Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Rebecca Margetts, Alistair Neal and Rachelle Shepherd-DuBey.

‘At the last meeting of the Health Overview and Scrutiny Committee the question of attendance of Wokingham Medical Centre at a Health Overview and Scrutiny Committee meeting, was raised. I would like to clarify that in October a request for information was sent to the Primary Care Networks as to the challenges and successes that their surgeries were currently experiencing. Representatives from some of the PCNs attended the Committee’s November meeting to provide information.  No formal invitation was issued specifically to Wokingham Medical Centre.’

To confirm the Minutes of the Meeting held on 5 June 2023.

The Minutes of the meeting of the Committee held on 5 June 2023 were confirmed as a correct record and signed by the Chair.

It was noted that Andrew Statham’s title was Director of Strategy, Royal Berkshire NHS Foundation Trust.

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 Pharmaceutical Services in Wokingham Borough.

David Dean, Chief Officer, Community Pharmacy Thames Valley, and Karen Buckley, Consultant Public Health, updated the Committee on Pharmacy Services in the Borough.

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

·       There had been concerns regarding the permanent and temporary closures of pharmacies in the Borough.

·       David Dean commented that the Lloyds pharmacies in Sainsburys had been removed.  Other pharmacies that remained were coping well with the uplift in patient numbers.  The supermarket pharmacies had had low patient numbers but had had extended opening hours, which was an issue which might need to be revisited with the ICS in the future.

·       Lloyds pharmacies in the Borough had now been sold to other existing pharmacies.

·       Recent challenges in pharmacy had included workforce, although this had improved substantially with improved availability of locums.  A new intake of newly qualified pharmacists was anticipated in the next few weeks, which would hopefully help to plug gaps in the market.

·       Supply chain remained a national issue.  There were ongoing issues around the supply of certain medications and the national pharmacy were in negotiations with the Government to try to alleviate this. 

·       David Dean was of the opinion that pharmacy was in a much better place than previously and were currently making plans for winter and the vaccination campaigns.

·       Karen Buckley indicated that the Council via Public Health was required to look at and assess the level of need.  A Pharmaceutical Needs Assessment (PNA) was produced every three years.  Should there be significant changes such as the closure of Lloyds, the data would be reviewed and any potential implications for residents assessed.  It had been assessed that the closure of Lloyds did not have significant implications.  Karen Buckley explained that the PNA used national guidance and methodology.  Factors such as the demographics for the local population and the future projections of the population, were considered.  Residents were surveyed for their views and expectations, and providers were consulted with on their capacity to meet current and future need.

·       In terms of assessing need, there were three main criteria.  With regards to accessibility, residents were expected to have a pharmacy within a 1-mile radius of their home or a 20 minute walk (in rural areas a 20 minute drive).  Some residents did not meet this.  There were 20 pharmacies within the Borough and 22 located within a mile of the border.  There was sufficient provision in terms of accessibility.  Provision and type of services was another factor which was taken into consideration.  Opening hours was another key factor.

·       Currently, there was a good level of provision in the Borough.

·       A Member indicated that there two pharmacies in Woodley, Boots and Day Lewis.  Both had seen increased patients following the closure of Lloyds, and she had received complaints from residents regarding long queues.  Some patients had taken their business online as a result.  She also expressed concern that Boots had announced that it would be closing some stores, and questioned whether this would impact the Woodley  ...  view the full minutes text for item 18.

To receive the Adults Services Quarter 4 & Year End 2022/23 - Key Performance Indicators.

Lisa Evans, Head of Complex Care and Support Service, and Lorna Pearce, Head of Safeguarding, presented the Adults Services Quarter 4 and Year End 2022/23 Key Performance Indicators.

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

·       The cost of living crisis, high inflation, and Adult Social Care being historically underfunded created a challenging environment.

·       Some providers had experienced financial viability problems.  This was a national issue.

·       Members were advised that 71% of targets had been achieved over the year.  Over the whole year there were no areas that were significantly below target.

·       There had been some slowing down in Quarter 4.  However, overall performance was strong.

·       Lisa Evans drew the Committee’s attention to the Hatch Farm accommodation project, for which the Council and its partners had won a national award for the Best Social Housing initiative.

·       Members were informed that it was highly likely that Adult Social Care would be subject to a CQC inspection, and this was being planned for.

·       Officers were aware of where the Council did not perform quite so well, and an ambitious transformation plan was in place.  This included a redesign of the Adult Social Care pathway, by September.

·       Members questioned why AS2 Social work assessments allocated to commence within 28 days of the request (counted at point of allocation) was red.  Lisa Evans indicated that this was a locally set target and was quite ambitious.  26% of people were waiting longer than 6 months for an allocation.  Aside from the last quarter the target had been met over the year.  An increased complexity in cases was being seen since Covid, which created increased pressure on waitlists.  It was hoped that improvement would be seen in the next quarter.

·       The Committee was informed that workforce continued to be an issue and that a Workforce Strategy was in place.  Adult Social Care was looking to grow its own and apprenticeships were being offered in Occupational Therapy for the first time. Recruitment campaigns had been reevaluated to understand how to best attract people to the Council into high pressure areas.

·       A Member questioned what type of providers were experiencing issues with financial viability, and how residents would be impacted.  Lorna Pearce indicated that it was often the domiciliary care market.  However, relations with providers had strengthened over the pandemic, and that officers talked to them early when they were experiencing difficulties.  Unexpected provider failure was therefore unlikely.  In the case of failure Adult Social Care would work with the provider to manage the transfer of customers to alternative provision.  Lorna Pearce explained how the Care Quality Governance Framework and the Provider Failure Framework operated.

·       Lisa Evans added that there were some problems in the Learning Disability Market relating to residential care.  The costs had escalated significantly which had placed pressure on the viability of providers.

·       Lorna Pearce commented that nationally there was a shortage in domiciliary care, however, there was reasonable capacity in the Borough.  Some providers may not be receiving the volume of  ...  view the full minutes text for item 19.

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

This item was deferred.

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:

·       Members requested that a further update around community pharmacy be scheduled.

·       Items discussed during the meeting to be scheduled for future meetings included an update around the process for creating new pharmacies, a briefing on care home planning, and an update on the Adult Social Care workforce and the possibility of subsidised childcare.

·       Ingrid Slade requested that the presentation of the Healthwatch report regarding Wokingham Medical Centre be delayed from the September meeting to allow Officers time to work with the surgery to produce a plan of action.

·       Some Members felt that all of the unscheduled items should be covered by the end of the municipal year.  Members sought clarification as to when the Committee would be able to consider the Autism Strategy. 

·       Officers were asked to amend the forward programme, scheduling an additional item for the September meeting.

RESOLVED:  That the forward programme be noted.