Oxfordshire County Council logo

Agenda and minutes

Venue: Rooms 1&2 - County Hall, New Road, Oxford OX1 1ND. View directions

Contact: Julie Dean Tel: 07393 001089  Email: julie.dean@oxfordshire.gov.uk

Items
No. Item

42/17

Apologies for Absence and Temporary Appointments

Minutes:

Cllr Jeanette Matelot attended in place of Cllr Mike Fox-Davies and apologies were received from Cllr Kevin Bulmer, Cllr Dr Simon Clarke, District Cllr Nigel Champken-Woods and Anne Wilkinson.

43/17

Declarations of Interest - see guidance note on the back page

Minutes:

District Cllr Andrew McHugh declared a personal interest on account of his appointment as a short-term locum at West Bar GP Surgery, Banbury.

44/17

Minutes pdf icon PDF 193 KB

To approve the minutes of the meeting held on 22 June 2017 and the special meeting held on 7 August 2017 (JHO3); and to receive information arising from them.

 

Additional documents:

Minutes:

The Minutes of the meeting held on 22 June 2017 were approved and signed as a correct record.

 

The Minutes of the special meeting held on 7 August 2017 were approved and signed as a correct record subject to the addition of the following to page 18, paragraph 2 (addition in bold italics):

 

‘Valerie Ingram, administrator of ‘Save Our Horton’ Facebook page urged referral and spoke in particular against the proposals for maternity services by reference to the individual experience ‘and the death of a baby’ suffered by a pregnant woman and her family.’

 

There were no matters arising.

45/17

Speaking to or Petitioning the Committee

Minutes:

The Chairman had agreed the following requests to address the meeting;

 

-        Brenda Churchill, Deer Park Medical Centre Patient Participation Group (Agenda Item 6 – ‘Advice from the Independent Reconfiguration Panel (IRP);

-        Sarah Lasenby, ‘Keep our NHS Public’’, Agenda Item 6 – ‘Advice from the Independent Reconfiguration Panel (IRP) – speaking at this item.

 

Sarah Lasenby, of ‘Keep our NHS Public’, addressed the committee to voice her  concern that by making piecemeal changes to services the Oxfordshire Clinical Commissioning Group (OCCG) was disguising cuts. For example, the changes now proposed for stroke rehabilitation services at Witney and Abingdon community hospitals were being made ahead of the Phase 2 Transformation consultation. She also questioned the clinical basis for this decision. Ms Lasenby urged the committee to instruct the OCCG to halt the implementation of Phase 1 decisions until the Judicial Review of the consultation process had run its course. 

 

46/17

Healthwatch Oxfordshire - Update pdf icon PDF 294 KB

10:15

 

Professor George Smith, Chairman of Healthwatch Oxfordshire (HWO) and Rosalind Pearce, Executive Director, will update the Committee on the activities of HWO since the last meeting (HWO5).

Minutes:

The Committee welcomed Professor George Smith MBE, Chairman, and Rosalind Pearce, Chief Executive Officer, of Healthwatch Oxfordshire (HWO) to present their regular update of issues/activities (JHO5). They undertook to circulate a list of all those invited to the postponed July 2017 primary care workshop to all members of the Committee. This workshop involved representatives from the Oxfordshire Clinical Commissioning Group (OCCG) , local Patient Participation Groups (PPG’s), local GPs and Locality Forum representatives, local politicians, members of the public and representatives from various voluntary organisations. Its aim was to help all to understand the issues involved for primary care in areas of Oxfordshire that were developing rapidly. Rosalind Pearce reported that the workshop was now scheduled to take place on 20 September 2017. She apologised for the inadvertent exclusion of local county councillors to the list and gave her assurances that in future they would be invited to similar events. The OCCG was urged by the Committee to take on such a role rather than the onus being on HWO to organise this types of event.

 

On a request from a member of the Committee, Rosalind Pearce also undertook to organise a stall in Thame about Stroke Awareness. HWO was encouraged to consider including South Oxfordshire in more of their planned events and to work with their counterparts across the border in Buckinghamshire. HWO was also urged to turn their attention to the Vale of White Horse area which was experiencing ‘stresses and strains’, including long waiting lists for services following patient discharge from hospital, for example in Physiotherapy and Speech Therapy, thus causing possible re-admittance to community hospitals and GP surgeries. This often gave a feeling of ‘abandonment’ for patients.

 

With reference to pages 28/30 of the HWO report, members of the Committee made reference to public concerns about the need for ensuring that there were no increases in GP surgery waiting times or in mental health support services for children as an outcome of the new proposals for Stroke Services within the community. In this regard, the Committee also added its concern in relation to difficulties experienced by the elderly when using IT to make an appointment, maybe resorting to a visit to Accident & Emergency. Rosalind Pearce added to these concerns stating that HWO had found people of a younger age continued to ask for face to face visits with the GP, rather than using Skype. She added that it was HWO’s view that designs for a new surgery could not be based on all patients owning a smart phone. Moreover that HWO was looking to develop a younger aspect of HWO which would include the voice of the young in debates.

 

When asked, Rosalind Pearce reported HWO’s concern that 400 patients from Deer Park surgery had not re-registered with another surgery. Furthermore, they planned to send out a co-authored letter alongside the OCCG to these patients emphasising that it was very important to do so for reasons of their own safety. She accepted the OCCG’s contention that  ...  view the full minutes text for item 46/17

47/17

Advice from the Independent Reconfiguration Panel (IRP) pdf icon PDF 796 KB

10:30

The Committee is invited to consider the advice from the IRP in response to the Committee’s referral to the Secretary of State of the Oxfordshire Clinical Commissioning Group’s (OCCG) decision not to re-procure services at Deer Park Medical Centre (JHO6).

 

As part of this, the Committee will receive an update on the OCCG’s progress in developing a plan for primary care in Witney; and consider how to develop and sustain an open, no surprises, productive and effective working relationship with the NHS. This paper is also attached at JHO6.

 

 

Additional documents:

Minutes:

Prior to consideration of this item the Committee was addressed by Brenda Churchill, Chair, Deer Park Surgery PPG. She stated the PPG’s concern that, although the IRP report had been published at the beginning of July, nothing constructive had been done in response to its content. It was only in the last few days, on 8 September, had a meeting with the local MP taken place. She added that there were fears that the OCCG was procrastinating due to the need to concentrate on the Transformation proposals. She also reiterated the point made by HWO that NHS England still needed to appoint an independent person, asking the Committee to ensure that the outstanding work highlighted in the IRP report be carried out quickly. Furthermore, feedback from Deer Park patients had indicated that progress had not been smooth in relation to services provided, such as repeat prescriptions (72 hour wait). She asked what would happen when there was more housing development in this area – asking would patients have to wait even longer?

 

Brenda Churchill also expressed her concern that Witney and its surrounds had not been included within the current work being undertaken by the OCCG on future primary care for Oxfordshire. The Witney PPGs were thus calling for at least one public meeting in order that the proper consultation could take place.

 

 

The Committee welcomed Catherine Mountford, Director of Governance, and Sarah Adair, Head of Communications, OCCG to the meeting. Referring to the points made by HWO and by Brenda Churchill she stated the following:

 

·        Since May of this year work had been ongoing on Primary Care sustainability. She pointed out that there were very different issues inherent in each locality to be looked at in relation to how to plan a strategic service. She added that there was a timeline for this work which had been published on the OCCG website and a web link would be made available to members of the Committee. In addition a template was being prepared on what patients felt were important in their primary care which would then go out to GP practices. She stated that the OCCG accepted the need to be open-minded and transparent about how surgeries would be staffed and funded etc. She assured the Committee that the OCCG accepted the responsibility to undertake this work in a proper manner and issues in West Oxfordshire such as housing growth were not being ignored. Catherine Mountford reported also that the OCCG planned two events in the West Oxfordshire area, at which the public would be involved – one in Witney and Eynsham and another in the surrounding environs within the area. A further event would also take place at the end of April 2018 focusing on funding. She added that an update would be given on meetings taking place and future work to be undertaken on the sustainability of primary care. This work would include a perspective on other issues such as longer waiting times in GP surgeries;

·        With regard  ...  view the full minutes text for item 47/17

48/17

Stroke Rehabilitation Services pdf icon PDF 322 KB

11:20

 

A briefing is attached on the proposed relocation of stroke rehabilitation beds in Witney to Abingdon Community Hospital (JHO7). Consultation with staff is planned for September.

Minutes:

Dominic Hardisty, Chief Operating Officer, Oxford Health Foundation Trust and Sara Bolton, Allied Professional from Older People’s Directorate, Oxford Health Foundation Trust attended for this item. The Chairman welcomed them to the meeting.

 

The Chairman began by expressing the Committee’s concern that the Toolkit process to ascertain whether the proposals were a significant change in service or not, had not been followed in this case. Dominic Hardisty explained the rationale to the proposals, as set out in the paper JHO7, which was that by amalgamating specialist medical/therapy services into one unit in the county, (based in Abingdon), this would allow a higher level of identity and provide a fully dedicated stroke unit with 20 beds.

 

The Committee asked Kate Terroni, Director for Adult Services, OCC, how the proposals aligned with Social Care in relation to the principle of patients being placed closer to home. She stated that, having discussed the proposals with Oxford Health, she had ascertained that there would be no real impact on Adult Social Care and she could therefore support the proposals.

 

A member brought the Committee’s attention to the concerns of staff working at Witney Hospital. She feared that the proposals were not in their infancy, as some stroke therapists had already left their jobs through their own choice. This had led to some insecurities amongst other support staff working at Witney. Dominic Hardisty responded that the Trust was working on how to support staff more in circumstances such as these, to accord with specialist training guidelines.

 

With regard to the point made about the apparent pre-empting of Part 2 proposals relating to the Oxfordshire Transformation Plan and delivering a ‘fait accompli’, without proceeding through the Toolkit process, Dominic Hardisty stated that the Trust was continually changing and improving services and a judgement needed to be made about what proposals needed to come before the Committee and how to do this. He assured members of the Committee that the Trust had tried to be open and transparent about its aims for this service.

 

They also pointed out that the proposals were for community-based rehabilitation for patients – which was a sub-speciality. It was not therefore a move towards a future vision of centralising services to the John Radcliffe Hospital.

 

Following discussion and in light of its concern that the proposals were being presented as a ‘fait accompli’ and would lead to community bed closures and the future centralisation of all services to the John Radcliffe Hospital, the Committee AGREED the following actions be undertaken with regard to the proposals:

 

·       that the Toolkit be completed and circulated and also additional papers be circulated - and to reserve judgement pending receipt of these;

·       to see an impact assessment of moving 10 stroke beds from Witney to Abingdon; and

·       to request a breakdown of plans for staff as there had been reports of a lack of communication to them, and resulting confusion and concern. This to include information about whether ancilliary staff would be transferred alongside other  ...  view the full minutes text for item 48/17

49/17

Director of Public Health's Annual Report pdf icon PDF 3 MB

12:20

 

The Director of Public Health will present his independent Annual Report to the Committee. Members of the Committee are asked to consider the key issues which it would like to see taken forward in the year ahead (JHO8).

Minutes:

Dr Jonathan McWilliam, Director of Public Health, presented his tenth annual report to the Committee. Members considered both the strategic and local issues highlighted in the report that could be taken forward in the year ahead (JHO9).

 

The Committee felt the report was comprehensive and easy to read, although there was some surprise at the absence of information about levels of dementia and frailty in Oxfordshire from the report.

 

In particular Committee members discussed the following points:

 

·       The pressures posed by an ageing population and difficulties obtaining accurate county population figures;

·       The importance of ensuring health impact assessments are completed as part of any service redesign;

·       How useful it was for all organisations to have a focus on primary prevention, particularly in relation to breaking the cycle of deprivation and supporting hard to reach groups;

·       The impact of loneliness and isolation on Oxfordshire communities;

·       How social housing was incorporated into healthy communities and the extent to which District/City housing authorities were meeting their affordable housing targets, including meeting the housing and employment needs of people with learning disabilities;

·       The importance of ensuring that health was considered in the development of Local Plans, including the extent to which the County Council Highways team is able to comment on plans in relation to air quality and how the development of new technologies, such as electric vehicles, was being taken into account;

·       The links between increasing educational outcomes and breaking the cycle of deprivation;

·       The effect of day centre closures on carers and health inequalities, as well as the funding of child mental health services and the effect this had on children’s carers;

 

Following consideration of the Director of Public Health’s recommendations in the report, the Committee AGREED to:

 

·       Explore the implications of government plans to stop the sale of diesel cars on air quality and how the County Council is planning to update its fleet;

·       Write to Oxfordshire MPs asking for their support for more legislation to reduce the levels of sugar, salt and fat in food and drink in order to combat obesity and drink related diseases;

·       Recommend that the Health Improvement Board has a focus on measures to prevent and reduce the prevalence of obesity;

·       Encourage the adoption of the “daily mile” in schools;

·       All Councillors should be provided with information on tackling loneliness and isolation;

·       Recommend that the Public Health team seek best practice and research from other countries where higher rates of breastfeeding are achieved, to inform Oxfordshire’s approach in this area;

·       Recommend that District/City councils routinely include health assessments in the development of their Local Plans. HOSC is also keen to scrutinise the ensuing work on this issue.

 

 

 

50/17

Chairman’s Report pdf icon PDF 387 KB

13:15

 

The Chairman’s report is attached at JHO9. This includes a copy of the referral letter to the Secretary of State made by the Committee in relation to the maternity services at the Horton General Hospital. Also included will be an update on the assurances agreed at the Board meeting on 10 August.

Minutes:

The Committee noted that Dr Alan Cohen had been appointed to the co-optee vacancy and he would be attending the next meeting.