The Wokingham Borough Health and Wellbeing Board approved the Youth Justice Plan and the Wokingham Area All-Age Autism Strategy 2024-29 and SEND & Inclusion Strategy 2024-29. Updates were also received from the Integrated Care Board and the Royal Berkshire NHS Foundation Trust, and the Board discussed the Wokingham Pharmaceutical Needs Assessment 2025-2028.

Prevention and Youth Justice Service: Youth Justice Plan

The Board approved the Youth Justice Plan, which covers the previous year and looks ahead to the next. Bea Nigolian, Prevention and Youth Justice Service Team Manager, highlighted a significant 55% reduction in first-time entrants into the Criminal Justice System in Wokingham, the largest drop in the South East region. The plan prioritises prevention and early intervention, with a year of additional funding secured for a Speech and Language worker to support young people with communication needs. A full vaccination clinic service has also been launched for those unable to access vaccinations through usual channels. Councillor Prue Bray, Deputy Leader and Executive Councillor for Children's Services, noted that the service had been rated Good by inspectors, with some elements, including staff, deemed Outstanding. Susan Parsonage, Chief Executive, commended the impressive reduction in first-time entrants and the positive impact on young people's lives. Councillor Stephen Conway, Leader of the Council and Executive Councillor for Housing, Partnerships and the Local Plan, praised the transformation of the service area and emphasised the importance of partnership working and early intervention.

Wokingham Area All-Age Autism Strategy 2024-29 and SEND & Inclusion Strategy 2024-29

The Board formally ratified and approved the Wokingham Area All-Age Autism Strategy 2024-29 and the SEND & Inclusion Strategy 2024-29. Jonathan Wilding, Programme Manager – SEND, presented the system-wide strategies, developed through collaboration and co-production. A key strategic priority is prevention, aiming to help families earlier and address the national pressure on the SEND system, which has seen increased demand, particularly following the pandemic. Provision is another core pillar of the SEND and Inclusion Strategy.

Councillor Bray highlighted the need for local specialised provision and noted delays in the development of two SEND schools, despite some additional SEND units being established in mainstream schools. She stressed that local efforts alone cannot fully resolve the issues, citing insufficient national funding and the need for a fundamental shift in the funding formula. She also pointed out that health services, crucial for therapy provision for children with SEND, require adequate funding. Despite these challenges, she praised the local partnership structure, noting that outcomes for children with SEND in the Borough are above average.

Matthew Tait, representing BOB ICB (Berkshire, Buckinghamshire and Oxfordshire Integrated Care Board), acknowledged the strategies were good but implementation would be challenging, requiring a joined-up approach. Councillor Conway echoed concerns about the national funding formula, stating that Wokingham is ranked 151st out of 151 councils for funding for adults and children's services, with the council ranked 150th receiving nearly double the funding. Dr Debbie Milligan, from NHS, questioned the mechanism for highlighting Wokingham's good work despite low funding. Emma Cockerell, Director Children's Services, explained Wokingham participates in a programme feeding learning back to the Department for Education and that conversations are ongoing to increase pace. Susan Parsonage added that the national funding formula is based on deprivation and does not recognise demand levels, and the Council is lobbying MPs for change. She also noted Wokingham's high productivity rating for children and adult's services. Councillor Conway expressed concern that demonstrating high performance on low funding might lead the government to believe further funding is unnecessary. Councillor Bray suggested the national funding formula should include a floor.

ICB Update

Matthew Tait provided an update on the Integrated Care Board (ICB), noting the implementation of a new operating model and ongoing recruitment to address over 200 vacancies. Amendments have been made to Place Partnerships to reflect consultation feedback, with an Executive Sponsor assigned to each Place, including Berkshire West. A Chief Medical Officer has been appointed, and interviews are underway for a Chief People Officer. Work is progressing on winter preparedness with Trusts and partners.

Mr Tait also mentioned the national Change Programme, a 10-year plan from the Department of Health and NHS England currently out for consultation. Susan Parsonage sought assurance that Wokingham would receive adequate focus under the new model, with Mr Tait suggesting the Berkshire West model might require a slightly different approach, potentially involving a two or three Executive sponsor model for Health and Wellbeing Boards. Councillor Prue Bray inquired about vaccination breakdowns for Wokingham and the location of adult and virtual paediatric beds within the Hospital at Home programme, with Mr Tait and Andrew Statham agreeing to provide this information.

Regarding the Joint Forward Plan refresh, Mr Tait stated that analytical work is underway to segment the population by local authority area for future disease modelling and resource utilisation, with an update expected by the end of December and at the next Wellbeing Board meeting in January. Councillor Stephen Conway asked about potential collective action in pharmacy, and Mr Tait confirmed the ICB is aware of the risks. Councillor David Hare, Executive Councillor for Adult Services, Health & Wellbeing, questioned if the ICB restructure was primarily for cost savings, to which Mr Tait responded that the operating model had to address a 30% reduction in running costs, but many changes were not financially driven but aimed at reframing and strengthening resource allocation. Mr Hare also asked about potential reductions in efficiency, and Mr Tait emphasised the need for partnership and reduced duplication, acknowledging challenges. Susan Parsonage queried the impact of the Autumn Budget statement on BOB, and Mr Tait indicated that funding cuts over the next three years were more likely, with any growth potentially diverted to pay awards and National Insurance contributions, in addition to BOB's £60 million deficit. The Board noted the update.

Royal Berkshire NHS Foundation Trust Update

Andrew Statham provided an update from the Royal Berkshire NHS Foundation Trust, highlighting the hard work of teams focusing on key operational standards. Finance remains a significant challenge, with the Trust behind on its efficiency targets. Mr Statham noted that financial settlements for the NHS as a whole would be challenging, necessitating continued partnership working, and that high demand is a particular financial concern, requiring consideration of care provision in different settings. Susan Parsonage questioned whether there would be increased investment in community services provided by local authorities, and Mr Statham emphasised the need to assess the value for money of existing community investments before considering further funding. Matthew Tait added that there would likely be some variation, with potential for ringfenced funding for good practice initiatives. The Board noted the update.

Wokingham Pharmaceutical Needs Assessment 2025-2028 November 2024 Update

The Board considered the update on the Wokingham Pharmaceutical Needs Assessment (PNA) 2025-2028. The Board has a statutory responsibility to produce a PNA every three years. Due to tight timescales, much of the operational work has been delegated to a BOB steering group. The Board agreed that the pre-consultation draft of the PNA would be signed off by the BOB PNA Steering Group before the final document is approved by the Board in September 2025. A new pharmacy had opened in Winnersh, which was noted as a positive development. Councillor Bray requested that photographs of the opening event be circulated to Board members. The Board agreed that the pre-consultation draft of the PNA would be signed off by the BOB PNA Steering Group and noted that the final PNA report would be signed off by the Health and Wellbeing Board in September 2025.

Forward Programme

The Board discussed its forward programme for the remainder of the municipal year. Matthew Tait indicated that planning work and the Joint Forward Plan refresh would be incorporated into future ICB updates. The Board noted the forward programme.