Agenda and minutes

To elect a Chair for the 2023-24 municipal year.

RESOLVED:  That Councillor Adrian Mather be elected Chair for the 2023-24 municipal year.

To appoint a Vice Chair for the 2023-24 municipal year.

RESOLVED:  That Councillor Rachelle Shepherd-DuBey be appointed Vice Chair for the 2023-24 municipal year.

To receive any apologies for absence

There were no apologies for absence.

Councillors Jackie Rance and Shahid Younis attended the meeting online.

To confirm the Minutes of the Meeting held on 27 March 2023.

The Minutes of the meeting of the Committee held on 27 March 2023 were confirmed as a correct record and signed by the Chair.

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 on Building Better Berkshire.

Alison Foster, Programme Director, Building Berkshire Together, and Andrew Statham, Director of Strategy, RBH provided an update on Building Berkshire Together.

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

·       Since 2019 the Royal Berkshire NHS Foundation Trust (RBFT) had been placed on the New Hospital Programme (NHP) as part of the Government commitment to deliver 40 new hospitals by 2030.

·       The Strategic Outline Case had been submitted in December 2020 and had highlighted three possible options –

Ø  Part new build/part refurbishment on existing site – est £785m

Ø  Whole site redevelopment  - est £995m

Ø  New hospital on a new site – est £1.3bn

·       The hospital was part of cohort 4 and would be full adopters of the new approach to building new hospitals (Hospital 2.0), which entailed standardised designs, centralised processes and modern methods of construction.

·       Members were informed that it was anticipated that through economies of scale, there would be a significant reduction in time and cost to build new healthcare facilities.

·       The NHP Team had been progressing the Programme Business Case (PBC) for this approach with HM Treasury.

·       In March 2023 the Secretary of State for Health had announced the total programme budget up to 2030.

·       Some hospitals which had significant issues which needed to be addressed sooner, had been added to the original programme list.  This would potentially have an impact on some other hospitals being delivered by the 2030 deadline.  The impact for scheduling for RBH was not yet fully known.  Alison Foster emphasised that there had to be phasing in the programme to ensure sufficient capacity in the supply of the market.  Consideration of different hospitals were at different stages of the programme.

·       The Trust’s funding envelope had not yet been confirmed in writing, although it was expected imminently.  It was recognised that as part of the New Hospital Programme, it would reflect that some costs would be kept centrally and there would be some expectations on savings on the Trust’s original estimates.

·       Further progress was starting to be seen.  A request had been received to update the Enabling Bid submitted in August 2022, to reflect matters such as current inflation.

·       The Trust had been progressing the Outline Business Case (OBC) with the limited budget available from New Hospital Programme (NHP).  This had included developing the RBFT Clinical Services Strategy (CSS) into a Clinical Model to get to a Clinical Brief which included a Schedule of Accommodation needed for the new hospital.  As part of the OBC process the Trust had progressed Board approval of the Critical Success Factors (CSFs), Investment Objectives (IOs) and long listed options.

·       Considerable engagement using a variety of mediums had been carried out around the long list options to get to a shortlist which could be thoroughly assessed and appraised. 

·       Engagement had included a public survey collecting 3,692 responses.

·       The result of the shortlisting continued to go through a process of validation.  Further input was being sought from stakeholders such as the Berkshire West United  ...  view the full minutes text for item 8.

To receive an update on GP contracts 2023-24.

The Committee were updated on GP Contracts 2023-24 by Sarah Webster, Executive Director for Berkshire West Place, Abid Irfan, Director of Primary Care, ICB, and Helen Clark, Head of Primary Care, BOB ICB.

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

·       Members were updated on the GP 2023/24 contracts and what this meant for Wokingham Borough residents.

·       The contract was the last of a five-year agreement.  There were several changes.

·       Key changes related to improving access for residents.  There was a focus on assessing the need or signposting at first contact.  There was also a focus on a same day assessment of need if there was an urgent need, and an appointment within 2 weeks for non-urgent primary care situations.

·       Wokingham was already in a strong position with regards to appointments within 2 weeks, with 86% of appointments being offered within 2 weeks.  Just over 50% of these were same day appointments.

·       Other areas of focus included improving Telephony in all practices.  Online platforms were also under consideration, although the continued importance of face-to-face appointments where required, was appreciated.

·       Recruitment was a key area of focus.  The contract allowed for flexibility in the range of roles which could be recruited into primary care.  Members were reminded of the Additional Roles Reimbursement Scheme (ARRS), under which funds were available for practices to be reimbursed for a range of clinical roles.  The contract gave further flexibility on how the fund could be deployed.  There had been successful use of the fund to date within the Borough.

·       The National Workforce Plan and pension reforms would help considerations on retaining the existing workforce.   Further information was anticipated from the National Workforce Plan.

·       There would be a big focus on removing the non-value adding steps which currently used a lot of primary care colleagues’ time.  Examples of how this could be achieved included greater use of other appropriate settings such as community pharmacy and improved self-referral pathways.

·       Better coordination with local authority planning departments, particularly as they produced their Local Plans, would also be a focus to ensure that the health needs of residents in new developments were taken into account.  It was noted that existing relationships were strong.

·       Each of the GP practices would be developing an access improvement plan and the ICB would be developing an overarching access recovery plan, which would be taken to the ICB in the autumn.  Sarah Webster offered to update the Committee further later in the year with regards to progress.

·       Members expressed concern about access to health facilities for residents in new estates.  One Member commented that the possibility of satellite sites to a large practice in central Wokingham had been raised, to facilitate seeing a GP for those in some of the new estates in the area.  He queried at what point consideration was given to creating new facilities for those who had to travel some distance to access a GP.  Helen Clark stated that this issue had been discussed over  ...  view the full minutes text for item 9.

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

Alice Kunjappy-Clifton updated the Committee on the work of Healthwatch Wokingham Borough.

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

·       Recruitment of volunteers, including community engagement volunteers, was ongoing.

·       Healthwatch was trying to increase its visibility in the community.  Members were requested to invite Healthwatch to community events.

·       The report regarding the Enter and View of Wokingham Medical Centre would be presented to the practice manager and clinicians for comment, in the near future.  The report would be taken to the Committee’s September meeting.

·       Healthwatch had undertaken a survey in April regarding residents’ priorities.  137 responses had been received.  Areas of concern identified included access and quality of GP services, NHS dentists, A & E, Adult Social Care and Ambulance Services.

·       Healthwatch was considering its work programme for 2023-24.  GP services and quality had been identified as a key priority.  More work needed to be undertaken to publicise new ways of working within GP practices.  Registration and access to appointments and GPs had been raised as issues by residents.

·       Healthwatch were in conversation with primary care regarding maternal mental health and improving access to appointments for expectant mothers. 

·       Dentistry continued to be an issue for residents.  Healthwatch would be focusing on access for pregnant women, many of whom were still struggling to access appointments.  Healthwatch would also be looking at access to dental appointments for those with learning difficulties.

·       Work would be undertaken to establish the particular issues that residents had with Adult Social Care and the Ambulance Service.

·       Women’s health and the menopause were both a local focus for Healthwatch Wokingham and a national priority for Healthwatch England.

·       The cost of living crisis was becoming a topic of concern.

·       A Member commented that children had access to free dental services.  He asked whether Healthwatch could also look at education for parents of young children and opportunities for children to have regular check-ups.

·       The Chair commented that he looked forward to the report regarding Wokingham Medical Centre.  Alice Kunjappy-Clifton asked Members to share any feedback that they had received from residents regarding Woosehill Medical Centre as Healthwatch had received little communication about the surgery.  A Member commented that a resident had reported an automated email response which indicated that a response would be provided within a month, which was considered overly long.  Another Member highlighted a delay in diabetes follow up appointments, whilst another Member commented that they had had a very positive experience with the surgery and suggested that there were some areas that worked well and others where improvements were required.

RESOLVED:  That the update on the work of Healthwatch Wokingham Borough be noted.

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:

·       The Autism Strategy item scheduled for the July Committee would be delayed.

·       The Committee requested an update on pharmacy services in the Borough.  Members commented that residents were experiencing difficulties as a result of pharmacy closures in some areas, and some remaining pharmacies were coming under pressure as a result of dealing with additional customers.  Ingrid Slade suggested that David Dean, Chair of Local Pharmacy Committee be invited to provide an update, and also to explain the impact of the widening of the Local Pharmacy Committee footprint from Berkshire West to Thames Valley.  Public Health could update about the Pharmaceutical Needs Assessment, which looked at the level of need in the Borough for pharmacy provision.

·       The Chair requested an item on the Primary Care Networks and in particular those which included Woosehill Surgery and Wokingham Medical Centre.

RESOLVED:  That the forward programme be noted.