Agenda item

To consider a report on the future commissioning of NHS Hydrotherapy services in Berkshire West.

Katie Summers, Director of Operations, NHS Berkshire West CCG, Caroline Tack, Head of Planning and Transformation, NHS Berkshire West CCG and Dr Debbie Milligan, NHS Berkshire West CCG, provided an update on the future commissioning of NHS hydrotherapy services in Berkshire West.

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

·       James Kent, Accountable Officer, NHS Berkshire West CCG, would be writing to the Chairmen of the Berkshire West Health Overview and Scrutiny Committees, to update them on the future commissioning of NHS hydrotherapy services in Berkshire West.

·       The hydrotherapy pool at the Royal Berkshire Hospital had been closed on numerous occasions due to maintenance issues.  Since the advent of Covid, the pool had been closed.

·       The pool was also used by private patients as well as NHS patients.

·       In Berkshire West, NHS hydrotherapy services were provided as part of the physiotherapy service within the main Royal Berkshire NHS Foundation Trust (RBFT) contract with the CCG.

·       Berkshire West commissioned circa 107,000 physiotherapy appointments per annum (across acute and community settings), of which a very small number, approximately 1800, or 1.2% represented hydrotherapy.  The service was used by approximately 300 patients per annum at a cost of £240,000 per year.

·       It had been agreed in July 2020 by the Berkshire West CCG Governing Body that a 12 week public consultation be undertaken to seek a broad range of stakeholder views in order to help inform the CCG in determining whether it should continue commissioning hydrotherapy services for NHS funded patients.

·       498 responses had been received.  Only 59 of these identified as being an NHS patient who had been prescribed hydrotherapy by a clinician.  Members were reminded that only a consultant or physiotherapist could prescribe physiotherapy.

·       Available evidence regarding the clinical effectiveness over land-based physiotherapy, was currently limited.

·       Based on the clinical effectiveness, value for money and analysis of the consultation, the CCG had agreed to not routinely fund NHS hydrotherapy services apart from on an exceptional basis via an Individual Funding Request (IFR).  The Committee was pleased that the service would still be available for those with a particular clinical need.

·       The CCG was looking for alternative hydrotherapy pools in Berkshire West to ensure that those patients who had a clinical need for the service, still had access to it. 

·       In response to a Member question, Katie Summers emphasised that the hydrotherapy service was not being decommissioned.

·       A Member questioned how funding for an individual patient could be applied for and if there was a limit to this funding.

·       Members questioned the date of the research regarding hydrotherapy and asked if there was more recent research on the benefits, available.  Caroline Tack advised that the Chartered Society of Physiotherapists would be working with the CCG to develop the critical criteria for hydrotherapy.  They would also advise on suitable alternative pool locations and be undertaking research on the benefits of hydrotherapy.  The Aquatic Therapy Association of Chartered Physiotherapists would also help identify alternative pool sites.

·       A Member questioned whether consideration would be given to using the hydrotherapy pool at the Royal Berkshire Hospital again should no suitable alternatives be identified, and new research highlighted the benefits of hydrotherapy.  Katie Summers indicated that this would be put to the Royal Berkshire Hospital to include within their business case. 

·       Hydrotherapy for NHS patients was usually for up to 6 weeks, as if a benefit had not been identified by then, it was unlikely that hydrotherapy would prove effective. 

·       In response to a Member question regarding services during the pandemic, Katie Summers clarified that hydrotherapy was just one type of treatment and patients would continue to be supported virtually or over the phone.

·       Members asked whether specific types of pools had to be used for hydrotherapy.  Katie Summers commented that hydrotherapy pools were warmer than normal swimming pools.  It was also important that they were accessible to all, including those with mobility issues. 

·       Some Members asked that no changes be made to the hydrotherapy service until alternative locations were identified.

·       A Member raised a question regarding medical staff having access to free parking in Council car parks during the pandemic, rescinded.  It was agreed that this would be followed up.

RESOLVED:  That the update on the future commissioning of NHS hydrotherapy services in Berkshire West, be noted.