Progress or decline of the Covid-19 epidemic is assessed by the R0 value, the average number of people infected by one infected person. Values known so far are: China (Wuhan) 0.1, Germany 0.7, Italy 0.8. A new generation of infected people according to the R0 value will appear roughly every week. The very small value from Wuhan indicates a rapid extinction of the virus to the point at which containment can be reasserted and any sporadic outbreaks suppressed. With its R0 around 0.8 Italy has only managed to halve the number of disease cases in the four weeks after the peak of infections. So to reduce the disease to a point at which sporadic outbreaks can be suppressed. say 100 cases a day, will take a further 11 weeks. And if the lockdown is loosened then things may go even slower. The figure from Wuhan was revealed by Harvard Professor Xihong Lin to the Science and Technology Select Committee on 16 April 2020 (starts about 15.45). She had made a detailed study of the patient data from Wuhan. The figure of 0.1 was achieved by interrupting the transmission of the virus within households as well as between households. This was done by placing all persons confirmed to have Covid-19 or showing symptoms of Covid-19 (there was a lack of testing at the time) in field hospitals while all other traced contacts were placed in hotels rooms (common air conditioning disabled) or other special accommodation where cross-infection was less likely. Children went with parents. In China this approach was mandatory, but it is possible that it could be quite effective as a voluntary measure in the UK. The suppression of disease was rapid; the field hospitals were only open from the beginning of February to the 5th March. The values for Italy and Germany are taken from an interview with Franco Locatelli, president of the health advisory council of Italy, in Corriere della Sera of 18th April. At present we are closely following Italy in the numbers of cases. So we may also be looking at a 15 week descent from the peak to a manageable state unless we can do better than the Italians in our interruption of disease.

The Governing Body of Berkshire West CCG will meet in public at 9.30-12.30 on Tuesday, 10th March 2020 at 57-59, Bath Road, Reading RG30 2BA. You can register online to attend here. Registration closes at 12 noon the day before the meeting. You are invited to submit questions relating to the agenda before a meeting takes place. To allow time to respond, we would ask that questions are submitted, no later than three working days in advance. In most cases, a response will be provided by email before the meeting. Questions that arrive after this time, or require a more detailed response, will be responded to by email after the meeting. To enable members of the public attending the opportunity to put forward an agenda related question to the Governing Body, all questions that have been submitted in advance of the meeting will not be discussed. The agenda includes an allotted time slot for public questions, and will be limited to one question per person. This will be subject to time available on the day and at the discretion of the CCG Chair. To submit a question please email: bwccg.enquiries@nhs.net or telephone 0118 982 2958. Please note: questions must relate to the agenda and are limited to a maximum of three per person.

Reading's Health and Wellbeing Board meets at 2pm on Friday 13th March 2020 in the Civic Offices at Bridge Street, Reading. Questions should be submitted about 2 weeks in advance to Nicky.Simpson@reading.gov.uk .

South Reading Patient Voice meets on Wednesday 15th Arpil at 6pm in Friends Meeting House, 2 Church Street, Reading RG1 2SB for a talk on "Population Health Management" by Katie Summers. Population Health Management is a new requirement on the Primary Care Networks, relating to health inequalities and hospital/urgent care costs. We hope to understand it better after this talk. There will also be reports and discussion of news from Healthwatch Reading, local Patient Participation Groups, Berkshire West CCG, Reading Borough Council, local NHS providers and the wider health economy.

The Berkshire West Primary Care Commissioning Committee meets at 1pm - 4pm on Wedesday 8th April 2020 at 57-59 Bath Road, Reading RG30 2BA. You can register here online to attend, registration closes at 12 noon the day before the meeting. The deadline for submitting questions, relating to the agenda for the Committee to consider, is 5pm three days before the meeting. Please email bwccg.enquiries@nhs.net:w or telephone: 0118 982 2922.

CANCELLED South Reading Patient Voice meets on Wednesday 15th Arpil at 6pm in Friends Meeting House, 2 Church Street, Reading RG1 2SB for a discussion and reports on Patient Participation Groups in our area. There will also be reports and discussion of news from Healthwatch Reading, Berkshire West CCG, Reading Borough Council, local NHS providers and the wider health economy.

At its meeting on 14th January 2020 at NHS Bath Road, Reading the Governing Body of Berkshire West CCG agreed to the proposal to appoint a single Accountable Officer for the whole BOB area (West Berkshire, Oxfordshire and Buckinghamshire). Buckinghamshire has already approved, and Oxfordshire will consider it later in January. The proposal was the first of three contained in an engagement document which also suggested merging the 3 CCGs and strengthening the "Place"-based Integrated Care Partnerships in each of the three constituent Places. The engagement exercise elicited 224 responses, with 42% of those whose origin could be identified being from the Berkshire West area and of those 68% were opposed and 24% had concerns about the proposal to have a single Accountable Officer for the BOB area. The opposition was not so strong from Oxfordshire and Buckinghamshire who already have a common Accountable Officer. Not one of those responding as a GP supported the proposal for a single Accountable Officer. The critical response drew proposals for mitigating actions from BOB, particularly creating the post of "Managing Director" at each of the 3 constituent Places. Responses cited the un-natural nature of the BOB area, the loss of local voice and accountability and democratic oversight, concern about the proposed savings, infeasibility of the Accountable Officer role, the importance of the Place-bsaed partnerships. Nevertheless, as the template of one CCG per Integrated Care System is proposed in the NHS England Long Term Plan, it is probably that some incentives will be applied to bring all three proposals to agreement, however ill-suited. Readers may wish to spot the deliberate mistake in the following quote from the job specification for the single Accountable Officer: "1.6 Politically, the local authority landscape is complex. BOB CCGs work with three County Councils (Oxfordshire, Buckinghamshire and West Berkshire), eight District Councils (West Oxfordshire, Cherwell, Vale of White Horse, South Oxfordshire, South Bucks, Aylesbury Vale, Chiltern and Wycombe), two Borough Councils (Reading and Wokingham) and one City Council (Oxford). The Chief Executive will be required to work collaboratively and effectively with all fourteen local authority partners". Hopefully this does not indicate the level of local awareness that will be applied to our health services in future.

NHS England is consulting on the initial service specifications for Primary Care Networks - covering the new aspects of service brought in with the networks. Please click here to access the service specification and the consultation survey. The consultation ends on 15th January 2020. The service specification describes 5 services:

1. Structured Medication Review and Medicines Optimisation
2. Enhanced Health in Care Homes
3. Anticipatory Care
4. Personalised Care
5. Supporting Early Cancer Diagnosis

The Berkshire West Primary Care Commissioning Committee meets at 1pm - 4pm on Wedesday 8th January 2020 at 57-59 Bath Road, Reading RG30 2BA. You can register online here to attend. Registration closes at 12 noon the day before the meeting. The deadline for submitting questions, relating to the agenda for the Committee to consider, is 5pm three days before the meeting. Please email bwccg.enquiries@nhs.net or telephone: 0118 982 2922.

The Governing Body of Berkshire West CCG will meet in public at 9.30-12.30 on Tuesday, 14th January 2020 at 57-59, Bath Road, Reading RG30 2BA. We understand that this meeting will discuss responses to the local consultation on the merger of the 3 CCGs for Berkshire West, Oxfordshire and Buckinghamshire.