For 2016-17 NHS spending was 145 billion which is 6.5% of GDP of about 2.2 trillion. Private health spending is thought to be a little above 1% of GDP or about 26 billion, giving total health expenditure of 7.5 - 8% of GDP, but adding in social care for international comparison, total health expenditure by international definition is about 9.9% of GDP. For comparison Germany, France, Sweden and Japan spend about 11% of (a larger per capita) GDP.

Pulse Today magazine has reported that NHS England is planning that ALL GP referrals should be prospectively peer reviewed and is arranging a system of funding to incentivise this. Experience shows that this can reduce the overall rate of referrals. A concern is that reviewers may be making decisions with insufficient information. It is very much to be hoped that our Council of Practices will take direct responsibility and accountabiilty for this rather than farming it out to an external entity. The original article can be found here.

The Primary Care Commissioning Committee for Berkshire West meets in public at 1pm on Wednesday, 13th September at Shaw House, Church Road, Newbury, Berkshire, RG14 2DR. If attending please register online. For details on asking questions at the meeting please see here.

Berkshire Healthcare NHS Foundation Trust, which provides mental healthcare and community nursing throughout Berkshire and out-of-hours GP services in Berkshire West, is holding its AGM at 2pm on Wednesday 13th September at Easthampstead Baptist Church, South Hill Road, Bracknell, RG12 7NS. The meeting is open to members of the public. If intending to be at the AGM please email Berkshire Healthcare Communications Team or let them know by phone at 01344 415736. The Trust Chair, Martin Earwicker, and Lead Governor, Paul Myerscough, will talk about the work of the Council of Governors; the Chief Executive, Julian Emms, and Chief Financial Officer, Alex Gild, will discuss Trust achievements over the year and priorities for 2017/18. There will be time for public questions. There will also be two clinical talks of general interest:

• Anxiety in Later Life, Dr Nicholas Woodthorpe, Consultant Psychiatrist in older people's mental health
• The Diabetic Foor - what difference can podiatry make? Diane Owen, Podiatry Services Operational Lead

Diabetes UK has welcomed this as we do - yet we would point to the relative lack of ambition in the pledge. Come on Berkshire West! Doesn't everyone, or their carers, need to get new understanding after diagnosis?

The NHS Clinical Research Network for Thames Valley and the South Midlands will be holding a drop-in event in the Victoria Hall of Reading Town Hall from 1.30 - 5.30pm on Tuesday, 12th September 2017. The event is organised to inform visitors about the clinical research going on in Berkshire and to give the members of the public a chance to get involved. For more details please click here .

Berkshire Healthcare invites you to drop in to Coley Clinic on 6th September 2017 from 11am to 4pm to learn more about Community Care for Heart and Lung conditions - the nurses of the Berkshire Healthcare NHS Foundation Trust who provide the service will be on hand to tell you about ECGs, spirometers, inhalers etc. Coley Clinic is at the closed end of Carsdale Close, Coley, Reading RG1 6DL. From town take the 11 bus to Coley, alight at the Roundhead stop and walk back to Carsdale Close and then along Carsdale Close to the clinic. A visit will give you a chance to find out more about the Community Nursing that was the subject of our meeting on 26th July.

The Governing Body of South Reading CCG meets in public at 9.30-12,30 on Wednesday 6th September 2017 at the Museum of English Rural Life, Redlands Road, RG1 5EX. To book your attendance or to find out about asking questions at the end of the meeting please see here. 

The Governing Body of South Reading CCG meets in public at 9.30-12,30 on Wednesday 6th September 2017 at the Museum of English Rural Life, Redlands Road, RG1 5EX. To book your attendance or to find out about asking questions at the end of the meeting please see here. 

GP practices throughout Berkshire West have voted for the 4 CCGs (Newbury and District, South Reading, North and West Reading and Wokingham) to merge to form a single CCG. The administrative leadership of the Berkshire West Federation has issued a proposal for the merger (see below) which has now been approved by voting by GP practices in the 4 Councils of Practices in Berkshire West. The proposal would maintain 4 local teams and 4 local Councils of Practices in the localities corresponding to the existing CCG areas to deal with local variation but there will also be an overall Council of Practices of the 50 or so GP practices in Berkshire West. The retention of local Councils of Practices is said to favour engagement with patients, but it is not clear how. Overall, there is little consideration of patient involvement, nor have patients and public been consulted. The next step will be to pass the proposal to NHS England for further consideration and action. The proposal also states that "the work associated with the CCG programme boards has grown significantly and these are now major transformation programmes supporting delivery of the Five Year Forward View and underpinning the ACS programme". Apart from the Primary Care Commissioning Committee, none of these boards meets in public and so very little is known to the public about these "major transformation programmes".