Agenda and draft minutes

Venue: Council Chamber - Town Hall, Maidenhead. View directions

Contact: Andy Carswell 

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No. Item



To receive any apologies for absence.


There were no apologies received.


Declarations of Interest pdf icon PDF 217 KB

To receive any declarations of interest.


There were no declarations of interest received.



Minutes pdf icon PDF 71 KB

To approve the minutes of the meeting held on January 30th 2019.


RESOLVED UNANIMOUSLY: That the minutes of the meeting held on January 30th 2019 be approved as an accurate record.


Q3 Performance Report pdf icon PDF 124 KB

To note the report and make recommendations.

Additional documents:


Members were reminded that ten key measures assessing performance had been set relating to adult services. At the end of Q3 six were on target or had been met, three were off target but within tolerance, and one was off target. The measure not met related to the percentage of people in the target cohort of being aged 40-74 to be offered an NHS healthcheck. However the Strategy and Performance Manager informed the Panel that this service was offered by the GP surgeries themselves and therefore it was difficult for the Council to have any direct influence. She also stated that this measure over exceeded its target last year. Regarding the measures that were off target but within tolerance, Members were told that these figures were still within national achievement target rates and related to small cohorts and were therefore subject to volatility.


Regarding the healthchecks, the Deputy Director Strategy and Commissioning informed the Panel that no particular demographics were targeted. They were paid for out of the Public Health Grant and the amount available was capped. It was hard to predict takeup because how the service was promoted varied between the different GP surgeries. Members were told that of the target of 2,258 residents to be offered a healthcheck, 884 had taken up the service.


Members said it would be useful if a line graph to track progress of the measures could be included in future, and for the percentage figures to be included in the main report as well as any appendices.


Cllr Lenton asked about healthchecks being offered to residents over the age of 74. The Cabinet Member for Adult Social Care and Public Health said the main reason for their introduction was as a preventative measure to aid early diagnosis of underlying health problems, and this would be given greater support in the future with a Government Green Paper. Healthcare Plans could then be created if necessary. Residents over the age of 74 were more likely to be regular visitors to their GP and therefore would be more likely to be aware of any conditions affecting them, so healthchecks were not necessarily offered. Cllr Lenton stated that his surgery was staffed by only one GP; Members stated that this was not legal and that Cllr Lenton should formally complain about this.


The Chairman stated it was pleasing that good progress was being made towards meeting targets and asked for the Panel’s thanks to be passed on to the relevant officers.


RESOLVED UNANIMOUSLY: That the Adult Services and Health Overview and Scrutiny Panel noted the report and:

i) Endorsed the Q3 2018/19 performance summarised in table 1 and appendix A.

ii) Requested the Lead Member for Adult Social Care and Public Health and relevant Heads of Service to focus effort to improve performance in areas just short of target or below target and maintain performance in the measures meeting or exceeding target.


Joint Strategic Needs Assessment pdf icon PDF 201 KB

To note the contents of the report.


The Deputy Director Strategy and Commissioning introduced the item and explained to Members that the JSNA was a joint duty delivered by the local authority and Clinical Commissioning Group to look at the future healthcare needs of Royal Borough residents. The JSNA helped to guide the future decision making process and identify any trends. Priority areas relating to the needs of working age adults and older adults had been identified. Looking long term it was proposed that a library of resources would be built in order to provide a more effective analysis of data, and for practitioners and commissioners to be able to better access information from certain points in time.


Cllr Majeed asked for more information on which audience groups had been consulted while assessing the JSNA, in particular whether religious organisations had been consulted. The Deputy Director Strategy and Commissioning said that groups such as WAMCF had been consulted, but added that more could be done to engage with certain demographics.


The Chairman asked how often the JSNA was reviewed and whether any new trends had been identified. He stated that previously the JSNA had identified a high percentage of obese people in his ward. The Deputy Director Strategy and Commissioning said that currently refreshers took place on an annual basis, which did not necessarily give practitioners the required information in a timely manner. In situations where trends were identified, a decision would be taken as to whether to target a specific ward or the whole Borough. Targeting a specific ward would be done if it was felt necessary. Members were told that the Joint Health and Wellbeing Strategy was the main strategy that was being followed at the moment, which would be subject to a refresh in the near future. It was accepted that more promotion of this strategy should be done.


Members raised concerns that issues relating to ethnic minority groups were not being adequately targeted. The Deputy Director Strategy and Commissioning said that these would be picked up on in the review of the JSNA. She added that a great deal of work had been done with health groups to tackle female genital mutilation, which was known to be a particular issue. The Cabinet Member for Adult Social Care and Public Health said these issues had been discussed previously at the Health and Wellbeing Board, and that it was important to discuss them in an appropriate context.


The contents of the report was noted by Members.


Update on Integrated Care System pdf icon PDF 291 KB

To note the contents of the report.


The Deputy Director Strategy and Commissioning informed Members that the Integrated Care System had been established with a view to ensuring better ways of working and collective responsibility between local authorities and healthcare providers. The Royal Borough was one of five local councils, along with three CCGs, that had been working together for three years as part of the Frimley Health and Care Integrated Care System to serve nearly 800,000 people. Members were told that some of the notable successes of the ICS were outlined in the main report.


The Panel was told that seven key programmes had been identified as part of the new System Operating Plan. There had been an acceptance that healthcare practitioners were not able to deliver this on their own and needed support from local authorities. There had been a possible risk identified of the Royal Borough not having sufficient influence in decision making, as a small local authority in a large ICS. However Members were informed that the Royal Borough had representation on all of the relevant Boards, and the new System Operating Plan was shifting towards being able to provide delivery of services at a more localised level and it was hoped this would enable the Royal Borough to have greater influence on service delivery. The Deputy Director Strategy and Commissioning said the Council’s former Managing Director had been heavily involved at the ICS in the past, and this had led to the Royal Borough’s input being recognised and valued. She added that she would be happy to provide future updates on the ICS to Panel.


Cllr Majeed informed the Panel that on a recent visit to hospital he had spoken to staff who were unhappy with the new computer operating system that had been introduced, as it was not as user friendly as the old system. Cllr Majeed stated his belief that the service users should have a greater input into any consultations on changes to ways of working. The suggestion was noted by officers.


Going forward the next major step would be to create a long-term five year strategy, which would involve a public consultation. The Panel had been identified as a key stakeholder in producing this strategy. One of the key aspects of the strategy was implementing changes to the way GP surgeries were organised.


The Chairman thanked officers for bringing the report to Panel. Members noted the contents of the report.


Feedback from LGA Peer Review on Delayed Transfers of Care

To receive a verbal update.


The Head of Commissioning – Adults and Children introduced the item and explained that the Council had received an invitation in 2018 to participate in a Peer Review of delayed transfers of care. This was based on analysis of local NHS performance; although the Council’s performance was strong, it was weaker amongst NHS partners. The Council was asked to determine the scope of the review and asked for there to be a focus on whether the current intervention systems the correct ones to reduce delayed transfers of care in the Royal Borough. A workshop to prepare for the review took place in February, which was well attended with around 50 people taking part. The feedback from this enabled the Royal Borough to complete a self assessment of its services before the Peer Review.


The review was conducted by a team of eight, who all had a background in adult social care or the NHS. They conducted a range of interviews with different teams and held a number of site visits over a three-day period, before providing feedback on the fourth day. Areas of good practice and initiatives that had been implemented to reduce delayed transfers of care were highlighted to the review team, as were challenges for future development. The Head of Commissioning – Adults and Children informed the Panel that the feedback showed the Royal Borough was a strong performer in respect of delayed transfers of care, and in particular were in a good position to strengthen their leadership across the health and social care sector and in the ICS. There was also positive feedback about the initiatives that had been introduced. A more detailed report giving more in-depth feedback would be provided within the next six weeks.


Cllr Majeed congratulated officers for the positive feedback. He asked if the review team had asked about issues relating to homelessness, such as mental health and drug dependency issues. The Head of Commissioning – Adults and Children said the review team had spoken to social prescribers and staff at Wexham Park Hospital. Although some issues with delayed transfers of homeless people out of hospital had been identified, it was not noted as a trend and affected other local authority areas covered by the ICS. The Panel was told that Healthwatch had also provided input on issues that had been reported to them. Cllr Majeed suggested that some of the smaller healthcare providers should be interviewed as part of any future reviews in order to get a fuller picture. The Cabinet Member for Adult Social Care and Public Health said the Windsor Homeless Project had been consulted as part of the implementation of the new homelessness strategy.


Regarding care homes, Members were informed that the Care Governance Board looked at the quality of provision. The latest ratings for care homes in the Royal Borough were extremely good. Members were informed that an item on care home provision could be brought to a future Panel if they wished.


Work Programme

To discuss items for future meetings of the new Adults, Children and Health Overview and Scrutiny Panel


Cllr Majeed requested a report on weekend A&E waiting times to be brought to Panel. Cllr Yong said the issue of housing being provided for carers should be looked at. She raised concerns that when the redeveloped Heatherwood Hospital was open, existing care home staff would seek employment there and leave a shortfall in staffing at care homes, which was exacerbated by housing not being affordable for them. Cllr Majeed added that workers at care homes or nurseries would frequently have to pay to park while at work and that they could not afford to do so, and asked if this could be looked into.


The Chairman thanked officers for all their hard work over the last municipal year. He said they provided an excellent service to residents and they should be proud of this. He also thanked Members for the levels of scrutiny they had provided. Cllr Lenton said the Council did a good job of providing adult services in the Royal Borough and that they should be congratulated.