Agenda and minutes

Apologies for Absence were received from Councillor Dr Christopher Hood and Councillor Jane Hanna.

To approve the minutes of the meeting held on 17 September 2009 (JHO3) and to note for information any matters arising on them.

The Minutes of the last meeting held on 16 July 2009 were approved and signed.

With regard to Minute 42/09 – Parkinson’s Disease Services – Roger Edwards reported that the PCT had responded in relation to recommendations (a), (c), (d) and (e). The Chairman and Deputy Chairman undertook to decide what action to take, once responses had been received from all parties.

There are no items from the LINk.

Members of the Committee questioned Adrian Chant, Locality Manager, Oxfordshire LINk, Mary Judge and Anita Higham, members of the Steering Group with regard to the update which had been circulated.

They were thanked for their report and for responding to the questions.

10.05

The South Central Joint HOSC Group meets quarterly. It comprises all of the HOSCs in the South Central region. The Oxfordshire HOSC has two delegates and a substitute.

A number of informal meetings take place during the year with senior managers from the PCT, ORH and OBMHFT. The purpose of the meetings is to keep abreast of emerging issues. The Chairman attends each of the meetings and it is necessary to nominate one more member for each meeting to attend with him.

The informal South Central Joint Health Overview & Scrutiny Group

The South Central Joint Health Overview & Scrutiny Group comprised all of the HOSCs within the South Central region. In previous years, the Oxfordshire HOSC had sent two delegates (together with a substitute) to these meetings. The Committee were asked to provide nominations to represent this Committee.

It was AGREED that the Chairman and Deputy Chairman would represent this Committee at these meetings. In the event that one or neither could attend, then a substitute, or substitutes would be sought from the Committee’s membership.

Informal meetings with senior managers from various NHS Trusts.

A number of informal meetings had taken place during the year, and in previous years, with senior managers from the Primary Care Trust and the other Trusts. The purpose of these meetings was to keep abreast of emerging issues. The Chairman attends each of the meetings as a matter of course, however, it was necessary to nominate a further member to attend with him.

It was AGREED that the Deputy Chairman would accompany the Chairman to these meetings. However, should there be an issue of interest to another member of the Committee, then that person would also be invited to attend.

Report by the Director of Public Health on matters of relevance and interest.

Dr Jonathan McWilliam, Director of Public Health, reported the following:

• His third Annual Report, reporting on 2008/09, which had contained recommendations for 2009/10, had been approved by the County Council on 8 September. The report aimed to continue the focus very firmly on the five main long term threats to public health, which were:

1. Breaking the cycle of deprivation.
2. An aging population – the ‘demographic time bomb’.
3. Mental health and wellbeing: avoiding a Cinderella service.
4. The rising tide of obesity.
5. Fighting killer infections.

There had been an emphasis throughout the report on two critically important areas:

1.      The impact of the credit crunch and the recession.

2.      The importance of carers;

·         Pandemic Flu – Preparations were being made for the second wave of pandemic flu. Its intensity could not be predicted. A major focus for the preparations was on ensuring good primary and secondary services and enough intensive care beds, the numbers for which could be expanded, if needed. Vulnerable groups would now be immunised at the appropriate time;

·         The Health & Well-Being Partnership Board were currently focussing on arriving at a shared plan on how services for older people might be commissioned jointly.

The Committee questioned Dr McWilliam on a number of issues with regard to the above.

10.30

The Transforming Community Services Policy had been launched by the Department of Health in January 2009 in order to strengthen PCT capabilities in delivering community services. It aimed to enable transformational change and support the provision of high quality care which was responsive to local patients and communities. Along with all other PCTs, NHS Oxfordshire had been charged with transforming the commissioning of services in line with World Class Commissioning criteria and assuring that organisational arrangements were fit for purpose. This comprised a wholesale review of community services and high level market analysis, together with a PCT Board decision on the most appropriate options for future organisational form for its provider.

A paper was before the Committee (JHO8), which was presented by Catherine Mountford, Director of Strategy & Quality, Oxfordshire PCT and Geoff Rowbotham, Managing Director of Community Hospitals, Oxfordshire.

Mr Rowbotham commented that the internal processes were about separating out the Community Hospitals Oxfordshire (CHO) strand from within the PCT. This process of change had been part of their focus over the past six months. It was designed to ensure that, as an organisation they could respond in an innovative way to allow challenge to be made more openly. He added that this would work as long as they worked in partnership with other providers. CHO coordinated a plethora of services within the community, which was a key part of its success. In reality, CHO was a separate entity, although legally it belonged within the PCT. It had its own Board, its own financial accounts and its own sense of direction. He added that there was a recognised need to get back to basics with the provision of community based health care. Over the next 6/9 months CHO would be looking at key core services such as district nursing to see how they might be driven forward, in partnership with key partners.

Members of the Committee asked a number of questions, some of which are included below:

Q         Much of Oxfordshire is rural  - will there be sufficient funding to allow district nurses to travel between patients? Where will you recruit from and has the Council got sufficient funding in place to enable it to happen?

R         (GR) CHO has the funding and can decide which areas it wishes to spend on. Mr Rowbotham stated that he had had a number of meetings with district nurses to hear their views.  He added  that Oxfordshire had an ageing profile with regard to district nursing staff and this needed a response and a strategy. At the moment the district nurses saw themselves ‘in limbo’, but there were exciting opportunities for the service.

Q         Will the services be in place at the right time? Are there sufficient resources in place? How will we find out whether patients are satisfied?

R         (CM) From a community point of view we have worked with the patients, public, CHO, ORH etc. We have got to get a lot better at checking patient experience  ...  view the full minutes text for item 52/09

11.15

The Oxford Community Hospital (Oxcomm) had existed on the Churchill Hospital site for a number of years, closing in May 2008 due to issues relating to facilities design, maintenance and control of infection. Alternative provision for community beds had been made at other community hospitals within Oxfordshire and at the Albany Care Home in Headington. In the autumn of 2008, the Oxfordshire PCT outlined to this Committee proposals for the re-provision of community services formerly provided by Oxcomm. In March 2009 Alan Webb, director of Commissioning, Oxfordshire PCT, made a commitment that 20 beds would be available for community rehabilitation by October of this year whilst a longer term proposal was being developed.

Community Health Oxfordshire (CHO) had been commissioned by the PCT to provide the service. It had now been confirmed that the service would be provided by CHO on the John Radcliffe (JR) site.

Carol Knott from CHO, Dr Peter von Eichstorff,  a Practice Based Commissioning lead for the City and Dr James Price, a specialist in care for the elderly, ORH, working in several of Oxfordshire’s community hospitals, gave a presentation on a document which was before the Committee entitled ‘Community Health Oxfordshire, City Community Hospital, Communications Strategy (version 1)’ and, at the invitation of the Committee, formed a panel in order to respond to questions.

Dr Price commented that there had been very positive engagement with the various partners in relation to the model, adding that the PBS partners were very happy with the way services would be delivered for their patients.

Q         Would patients residing outside of the City be able to use the facilities offered by the City Community Hospital?

R         (CK) We would like to get patients as close to home as possible. There are very definite criteria for patients admitted to wards.

(JP) No Oxfordshire community health services have an absolutely defined geographical area. We have to take into account the clinical needs of the patient and the facilities provided. If a bed is not available at the Oxford City Community Hospital then there will be alternative facilities at other community hospitals. We juggle with this  every day, looking, not simply where the patient lives, but where their relatives live, where the appropriate facilities are and the needs of the patient.

Q         Is the sensory garden on the same level? Would it be possible to have the number of beds available and how many of the patients got their first choice? What makes it a community hospital rather than merely a ward in the JR Hospital?

R         (CK) The sensory Garden will be on level 4 – it is currently being developed.

With regard to the bed numbers, the Commissioners will provide a written answer to that. The Hospital offers up to 20 beds on a flexible basis. Physically there is a footprint of one ward at the moment. It would be difficult to push extra beds in but, if necessary,  we would use escalation beds elsewhere.  ...  view the full minutes text for item 53/09

12.15

The Committee is asked to consider items that members might wish to see included within the Committee’s Work Programme during the coming twelve months.  Depending on the items chosen decisions will be required on whether work would be undertaken by the whole Committee or by working groups.

Members are reminded that these items would be in addition to issues that would have to be considered in response to plans and proposals from the local NHS

The Committee were asked to consider items that it might wish to see included within the Work Programme during the ensuing twelve months. The Committee was advised that, depending upon the items chosen, decisions would be required on whether work would be undertaken by the whole Committee or by working groups. Members were reminded that these items would be in addition to issues that would have to be considered in response to plans and proposals from the local NHS.

It was AGREED that the following items would form the Committee’s work programme for the coming year: each issue to be examined in ‘select committee’ style format:

• NHS Trusts employing older workers (for example, up to 70 years of age) with flexibility around hours and duties;
• Mental Health – to review strategic progress on common mental health issues;
• Partnership working to improve people’s health and prevent illness (it was anticipated that this would include health inequalities);
• Alcohol misuse; and
• Access to NHS Dentistry.

Members of the Committee undertook to contact Roger Edwards by Friday 25 September giving their preferences with regard to a priority for the above items and the outcomes would be reported to the next meeting.

12.30

·        Further information on Parkinson’s Disease services

·        Informal meeting with the Chair and Director of Planning and Information at the ORH       

·        Meeting with the Chief Executive and Medical Director of the PCT

The Committee noted the following:

·         Further information on Parkinson’s Disease services (see Matters Arising above);

·         An informal meeting had taken place with the Board Chair and the Director of Planning & Information, ORH;

·         An informal meeting had taken place with the Chief Executive and Medical Director, Oxfordshire PCT;

·         Joint work had taken place with the Buckinghamshire HOSC in relation to concerns about the provision of care of patients at Thame Community Hospital. With regard to this it was AGREED that Councillor Nick Carter, local member for Thame, would represent the Committee on this matter; and that he would provide a report back; and

·         The 19 November meeting of this Committee would have as its main item, proposals for the future of services at the Horton Hospital, Banbury. This followed from the detailed work that had been ongoing since the Secretary of State for Health rejected the proposals for change as proposed by the ORH. In view of the importance of this matter for people living in Banbury and its surrounding area, it had been agreed that the meeting should take place at Cherwell District Council, Bodicote House, Banbury, starting at 10am (pre-meet at 9.00am).

12.45

An update on progress made by the working group

An update was given on progress made by the working group.

12.50

To inform the Committee that a Joint Committee has been set up to review the work of the South Central Ambulance Service (SCAS) with particular reference to their performance in rural areas. The review will take place in late November/early December. The Committee will comprise members from Oxfordshire, Buckinghamshire, Hampshire and West Berkshire plus non-Councillor members.

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­­­­­­­­­­­­­­­­­­­­Pre-Meeting

There will be a pre-meeting at County Hall on the day of the meeting at 9.00 am for all members of the Joint Committee.

(a)   The Committee were informed that  Joint HOSC Committee had been set up to review the work of the South Central Ambulance Service (SCAS) with particular reference to their performance in rural areas. The review would take place in late November/early December. The Committee would comprise members of the Oxfordshire, Buckinghamshire, Hampshire and West Berkshire HOSCs, and would include non councillor members; and

(b)   Councillor Don Seale, Chairman of the County Council’s Adulst Services Scrutiny Committee, informed members of the work being undertaken by his Committee, in conjunction with John Jackson, Director for Social & Community Services, to provide a response to the Green Paper entitled  ‘Care & Support: Shaping the Future of Care Together’.

The meeting closed at 12:30 pm.