Western Berkshire CCGs are consulting on their implementation of the nationally announced policy of ending the prescription of certain common medicines and special foods - such as paracetamol and gluten-free foods.You can answer a consultation on this by clicking here . The consultation also asks about changes and restrictions on repeat prescriptions and on the prescribing of vitamins, suplements, sunscreen and camouflage preparations. The consultation ends on 28th April 2017. It is known that the process of prescription is relatively costly - designed to safely distribute potentially harnful and costly medicines. Paracetamol and Ibuprofen are relatively cheap, and it is claimed that gluten-free foods have become more widely available and cheaper. There is still concern for those who find themselves in straitened circumstances, perhaps on benefits. The proposal is that the GP should advise the patient to make an Independent Funding Request (IFR) if they find it difficult to purchase these medicines or foods. The IFR committee, which approves these exceptional prescriptions, is thought to meet monthly, so there is potentially a considerable delay. Would not if be more efficient and more likely to provide continuuty of care if GPs were themselves allowed to make this decision and prescribe these medicines and foods for those in difficulty?

Western Berkshire, covering Reading, Wokingham and Newbury areas, has been selected as one of 9 areas (most others are STP areas) to have early Accountable Care Systems status. This gives the area full control over more of its funding, including primary care and specialist care and delivers more freedom for the commissioners. NHS providers in the area will integrate horizontally to improve patient treatment pathways. GP practices are expected to integrate into units serving 30,000 to 50,000 patients which can deliver a wide variety of services to their population. The emphasis will be more on integration and cooperation than on competitive tendering. The requirements for areas to become Accountable Care Systems are the following demands which make a radical shift away from terndering individual services or practices to the management of population health over a wide area:

• Agree an accountable performance contract with NHS England and NHS Improvement that can credibly commit to make faster improvements in the key deliverables set out in this Plan for 2017/18 and 2018/19.
• Together manage funding for their defined population, committing to shared performance goals and a financial system control total across CCGs and providers. Thereby moving beyond click of the turnstile tariff payments where appropriate, more assertively moderating demand growth, deploying their shared workforce and facilities, and effectively abolishing the annual transactional contractual purchaser/provider negotiations within their area.
• Create an effective collective decision making and governance structure, aligning the ongoing and continuing individual statutory accountabilities of their constituent bodies.
• Demonstrate how their provider organisations will operate on a horizontally integrated basis, whether virtually or through actual mergers, for example, having one hospital on several sites through clinically networked service delivery.
• Demonstrate how they will simultaneously also operate as a vertically integrated care system, partnering with local GP practices formed into clinical hubs serving 30,000-50,000 populations. In every case this will also mean a new relationship with local community and mental health providers as well as health and mental health providers and social services.
• Deploy (or partner with third party experts to access) rigorous and validated population health management capabilities that improve prevention, enhance patient activation and supported self- management for long term conditions, manage avoidable demand, and reduce unwarranted variation in line with the RightCare programme.
• Establish clear mechanisms by which residents within the ACS defined local population will still be able to exercise patient choice over where they are treated for elective care, and increasingly using their personal health budgets where these are coming into operation. To support patient choice, payment is made to the third-party provider from the ACS budget.

 Lise Llewllyn, lead Public Health consultant for Berkshire, has prepared her annual report on Reading. The report reviews the main causes of preventable deaths in Reading, comparing local with national figures. A startling point made by Dr Llewellyn is that "Smoking accounts for 90% of health inequalities".

BBC Radio Berkshire will host the Brighter Berkshire Year of Mental Health campaign 2017 on Monday 20th March 11am-1pm, with a programme featuring childrens' mental health. Look out for these monthly broadcasts through 2017. Find out more about the Brighter Berkshire campaign. Find out more about the Brighter Berkshire campaign on Twitter. Sign up to the Brighter Berkshire mailing list

The Reading Borough Health and Wellbeing Board meets in the Council Chamber at the Civic Offices, Bridge Street, at 2pm on Friday, 24th March 2017. Topics to be addressed include the BOB STP, the Berkshire Suicide Prevention Strategy, the Connected Care strategy and aspects of Public Health. Click here for the agenda. Click here for the full papers for the meeting.

South Reading Patient Voice will meet at 6pm on Wednesday, 29 th March 2017 at RCLC, 94, London Street RG1 4SJ to hear how patient records will become accessible from all treatment sites through the Connected Care programme from Project Manager John Devine. We will also hear news from Patient Participation Groups around the CCG area and from Healtwatch Reading.

We understand that the two practices at Milman Road are likely to merge. Melrose Surgery is also likely to merge with London Road Surgery, followed by closure of London Road Surgery - patients of London Road Surgery may be able to choose whether to transfer to Melrose Surgery, or Kennet, Pembroke or Eldon Road practices.

GP surgeries in Reading are working in groups to provide larger units which can offer additional treatments and services and extended hours. University Medical Group already unites the Northcourt Avenue and Whitley Villa surgeries. South Reading and Shinfield Practice has been proposed to join the group. All the other surgeries in the South Reading CCG area are organised into the South Reading Alliance. This contains three clusters of practices. Each cluster will make arrangements for extended hours and additional services.

Tilehurst Cluster

• Tilehurst Village
• Westwood Road
• Overdown Road
• Grovelands

Whitley Cluster

• Milman Road (Kumar)
• Milman Road (Mittal)
• Longbarn Lane
• Chancellor House
• Christchurch Surgery
• Whitley Wood Lane

Central Cluster

The central cluster has three groups of surgeries.

A Group

• Pembroke Surgery
• Pembroke Eldon Square
• Kennet Surgery

B Group

• Melrose Surgery
• Eldon Road Surgery

C Group

• Reading Walk-In Centre
• Russell Street Surgery
• Coley Park Surgery
• Burghfield Surgery
• Abbey Medical Centre
• Chatham Street Surgery
• London Street Surgery

The practices of the South Reading Alliance have the following areas of focus for 2017/18.

1. Reducing variation amongst member practices and supporting practices in difficulty.
2. Reviewing their estates strategy
3. Exploring innovative business/restructuring opportunities
   1. Clinical research in primary care
   2. Different contractual models e.g. MCP contract
   3. Managing urgent and planned care differently
   4. Shared indemnity cover
4. Improved collaborative working
   1. Supporting CCG with IT interoperability pilot systems
   2. Shared workforce: clinical pharmacist role to be shared across 2 clusters
   3. Work with CCG to align community health and social care around clusters

The new Integrated Care System for the western part of Berkshire, under chair Luke March, has produced a draft strategy for the NHS in western Berkshire. The document is available below. The western Berkshire Accountable Care System (ACS) is a coordinating body, formed by Memorandum of Understanding, between the main NHS healthcare providers, Royal Berkshire Hospital and Berkshire Healthcare and the Clinical Commissioning Groups for the constituent areas. It is expected that local authorities, with their health and caring responsibilities will also be associated with the The ICS is planning to see primary care organised into larger "hubs" of practices, around which extended community services can be organised. The frailest part of the population will be offered more services in the community to avoid their reaching a crisis demanding emergency care. Some outpatient treatment will move from hospital to the hubs. Prevention of ill-health will be supported. Mental health services will be expanded and made more accessible. Treatment pathways are to be made more efficient as the separate providers integrate their services.

BBC Radio Berkshire will host the Brighter Berkshire Year of Mental Health campaign 2017 on Monday 20th February 11am-1pm, with a programme featuring Mental Health First Aid. Look out for these monthly broadcasts. Find out more about the Brighter Berkshire campaign. Find out more about the Brighter Berkshire campaign on Twitter. Sign up to the Brighter Berkshire mailing list