Agenda and minutes

Venue: Via Video Conference

Contact: Liz Wheaton 


Webcast: View the webcast

No. Item


Apologies for absence/changes in membership

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Apologies were received from Mr B Roberts, Mr G Powell, Mr G Hollis and Mr L Wood.


Declarations of interest

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Julia Wassell declared that she was Chairman of the mental health sub-committee which was part of the Wycombe Community Board. Mr Z Ahmed declared that he was also a member of this sub-committee.


Minutes pdf icon PDF 634 KB

The minutes of the meeting held on Thursday 4th June 2020 to be confirmed as a correct record.

Additional documents:


The minutes of the meeting held on Thursday 4th June 2020 were confirmed as a correct record.


Public Questions

No public questions have been submitted for this meeting.

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There were no public questions submitted for this meeting.


Chairman's update

For the Chairman to update Members on health and adult social care scrutiny activities since the last meeting.

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The Chairman updated Committee Members on the following issues:


·         Buckinghamshire Healthcare NHS Trust’s Annual Quality Account 2019/20 – the Select Committee had received the draft quality accounts and a small group of Committee Members were working on the response, which would be circulated to the full Committee in due course for their comments before submitting the final version to the Trust.

·         Proposed closure of New Chapel Surgery, Long Crendon – the Chairman reported that she had been meeting with the key people who were involved in this and information would be shared with the Committee Members over the coming weeks.  The consultation process was due to end on 23rd November 2020.


Mental Health services pdf icon PDF 893 KB

The Committee will hear from representatives from Oxford Health NHS Trust who provide mental health services for the residents of Buckinghamshire.  Members will examine the access and quality of the services provided, particularly in light of the current Covid-19 situation.



Dr Nick Broughton, Chief Executive, Oxford Health NHS Trust

Ms Debbie Richard, Managing Director, Mental Health

Dr Vivek Khosla, Clinical Director for Buckinghamshire



Report attached

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The Chairman welcomed Dr N Broughton, Chief Executive, Oxford Health NHS Trust, Ms D Richards, Managing Director, Mental Health and Dr V Khosla, Clinical Director for Buckinghamshire.


The following main points were made during their presentation:


·         Oxford Health NHS Trust was one of the largest providers in the country with over 6,500 staff providing services across Oxfordshire and Buckinghamshire (700 staff were based in Buckinghamshire plus 200 in third party providers across Buckinghamshire).

·         The Trust was part of the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System and had re-organised its services to reflect this.

·         The Trust provided all age services in Buckinghamshire.

·         There were three main pathways – Adult and Older People, Children and Young People and IAPT (access to psychological services for people suffering with anxiety and depression).

·         The Whiteleaf Centre in Aylesbury hosted inpatient services and there were currently four sites in Wycombe with plans to bring three sites together on Easton Street.  This project had been delayed due to the current Covid-19 pandemic.

·         The CAMHS service had a single point of access and patients were then triaged to the appropriate service.  For adults, referrals were mainly via the GP but they could also self-refer.  There were plans in progress to make this service a single point of access as well.

·         The referral rate had continued to grow over the past two years and last year the CAMHS service saw more patients than it was commissioned to see.  During June and July, the referral rate had spiked.

·         In Buckinghamshire there were a large number of children diagnosed with autism and ADHD.

·         Healthy Minds was one of the best performing services in the country and had been operational for over 10 years.

·         The NHS Long-Term Plan, published in 2019, made a commitment to invest in mental health services.  Historically, mental health had been relatively underfunded and was struggling to meet demand for services.

·         The Trust was rated “Good” by the Care Quality Commission and its ambition was to be outstanding across all services.

·         The Trust had created a crisis team with safe havens in Wycombe and Aylesbury which was run by Bucks Mind.

·         The current Covid-19 pandemic had impacted on three specific services which had ceased due to the reliance on face-to-face contact but most other services had continued, with limited capacity.  Services had been offered digitally as the first port of call and then face-to-face if needed.  Young people had been particularly receptive to the digital offer.

·         A 24/7 mental health helpline had been established to divert the pressure from 111 and A&E.  Whilst this offering had been established quickly, it was deemed unsustainable so the Trust was working with commissioners to find a solution.

·         There was a Mental Health Liaison service at Stoke Mandeville which also fed into Wycombe.

·         The Trust experienced unique recruitment challenges in South Buckinghamshire due to the high cost of living and competition with London jobs and salaries.  The Trust was looking at ways to make the “offer” more attractive.  The  ...  view the full minutes text for item 6.


Refreshed Health & Wellbeing Strategy

The health & wellbeing strategy has been refreshed and a consultation will be launched shortly asking for feedback on the draft strategy.  Members will be asked to review the strategy and submit their feedback as part of the consultation.


This item is for Committee Members to have a general discussion about the refreshed strategy.



The draft strategy will be circulated to Members shortly and a link will be made available in the minutes.

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The Chairman read the following statement, prepared by the Lead Policy Officer for the Health & Wellbeing Board.


“The Health & Wellbeing Board will be seeking views on the refresh of the Joint Health & Wellbeing Survey, Happier Healthier Lives – A shared plan for Buckinghamshire which is due for publication in early 2021.  There will be a strong emphasis on three cross cutting priorities – Tackling health inequalities, mental health and community engagement.


The document will be online for 4 weeks and HASC Members are encouraged to respond and share with their partners.  It is important to highlight that the action plan that will accompany the strategy will bring in the evidence from recent “listening exercises” and consultation on Health & Social Care services and county wide Covid Recovery Plans.  The action plan will predominantly focus on health & wellbeing recovery in its first year.  The engagement document will be discussed at the Health & Wellbeing Board on 6th October and then finalised at the Board meeting on 10th December.”


The Chairman concluded that the link to the refreshed health and wellbeing strategy would be circulated to Members shortly and Members were encouraged to respond to the consultation and to share the strategy with others.


Primary Care Networks pdf icon PDF 1 MB

Primary Care Networks (PCNs) were launched in June 2019 and ambitious plans were put in place to deliver a number of projects across the networks over the coming years, including recruiting to a number of newly created roles.


As part of the Time for Care Programme, NHSE&I is providing support to practices, PCNs and the Clinical Commissioning Groups to capture the learning and improvements that have arisen through the Covid-19 pandemic.


This item will provide the Committee with the opportunity to hear more about the work of the PCNs, as well as examining how GPs and patients have coped with the changes in how primary care has been delivered in light of Covid-19 and the recovery plans.



Ms Louise Smith, Director of Primary Care

Dr Rashmi Sawhney, representative from the Primary Care Networks in Buckinghamshire

Mr Mike Etkind, representative from a Patient Participation Group



·         Power point slides - attached

·         Scoping report from the work with Primary Care representatives and the Time for Care team, NHS England (June 2020) - attached

Additional documents:


The Chairman welcomed Ms L Smith, Interim Director Primary Care and Transformation, Clinical Commissioning Group (CCG), Dr R Sawhney, GP at Riverside Surgery and CCG Clinical Director, Dr S Jinah, GP at Hughenden Vale Surgery and Mid Chiltern Primary Care Network (PCN) Clinical Director and Mr M Etkind, representative from John Hampden Surgery Patient Participation Group.


During their presentations, the following main points were made:


·         The Covid pandemic had halted the development plans for the Primary Care Networks, although some recruitment had taken place during the last few months (with interviews taking place via Zoom).

·         Remote working for GPs had been set-up very quickly, prioritising those that had to shield or look after their families.  Hubs were set-up to deal with symptomatic Covid patients, who were filtered through the 111 number.

·         The CCG had worked with the Time to Care team and Patient Participation Groups (PPGs) to identify the benefits and challenges through lockdown and this feedback would be used to discuss what would continue in the recovery stage.

·         The CCG was working closely with Buckinghamshire Healthcare NHS Trust to see the backlog of patients as part of the recovery plan.

·         Phase 2 and 3 of the recovery action plan had been mandated by NHS England.

·         There was general consensus by GPs that online consultations had worked well and there were plans to maintain these in the recovery phase as well as face-to-face consultations, where necessary.

·         Primary Care Networks had submitted their 20/21 workforce plans which included identifying which additional roles they needed within their networks, including social prescribers, pharmacists, dieticians and podiatrists.  A second plan to take them up to 2023/24 needed to be submitted by the end of October.

·         A group had been set-up to define clinical harm, quantify and monitor this issue and the learning from this group would be shared across the system.

·         Health checks would be promoted to vulnerable groups with the aim of picking up underlying issues.

·         There was a pilot study with care home staff to assist with recognising clinical deterioration (RESTORE 2).  A Primary Care Network Care Homes page was being developed to bring all the relevant information together in one place.

·         It was acknowledged that a co-ordinated approach would be required to improve housing conditions, particularly the impact of poor housing on health conditions such as asthma and COPD.

·         The new contract with NHSE included an increase in the use of digital technology to around 50% of patients so the Covid pandemic had accelerated the introduction of this.

·         During the lockdown, General Practice and pharmacy was still open – calling patients to reassure them, sending out shielding letters, dealing with prescriptions, emergency blood tests and delivering medications, etc.  Appointments were held by phone and/or video-consultation.

·         Personal Protective Equipment had been an issue in the early days of the pandemic with poor quality PPE.  A number of volunteer groups made visors for those working in primary care.

·         It was acknowledged that there would be an unprecedented demand on flu  ...  view the full minutes text for item 8.


Work programme pdf icon PDF 144 KB

The Committee will discuss the work programme and agree the items for the next meeting.



All Committee Members



Work Programme attached

Additional documents:


Committee Members discussed the draft work programme and agreed the following items for the November meeting:


·         Pharmacy services;

·         Support for carers and key workers;

·         Buckinghamshire Integrated Care Partnership (ICP) Engagement Programme: Working together to improve health and social care in Buckinghamshire;

·         Joint health scrutiny committee for the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS);

·         Director of Public Health Annual Report (item to note).


Date of next meeting

The next meeting will take place on Thursday 5th November 2020 at 10am.

Additional documents:


Thursday 5th November 2020 at 10am.