Agenda and draft minutes

Health Overview and Scrutiny Committee - Monday, 8th November, 2021 7.00 pm

Venue: Council Chamber - Civic Offices, Shute End, Wokingham RG40 1BN. View directions

Contact: Madeleine Shopland  Democratic & Electoral Services Specialist

Media

Items
No. Item

36.

Apologies

To receive any apologies for absence

Minutes:

Apologies for absence were submitted from Jenny Cheng and Carl Doran.

 

 

37.

Minutes of Previous Meeting pdf icon PDF 245 KB

To confirm the Minutes of the Extraordinary Meeting held on 21 September 2021 and the Minutes of the Meeting held on 29 September 2021.

 

Additional documents:

Minutes:

The Minutes of the extraordinary meeting of the Committee held on 21 September 2021 and the meeting held on 29 September 2021 were confirmed as a correct record and signed by the Chairman.

38.

Declaration of Interest

To receive any declarations of interest

Minutes:

There were no declarations of interest.

 

39.

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 www.wokingham.gov.uk/publicquestions

Minutes:

There were no public questions.

 

40.

Member Question Time

To answer any member questions

Minutes:

There were no Member questions.

 

41.

Royal Berkshire NHS Foundation Trust

To receive an update from Royal Berkshire NHS Foundation Trust.

Minutes:

The Committee received an update on the Royal Berkshire NHS Foundation Trust from Raghuv Bhasin, Director of Systems Partnerships.

 

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

 

·       Raghuv Bhasin outlined current key areas of focus for the Trust:

Ø  Pressure on the Emergency Department – a 20% increase in attendances had been seen compared to the same period in 2019/20, the second highest increase in the South East.  This had put pressure on staff and capacity within the Department. Safety and quality was prioritised, with patients being seen within the first 15 minutes for an initial assessment.  A campaign was being launched around winter pressures which would focus on three principle themes; being prepared for winter; knowing which service to choose; and engaging with primary care in multiple different ways.

Ø  Elective recovery – there was a significant backlog due to Covid.  The Trust was one of few Trusts in the country that had maintained its referrals throughout the pandemic.  However, there were less referrals as fewer patients had visited their GP during the pandemic.  The Trust was trying to deliver elective activity over and above levels delivered in 2019/20.

Ø  Safety and quality – ensuring that patients with an urgent need, such as having cancer, received rapid access to treatment.  All patients on waiting lists were risk assessed, ensuring that capacity was maximised.

Ø  Impact of Covid – case rates were rising.  A slight increase in hospitalisations were being seen.  There were about 40 patients at any one time with Covid, some in intensive care.  Covid had had a big impact on staff resilience.  Staff in intensive care and respiratory wards had found it particularly challenging to take annual leave.  Continuing to operate at such a high level during the pandemic had had a big psychological impact.   The Trust was focusing on staff resilience and wellbeing.  Precautions such as social distancing and mask wearing, to minimise Covid infections were continuing.

Ø  Partnership working – the Chief Executive had visited a large number of primary care practices to understand how the Trust could improve the interface between the Trust and Primary Care.  The Trust was working more closely with Berkshire Healthcare to deliver more joined up services, such as the Long Covid clinic, which was jointly provided.  Work was being undertaken with Berkshire West Integrated Partnership regarding priorities for the next year.

Ø  Health inequalities – an analysis had been carried out of patients who did not attend out patient appointments.  There was a disproportionate amount in the lower income decile.  The Trust was working to engage more and to provide improved access to outpatient appointments, to minimise health inequalities.  Four Public Health priorities had been developed.

Ø  Development and growing the organisation – a five-year partnership had been signed with the University of Reading (Health Innovation Partnership).  In addition, the Trust continued to invest in its Digital Hospital, developing new patient portals, electronic models of consent and a digital approach to outpatient appointments.  Members were also  ...  view the full minutes text for item 41.

42.

GP Practice provision and GP services pdf icon PDF 358 KB

To receive an update on GP practices and GP services.

Additional documents:

Minutes:

The Committee received an update on GP Practice provision and GP services from Katie Summers, Berkshire West CCG.

 

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

 

·       Unfortunately, Dr Milligan and Dr Sharma had been unable to attend the meeting to provide the views of a GP.  Katie Summers read out a statement from Dr Sharma which highlighted some of the difficulties that GPs were facing.  GPs were providing more appointments than ever, with demand up 30-40% from 2019.   A lack of ambulance services, district nursing and rapid response exacerbated issues.  Dr Sharma encouraged Members to promote the NHS.uk website, which was a good source of information and promoted community pharmacy as a point of contact.  He would be producing a video on this in the near future. 

·       Katie Summers outlined some of the challenges that Dr Sharma had faced recently.  For example, he had been unable to get an ambulance for a potentially sceptic 80-year-old and had had to transport the patient to the hospital himself to be assessed.  Another patient, a 20-year-old, had been visited twice in a week by the paramedics for a urinary tract infection and separately, for a headache, which was not an appropriate use of resources.  20–40-year-olds in particular needed to be educated about the appropriate use of services.

·       Demand had increased with the easing of restrictions across the health service including primary care.  The Committee noted activity in the Primary Care Networks. 

·       The pressure was linked to a backlog in demand and extra secondary care work.

·       The percentage increase in consultation activity across PCNs had varied during July 2019 –July 2021 - ranging from 17% - 155% (Wokingham West PCN) increase.

·       Across Berkshire West there had been a 76% increase in consultations in their various forms.

·       Face2face / telephone consultation data showed a decline in these types of contacts in some PCNs, although a 5% increase overall.  This decline was a likely consequence of national SOP changes at the start of the pandemic introducing total triage model that ensued GP services were sustainable and safe.

·       It was noted that activity might not reflect true demand or activity, i.e. online requests (emails, practice website requests, text consultations) which had become vital tools in communication and consulting with patients, although there had been a national drive to map all appointment types and improved data is expected.  Pre Covid the majority of patients would phone for an appointment.  Now there was a greater use of online appointments and phone triage.

·       Face2face consultations were taking longer due to Covid infection control measures, at an average of 20 minutes.  Telephone consultations were a lot shorter, leaving more time for GPs to spend with the most vulnerable patients, in a Face2face appointment.

·       Although some patients wished to return to face2face consultations, the new, flexible ways of consulting had been appreciated and taken up by many including those who preferred not to attend the surgery for work or health reasons unless it was necessary for them to do  ...  view the full minutes text for item 42.

43.

Healthwatch Wokingham Borough pdf icon PDF 2 MB

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

Minutes:

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

 

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

 

·       Healthwatch Wokingham Borough had produced a report ‘Caring during Covid.’

·       Members questioned whether Healthwatch had been happy with the level of response received and were informed that Healthwatch had hoped for approximately one hundred responses, which had been received.  The three focus groups had been very helpful for information gathering.

·       Many carers had found the easing of lockdown difficult as they often had to remain shielding whilst others returned more to normality.

·       A Member commented that it was surprising that 40% were not registered as carers with their GP.  Nick Durman commented that this was a key recommendation.

·       A Member questioned whether there were networks for carers and was informed that there were various carers groups.  They had not been able to operate in the same way during the pandemic and many had met online.  Many groups were starting to meet in person again as restrictions had lifted.

·       Members felt that it was a thorough report and questioned what the Committee could do.

·       Nick Durman emphasised the benefit of collaborative working.

·       Members were reminded of the Strategy into Action, one of the workstreams of which would focus on carers.  The Deputy Executive Member for Health, Wellbeing and Adult Services referred to the Strategy into Action structure which was being addressed by the Wokingham Borough Wellbeing Board.

·       The Committee were supportive of the recommendations within the report.  The Chairman indicated that she would write to the Executive Member for Health, Wellbeing and Adult Services indicating the Committee’s support for the implementation of the recommendations.

 

RESOLVED:  That

 

1)    the update from Healthwatch Wokingham be noted and Nick Durman thanked for his presentation.

2)    The Chairman write to the Executive Member for Health, Wellbeing and Adult Services indicating the Committee’s support for the implementation of the recommendations.

3)    An update on the implementation of the recommendations by WBC, be requested for January.

44.

Forward programme pdf icon PDF 211 KB

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

Additional documents:

Minutes:

The Committee considered the forward programme for the remainder of the municipal year.

 

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

 

·       Members agreed to schedule an additional meeting in February and to request a further update from the Royal Berkshire NHS Foundation Trust and also a presentation regarding maternity services.

·       Members wished to receive a further update on the tailored support that was being offered to the four GP surgeries that had performed less well in the GP Patient Survey.

·       The Committee requested that the Autism Strategy be scheduled as appropriate.

 

RESOLVED:  That the forward programme be noted.