Agenda and draft minutes

To receive apologies for absence and to note the attendance of any substitute members.

There were no apologies of absence

Members are asked to declare any disclosable pecuniary or affected interests and the nature of that interest, including the existence and nature of the party whip, in respect of any matter to be considered at this meeting. Any Member with a Disclosable Pecuniary Interest in a matter should withdraw from the meeting when the matter is under consideration and should notify the Democratic Services Officer in attendance that they are withdrawing as they have such an interest. If the Disclosable Pecuniary Interest is not entered on the register of Members interests the Monitoring Officer must be notified of the interest within 28 days. Any Member with an Affected Interest in a matter must disclose the interest to the meeting. There is no requirement to withdraw from the meeting when the interest is only an affected interest, but the Monitoring Officer should be notified of the interest, if not previously notified of it, within 28 days of the meeting

There were no Declarations of Interest.

Cllr Egglestone, Chair of the Health and Care panel to recap the scope and aims of the review and to run through a plan of activity for the review.

Cllr Egglestone, Chair of the Health and Care panel provided a recap of the scope and brief plan of activity that would take place for the review.

Cllr Wright, Executive Member for Adult Services, Health and Housing, was invited to provide an introduction.  It was explained that an email received from a concerned resident had prompted Cllr Wright to ask some questions about sexual health provision within the borough.  These were addressed by Rebecca Willans, Consultant in Public Health, who was able to provide updates on services within the Borough. A visit to the Garden Clinic in Slough also provided first-hand experience of services.  It was felt that it would be useful to investigate further the provision of sexual health services for young people to see if there were any gaps.  If services were being stopped what plans were in place to replace them.  Support for the review into sexual health services for young people was acknowledged.

Cllr Welch, Vice Chair of Health and Care Panel, to share details of concerns received from a resident.

This was noted by Cllr Wright during her introduction.

Rebecca Willans, Consultant in Public Health, presented some slides covering the following points:

·        Berkshire Healthcare Foundation Trust (BHFT) held the main contract for sexual health services. A subcontracted company called SH24 provided the home STI test kits as part of the new service specification.  This was being reviewed to make sure the quality and supply was better matched to meet demand in Bracknell Forest.

·        Eight out of eleven GP’s provided long acting reversible contraception.

·        One pharmacy in 2022/23 provided Emergency Hormonal Contraception (EHCP) for those aged 13-24.  These can be purchased from any pharmacy, but the national service specification recognises that many within that age group wouldn’t be able to afford to purchase it.  Safeguarding and sexual health promotion advice also formed part of this service.  It was anticipated that there would be further uptake of pharmacies within Bracknell Forest signing up to this. 

·        STI positivity rates have fallen in recent years, which means fewer people testing for STIs are found to have them. STI positivity rates have fallen in recent years, which means fewer people testing for STIs are found to have them.  This highlighted that people are more informed and felt able to get and STI test if they thought they were at risk.  Bracknell forest positivity rates were significantly lower than the national rate and in line with local authorities with a similar level of deprivation.

·        Bracknell Forest were performing statistically significantly better than local authorities in a similar area for HIV testing.  Lots of people were coming forward for HIV testing across different protected characteristics groups.

·        Prescription rates for Long-Acting Reversible Contraception (LARC) were higher that national rates but slightly lower than similar local authorities.  Geographic coverage of GP’s who offered LARC was good. 

·        Under 18 conceptions, one of the main indicators used to look at sexual health among young people, was lower than the national average.  This had been lower than the national average since 2004.  In Bracknell, data suggested young people had good take up of contraception in GPs, compared to the average in Frimley ICS.

·        Specialist sexual health service, provided by BHFT until June 2026, had performed well over the last 5 years against its key performance indicators.  No complaints had been received during the last two years.

·        Most Bracknell residents chose to access the service from the local service provider.  Data suggested there were many factors affecting choice.  People may not want to attend a service close to home to protect anonymity.  Online access increased during the pandemic and this remained high.  Over 90% of Bracknell Forest residents were choosing to use locally commissioned services over other bordering local authority areas.   This highlighted a level of satisfaction with local services.

·        A health needs assessment was completed in 2023 and was currently in draft form.  Some high-level findings identified included:

o    Although performing well for many of the HIV indicators, Bracknell Forest were below the national target for late HIV diagnosis as a whole and it was felt that access could be improved  ...  view the full minutes text for item 9.

In response to questions, the following points were noted by Rebecca Willans:

·        The Health and Care panel would be provided with a breakdown of costs for services for the previous financial year and projections for the next financial year. Service specifications would be provided for sexual reproductive health services provided by Berkshire Healthcare Foundation Trust, pharmacy provision of emergency hormonal contraception service and long-acting reversible contraception provided by local GP’s. Action – Rebecca Willans to send this information.

·        The contract Berkshire Healthcare currently work to, due to end in June 2024, is a block contract and therefore didn’t specify the number of days or specific opening hours that it would need to provide. This would be worked on for the new service specification where they would be asked to review the number of sites and online provision to make sure the needs of face to face and online appointments were met.  This was being worked on and anticipated to be in place from 1 July 2024.

·        The key performance indicator for a face-to-face appointment was within two days.  98% of people were seen within two days of contacting the service.

·        Social media was previously managed by a Public Health communications team who undertook a lot of promotion, particularly around the Safe Sex Berkshire website and national campaigns. The team no longer received funding.  Work now took place with Bracknell Forest communications team providing communications around items like promoting HIV testing week.  Work was taking place with colleagues in West Berkshire who funded the Safe Sex Berkshire website.  A review of the website was being scoped to make sure the requirements of local people was met.

·        School nursing services are commissioned by the local authority and not managed by Public Health.  Action – Rebecca Willans to provide the contract for school nurses on sites at schools to the panel.  It was noted that schools are legally required, at Primary and Secondary, to provide sex and relationships education.  Since the introduction of the academy model, there was uncertainty over the extent of influence within this from the council.  This was noted as a good point to understand further and it was hoped the review might investigate this.

·        Publicly available data, from a national data set called GUM CAD, on the number of Bracknell Forest residents who attend the Garden Clinic in Slough would be shared. Action – Rebecca Willans to provide this.  A challenge regarding this data is how open people had been in identifying themselves.  It was noted that the Garden Clinic is a tier 3 provision and some people who contact the clinic in Bracknell may be referred to Slough due to the nature of their request.

·        Based on information from the health needs assessment, late diagnosis of HIV could be due to reasons such as lack of understanding of the healthcare system within the refugee and asylum seeker populations.  This was being addressed through outreach work with these groups.  Further reasons could be late diagnosis within groups who didn’t  ...  view the full minutes text for item 10.