Agenda and minutes

To receive any apologies for absence

An apology for absence was submitted from Councillor Rebecca Margetts.

To confirm the Minutes of the Meeting held on 6 November 2023.

The Minutes of the meeting of the Committee held on 6 November 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 a presentation on the Berkshire Coroner’s Service.

Members received a presentation on the Berkshire Coroner’s Service from Matthew Golledge, Public Protection Manager, Reading Borough Council and James Crosbie, AD Planning Transport and Public Protection, Reading Borough Council.

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

·       Reading Borough Council hosted the Coroners Service on behalf of all of the Berkshire authorities.  The service was operated under a joint arrangement.

·       The Coroners Service was located in the Town Hall in Reading.  There were two courts, a jury room and office facilities.

·       Matthew Golledge outlined the staffing structure within the service.

·       Under the Coroners and Justice Act 2009, local authorities were required to fund a coroner service. 

·       The primary purpose of the Coroners Service was to investigate deaths that were violent, unnatural, unexplained or that had occurred in custody or otherwise in state detention.

·       The role of the Coroner included –

Ø  providing bereaved families with answers as to how their loved ones died with the assurance that an independent judicial process has investigated any relevant concerns.

Ø  contributing to the accurate registration of deaths, thereby enabling more secure analysis of trends in public health

Ø  carrying out an enhanced investigation where the state’s responsibilities under Article 2 of the European Convention on Human Rights (‘ECHR’) (the right to life) were engaged.

Ø  considering whether any circumstances revealed by an investigation give rise to a risk of future deaths and alerting those who might be able to mitigate or eliminate such risks.

Ø  investigating treasure finds, allowing museums to acquire treasure and appropriate rewards to be paid.

·       In 2022 there had been 7096 deaths in Berkshire, 2257 of which had been reported to the Coroner.  871 postmortems had been carried out.  75 Histology and 222 Toxicology investigations had been carried out.  23 noninvasive postmortems (CT scanning) had been carried out.  438 inquests had been undertaken.

·       Matthew Golledge highlighted performance in different areas, against England and Wales. 

·       The number of less invasive postmortems (CT scanning) carried out was low nationally and lower again in Berkshire.  CT scanning was starting to become more widely used across the country but was dependent on availability of a scanner and cost.  The service was looking to develop in this area.

·       The mortuaries used were based in Royal Berkshire Hospital and Wexham Park Hospital and were run by Berkshire and Surrey Pathology Services.  The contract was in place until 2027.

·       Across Thames Valley consideration was being given to a regional mortuary, which would potentially be a Centre of Excellence, serving a number of authorities.  An options appraisal around possible locations was in process.  Consideration would need to be given to the benefits of a regional mortuary against local mortuaries and vice versa.  Local mortuaries were already under pressure. 

·       Members were informed that postmortems cost approximately £500, not including pathologist fees.

·       Local authorities were required to fund the removal and transportation of the deceased to the coroner.  There had previously been some difficulties in procuring this service.  Traditionally this service had been provided  ...  view the full minutes text for item 48.

To receive a presentation on the BOB Primary Care Strategy.

Sanjay Desai, Head of Primary Care Operations, BOB ICB and Helen Clark, Deputy Place Director, BOB ICB presented the BOB ICS Transforming Primary Care Executive Summary.

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

·       The Integrated Care Board (ICB) covered a population of around 2 million people. 

·       Primary Care related to GP practices, pharmacy, optometry and dental services.

·       Sanjay Desai outlined the approach to developing the Strategy.  Focus groups had been carried out with key stakeholders to better understand their views.  A system wide workshop had been held in November 2023.

·       A draft strategy had been produced and the engagement phase was currently in progress, ending late February.  The ICB was consulting with as many people and groups as it possibly could.

·       The Committee noted some of the areas where it had been identified that the system had particular strengths that could be built upon.  Members were informed of the Pharmacy First service.

·       Sanjay Desai highlighted some of the challenges including worsening experience of accessing primary care, workload pressure, mismatch between capacity and demand, and capacity being difficult to grow due to funding, recruitment and retention issues.

·       It was important that the patient received the right support to meet their needs the first time they made contact.  Enablers for this included workforce, digital and data, estates, and resourcing.

·       Supporting patients to self-manage their conditions where possible was important.  There was a desire for GP colleagues to work more at the top of their licence, seeing more complex cases, whilst less complex needs were met via self-management and other routes such as pharmacy services.  The Committee was reminded of the Care Navigators based in GP practices.

·       Personalised, proactive care would be provided for people with complex needs, supported by Integrated Neighbourhood Teams.

·       The prevention agenda was integral, helping to reduce pressure on the overall system.

·       Sanjay Desai outlined activities relating to the four enablers workforce, resources, digital and data and estates, which would be essential to delivering the vision, for example maximising the uptake of apprenticeship roles and developing the workforce through the apprenticeship levy.

·       A phased approach would be taken, working with cohorts, across three priorities – non complex same day care, Integrated Neighbourhood Teams and Cardiovascular Disease prevention.

·       A Member asked how feedback on the Strategy would be achieved and if an engagement strategy would be produced.  Sanjay Desai responded that the ICB was engaging with Healthwatch and as many different groups as possible.  Members were asked to let the ICB know of any groups that they felt should be contacted.  A Member commented that the majority of residents were not members of focus groups, and that further creativity around communication was required.  Helen Clark emphasised that lots of activity was already in progress and that it would be an iterative process, building on existing work.

·       A Member commented that the Council was seeking to become a Marmot environment and suggested that this be referenced within the Strategy.

·       In response to a Member question regarding  ...  view the full minutes text for item 49.

To receive the BOB Integrated Care Board update.

The Committee received the BOB ICB Board update.

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

·       Helen Clark indicated that the report detailed the key areas that the ICB was working on, particularly the Primary Care Strategy.  She also highlighted the stakeholder newsletter and the updates regarding Covid and flu vaccinations.

·       A Member asked about the backlog in appointments created by strikes, and whether plans were in place to address this.  Helen Clark indicated that this was not an area that she was directly involved with.  The report highlighted the impact of earlier phases of industrial action, and work undertaken in response would be factored into ongoing work to reduce waiting times.  She indicated that she would seek further information on the matter.  In response to a Member question Helen responded that discussions would be taking place with the Royal Berkshire NHS Foundation Trust.

RESOLVED: That the BOB ICB Board update be noted.

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

Alice Kunjappy-Clifton provided an update on the work of Healthwatch Wokingham Borough.

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

·       Recruitment of volunteers was still ongoing and work to increase the visibility of Healthwatch continued.

·       The GP Access project had begun in October and 150 surveys had been received from Wokingham Borough.  Focus group discussions around the new ways of working, care navigators and the NHS App had been held.  A report was due at the end of March, which would also be shared with the ICB. 

·       Engagement had been carried out face to face and also online.  Sessions had also been held outside working hours.  In response to a Member question Alice Kunjappy-Clifton indicated that the evening engagement sessions had been online only. 

·       Healthwatch had asked about the experience of those with learning difficulties with dentistry.  Whilst only a small number of responses had been received, the emerging themes had been similar.  For example, some had felt that the dentists had not explained what would be happening during their appointment.

·       Members were pleased to note that Healthwatch staff would be present in the Hub every day.

·       A Member questioned whether Shinfield GP practices had been involved in the GP Access project and was informed that they had been invited to participate. 

·       Members asked that it be clarified which church in Woodley and which Waitrose in the Borough Healthwatch had visited.

·       The Committee was informed that Healthwatch would be reviewing the report from the Wokingham Medical Centre Enter and View and its recommendations.

·       A Member requested that Healthwatch formally contacted the Patient Participation Groups in the different Primary Care Networks and establish their membership, when they met, and how to access copies of the minutes of their meetings.  It was noted that a Patient Participation Group was a contractual requirement.  Alice Kunjappy-Clifton indicated that a newly appointed Senior Engagement Officer would be looking at the PPGs in the future to establish what arrangements were in place across the Borough.

RESOLVED:  That the update on the work of Healthwatch Wokingham Borough be noted, and that Alice Kunjappy-Clifton be thanked for her 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:

·       Members asked that a glossary be included in future agendas.

·       A Member requested a briefing on vaping among school children, in the new municipal year.

·       Linking back to the item on the coroner’s service, a Member commented that an elective CT scan could cost families between £850 and £1250.  Some Members felt that families should not have to pay should they request a CT scan over a more invasive postmortem.

RESOLVED:  That the forward programme be noted.