To receive any apologies for absence.

Apologies for absence were received from Councillor Reynolds, Tessa Lindfield and Prince Obike.

Kevin McDaniel and Lin Ferguson would be late joining the meeting due to a clash of meetings, they hoped to join at around 4pm.

To receive any declarations of interest.

There were no declarations of interest received.

To consider the minutes of the meeting held on 11^th July 2023.

AGREED UNANIMOUSLY: That the minutes from the meeting held on 11^th July 2023 were approved as a true and accurate record.

Mark Beeley, Principal Democratic Services Officer – Overview and Scrutiny, took the Board through the actions from the last meeting.

The action “Alex Szantai to share contact details of the Berkshire coordinator with Stephen Dunn” was unconfirmed, Amanda Gregory said that she would check this with Alex after the meeting. All other actions had been completed.

ACTION – Amanda Gregory to confirm if the above action from the previous meeting had been completed.

To receive a presentation on long covid, its affects and the impact on residents in RBWM.

Reporting officers:

Dr Karen Redman - GP Specialist

Jolene Eddowes - Specialist Occupational Therapist

Dr Karen Redman, GP Specialist, and Jolene Eddowes, Specialist Occupational Therapist, gave some context on Long Covid to the Board. Long Covid could affect anyone and was defined as the continuous development of new symptoms after an initial Covid infection, which lasted for at least two months with no other plausible explanation. There were a number of symptoms from Long Covid, with over 200 different ones being reported nationally. Fatigue and shortness of breath were the most common symptoms.

Around 1.9 million people were currently living with Long Covid, while 1.5 million were living with adversely affected daily activities. There were 90 specialist adult clinics in England which had been set up to look into Long Covid and its long term affects. The mean age for those suffering with Long Covid was 48 years, almost 70% were female, with a similar number being of working age. Symptoms could have an impact on employment and this included changing roles, reduced hours or even being on sick leave as a result. The highest number of those affected were people who had worked in the healthcare system or adult social care.

The Long Covid service had been set up to meet the needs of the unique patient group, with multiple pathways to provide a holistic person-centred journey. Data on symptoms and cases were registered in system insights and could be used to identify how many cases of Long Covid had been recorded, but this was reliant on GPs identifying symptoms as Long Covid. The guidelines were currently under review and the NHS were currently awaiting next year’s funding. A significant amount of data on Long Covid had been gathered over the past couple of years to inform practise.

Councillor Werner mentioned Myalgic encephalomyelitis, also called chronic fatigue syndrome, and the link which had been found between various viruses. He asked if Long Covid was a form of post viral rehabilitation and whether considering this comparison was useful when using what was already known about ME.

Karen Redman explained that experts felt that they should be kept separate. However, there had been a school of thought that research was still in the early stages so it could not be ruled out. There were around 3,000 studies each quarter but there was no good evidence for Long Covid and what treatments there were that could help it going forward. Chronic fatigue had a negatively about it as it was longstanding. Long Covid patients were recovering over time and being provided with support on how to cope with the symptoms.

Councillor Price commented on the impact on the individual, on society and on the council. It was noted that Long Covid affected approximately 2.5% of national population and this would therefore affect a good number of local residents. Councillor Price felt that there was not much information about Long Covid available, for example telling people what help was in place. The council wanted to improve the local economy but employers are unable to find staff  ...  view the full minutes text for item 350/15

To consider the Healthwatch Windsor, Ascot & Maidenhead 2022-2023 Annual Report.

Reporting officer:

Joanna Dixon – Healthwatch Windsor, Ascot and Maidenhead Engagement and Volunteering Officer

Joanna Dixon, Healthwatch East Berkshire Manager, presented to the Board the Healthwatch Annual Report for 2022/23. Almost 4,000 people had shared their experiences with Healthwatch, which helped to raise awareness of the issues in healthcare. The report highlighted:

• Work done with primary care commissioners to develop information for residents regarding access to local minor injury and walk in services.
• Audited GP websites and called telephone lines in all practices, following this a website template was produced which was offered to all surgeries.
• Report shared with Frimley ICS about patients waiting for hospital treatment.
• Called for an urgent response to hospital waiting lists and better communication, the NHS set out a recovery plan in response to address the backlog.
• Engaged with South Asian unpaid carers about their experience of accessing services, RBWM employed a carers social care practitioner to offer support.
• Healthwatch England continued to lobby for change at a national level.
• The engagement officer spoke with people with various health inequalities including adults with learning disabilities, homeless people, various community support groups, the elderly and children.

Four top priorities had been identified for 2023/24, on primary care, exploring concerns around urgent treatment, the home first project, and the enter and view programme.

The Chair felt that Healthwatch had done a lot of good work and had helped ensure that the community had access to local healthcare. She asked if Healthwatch was a lobbying organisation or was more designed to gather information.

Joanna Dixon explained that lobbying took place more at national level, Healthwatch East Berkshire had a role to flag issues in the local area.

The Chair noted when reading the full annual report, there was a patient who had been off rolled by their GP surgery. The advice that had been given by Healthwatch to the individual was signposting towards how to register with a GP. The Chair considered whether Healthwatch could offer further support and go beyond signposting to information.

Joanna Dixon said that Healthwatch would normally contact the GP practice to understand the context but additional support could be given.

The Chair said that too many people were going straight to A&E for help but it was a struggle to get GP appointments. She wondered whether Healthwatch could campaign on these kind of issues. This could be discussed as part of a future item, considering how to keep people away from A&E and so that usage was only when needed.

Joanna Dixon responded by saying that same day services were a different model of delivering healthcare, Healthwatch would need to receive feedback from local people who had issues with the current service for this to be investigated.

Councillor Werner raised the issue that residents were not contacting Healthwatch because their response could often be dismissive and were passing on information rather than taking action. Councillor Werner suggested that Healthwatch could review how it responded to resident healthcare issues in future to try and gain better outcomes.

Stephen Dunn, Director of System Delivery & Flow  ...  view the full minutes text for item 351/15

To receive information on the:

·         Winter Preparedness Plan

·         Sunningdale Health Hub

·         Walk in urgent care services in Maidenhead, Windsor and Ascot

Reporting officers:

Alexandra Tilley - Director of Operations - RBWM / Primary Care Transformation

Stephen Dunn - Director of System Delivery & Flow and Royal Borough of Windsor and Maidenhead

Stephen Dunn said that work had been done by NHS Frimley on the urgent and emergency care service plan, against high financial pressures. Demand had continued to increase, particularly with recent disruption from strike action and financial challenges. There had been an additional 50 patients per day at Frimley Park compared to this time last year. The strategy was moving forward and considering winter priorities.

The urgent emergency care transformation plan had been developed in spring, at the start of the financial year. A letter from NHS England set out the requirements for this forthcoming winter and what was needed to prepare. The letter contained lots of guidance and responsibilities and was publicly available. There were four main areas of focus:

• Continue to deliver UEC recovery plan by ensuring high impact intervention were in place.
• Completing operational and surge planning to prepare for winter scenarios.
• ICBs should ensure effective system working across all parts of the system.
• Supporting our workforce to deliver over winter.

Stephen Dunn outlined in detail some of the targets of NHS Frimley with regards to the Intermediate Care Response, primary care, community services, children and young people, and communications and engagement.

Kevin McDaniel, Executive Director of Adult Services and Health at RBWM, and Lin Ferguson, Executive Director of Children’s Services and Education at RBWM, joined the meeting.

Stephen Dunn updated the Board on the Sunningdale Health Hub. NHS Frimley continued to be committed to the project and the building was planned to meet both current and future needs. There had been one technicality which had been worked through with the landowners and full planning permission had been received in September, NHS Frimley had three years to build the health hub. Commercial negotiations were ongoing and the team were waiting for funding to be unlocked. The Sunningdale Health Hub was planned to be open in either 2025 or 2026.

Councillor Werner commented that it was good news that the project was still going ahead. He asked if there were any barriers or hold ups from the council, and if so what he could do to remove them.

Stephen Dunn confirmed that there were no barriers from the local authority which he was aware of, he said that there had been great support from colleagues at RBWM. The team were doing everything they could to keep moving the project forward.

Stephen Dunn moved on to discussing walk in services across the borough. NHS Frimley was working through winter plans and looking at models to target inequalities and the anticipated high usage of A&E. St Marks was important to the local community, the urgent primary care service had capacity for minor injury and minor illness appointments. NHS Frimley would be continuously evaluating the impact on the service and that it met the needs of local people. The team had done a leaflet drop earlier in the year to show how primary care was changing. The new service offered longer opening times than before and a wide range of  ...  view the full minutes text for item 352/15

To receive an update on the Better Care Fund.

Reporting officer:

Prince Obike - Integrated Care Transformation Senior Manager

Prince Obike had submitted his apologies for being unable to attend the meeting, this agenda item was therefore deferred to the next meeting.

To be updated on the work being undertaken with the Local Government Association.

Reporting officers:

Claire Lowman – Service Lead for Public Health

Georgia Careless – Public Health Programme Officer

Georgia Careless, Public Health Programme Officer, said that a ‘Prevention Matters’ workshop had been delivered on 25^th September in partnership with the LGA. Around 10 Councillors had taken part, including a number on the Health and Wellbeing Board, and the workshop had considered the local context, why prevention mattered and the role of Councillors in prevention in their local communities. The training offer also supported the next round of the RBWM innovation funding.

Claire Lowman, Service Lead – Public Health, updated the Board on the LGA support offer. A desktop exercise had been completed in early October to inform the strategic direction and priorities of the Board going forward, this had been completed by an LGA peer associate. Over the coming couple of months, 1 to 1 conversations would take place with Board members and ICS colleagues and a three hour workshop was planned for January 2024.

The Chair had attended the Prevention Matters workshop and felt that it had been a really productive session. Health and wellbeing was an issue which every Councillor should take an interest in. She suggested that an update on the work with the LGA could be delivered at the April meeting as a lot of work on this would be taking place throughout January.

ACTION – Update on the support offered to the Board by the LGA to be given at the April 2024 meeting of the Health and Wellbeing Board.

To receive an update on the Housing team.

Reporting officers:

Emma Congerton - Housing Strategy & Inclusion Manager

Alex Szantai – Housing Operations Manager

Amanda Gregory, Assistant Director of Housing, Environmental Health and Trading Standards, updated the Board with the latest data from the Housing team. There were currently 424 homelessness cases, 627 cases on housing register waiting for social housing offer and 230 in temporary accommodation. Social housing was in short supply and there was no average waiting time but waits were quite lengthy. Considering temporary accommodation, there was a shortage in the borough. Demand was high and the council did not have its own housing stock. There were a large number of cases to deal with and pressures across the team. On Asylum hotels, decisions on asylum cases were coming through but not all of these would be provided housing by the council.

To hear about the Children and Young People Suicide Protocol.

Reporting officer:

Sue Foley – Consultant in Public Health (Children, Young People and Families)

Sue Foley, Consultant in Public Health - Children, Young People and Families and Suicide Prevention, said that RBWM was similar to national and south east suicide rates although in 2022 there had been a slight spike. A deep dive analysis by the team had been undertaken but no themes were discovered which explained the spike. Children and young people were a vulnerable group, the Pan Berkshire Prevention Group and East Berkshire Suicide Prevention Group regularly met to discuss actions and what could be done to prevent suicides in young people. The Pan Berkshire Strategy had been halted and reviewed but it was now ready to be implemented. This strategy and the new National Strategy would be incorporated into East Berkshire and RBWM action plans which were currently being developed. A position statement would be presented at the next Health and Wellbeing Board. A postvention protocol was the organised response in the aftermath for a suicide to mitigate the negative effects to those that had exposure of the suicide. An RBWM Schools and Colleges Postvention Protocol was being developed. A task and finish group had been held with a number of different agencies, to make sure that the protocol worked for all. The protocol followed a number of key steps.

The Chair asked if the team worked in partnership with No22, who were a youth counselling service.

Sue Foley confirmed that the team did some work with No22, they worked with a number of partners in the voluntary sector so that as much support could be given to young people as possible.

The Chair asked what the timescale was planned to be for the protocol to be published and adopted.

She was informed that the protocol would be likely be completed in the next couple of months along with the action plan.

The Chair suggested that the protocol and accompanying action plan could be considered by the Board at the next meeting in January.

ACTION – The Health and Wellbeing Board to consider the children and young people suicide protocol action plan in January.

Proposed dates for 2024:

·         Thursday 25^th January 2024

·         Tuesday 23^rd April 2024

·         Tuesday 16^th July 2024

·         Tuesday 8^th October 2024

The dates for 2024 were confirmed to be:

·         Thursday 25^th January 2024

·         Tuesday 23^rd April 2024

·         Tuesday 16^th July 2024

·         Tuesday 8^th October 2024