South Reading CCG have appointed Wendy Bower as Lay Member of the Governing Body with responsibility for Patient Engagement. Wendy fulfills the same role for the North and West Reading CCG and has a background in nursing and nurse education. She lives locally in Wokingham.

Eye specialists say hundreds of patients suffer irreversible sight loss every year in England because services are overstretched and under-resourced. The president of The Royal College of Ophthalmologists, Prof Carrie MacEwen, writing for the BBC's Scrubbing Up, warns the NHS is struggling to keep up because of a "perfect storm" of increased demand, caused by more eye disease in an ageing population which requires requiring long term care. She says the current treatment targets fail to reflect the critical importance of follow-up appointments, which may be delayed for months or even years. "Many eye diseases which can cause sight loss are more common in older people and our aging population means the demand on ophthalmology, like all areas of healthcare, is increasing like never before."

Reading Borough Council is responsible along with the local NHS for arranging support services for carers. After a re-tendering exercise jointly with West Berks Council the contract is to be given to Carers Trust East Midlands who are based in Nottingham. Support will shift from Berkshire Carers to Carers Trust East Midlands at the end of March 2016. Anyone who wants their newsletters or other communication to be continued by the new provider after March 2016 should contact Berkshire Carers with details of their name, address, phone number and email address asking that these details be passed to the new provider. This could be by email to helpline@berkshirecarers.org or by phone to 0800 988 5462. This needs to be done before 31st March. The new provider can be contacted on their helpline 0118 324 7333.

We heard some time ago that South Reading CCG was asking Governing Body Lay Member Christopher Mott to stand down at the end of March 2016. The Western Berkshire Federation aims to avoid all lay member posts having to be replaced at one time. Christopher Mott has been Lay Member for Public and Patient Engagement for two years. Many will remember his genial introductions at major consultation events. It was easy to recognise his commitment to involving public and patients in the development of our local NHS. His regular attendance at South Reading Patient Voice meetings has kept members well informed about these developments. We can only hope that he will continue his interest and involvement in our local he alth services. The advertisement for Christopher's replacement as Lay Member for Publiic and Patient Engagement is now published. We can only hope that someone else with as much to contribute will step forward.

A widely-drawn task force on mental health care appointed by NHS England has issued its report with a strategy for the next five years. The report has a wealth of information and recommendations with a focus on equalities and standards of care.

The report of the National Maternity Review, published in February 2016, sets new ambitions for the maternity services and services to mothers before and after childbirth. It calls for:

1. Personalised care
2. Continuity of carer
3. Safer care
4. Better postnatal and perinatal mental health care
5. Multi-professional working
6. Working across boundaries
7. A fair payment system to enable all this

Here is a recommended personal commentary with a National Childbirth Trust perspective (scroll down to 23 Feb 2016 item).

NHS England has asked CCGs to work together to integrate primary, secondary and social care in a place-based system of provision of person-centred care. In Western Berkshire the approach chosen by the four CCGs (Newbury, South Reading, North and West Reading and Wokingham) is to form an Accountable Care System (ACS) clustered around the Royal Berks Hospital as the main acute provider. The CCGs and the main providers are to cede some sovereignty and work together under a common direction to integrate services. Payment structures are to be revised and patients' treatment to be coordinated between different providers. As the local authorities, providers and the CCGs in Western Berkshire have been working together for some time there is a basis for collaboration and cooperation. A model for this transformation is the change that occurred in New Zealand in 2001 when the provider/commissioner split was abolished and healthcare placed under the direction of District Boards. The success of an integrated development under the Canterbury District Health Board is cited as supporting evidence for this model. However, NHS England has decided that the right area ("footprint") over which to plan the service transformation was not Western Berkshire but a much larger area - Buckinghamshire, Oxfordshire and Western Berkshire (BOWB). It may be that they had the current reorganisation of Urgent and Emergency Care in mind, and intend to place the Oxford University hospitals as the Major Emergency Centre for the BOWB region. The current reorganisation of Urgent and Emergency Care is led by Prof Keith Willett of Oxford. The latest operational plan from South Reading CCG proposes to continue with the ACS development over Western Berkshire under the overall BOWB regional planning. The plan considers which functions should be allowed to the top-level BOWB region planning and which decided within Western Berkshire. The functions to be allowed to the the top-level BOWB region are:

1. Specialised commissioning (takes place on an even wider basis)
2. Workforce
3. Procedures of Little Clinical Value and determination of Clinical Priorities
4. Primary Care provider development
5. Commissioning Support Unit
6. Urgent and Emergency Care

At a recent Reading Borough Council meeting on 22nd March 2016, a motion was passed emphasising the importance of local democracy and decision-making for local healthcare ( see document linked below).

Have your say about Berkshire Healthcare Services - Community Healthcare and Mental Health Services 9:30am Wednesday 23rd March, Hilton Hotel, Reading see location and access here Berkshire Healthcare Foundation Trust is keen to hear from anyone who is or has been using its services, particularly; in-patients (mental health), community mental health team and older people's mental health, out-of-hours (Westcall), community nursing, speech and language, CAMHS and talking therapies. Please join BHFT on Wednesday 23rd March for a morning of short presentations followed by table discussions lead by health practitioners. For further information and to register your attendance please visit Sarah Morland at Reading Voluntary Action on sarah.morland@rva.org.uk .

The House of Commons Public Accounts Committee has issued a critical report on the state of the finances of Acute Hospital trusts. Extraordinary evidence from a Trust Finance Director talks of the pressure from the NHS regulators to use "wheezes" and questionable adjustments to make the Trust's revenue accounts conform to NHS England's targets The report concludes, "The Department of Health, NHS England and NHS Improvement have not taken action soon enough to keep trusts in financial balance. The target for trusts to make 4% efficiency savings across the board is unrealistic and better data is needed for more informed savings and efficiency targets. Failings in the system for paying providers need to be addressed as a matter of urgency, with NHS Improvement and NHS England acknowledging that the current system is not fit-for-purpose as it does not incentivise the right behaviours needed for joined-up healthcare services. Spending on agency staff has contributed to trusts financial distress, and action to tackle this problem is welcome, albeit late. The NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.

The NHS England performance report for January 2016, appearing only on 10 March 2016, shows many targets missed with the worst performance for waiting in A&E since figures became available. The January 2016 performance report for NHS England shows the following, among others:

• There was a 10.1% increase in A&E attendances over January 2015 (although the year to January shows only 0.6% increase over the previous year). The Royal Berkshire Hospital A&E department was exceptionally busy in early 2016 although the Reading Walk-In Centre showed no corresponding surge in attendance.
• Only 88.7% of patients in A&E could be treated, discharged or admitted in the four-hour target time, against the target of 95%.
• Emergency admissions to hospital were up 4.6% year on year.
• Only 69.9% of Red 1 ambulance callouts arrived within the target 8 minutes against the target of 75% - the eigth month of misses.
• 2.1% of patients waiting for diagnostic tests had been waiting for more than the six week target against a target of 1% last achieved in November 2013.
• Only 81% of patients waiting for first definitive treatment for cancer were treated within the 2 day target against a target of 85%.