Transcript

So, do we have any apologies for this evening, please, Esther? I've received apologies from Councillor Harrison and Councillor Collins, and I believe Councillor Virgo will be joining us a bit late in the meeting. Rebecca Willens is also potentially running a bit late, but she will be joining us. Thank you. And does anyone have any declarations of interest, please? One. No. Thank you. And can we, as everyone's seen in the minutes of the last meeting, and anyone need any changes, everyone happy with them? Yeah, happy with them, no changes needed. Thank you. All right, well, thank you to the team from Berkshire Healthcare Trust. As you know, we've been looking into the sexual health within the borough, and we've put together, obviously, if you'd like to show your presentation, and then we've got some questions for you if you don't mind. Yeah, sure. Thank you. I'll start, I'll just take my camera off whilst I'm sharing, and so just bear with me. Can everyone see that? Yeah, thank you. Should we do some introductions who we are just for information before we start the presentation, or you want us to do later? No, please, that'd be brilliant if you'd love to introduce yourself, so do apologize. Raza, if you want to take the presentation down for a minute, then we'll increase our self, then we can start the presentation. Thank you. Sure. Yeah, my name's Raza Ahmed, the service manager for sexual health service. Since 31 is our next. Hello, everyone, I'm Sunita, I'm lead nurse for sexual health service as well. June, do you want to go next? Good evening. I'm June Carmichael, I'm the associate director for contracting and service development for the first. Good evening, everyone. My name is Shreen Lagiri. I'm the service director for shared deal care, for bar shared care. What do you want? Okay, shall I start? Yes, please. Yeah. And so sexual health service is provided by bar shared health care trust across East Berkshire from multiple locations, including Bracknell. Here, Bracknell sexual service, provides skimped help Monday, 10 till six o'clock, Bracknell and walking and college Tuesday 1130 till 1 30, which is a walking clinic for young person's clinic. Bracken walk youthful, which is a walking clinic on Tuesday three till five o'clock, skimped hill again Thursday, 10 till three, and then skimped hill Thursday at three till six o'clock is a walking clinic for young people. This. Bracken service is a walking service as well, welcome patients as walk ins. We offer online appointments where patients can book coil and implants and symptomatic appointments where patients who have symptoms, they can book appointments. And we have asymptomatic clinics as well for online asymptomatic is where patients don't have symptoms or underlying issues. They can order online STI kits, which are sexual transmitted infection kits online through safe sex box your website. If the kits are unavailable, they can go into asymptomatic clinics where they can be seen by a clinician for lines are managed Monday to Friday. Long people's clinic just to reiterate this is the 13 and plus of age group. And what do we offer services offered in Bracknell STI testing. This is asymptomatic where patients don't have any symptoms and they can that's offered at Bracknell emergency hormonal contraception condoms, contraceptive pills, long acting reversible contraception, pregnancy testing, uncomplicated STI treatment, symptomatic patients are seen here as well. If it's content complicated symptomatic treatment or complex care, this is referred to slow, which is our level three service health promotion is provided through our safe sex box your website, for example, educational videos, leaflets, any social media that is done via box your health care network through our social media team. So the overview of the service currently where are we at the minute service has made significant progress in key areas so far that enables the service to do more transformation work to improve access, feedback and patient care. We have automated patient feedback, which is I want great care where patients can leave feedback via the get an SMS if they're visually impaired or with disabilities, they can get a paper copied from the clinic to leave feedback. And this is the fed back to the patient feedback for data, a data set to monitor and improve the service bookings, online bookings due to pre-COVID, when COVID hit, we were one of the services where patients could book online and get their sort of virtual appointment and book online as well to see a clinician. And testing which is available now through safe sex box your website where they can order the kit, get that delivered at home and send that back and they'll get their results. We have health promotion which we've done through social media via TikTok, Facebook, Instagram to get educational messages through there which what I mean by that is the sexual health week, the AIDS week, and just to get the message across to our patients, sign the sexual therapy and GP referral pathway that's embedded with the GP services where they can send referrals to sexual health services through their system via sexual health service. The pathology results, this is where service users can get results via text message, the negative if it's positive, then the pathway for that is managed by our health care assistants for aftercare. Service improvements and developments, the four key areas or themes that we're in is digital efficiency, outreach and optimizing care. The work streams, the first work stream is digital, digital is self care where STI testing kits for underserved population, we're looking at deprivation codes, we're looking at age groups part of that digital journey to make improvements and revise that digital pathway for what we've got currently, direct messaging, this is where patients can contact clinician directly, this is part of work stream one, where patients can contact clinicians directly. Work stream two, efficiency, digital pick-up of medication, this is reducing unnecessary clinical time and allowing people to pick up their medication or without an appointment where clinical appropriate. Automating insight where we can look at our data, get a bit more digital with our data to help us explore our performance and identify efficiencies and promoting sexual health where we will develop objectives and outcome measures, outreach where we want to work with the sex workers and health inequalities and silencing and people with disabilities, currently we've got project in flight in regards to delivering and working with silencing around the locality part of the GILIAD project where we work in closely with hotels and GP services to improve access to sexual health services, work stream four is optimizing care where we're building a data focused mindset, cross training of a staff, patient forum, what we need to ensure that our services are providing the best care and experience for patients. Once all our initiatives are implemented, the service will better empower people to take control of their care through digital innovations, operates in a streamline data informed way, delivers the right level of care at the right places and delivers for the whole community. Thank you. Any questions? Thank you. I'd like to congratulate you on that and say what a brilliant job the team are already doing. May I just ask a question? When you say that you're sending the TS3 go over to town, over to Slough, what percentage is that? How many have to leave Brattle to choose the facility at Slough for that reason alone? Yeah, sorry, it's not a percentage, it's if it's complicated, where they refer back to level three, where we've got a level three service at Slough. So what would that be for? And so that's your complicated GUM, complicated, you know, if they've got, if they can't be seen a level two, a Brattle is directed towards level three, which is at Slough. Sorry Caroline, Sunita, you might be able to explain a bit more clinically what the difference between level two and three that helps Caroline. Thank you. Hi, yes, so level two is where we're treating uncomplicated SDIs. So I'll just use a very simple example, please do let me know if I need to clarify further. So if we have a woman who just, you know, attends with a designer discharge but doesn't have any low abdominal pain, anything like that, then that's something that we can see in Brattle because that's uncomplicated. But complicated, if they have any abdominal pain, if they're pregnant, they have genital sore and other physical symptoms, then they fall on the level three. So those are the patients, but however, if there's something we can do for that patient there on the day, we'll still do it because, you know, if we think there's some antibiotics we can start them and then follow them up in Slough, we'd still do it because at the end of the day, patient care and, you know, their comfort is more important than anything else. But if, you know, they slowly fall outside the remit of level two, then they get referred. But then again, what we do, we contact Slough as a clinician and give them a date and time to come to Slough when we know that those patients expected and they're seeing there and then. So it could be, you know, on a very day depends on what the patient would, you know, prefer. So yeah, so that's arrangement that we make ourselves. Thank you. Councillor MOUCH. Hi, thank you for that presentation. I just have some questions around what you're planning to do digitally. As you say, you want to have more direct messaging. Is there any plans to update your website at all? Yeah. So just coming back to the digital journey, part of the Safe Sex Boxure and the online STI, that is part of the work stream. So we're looking at how we can streamline that, make that a lot easier for our patients. There is a piece of work that we're working with our sort of more comms team, digital team in regards to get some educational videos in regards to that and that is in the pipeline. And do you have a time scale on that to be completed? Yeah, so it's going to be around 1st of July, we're looking at and we have regular meetings with our commissioners in regards to that, where we are with them. But yeah, we are on track in delivering that. Thank you. Can I come in just to clarify a couple of things, while we're doing some of digital work in the Trust, find some videos and education side a bit. If my understanding is correct, Safe Sex Boxure website is not Boxure Healthcare website. So I just wanted to clarify that point, where we can do it from a Boxure Healthcare. We will try and do it, but some things we need to work with commissioners on that website is not Boxure Healthcare, just to clarify. Thank you. Great. Thank you. Thank you. Councillor Amvergo. Thank you, Caroline. Got a few questions, actually, if I may ask them. There are, in the figures that I've been given from Bracknell anyway, nearly 900 people that are now referred from Bracknell to Slough. So my first question is, it isn't a small number, this is a huge number, actually. But just before we get to that point, could someone tell me, are we paid, do we have to pay, as a council, for the people that are referred to Slough? Is there an extra payment beyond the contract, please? Do you want me to come in there? Yeah, please, yeah, June. No, so the way that we're commissioned determines where patients go. So because we don't have a full level three service in Bracknell, we relocate the people to Slough, or working within the financial envelope within the contract. Okay, so we don't have anything more than the contract. So basically, the answer is no, we don't pay for that, okay. Then my second question would lead on to that. I mean, I've been to both alphits, actually, both to Bracknell and Slough. And I met Reza, and he was very kind to help me, and I've met Jan at the Bracknell Clinic. Now I have to be, I had to be candid with you, okay, clearly it's chalk and cheese. Bracknell looks like a very poor cousin to a very, a very affluent uncle, if I'm going to put it that way. Now what I don't understand in the system, so I haven't read all the conditions of tier one and tier three, but clearly Bracknell needs more help. I mean, anyone can see that in my life. It's not coping with the demo. That's absolutely true and borne out by people. Now if we decided to, how do you, I haven't hexted him, I haven't, I haven't, I haven't ever frozen him, honest, he might want to put his camera off, that might help his bandwidth a bit. Yeah, we will wait for Tony to come back, but on those points that he was raising, obviously next year, there's going to be where you're currently located in Bracknell, it's going to be change, isn't it, because the new building, yes, so have you got any influence in that to basically what Tony was saying with regard to making it just more welcoming, because I know it's the building itself, it's not you, it's literally when you're going to skimp it here, it is old, and it hasn't got any signage outside, it isn't welcoming for people going to the garden clinic, but would you be able to have an input in, have they asked you with regard to that moving forward, as a clinical department who's going to be using that building? I'm happy to respond on this one, and we're working with the ICPs and we're working with the primary care, because of the part of the next door development, it's going to be called I think a Bracknell Health for, so Bracknell Health Center, I think. We are working with the ICP, some of the BHFT services will be part of that new provision from the building side of it, and some of the things we are exploring is what is possible in terms of should be, the clinical aspect of should be delivering from the new build part of it, and there will be some services within the existing building, which is Kim Britt Hill side of it, but we can look at that side of it when it comes closer to that one and see what is possible, but at this point in time, the BHFT is working with the partners to influence that. Excellent, how's that influencing going? Because one of the things Councillor Vergo noticed, we sort of sent him, he was supposed to be on the secret mission, but either way, he did notice that obviously there was no signage going in, and then you had to, if you weren't quite sure, you had to ask a lady at a desk, and then it was difficult to navigate, and we were just waiting for the new building. Can I take that over? Sorry, the IT is obviously... I just wait, I was ad-libbing till you came back to him. Thank you. Thank you. Yeah, I mean, putting up a sign, it doesn't take 10 minutes, frankly, but it isn't, so that's the first thing. Going back, I mean, I'm more interested in the health, actually, to be honest. It obviously needs a lot more help in Brackmore. There's no one, I think, that would argue with this. If we decided to put a doctor there and increase the outreach, not the outreach, but the nurses, how could we achieve that? Could we have to renegotiate the contract, could we put an additional amendment to the contract? How would you suggest? Because I think anyone that understands this and goes their needs, it needs more help in Brackmore. It's a growing town, at the moment, the supply is not worth the town, it isn't, and that's not to say the staff are brilliant, of course they are, I've met them, they're terrific, but they can't do what they can't do, you know, it's impossible. So how do we move this forward, who would like to answer that one? June, would you like to come back on that one? Yeah, and my colleagues can come in too. I think that the first thing that we would say is that the contract can be varied, you can make a change to that contract just by raising a variation. I suppose you've got two ways of looking at it, if you're financially challenged and the money is the money, so the money that's in for Brackmore's is all you can afford, then one thing you can do is change what we deliver for that money, so you might change the emphasis on getting your Brackmore population under the level three, better seen in Bracknell and stop doing something else, that's one way you could do it, probably not the ideal story, or we would have to look at what resource would be needed to deliver. And I suppose if I may just interrupt you there, June, I suppose what I'm saying is if you look at Slough and you look at Brackmore, I mean in Slough there's an HIV clinic which is brilliant, obviously brilliant for a reason, clearly, but it's brilliant. We're nowhere near that, of course, but rather than go to the full amount of Slough, I'm thinking of money as well, could we not go a half way house and say, right, what we'll do is, I mean Carolin's already mentioned there'll be a new building, the building's terrible, to be honest, let's be honest, it's shocking, but putting that aside, could we increase it with a doctor outside the contract and make it like a tier two plus contract and an extra nurse and then you could bill us, if you have those staff, of course, I don't know, maybe you don't even have the staff, I'm not sure. That's kind of what I was saying in my second point, you know, you can increase the resource and by resource I mean whether it's a doctor or the right clinical level in Brackmore to attend to those more complex cases, just I think you know this already, I'm sure you know this already, but the HIV clinic that's in Slough is actually commissioned by NHS England to serve the whole of the Easter of Barca, it just happens to be next to the garden clinic or part of the garden clinic. So I would say we could quite easily come back to you with a proposal, if you wanted to have a tier two and a half or a tier three service, what would that look like and what would it need to deliver and cost that up for you, we could do that relatively quickly and then it's about choices you make. So I don't want to stick to the, I mean I'm saying I'm the commissioner, which I'm not, but I don't want to stick to you know tier three has to have this and that's to that and that's it. I mean I'm guided by the clinicians, I'm guided by RAAS, I'm guided by other people to increase the service clinically, a doctor and an extra nurse would make a hell of a difference to that system. And we could cost that up for you. Yeah, okay, that would be brilliant. Thank you. Well, I don't know with, I don't, what I don't know is whether we've got the resource that could work. Well, that's my second question, people in, yeah, we can look at that. So, so if I'm hearing you, we need to cost up for a doctor and a nurse. Yeah, I just be interested, if that's with, with your permission Caroline, to see what that cost would be. I think yeah, it would be interesting to look into it. I also think though that the most important thing is from the service providers, they, they can honestly tell us if that's what is needed in Bracknell, if they've got those people going to them that they have to pass on, that they feel that we could be dealing with within the borough, because they're the ones with the numbers. I gather that was true though, RAAS, isn't it? I mean, we had this conversation between you and I, and you said to me, to be fair, that a doctor and an extra nurse or two would make a world of difference to Bracknell, which, because it's not coping with the demand. And to be up to now, I want to be candid about this, to, to send 900 people from Bracknell to slough with the really poor public services we have, you know, in terms of transport, it's just not acceptable. So, yeah, no, I completely agree with what Caroline's saying. We need to know exactly the figures, we need to know the data. I agree with you, Tony, if it's needed, yes, absolutely, you know, we should look at it, but we need to know the data first and we need to have that. I agree, but I, where I, where I slightly disagree is that, I mean, I'm not making this up. I mean, I'm not saying Tony knows more than the clinicians. This has come from listening to clinicians and understanding what they're seeing on the ground. And I think that needs to be looked at straight away. We can't have a town that is in a rather poor provision for sexual health. We just can't, you know, and some, some of this door to get this done. I do think, though, what we have to remember is we started this and we spoke to BEX about what was really sort of, if there were, and it was anything we could look into. And that was the fact that we had a lower testing rate in chlamydia. And we also had slightly, you know, later diagnosis of HIV. If we managed to get people going forward a lot earlier, which is our goal, would the clinic be able to cope with that extra demands unless we did something? It's all right, saying to a service, we would like to see this, this, this, and this. We want the numbers improved on this and saying to the residents get along, get tested. But if the facility would then struggle, that makes it a whole different, a whole different ballgame, and it's up really as well to, to the facility to sort of say to us, well, yeah, we would love to do that. And you, you said that, you know, extra people to us. So we can hit these figures, but I mean, I got the feeling capacity to deal with them. What Caroline is saying, I got the feeling when I went to, to Bracknell, that they felt like they were locked up in a small room, almost with the lights off, and no one knew about their service. I mean, that's when I got the feeling, and that may not be all true. But it certainly looked like that when I went there because, first of all, I couldn't find it. I mean, that's a fact. There's no signs. And secondly, they're in a cupboard. I mean, honestly, this is not acceptable. Now, I'm not blaming the commissioners, I'm not blaming Bracknell's health. But what I'm saying is we have got to improve this service and we can't wait for three years to do it. Yeah, but we have the new building that will be in place. Yeah, but we don't have the staff, Caroline, at the moment, because we're a tier two and that's not going to change. OK, June, did you want to say something? Yeah, I think one of the things that's really important. So, you know, we would agree that data only tells you half the story. So if you're getting complex cases going from Bracknell, we will have that data and we will know how many it is, that would allow you then to judge whether you need to have full time people in the clinic, whether you could do it two or three days a week and still improve the service of Bracknell. And I think, and my clinical colleagues will say, it's not necessarily about bringing up capacity by improving some other elements, the determination of what staff we bring in to take this up to a different level is based on skill set rather than being up capacity slightly. I agree. I think the data is really important and we can look at that to see how many it is. We could then, when we do the costing, we could advise you that we think we might be able to do that on two or three days a week rather than five. When you go down to that granulation, though, recruiting people on two or three days a week is much harder than recruiting people on a five-day week, so we could look at that. But I think the message we're hearing is clear. I think it's one that we've talked about before. And I think, you know, Caroline, thank you for your support in terms of the building. We all know that there's parts of Bracknell that have been needing updated for many, many years. We were in Fitzwilliam House for years and we moved out about a year ago. So, you know, we know that the building is not fit for purpose and we know that we need to have something better. But I think if we go away off this call and think about what is the number of people we're trying to prevent going to SLOW, because we know the transport infrastructure is not good enough, then we could then come back to you with some kind of proposal. We could do that fairly quickly. We're not talking about taking that to do that. That's great. That's great. That's great. Just to sort of jump in before you say anything, the other thing is, I mean, things can be improved straight away. I mean, on the website, and I misunderstood this, I thought this was Bracknell. There's actually no reference to the gay community, the LGBT community at all, and that's something we could change now. We could do it tomorrow if someone worked on it, you know, and it would make it more presentable to those people. I mean, I agree with June and I'm pleased June said this, because statistics will only tell you how hard the story, you know, a lot of people that can't get what they get from Bracknell will go to Wheeling or they go to, you know, somewhere else. I mean, it's in this, it's absolutely right because they feel that they've got to do it in a very discreet way. So let's not just, let's listen to the clinicians on the ground who are doing it and listen to the people, and they know what's going on there, because when I was there, three people turned up and didn't have appointments, they just turned up, and that was just in an hour in Bracknell. So, you know, I'm sorry to keep on about this, but I feel passionate about this now. We have got to improve this service, and that's it. Okay, sorry, Caroline, I've got to offer that, actually. No worries. Here we are, if you'd like to. Yeah, I'll come in. Yeah, just a couple of things in relation to signage. We have already locked the call, okay, so with the signage kind of area, we are working with our state's team to improve the signage side of it again. It's within the fact, as we can try and do that one. Again, absolutely, I agree, we need to develop the services, what is appropriate for the local population requirements around it, but we do have our own constraints with the workforce skills and the money and the finance and the commissioning side of it, but if we've got more flexibility, if you've got more resources, Box Health Care will do everything to enable that improvements to happen in Bracknell. Thank you. Thank you. Councillor WELCH. Yes, just to actually highlight something Councillor Virgo said about, which is that they feel that it's not known that they're there and nobody knows about it. That's why I was asking about your digital offer at the beginning when that would be done by, because we all picked up on parts of the website we believe could be improved, for example, the walking clinic. It wasn't very obvious, you have to go halfway down the page to see that that's there. Also the times of your phone lines, it said throughout the week on your website and then you phone and it tells you it's Monday to Friday, so we thought that could be better defined on your website. I mean, if you get all of these aspects really done well on your website, I think it will encourage a lot more people to go there. And also sort of commenting on what Councillor WELCH's has said. When I saw your slides, I didn't know you went to Bracknell Walk because when you go onto the Garden Clinic, it just talks about the Garden Clinic and I didn't know how that was like shared to anybody unless those young people were actually physically going into the youth club and finding out. But I didn't know how that was then advertised through schools, because if it's not on the website and that's the one that you're directed to, how do the young people find out about that one? Yeah, just before Beck's comes in, currently Caroline, it's done through newsletters at the schools and the notice boards in regards to that and there's sort of social media team in regards to that. We have got the social media team who are working on that and that should be in place by end of this month. In regards to the website, we'll take that away and we'll talk to Bracknell Forest in regards to that. Thank you. Thanks. Hi there, can you hear me okay? I can. Thank you. I'm in my car on the way back from my famous group, I haven't been off having fun. But it was a good fun, but anyway, I was just coming in to clarify about the website situation. So I've put in the chat, I don't think it's come through to clarify, yes, safe sex Berkshire is set at a website that the Council's in Berkshire manage and the Commissioners in Berkshire East are working with the Commissioners in Berkshire West to review that site. The reasons being that we've done some analysis, I think it's called user generated analysis. If you remember the public looking for an STI test kit or advice or contraception, what sorts of things come up on Google searches, what come sorts of things come up on smartphones and also with young people who've been looking at their feedback from focus groups and the overwhelming sort of findings really have been that safe sex Berkshire is hidden. So it's, it, unless you know that safe sex Berkshire exists as a website, you, you don't find it. It doesn't come up even in the top 10 Google searches and we'd have to do a lot, we'd have to invest a lot of comms where it's kind of changed that, but also for younger people as I've reported last time, actually anything with sex in the, in the title that it might be blocked on their smartphones or they wouldn't want it on their search history. The second thing is that the NHS brand is really strong. I mean that comes from national surveys, our locals, focus groups with younger people and also that's what's most prominent so NHS choices which you can go online and you can search for any site and that's where you'll get the full list of all the local sexual health services depending on what you need. So the scope of the review we're doing with Berkshire West Commissioners is do we still need a local website or is that just adding another layer of unhelpful complexity or do we make sure that the NHS sites that are available are really good quality including the NHS choices one that we can make sure the content is up to date on and then if we do have a local website just scoping what resources needed so it doesn't cost necessarily that much to set up a website. It's the investment in the communications teams that go behind making sure the contents up to date is useful, is being promoted to all the things being discussed here. So the timeframe for the scope of that review and the safe sex Berkshire website, the contract with the current web providers due to end of March next year so there will be something up and running well before then but we're still negotiating with the Berkshire West Commissioners precisely the timeframes for that review but it is in the next sort of six months or so that the analysis and the kind of options appraisal will be complete on that work so I just wanted to clarify that that difference between the Berkshire Healthcare Foundation Trust website, Safe Sex Fortune and the NHS Choices websites. Thank you Bex. Can I just ask, you might have mentioned this, I do apologise if you have. So when a young person, if they want to, if they go on their school's website, is the information on there as well? So it could be, so I think there could be work with schools locally to ask them to one block that website. I think you can specifically add certain sites as safe sites because all you're thinking of is like you said, for a young person at home, they can't like type in the word sex, they get blocked, they don't want mum and dad to see it but if they've literally just gone into their school website and it's got listing on there the opening times etc or where they could go, they're not even putting those words in, it's just something, if anyone was looking they could say, right, I was just checking site about school, I just wanted to, you know, and no one knows any different, they're just on that school website and I thought it might be quite a nice safe place where they could look that's not going to get blocked by them and also it's something, you know, it's only going to be a time or date that the school might have to amend because really that's more or less set in stone when those opening times are, I just want to do something that could be done as a form of, yeah. I think that's a really important point and I think that is something that could be actually much more quickly than the full review of the website just to kind of look at, is there some web content, be it a web page that we could make available to schools just so that within their own sites they could host something, we have to be careful with, obviously once information's out there it needs updating, so I think that's something I could pick up with colleagues in BHFT and think, how can we safely signpost the schools to a source that we're happy is going to be kept up to date in terms of clinic times and telephone numbers, because that is part of the problem at the moment, we're so six bucks as well, if something changes in BHFT, we have to follow through to the information on safe sex barks and obviously if we miss that, even if it's for a couple of days it can mean we're spreading, there's misinformation out there in terms of that, clinic times etc, but that's something we would definitely follow up on quicker than the reviews finished to make sure there's accurate information out there and accessible to young people. Thank you very much, Bex, Councillor COCKwyn. Hi everyone, it suddenly occurred to me I'm backtracking actually to the signage, I believe Skimbit Hill is owned by property services, it is, isn't it I believe, well couldn't they be responsible for the signage, because I know they're doing it at Great Holland's Health Centre. What we are going to do, what we have done is we've locked our call because of the BHFT anyways, but we do work with NHS properties to make those improvements, so it is a channel we have to use it through our estates, by its property services. Okay, thank you, does anyone got any further questions or points they'd like to raise? Sorry, Councillor, another thing actually, would it be possible for June to come back to the committee with those costumes, and also maybe appraising from your team what you think would better brighten off, I mean I'm throwing all these things out, but I mean the team must know really what would make this situation better, and of course I've just come off a climate change committee, so the one thing they'd say as well, we don't want people keep going to slough, why are we doing this? You know, so he's working together, isn't it? Yeah, so I think what we would do under Shree's leadership, he would work with his clinical team to work out what would be needed to give you the enhancements that you're looking for, we would then work with finance colleagues to cost that up, and then I could send you something formal, so that's kind of the governance loop that we would go through, we would have to talk to finance colleagues, and look, we can turn this around, I don't know, Shree a couple of weeks? That's fantastic if you can do that, that's brilliant, brilliant, thank you. Thank you, so once again, thank you to all the barks here, team, it's really lovely to meet you, and hopefully we can make this really positive, when the new building is there, I'm going to personally have Toni with a bottle of wine against the side, doing open. We'll put this down, I think it's on the plane actually, don't we, it's good enough to say? But you know, what I would say, Caroline, is we would encourage these conversations to keep going, if you've got any questions at all, just then shoot them over to Shree and the team, and we're happy to answer any questions you've got in the future. And thank you for the team, thanks for the team, because they're doing some fun sterling work, so thank you. Great, they do a great job, certainly are, and thank you for joining us, and enjoy the rest of you evening. Pleasure, thank you very much. Thank you, and have a good evening, bye, thank you, thank you, bye bye everyone, bye. Hello, yes thanks, and I can't say, would you like me to stay for the latter half of the, the latter section of the meeting, I'm happy to, or I can drop off whatever you prefer. You can get out of your car now, Bex, I'm happy to say, slow and where I live, so I will continue my journey, but look forward to any of the questions that might come out between now, and I appreciate next week's the recommendations, but anything else comes to mind, and obviously Esther said, go through her and I'll be happy to have lovely, lovely, thank you, thank you all, bye, thank you, everyone's, everyone's dropped off, yeah, everyone, well apart from Sophie, Sophie's still here, Sophie, Sophie, you know you had to say, it was, I was politely letting the others go, I'm used to working in this environment with people there, being asked to leave whilst you sit there silently waiting. Yeah, that's it, you're just thinking, so just, that's the basically sort of sum up, that was really helpful I think, and if we can work with them, and a lot of the things that we are putting forward aren't of any cost to the council, and if they are, it's only to improve the service, it's, if it's needed, which is what we want as recommendations, I'm absolutely sure, so what the plan is, next week it's in person, we will be discussing the recommendations and voting on them, so therefore it's got to be in person, if of course the most important thing is all agreeing and also the wording on everything, so if anyone has any thoughts beforehand or wants to run anything past us, I think that's a good point because sometimes when you're in that environment of a room, and you're face to face, sometimes it can be all, do I really want to say that, is that a recommendation? So you know, anyone who feels like they just want to sort of, issue ease? I was just going to say, I would suggest, you know, any recommendation, even if you feel it might be a bit rough around the edges, you know, put it in, and then we will look at it, and if we need to tweak it, I mean, mine will probably be a bit rough, for example, and then it might be tweaking on the wording. Yeah, absolutely perfect. I think from what we've had, we're not going to be able to get another survey done in time from the other young people, and it would really have to be done, but then that's the recommendation in itself, that we've looked at the school's ones, can we have a survey done by whoever is best pleased to do that survey to make sure that what they say they're doing, they are doing, and if there's any improvements the young people feel that should be made regarding what they receive in school is, once again, a recommendation. The fact that we've mentioned about this new bill, we're not asking anyone to do anything tomorrow, but this contract comes up for renewal again in 2026. So basically, Councillor Wright will be looking at it from the middle of next year. So it gives her then plenty of time for all this feedback to come back, a new building to be opened, and anything that then it's, even if we don't get the data back in time of how long, how many people are really using it, if we know there is a need, we can recommend she looks at that need due to the changes and, you know, more people living in the borough, so many going over there. It's up to her as a recommendation to look at that and say what we need by talking to them and looking at different contracts that might match our new town. So anything like that, don't think we've got to go and do it, we're just putting it forward. I'm just going to put a word in for those of us who are in, yeah, outer reaches of the borough to say it's not just the town. We have scientists and crowfallen down in the southern part, which very often gets overlooked compared to the town itself. Yeah, absolutely, and if you're that side as well, slough is a lot further than it is from this side. And I don't think the public transport to get there if you're a young person without access to a vehicle and you're trying to get somewhere, perhaps without having to have the conversation with your parents and looking at some of the looking at some of the opening hours for some of them is thinking, mmm, you're going to struggle to do that one without having a difficult conversation? Exactly. And it's, I mean, if you knew, and I mean, I didn't realize they were at the youth club, that that was something I thought they just did. But if if I was a young person, I knew and I knew I couldn't sort of get out, if I could say to my parents, I'm going to the youth club tonight, they would never know any difference. No. And the parents, of course, would encourage, or you're going to the youth club, that's good. Of course. It's advertising, it's advertising, all of that, isn't it? Which is why, I mean, it shouldn't cost a fortune to be trying their digital offer and what people can see straight away, you know, to what is there. I mean, I haven't sort of checked, I don't know if you're actually on the Bracken youth club, does it advertise that they're there? Because if you're looking at a youth club, you would have thought that you would, or what song tonight at the youth club. Hmm. I don't know, you'd have to, yeah, check if they do, advertise it. And if they don't. Why not? Well, exactly, you know, it is getting over this stigma as well, that it, and it's just something that, you know, it's just part of, we have this here on this day, as a normal activity. I think even if the building wasn't, you know, being completely revamped, and if they weren't already kind of looking at their digital offer and what they can improve on, I still think there's a lot of recommendations we can put forward that shouldn't cost any money or cost a fortune, you know, compared to what Tony is suggesting with going up a level on the service, which will cost money without, which will, and we don't know how much, but I mean, as the town grows, and we will see more money per head, that might be a way going forward. But at this moment in time, we know the council hasn't got any money. The thing that we can pass over to the service providers or public health England because it's their responsibility, we have to. But our goal is at this moment in time to ensure if nothing else, it's communication to the young people, it's making sure obviously that, you know, if they could add it to the website, if you've just got Google Garfield, your mum and dad don't know what you're looking at and your search history says Garfield, no more, no less, it's just, to me, it's quite basic things really that you'd think of how would a young person then deal with this. Yeah, and having it on the schools, all the schools websites would be for everybody in the bar, for example, all areas of the baron, you know, not just the town. Exactly, because that would go on to Edge Barrow, every school with the age pupils and every college facility should have that. And also, we found out that- I think you have to assume that it has to go on to any school website that's got children of secondary age or a baron, regardless of whether they've specifically got a sick form college because people who are technically underage particularly are actually- Oh, absolutely, absolutely. Well, they're the ones you need to get to the most, let's be honest, exactly. They need to know where to go and- And it'll be the ones that will be most concerned about asking. Yes, because theoretically, they've done something wrong in their eyes and that they're worried, they're scared, they don't want anyone to find out. So even going into where that location is, if their mum and dad, you know, are patients of forest health or evergreen, there's always a chance of a neighbour or whatever else spotting them, they're not going to be in the youth club. So I mean, it's highlighting all of that, which we didn't know about, but also I think it comes down to every time we've asked for the data from them. I know that it says it's circumstances as well, but when you're putting forward any money proposals, it's going to come down to the data. How many people actually, I mean, we say, you know, 800 odd are being sent over there. If we moved up to a tier two plus, then how many would we still send over that we still haven't got the facilities to be able to deal with that? So that would be something else. So our recommendation could be that the executive looks into what the possibility, what that could look like, to save our residents having to go there. Don't remember, we're not trying to solve this, but we're trying to put enough evidence forward that that's what should be looked at and if extra money needs to then be added at the end of the day, public health England, give them the money to run that service. And it would be up to the executive to talk to public health England and say, we need now need this, not down to us at all. It's just the recommendations that we're putting, which I think we've got quite a few, and I don't think that any of them are, that they're not stupid by having signage, by having leaflets. To me, it's, I'm sure as you're all thinking, it is basically... No, particularly costly either. No, exactly. There's probably loads we can put across before I would say it's kind of last resort to suggest we need to pay more and move up a tier and it would be interesting to see what the actual data is. But then you could have the argument that if people don't know it's there, the data is going to be pretty skewed data, isn't it? Because people aren't going there in the first place. Yeah, well, but the thing is though, that if you're asking for anything extra and the whole brief was, people aren't, you know, we've got lower detection rates of chlamydia, so we want more testing. We've got a late rate of HIV diagnosis. So the whole point really of it is like, if they had all those extra people going through the door, could they cope? Because we don't want them to then send another 2-300 over to Slough, just because they can't cope with what we're sending them. But then that's not for us to worry. Once again, that would be part of whoever negotiates the contract on that to say, and it's also they that they would then, I would like to think BHFT would then talk and say, right, okay, we're now struggling. Because these councillors did this, we've now got extra people coming in because they realise we're here and we're offering this fantastic service and we can't cope with it. So it's looking at the whole thing. Jeremy, anything you'd like to add? And you're sorry, you're still muted, Jeremy. There's a lot of people trying to swallow. I have a husband who came in, he cooks me dinner, so I thought I would. I didn't want you to see me eating, but I'm listening, so I came in saying to the dog, and luckily I was muted. The only thing that I probably would have liked to have put in a copy, put it in some sort of recommendation was that my role last week or a couple of weeks ago was to look at pharmacies. And I'd probably would have liked to have said how much influence or do they have any say, do they communicate with the pharmacies about providing emergency contraception? I don't know how much, if that's sort of done alone by the pharmacies, or do they actually liaise with the garden clinic or the Berkshire Healthcare Trust? I mean, how does it work? Are they stand alone and just get funding for the contraception, or do they work with them? Does that all come out? I think there's a lot of more stand alone. I thought that that's it. But like you suggested though, last week, that was a perfect recommendation that not all of, we've got town centre again, like Sophie rightly said, that it's not all, we haven't got many chemists in Crothon, it's offering that service, great super drug groups, etc. Bullbrook. Yeah, I mean, fantastic. But what about that? It's not just the town centre. It wasn't even, it wasn't even all the pharmacies around the town. It's very few. Yeah, it's very few. And you know, I mean, obviously the garden clinic isn't open or weakest. Like Teresa said, you have to ring and the outer vowels. The number isn't always picked up. And if you're living close to pharmacy, if you're feeling that you need to get urgent help, that's the obvious place to go. So because it's local, you don't have to travel anywhere. Obviously, you know, the clinic provides sexual health advice and he got infections or whatever you probably need to go to a clinic. But just drugs to end an unwanted pregnancy, it's all that someone is. And if you're being looked after by a pharmacy to make sure that it's safe, then that's all you probably need, really. And the pharmacies are open much more, they're open longer. Yeah, and you've got the 9-6 and Saturdays. But obviously, if they're not, if they're stand alone, how do you encourage them to offer that service? Actually, I think that perhaps the executive team could talk to the pharmacist to open that offer up to make sure there is one within such distance from each area. I mean, because Crothorn definitely needs one, Santa's definitely needs one. So that could be a good recommendation. And also the fact that themselves, I mean, it's very much at the moment of Indian HS pharmacy first. And most people are thinking, yeah, but what, what, what should I go there for? So it would be really nice, even if, even if it was something simple, that it was a standalone webpage, perhaps we could add on to the BFC website that says this, these are the pharmacies that offer this, this and this. And if you get on my recommendation for the website, that's your recommendation. The other thing is, I noticed when I did the first, I think it was the first or second slide and it had places that suit people, young people could access to get help. And I noticed back and forth and closed because I'm there. I've actually contacted, I'm still waiting for a reply from our student services who are not always on our site, they tend to do multi-sights, because I wanted to see what advice they have when there was a leaflet or advice or what sort of document we have regarding sexual health. So when I get that, I will present that to see what they're offering and see whether it's similar or the same as what the school's six forms are offering. It'd be interesting. They actually are having a weekly session, which I didn't know about, which means it's not obviously being, I mean, I walk around the college from the time and I'm not seeing it. So, you know what I mean? They're in a side room, nobody knows. Yeah, well, this is actually what we just said though, about the youth club. It just makes you wonder, are they, is it perhaps not the busy being used there at the garden clinic, because they're already getting what they need from the youth club and also the college? We don't know, because that's not advertised. And do those in the college and those other children, did they actually know that they're there? No, exactly. No, no, no signs up in the college then, Jerry. I must be honest with you, maybe I'm not consciously looking, but I have had to look out this week, because I mean now that I realise there's one every Tuesday, I'm going to have to see whether that's advertising. I was going to say, yeah, you in tomorrow, Jerry? Yeah, I'm in tomorrow. Yeah, I'm in every day. Yeah, but, yeah, but the thing is, I used to be downstairs, it was the hub of everything going on, because we were with admissions and student services, so we were all in together, so I was much more aware of what student services were offering. I know that you offered free condoms, they used to give them envelopes to people, but now we're all in different areas, you don't actually have the conversations for people to find out what's going on. So, but I will chase up, I mean, I'll chase up, she hasn't answered my email, and I'm sure she will once, you know, I might just say, can you just send me what you've got, tell me where you're signposting this information, because it should be on some notice board, I thought. Yeah, they do have to, they have digital ones, so where they're offering things, so maybe, maybe I'm just not going to wear a bit, but I need to have a little bit of a certain new section area. No, they have anti-smoke, they have anti-smoke, they have anti-smoke, I mean, they have something in the middle of the college, we've got like a big cafe area, it's open plan, not going to have a table with different things as you go in, but I haven't seen anything sexual health-wise, but I will find out, I'll find out, lovely. Maybe it's still going, you know, on the Tuesday, and it's not that obvious to you and you walking there. I think we should be well-liting this. Yeah, well, I mean, maybe I just walk around my eyes close, but I don't think I do, because I am aware of cake stands and, you know, all the different things and, you know, all that sort of thing, so I would have thought something as important as that should be obvious. Exactly, if you do your sort of secret squirrel bit in there, Jerry, if you've got to sort of find out what they actually offer. I will, I'll just ask. Because I just say to me, you need to tell me what you're offering, and she will, she'll tell me, because I mean, I have access to, you know, I sort of work with students that need access arrangements, and I know what's, I've access to EHCPs and things, so they won't have any problem. If we have a problem, a kid does not do in so well, they will tell us what's going on so that we can help them out with their exams and things. So I tend to know quite a lot about what's going on, you know, so, yeah. Absolutely. Yeah, so. Thanks, Jerry. And, Julie, do you know, because obviously you've got the Waze Youth Club that we're working a lot with at the moment. Yeah. And I should imagine they deal with older children as well. Yeah. Is there any service or do the Waze point them to the other youth club? I don't know, but I will find out, I'll ask. Because that would just be interesting when we put our recommend, I mean, I think the whole thing around this has been very, very much about fantastic service going on, but no one really knows how to get that it's A there, or B, how to find out if it's there. And, yeah, I mean, I was just looking to see what they're actually is emergency contraception wise down in the, this is one of these odd things. I live in Sandhurst, but my children don't go to school in Sandhurst, and I am not a counsellor for Sandhurst at the borough level. So I haven't really looked into what's going on down here, but just looking to see what what there actually is down here. And it appears that there is a drop in at Sandhurst School at Sandhurst, Sandhurst Youth Centre, that is providing emergency contraception. What else are they signposting? Yeah. So I will try to find out a bit more about that from one of the counsellors that does have a responsibility to use down in this area. Probably we should try and we should find out about Crowfawn as well, if they've got the same copy. Well, again, one of the chemists there does is listed on the NHS website is providing emergency contraception. And it's right on the high street. So most of the kids that go to Edgebury would have access to walking past it on a regular enough basis. Yeah. Okay. And then the question is, then, if you've only, well, I suppose at least if you've got a chemist in Crowfawn, Sandhurst, and there is also, there is a chemist as well in ours more, again, within probably, that would be about three minutes walking distance of the Santa school, as well as the youth centre drop in. So, I mean, even, it sounds like you can get help in the town centre and you can get some help, obviously in Crowfawn and Sandhurst, but it would potentially... I don't like to know if it's signposted to actually to the clinics, because that's only the contraception part of it. How are they actually being signposted to anything else? Exactly, because if they're asking for emergency contraception, the aunts are there, really, they've had unprotected sex. Yeah. Yeah. And everything else that then goes along with it. And are they being asked those questions really of, like, you know, do you feel, or do you know about this if you need it? Here it is. Yeah. But then, if it's... I still do think that, you know, okay, they're going to improve what they've got, but it'd just be really nice if the schools could have it on there as well as a complete package. Sorry. One other question. As you're saying, obviously, it's kind of separated for the pharmacies. Do... Is it possible to get the data on how many people of a certain age are coming in for the emergency contraception, or is that something we couldn't even get? Because it'd be interesting, wouldn't it, to see if it's a big number, then we are failing, aren't we? Because essentially, they should have the information on safe sex, and hopefully that would cut through, and it would be less of a number, going in for the emergency contraception. I don't know, because do you fancy to collect that kind of data? It would actually be, yeah. I don't know. Just another point talking about pharmacies. When you walk into one, they offer you so many services now that have things about, leave it some blood pressure checks, diabetes, all these, you know, things that you couldn't get early intervention for. And when I went into superdrug to find out about emergency contraception, the pharmacist came up to me, she said, Do you want your blood pressure checked? And I said, Well, no, it's fine. And she's popping off for a service, isn't it? I'm thinking away and thinking about it now. There's nothing about sexual health or STDs. I mean, there should be a leaflet, I don't know whether they're up again, but I mean, that's as important, really. There's no reason why they shouldn't have leaflets. With that, there's no reason why every pharmacist, even they can't offer anything. They could reach that information about where to go, but they don't. Yeah, I fully imagine. When this new building opens, I think it almost, at the moment, has been stated no thought of their own. It's hidden away. It's almost like, oh, you know, you're sneaking in, like, and sneaking back out. If it's just treated as something that is as normal as anything else, and it's just the service that is being offered by the NHS and its providers, then once that's normalized and it should be the same with leaflets in chemists, et cetera, it's nothing to be embarrassed about. It's just... Of course, it shows a stigma there, doesn't it? It shows it's still super-ticed because they don't have to sleep with it. Exactly. So imagine how that feels and they're not showing anything, and that's for heterosexual couples. If there's any diversity to that, imagine how they feel without being able to get any information whatsoever, because it's hidden away. It's almost... That makes them want to hide away, because they don't... Yeah, if it was just then commonplace, they wouldn't feel embarrassed, but because it's not their access, they feel... Yeah. I just had a question about the leaflets. Do we really feel we should be pushing leaflets? Because, I mean, younger people probably would just prefer poster with a QR code now. I mean, it's all very, you know, it's bad for the environment. It costs money to print leaflets in the first place. Yeah, the only thing is, I'm just thinking that some people, we've got to think of absolutely everybody. Some young people don't have phones. There's got to be... Like they said, when they do their feedback, people can fill a form in online, or they can collect a paper copy. So I think we... It doesn't mean they're going to have loads of paper copies, but we've still got to be able to offer that. And I hope, as part of a Pride event that we're having this year, I would love the garden clinic to come down and be part of it. Yeah, I'd like to help. I mean, once again, I know that isn't necessarily... Well, it is really. It could be a recommendation because we've got this facility and then it gives people a chance to go up and ask any questions. Yeah. Because it will be more... If everyone, you know, that's something I would be recommending. Yeah, I would. We're going to have stalls on that there. So once again, it just makes it more open, more normal. You know, they walk away, or do you just leave so and so from the garden clinic? Hopefully there's a space left because it's not far off, is it? Pride. We will find a space. Okay. Because I think it's important and I think it'd be nice for them to get their message across in a really positive way as well. Yeah, I completely agree. I hope that we can do that. 100%. That'd be really good, I think. I like exactly what the offer is for people who were not aware of what is there. And you wouldn't, perhaps, feel that it is a service for me. I don't really want to go in and ask. Because it's just anything. Even at the minimum, you know, they could be given out condoms to people, that type of thing, on the day. Yeah, it could be something. I mean, that's something that could be whoever, I mean, as it's being organised, it's like the executives could perhaps look at and then it could show our commitment as well to what we've been looking at and also give them a chance to promote themselves, have a list, tell them it is at the youth centre, tell them, you know, where to go and have the list of everywhere. Be really, really good, because everyone from the borough at some point, hopefully, will call into that event as well. Yeah, you'll get a mix of people at that event as well, like last year. Yeah, exactly. And that also gives, even if somebody isn't from the area, but has travelled and thinking, I didn't want to go in my own area, but they've got this service, that's brilliant. Yes. Well, thank you. I'm sorry. I'm going to have to drop off. Yeah, absolutely. I'd like to apologise for going over. And I look forward to seeing everyone face to face. What time next week? It's 6 30. 6 30. Okay. Yes, I'm sorry.