupational Therapists, and support staff.  All referrals came through a common point of entry.  The team dealt with adults with a severe and enduring mental health need.  There were single integrated processes under the joint management.

·       Within the Community Mental Health team there was a psychological service.  There was also a Carers Worker who could undertake carers’ assessments, and assessments under the Care Act for funded care packages.  Work was carried out with the ICB to jointly fund packages where people were entitled to health and social care support as a jointly funded care package.

·       Accreditation with the Royal College of Psychiatry had been recently achieved for a further 3 years.

·       Talking Therapies provided treatment for common mental health problems e.g., depression, stress, anxiety, or phobias.  Christine Dale outlined how this service was delivered, such as workshop, videos, and guided self-help.

•        The Crisis Resolution Home Treatment Team offered a 24/7 immediate risk triage assessment by the duty team.  It had suffered no reduction in service during the pandemic and the workforce had remained consistent.  However, drug and alcohol cases had increased during the pandemic, as had the complexity of cases and psychotic presentations.  One of the issues for the team during the pandemic had been a fear of job losses following the introduction of mandatory covid vaccinations for health staff.  Reduced capacity of other services had also increased workload.

·       Members were informed of the Psychological Medicine Services.  Since March 2022 the team had operated at full pre pandemic levels.  However, the demand for psychiatric beds remained above the expected norm, although this was similar to the national picture.

·       The Recovery College, developed in 2020, was a prevention service open to residents and staff over 18 plus.  Co-produced courses focused on improving mental health and wellbeing.  The college aimed to help people become experts in their own self-care and enable family, friends, and staff to better understand mental health.  The service had been shut down because of Covid and had moved online during the pandemic.  A hybrid approach was now offered.

·       The Mental Health Integrated Community Service (MHICS) offered an integrated primary-care service to individuals who suffered from significant mental health needs and which were  ...  view the full minutes text for item 30.

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

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

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

·       The Committee welcomed Alice Kunjappy-Clifton, the new lead officer for Healthwatch Wokingham.

·       Healthwatch had been hearing a lot of the same issues as those reported by the GPs around patient expectations.  Healthwatch was ready to support with communications.

·       A lot of work was being undertaken with the ICB.

·       NHS dentists continued to be a topic of interest.  In response to a Member question regarding the future of dentistry, Sarah Deason indicated that it was part of a national issue that Healthwatch England was looking into.  Ingrid Slade added that an extraordinary Health Overview and Scrutiny Committee meeting on dentistry was being arranged, with the new commissioning responsibilities moving from NHS England to the ICB.

·       Engagement was up 80% on the first quarter.

·       A Member commented that the information on the Healthwatch Wokingham website regarding more information on becoming an Advisory Group member took you to a report from 2018.  She went on to question whether there had been any success in recruiting Advisory Group members.  Sarah Deason agreed to check the weblink and indicated that two Group members had been recruited so far.  She could provide the role description and appreciated any help Members could provide in recruiting additional Group members.

RESOLVED:  That the update from Healthwatch Wokingham Borough be noted and Sarah Deason and Alice Kunjappy-Clifton be thanked for their presentation.

To consider the forward programme for the remainder of the municipal 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:

·       An extraordinary meeting to consider dentistry would be held on 17 January 7pm.

·       The Committee felt that there should not be too many main presentations items on the agenda to enable items to be given sufficient consideration.

·       It was suggested that Members receive a written briefing on the continence service, and if there were further concerns, to invite service representatives to a future meeting.

·       With regards to the pressing need for communications regarding prevention and self-care, raised by Dr Sharma earlier in the meeting, Members felt that swift action was required.  The Chair agreed to contact the Communications Team and Ingrid Slade to ascertain how this could be quickly progressed.

RESOLVED:  That the forward programme be noted.