The Health Overview and Scrutiny Committee met to discuss the work of Healthwatch Wokingham Borough, the Connected Care programme, and the Public Health budget. Key concerns raised included difficulties with GP access, the usability of the NHS app, and the adequacy of the public health grant to meet the needs of the Wokingham population.

Update on the Work of Healthwatch Wokingham Borough

Alice Kunjappy-Clifton, Lead Officer for Healthwatch Wokingham Borough, presented an update on their activities. A significant theme emerging from 92 resident cases was difficulty in securing GP appointments, with 24% of individuals experiencing this issue. While this was a universal problem, feedback was most concentrated on three specific GP practices: Wokingham Medical Centre, Woodley Centre Surgery, and New Wokingham Road Surgery.

The report also highlighted communication issues (18%), hospital waiting times (15%), mental health access (12%), and coordination of care (10%) as key concerns. Healthwatch is focusing its 2026-2027 work plan on influencing system change, including improving discharge processes, strengthening service pathways, and enhancing digital access and support. A particular focus will be on Neighbourhood Health, aiming to improve local access to services and reduce digital exclusion through workshops and digital inclusion work.

Concerns were raised about the usability of the NHS app, with many users, including young people, struggling to navigate it. Healthwatch is working with the Thames Valley Integrated Care Board (ICB) and their digital team to address this. Councillor Caroline Smith noted that while the NHS app is useful for many functions, direct GP access remains a critical issue, especially if patients are being told they can only use digital platforms to book appointments. Councillor Chris Johnson highlighted the upcoming demise of landlines in 2027, which will impact those without mobile phones or digital access.

Mark, a representative from the Thames Valley ICB, acknowledged the variation in access to GP surgeries and suggested that a lack of prerequisite patient engagement might be an issue for practices shifting to digital-only models. He confirmed that the ICB is aware of the challenges and is working to improve engagement.

Connected Care Programme

Mark provided a briefing on the Connected Care programme, an information-sharing initiative supported by Wokingham Council and other Berkshire councils. This programme allows health and care professionals to access critical patient information at the point of care, including GP, community, mental health, and social care records. The system supports 4.2 million residents and 14,000 professionals across Berkshire, Thames Valley, and Surrey.

The key benefits of Connected Care include reducing duplication of tests, improving patient safety, and enhancing the patient experience by preventing individuals from having to repeat their narrative to multiple professionals. In Wokingham specifically, over 3,000 professionals accessed shared records for over 80,000 patients in a 12-month period. The programme is seen as crucial for shifting care from acute settings to prevention and supporting neighbourhood working.

Discussion also touched upon data governance and consent. The programme operates on an implied consent basis for direct care purposes, with robust information governance frameworks in place. Residents can object to their data being shared, and while direct care data sharing is generally not opt-out, secondary uses of data can be opted out of. Data quality is a key focus, with the programme driving improvements as more professionals use and are aware of the shared records. The system is also used by 111 and ambulance services, though access for call handlers is limited to clinical staff.

The discussion also highlighted that the proportion of NHS spend on primary care has decreased, despite its increasing importance to residents. The programme's data is being used to understand how different population segments consume NHS resources, with a focus on high-need patients who use significantly more resources. Projections indicate a 12% growth in this high-need patient group in Wokingham over the next five years, underscoring the need for transformation in NHS service configuration to ensure sustainability and good outcomes.

Public Health Budget

Caroline Vass, Director of Public Health, provided an update on the Public Health budget for 2026-27. Wokingham Borough Council receives £6.862 million, which is the third smallest public health grant in the country and the lowest per capita allocation (£36.66 per head). Of this, £230,000 is ring-fenced for smoking cessation and £966,873 for drug and alcohol treatment and recovery services.

The grant is ring-fenced to ensure it is spent on prescribed functions, which include sexual health services, NHS health checks, health protection, public health advice to commissioners, the National Child Measurement Programme, and 0-5 services (health visiting and school nursing). Non-prescribed but eligible functions include weight management, physical activity, mental health services, and suicide prevention.

Councillor Vass highlighted that the grant allocation is based on historical spending and does not adequately account for changing population needs or hidden inequalities, particularly socioeconomic differences that impact health outcomes. Wokingham's grant is significantly lower than statistically similar local authorities, and the proportion allocated to drug and alcohol services varies considerably.

The committee noted that 31% of the budget (£2.1 million) is allocated to the 0-19 programme (health visiting and school nursing), which is a similar proportion to other local authorities. However, concerns were raised about the relatively low number of service users for drug and alcohol treatment services compared to the allocated budget. Caroline Vass explained that the 0-19 programme is a universal service, whereas drug and alcohol services are targeted. She also noted that a significant portion of the budget is spent on staff salaries and commissioned services, which often have multi-year contracts.

The discussion also touched upon the need to address hidden needs within the population and make them visible. The council is working on a Marmot Borough approach, focusing on getting behind the average to identify and support groups who are not achieving desired outcomes. The committee also discussed the commissioning of services from providers like Cranston for drug and alcohol treatment, with a desire to understand more about these organisations.

Optalis Stakeholder Report

The committee briefly discussed the Optalis Stakeholder Report. Councillor Mike Smith expressed that the report was brief and lacked sufficient data to understand the services Optalis is delivering for the £14.7 million budget. He requested more detailed information on the services provided.

Forward Programme

The committee reviewed the forward programme for the remainder of the municipal year. Items scheduled for future meetings include dentistry and care homes, the all-age autism strategy, the South Central Ambulance Service, and public health and adult social care KPIs. Councillor Caroline Smith suggested adding a discussion on emergency scenario planning and the role of the public health team in responding to serious incidents, such as outbreaks. The committee also discussed advice for university students regarding meningitis vaccinations.