The Health Overview and Scrutiny Committee met on Thursday 15 October 2026 to discuss the performance of the South Central Ambulance Service (SCAS), plans for winter pressures, and the performance of Adult Services. The committee received updates on SCAS's operational pressures, including response times and a major incident declared during the summer heatwave. They also reviewed the Royal Berkshire NHS Foundation Trust's winter planning initiatives and the key performance indicators for Adult Services in the first quarter of 2026/27.

South Central Ambulance Service Update

The committee received an update on the performance of the South Central Ambulance Service (SCAS) in the Wokingham Borough between April and September 2026. Paul Jefferies, Assistant Director Operations for SCAS, highlighted the significant pressures the organisation had been under, receiving nearly 11,000 999 calls during the period. He explained that 17.2% of calls were managed through incident coordination centres, with advice given over the phone or alternative care arrangements made. Of the remaining calls, 33.1% involved an ambulance response where treatment was provided at home, and 49.7% required conveyance to a hospital.

Response times for Category 1 calls, such as cardiac arrests, remained stable with a mean response time of 9 minutes and 9 seconds. However, Category 2 calls, which include patients with life-changing or life-limiting conditions like strokes, represented the largest demand, accounting for approximately 50% of calls in the Wokingham area. The mean response time for these calls was 31 minutes and 26 seconds.

SCAS was operating under its Resource Escalation Action Plan (REAP) at Level 4, indicating significant pressure, a situation mirrored across most ambulance services nationally. The prolonged summer heatwave led to the declaration of a major incident and a business continuity incident, with call volumes peaking at around 4,500 in a 24-hour period, significantly exceeding the planned 1,800. This necessitated a mutual aid request, resulting in 15 vehicles and a team leader being deployed from Yorkshire for 72 hours.

Handover performance at local acute trusts was also discussed. At Royal Berkshire Hospital, the average handover time was 19 minutes and 29 seconds, with a clear-up time of around 15 minutes, making ambulances available for the next incident within approximately 25 minutes. SCAS was noted as the second-best ambulance service nationally for handover times. Similar handover times were reported for Wexham Park Hospital.

The committee was informed that SCAS was working with partners, including acute trusts and the Thames Valley Integrated Care Board, to improve patient flow. Clarification was sought on hospital transport decisions, with geography being a key factor, and Royal Berkshire Hospital being the primary receiving hospital for Wokingham and Bracknell.

In response to questions about learning from the major incident, Mr. Jefferies confirmed that a debrief and after-action review had been conducted, leading to a report for SCAS's Executive Management Committee and a need to refresh business continuity plans. Plans were also in place to manage anticipated winter pressures.

A councillor raised concerns about SCAS ranking 10th out of 10 in an NHS England Ambulance Trust league table, particularly regarding Category 2 response times. Mr. Jefferies acknowledged the pressure, linking it to funding and operational hours, and highlighted ongoing work with the South East region on an improvement and recovery plan. He also noted that SCAS receives less funding than some other trusts.

The committee asked how the council could support SCAS, with Mr. Jefferies suggesting assistance with public messaging to encourage people to consider alternatives to calling an ambulance and to ensure they have necessary medications. The committee noted this suggestion.

The committee thanked Paul Jefferies for his presentation.

Winter Pressures Planning

Andrew Statham, Chief Strategy Officer for Royal Berkshire NHS Foundation Trust, provided an update on winter pressures planning. The planning was based on sustained and increased demand experienced earlier in the year, with Emergency Department attendances up by 8-10% compared to the previous year.

The winter plans focused on four key areas:

1. Proactive Support for Frail Individuals: An additional proactive service would offer reviews for approximately 1,000 frail individuals across Berkshire West, focusing on care support planning and identifying gaps. Patients from need groups 10 and 11 (over 65 with long-term conditions) would be selected, with 333 patients from each Berkshire West area identified.
2. Bolstering Alternatives to A&E: Work was underway to enhance alternatives to the Accident and Emergency department, such as the Urgent Care Centre, and to strengthen the urgent care response team in collaboration with Berkshire Healthcare Foundation Trust.
3. Maximising Hospital Discharge: Efforts were being made to improve patient flow out of hospitals by working with social care and community hospitals to ensure appropriate onward care for patients ready for discharge.
4. Communication and Prevention: A focus would be placed on promoting vaccinations, winter preparedness, and alternative support routes like NHS 111, Urgent Care Centres, and pharmacies.

Voluntary and community service providers would be involved in preparedness discussions due to their supportive roles. Mr. Statham urged the committee to encourage vaccination uptake and for all partners to consider how they could enhance their capacity to manage the winter period. He stressed the importance of leadership focusing on commitments and addressing any obstacles.

Concerns were raised about improving hospital discharge and handover to social care. Mr. Statham acknowledged the local authority's efforts and the importance of utilising committed funds, noting that Berkshire West was running approximately 10% behind agreed targets.

Regarding staff support during the winter, Mr. Statham stated that the Royal Berkshire NHS Foundation Trust invested in staff wellbeing and had low staff sickness rates. However, he noted a rising trend of violence against staff from patients, and the Trust was working with Thames Valley Police on protocols for such incidents.

The committee inquired about the number of patients ready for discharge but awaiting their next placement. Mr. Statham estimated this to be around 40-60 patients per day across Berkshire West and agreed to provide figures specific to the Borough. He also noted that the time taken for patients to return home with a care package had increased over the last two years, while discharge to care homes had reduced, except in Wokingham. Wesley Hedger, Service Director - Adult Social Care - Strategy, Transformation and Commissioning, added that Wokingham performed well in social care-managed placements into care homes, but highlighted difficulties with care home placement availability and funding.

The committee thanked Andrew Statham for his presentation.

Adult Services Quarter 1 2026/27 Key Performance Indicators

The committee reviewed the Key Performance Indicators (KPIs) for Adult Services for the first quarter of 2026/27. The report indicated that all presented KPIs were rated as 'green', meaning they were meeting their targets. However, benchmarking information for the new national indicators, recently introduced due to changes in data recording, was not yet available. Future reports would feature one indicator per page for improved clarity.

Wesley Hedger presented the indicators, noting that in relation to safeguarding, 148 Section 42 enquiries had been raised, with risk reduced or removed in 142 cases. The remaining cases could involve individuals who, with capacity, chose to accept a level of risk after receiving advice.

The committee discussed why achieving 100% for some measures might be unlikely. Regarding the proportion of long-term support clients reviewed within a 12-month period, it was explained that waiting cases were monitored weekly and prioritised based on risk and individual circumstances.

Discussions also covered accommodation outcomes for adults receiving long-term support. The indicators differentiate between individuals living at home or with family, by age group, and whether they have a learning disability. Wokingham was noted for its strong performance in supporting people with learning disabilities and other working-age adults to live in community settings, while acknowledging that residential care remains appropriate for some.

The committee noted that 381 individuals aged 65 and over were residents in council-funded care homes. Occupancy levels in council-owned homes, including Bluebell House, Suffolk Lodge, and The Hollies, were also discussed.

The distinction between self-directed support and direct payments was clarified. Self-directed support allows individuals to arrange their own care, with the council commissioning services on their behalf, while direct payments provide a personal budget for individuals to manage their own care. Of the 1,395 long-term support clients (excluding those in residential care), 366 received direct payments, a take-up rate that, while relatively low, exceeded the national average. It was noted that direct payments are not suitable or preferred in all cases.

The absence of waiting-time measures in the current indicator set was discussed, with a placeholder included pending confirmation of the national methodology from the Care Quality Commission.

The committee noted the report and performance.