Agenda and minutes

Apologies were received from Cllrs Adoh and Turner

Cllr Angela Macpherson, Cabinet Member for Health & Wellbeing sent her apologies.

Cllr Poll declared that his wife works as a Project Manager for Health on the Highstreet

That the minutes of the meeting held on Thursday 12^th October to be confirmed as a correct record.

The minutes of the meeting held on 12 October 2023 were confirmed as a correct record.

The Chairman provided updates on two action points from the minutes:

• The Chief Operating Officer, Buckinghamshire Healthcare NHS Trust had been working through the action points arising from the discussion on the System Winter Plan.

As a result of various discussions, the Head of Operations, South Central Ambulance Service had been better informed of road closures due to HS2 and E-W Rail.

Public Questions is an opportunity for people who live, work or study in Buckinghamshire to put a question to a Select Committee. The Committee will hear from members of the public who have submitted questions in advance relating to items on the agenda. The Cabinet Member, relevant key partners and responsible officers will be invited to respond.

Further information on how to register can be found here: https://www.buckinghamshire.gov.uk/your-council/get-involved-with-council-decisions/select-committees/

There were no public questions.

The Chairman will update Members on recent scrutiny related activities since the last meeting.

Visit to Waddesdon Wing, Stoke Mandeville Hospital
A small group of Committee Members  had recently visited the new Waddesdon Wing at Stoke Mandeville Hospital which had been built to provide children’s and maternity services.

Members made the following comments:

• The Members were shown around by a consultant paediatrician, who was delighted with the new facilities;
• Clinicians had been greatly involved with the design of the facilities, working with the architects;
• There was a special area dedicated to the needs of children with mental health issues; 
• The maternity facilities and children’s ward were very impressive.

The Chairman thanked the Members who had attended.

The Chairman explained that a draft ICB Primary Care Strategy was expected the week commencing 18^th December 2023.  The Buckinghamshire, Oxfordshire and Berkshire West (BOB) Joint Health and Overview Scrutiny Committee (JHOSC) would be reviewing the strategy as part of its work programme, but there was also an opportunity for the HASC committee to provide feedback.  The Chairman asked for  volunteers to undertake this task and Cllrs Thomas and Wassell expressed an interest. The strategy would be circulated once received.

                                                                                         Action: Principal Scrutiny Officer

The next BOB JHOSC meeting will be held on 24^th January 2024

The first formal meeting of the Bedfordshire, Luton and Milton Keynes JHOSC had taken place on 27^th November 2023.  Cllr Mordue had attended remotely and reported that the committee had elected a Chairman and Vice Chairman and discussed the work programme and the ICB’s Five Year Forward Plan.

In 2022, the HASC Select Committee set up an inquiry group to review the development of primary care networks (PCNs) in Buckinghamshire.  PCNs were set up to bring general practices together to work at scale, improving the ability of practices to recruit and retain staff, manage financial and estate pressures and to provide a wider range of services to patients.  In Buckinghamshire, there are 13 PCNs.

The inquiry group’s report made 17 recommendations which were aimed at both the Council and health partners.  The progress in implementing the recommendations was reviewed by the Committee six months ago and this is an opportunity for the Committee to review the progress a year on.

Presenters:

Anna Marcus, Head of Primary Care Integration, Integrated Care Board

Philippa Baker, Place Director, Integrated Care Board

Bobby Pozzoni-Child, PCN Business Manager (Mid Chilterns PCN)

Angela Macpherson, Cabinet Member for Health & Wellbeing

Tiffany Adonis-French, Adult Social Care Service Director (Operations)

Papers:

Updated recommendation table to reflect 12 month progress

Development of Primary Care Networks Inquiry report

The Chairman welcomed the following presenters to the meeting:

Tiffany Adonis-French, Service Director, ASC Operations

Philippa Baker, Place Director, Buckinghamshire

Anna Marcus, Head of Primary Care Integration, Integrated Care Board (ICB)

Bobby Pozzoni-Child, Strategy Manager, Bucks GP Provider Alliance

The Chairman started by asking for clarification around the ICB’s  Primary Care roles.

• The Place Director explained that a staff consultation had taken place across the  Buckinghamshire, Oxfordshire and West Berkshire Integrated Care Board resulting in the creation of a new dual role which combined the Bucks Primary Care lead function with a system, primary care integration role across the ICB. Anna Marcus had been appointed to this role.  It was confirmed that Simon Kearey was the Senior Programme Manager of Primary Care Integration. 

The Chairman explained that in September 2022, the Select Committee had undertaken an inquiry  into the development of Primary Care Networks (PCN) in Buckinghamshire. 

• The report made seventeen recommendations of which all were agreed in full, or in part, by the Council and the ICB. 

A six month, progress report had been presented to the Committee and this item was now the 12 month progress monitoring of the recommendations made in the report.

The Place Director stated that there had been a misunderstanding in relation to recommendation 3 which was for an annual report to be presented to Members with specific  information on progress across the PCNs

She advised that an annual report would be produced after the committee meeting which would include:

• Answers to any questions that had been raised at the committee meeting;
• Details of the broad picture around the PCN and the wider primary care strategy;
• Data relating to the recruitment status of each PCN by additional role, including new roles introduced this year;
• National developments around PCNs.

She went on to say that some key areas of focus would be:

·       The improvement in the monitoring of PCN developments and data collection;

·       The new roles funded by the Additional Roles Reimbursement Scheme (ARRS);

·       The caps which had been removed on the mental health practitioners;

·       The national audit of GP websites and IT support for GP practices in Buckinghamshire;

·       Patient Participation Groups (PPGs) - engagement and outreach work;

·       Integrated Neighbourhood Teams with particular mention of the progress with mental health services

Members asked some general questions, during which the following points were made:

• A Member asked whether the annual report would include details on GP provision in Buckinghamshire. The Strategy Manger explained the Bucks GP Provider Alliance acted as the face of general practice and a front door to communicating with GPS. A good example of what had been achieved was the provision of Electrocardiogram (ECG) tests in every GP practice in Buckinghamshire.
• In response to a question on the difference in appointment booking software between GP practices, the Strategy Manager confirmed that differences do exist. Two-week appointment waits had been monitored.  Sometimes it had been difficult for patients to make appointments for long-term reviews.  She was aware of particular practices where there had  ...  view the full minutes text for item 6.

Each year the Director of Public Health produces an annual report on the health of the population. 

This year the report focuses on mental health.  The Director of Public Health Annual Report 2023 describes the factors that support good mental health, identifies groups that are at risk of poorer mental health and makes recommendations for the Council and its partners to promote mental health and wellbeing.  The report is a call to action for partners in Buckinghamshire.  Partner organisations will be asked to reflect the recommendations in existing multi-agency plans, for the Start Well, Live Well and Age Well Health and Wellbeing Board Strategy.

Presenter:

Jane O’Grady, Director of Public Health

Papers:

Director of Public Health Annual Report 2023, Mental Health Matters – Executive Summary

Director of Public Health Annual Report 2023, Mental Health Matters – Full report

The Chairman welcomed Dr Jane O’Grady, Director of Public Health, to the meeting.

The Chairman said that although this was about this years’ mental health report, in future the Committee would like to see evidence of how the recommendations in the annual report had led to improvements across the system.  The Director of Public Health  explained that the recommendations in last years’ annual report on cardio-vascular disease were aimed at, and delivered by, a wide range of organisations including primary and secondary healthcare providers.   Improvements had been made in a number of indicators and an update had been provided to the Health & Wellbeing Board and the Opportunity Bucks Board.  It was agreed to bring an update, with partners, to a future meeting.

Action: Director of Public Health

The Director of Public Health urged Members to support the legislation for a smoke free generation.

In introducing the 2023 annual report, entitled “Mental Health Matters”, the Director of Public Health noted that the report did not deal with the huge subject of mental illness, but focussed on promoting good mental health and what the council and its partners could do to promote this. She further pointed out that one of the most important areas to focus on was supporting mental health in pregnant women and supporting children in their early years.

During the discussion, the following key points were made:

• A Member was pleased to note that childhood trauma was mentioned in the report.  She was concerned that there had been insufficient support for children given that there was a three-year waiting list for Child and Adolescent Mental Health Services (CAMHS). She asked about the KPIs, actions and specific outcomes.  The Chairman added that the report is a challenge for HASC as a scrutiny committee as it does not contain certain data.  The Director of Public Health explained that the committee had early sight of the report and that the report would then be disseminated to partner organisations for action.  Partners would incorporate their actions into existing multi-agency action plans to support the mental health of adults and children and that these would be monitored by the Health & Wellbeing Board.
• The Chairman asked if there was a list of organisations which were expected to take up the recommendations of the report.  The Director of Public Health mentioned Oxford Mental Health and the wider NHS, the public health team, planners and Opportunity Bucks.  She explained that the report would be used by the public health team to hold partners to account, however, it was up to partners to decide how they wanted to respond to the report as they would know best what they could do within their organisation.
• In response to a  question about measuring the outcomes of those groups identified in the report, the Director of Public Health mentioned a survey of 50% of schools to explore the health of primary and secondary school pupils. The waiting list for CAHMS was also a priority and Oxford Health would be able to  ...  view the full minutes text for item 7.

Ms Z McIntosh, Chief Executive, will update Members on recent projects undertaken by Healthwatch Bucks.

Papers:

Update attached

This update will be given in the meeting in February 2024

For Committee Members to discuss and agree the items for future meetings.

Papers:

Work Programme

The following items would be reviewed at the next meeting:

Dementia Review – 6 month recommendation monitoring;

Adult Social Care – review of the improvement plan.

It was agreed to move the review of the Autism Strategy to a future meeting.

The next meeting is due to take place on Thursday 29^th February 2024 at 10am.

Thursday 29^th February 2024 at 10.00am