Councillor Nick Carter attended for Councillor Dr Simon Clark, Councillor Jeannette Matelot for Councillor Hilary Hibbert-Biles and apologies were received from Councillor Nigel Champken-Woods and Councillor Monica Lovatt.

The Chairman took this opportunity to welcome the Committee’s new co-opted member, Barbara Shaw to her first meeting.

Dr Alan Cohen declared a personal interest in relation to the Agenda as a whole on account of him being a trustee of Oxfordshire Mind and Councillor Mike Fox-Davies declared a non-pecuniary interest in Agenda Item 7 on account of his previous work in private health care provision and his employment as a senior member of the In Health Team.

To approve the minutes of the meeting held on 7 February 2019 (JHO3) and to receive information arising from them.

For ease of reference when considering the Matters Arising from the 7 February 2019 meeting, a list of actions is attached at JHO3.

The Minutes of the meeting held on 7 February 2019 were approved and signed as a correct record (JHO3).

William Walton presented a petition to the Committee on behalf of the organiser of the petition, Alan Davidson of ‘38 Degrees’, in relation to Agenda Item 7 ‘Regional PET-CT Scanning Service – Provision’ stating the following

‘Stop the privatisation of cancer scanning at Oxford’s Churchill Hospital. Please intervene in this decision and stop private companies from running this cancer scanning service’.

Signed by 9,712 residents of Oxfordshire

Mr Walton told the Committee that he had been a former patient at the Churchill Hospital. He was discharged two years ago but was participating in a long-term trial which required a number of scans. He stated that many people in Oxfordshire were concerned about this possible privatisation of a health service, which would serve to fragment a very good working system which was rooted in collaboration with other NHS services. He added that the public was outraged at the lack of real communication and evidence and the injury being done to a centre of excellence.

Julie Dean reported the following requests to speak at this meeting – all relating to Agenda Item 7. All addresses were to be made at Agenda Item 7 prior to Committee consideration of the Item:

-       Suzy Drohan (on behalf of Analise Dodds, MP)

-       Liz Peretz (on behalf of Didcot Town Councillor Cathy Augustine)

-       Oxford City Councillor Louise Upton

-       Jackie Beaumont – member of the public

-       Jean Simmons – a member of the public

-       Mr John Lowe – retired clinician

-       Rebecca Rue – a member of the public

-       Rob Lawrence – a member of the public

-       Barry Neville – a member of the public

-       Oliver Ormorod – clinician

-       Anita Higham – member of the Council of Governors, OUH

10:15

The Committee’s Forward Plan is attached at JHO5 for consideration.

The Chairman reported that he had met with the Chairman of Performance Scrutiny Committee, Councillor Liz Brighouse OBE, to discuss how to delineate the range of issues around mental health service in relation to each Committee’s functions, in order to avoid any duplication. It had been decided that Cllr Brighouse would write to the Chairman of this Committee two weeks prior to a HOSC meeting listing those issues which it was thought suited the role and function of this Committee better. These would then be included in the Committee’s Forward Plan for consideration at its next meeting.

Following consideration, the Committee AGREED the following:

(a)  with regard to the November 2019 meeting – Mental Health item – the Committee asked that the report would clearly state the particular mental health contracts this item related to;

(b)  to add a report on the Local Health Needs Assessment Framework in OX12 and the Wantage Hospital Task & Finish Group to the Agenda for the next meeting in June 2019; and

(c)  with regard to the Health Inequalities Commission’s update in six months’ time – to present a strategic plan indicating where the remaining recommendations would be reported and managed.

10:20

This item provides a report (JHO6) on the key issues for the CCG and outlines current and upcoming areas of work. It includes a summary of the NHS Long Term Plan.

The Committee had before them a report (JHO6) on the key issues for the OCCG, together with the current and upcoming areas of work. These included:

·         The NHS Long Term Plan

·         Gynaecological Services – Outpatients

·         Oxfordshire Vasectomy Service

·         South Oxford Health Centre

·         Judicial Review Appeal

Louise Patten, Chief Executive Officer, OCCG attended the meeting, together with Dr Ingrid Granne, Clinical Lead for Gynaecology, OUH.

Louise Patten introduced the report, highlighting the following:

-       The NHS Long Term Plan – she advised that the Kings Fund had given a good summary of the Plan itself. Group practices, rather than individual GP practices would be working together, via Primary Care Networks, which would ensure a more equitable distribution of services. Mental Health and digital services would be more of a focus also, via digital technology. In relation to Mental Health services, she explained that the changes would relate to the delivery of services in more of an integrated way across the system so that people would only be assessed once, and an efficient pathway of care would be in place;

-       Gynaecological Services - it had been agreed to look to refer patients to alternative providers for a period of 3 months, as a means of tackling the waiting times at the OUH. Dr Granne informed the Committee that the numbers of patients waiting over 18 weeks had now been halved and capacity extended. OUH was also developing a business case to employ additional consultants to ensure that targets were hit. She reported 2,200 patients were awaiting their first appointment. She added that there had also been changes in the operative capacity and theatres could now meet the number of operation requirements. The theatres were also being refurbished in order to cope with the flow. With regard to GP referrals for the location of gynaecological services, it was the GP who made the decision, together with the patient. Quicker appointments depended upon whether the patient was happy to travel to Berkshire or Buckinghamshire. A report giving information on where patients went for their treatment would be submitted to the Committee in due course. In response to a concern from a member of the Committee, she gave her assurance that theatre capacity would also be increased in the north of the county. In addition to this, outpatients would be re-designated to the Horton Hospital;

-       South Oxford Health Centre - Louise Patten reported that a mini-procurement exercise was to be undertaken to seek a local resolution. Furthermore, the OCCG was planning for a worse - case scenario in order not to waste any time.

Prior to questions from the Committee on the above issues, Louise Patten was asked when the Physiotherapy services were due to return to Wantage Hospital. Louise Patten responded that the planned date was within the following six weeks, adding that the provider had to agree that the venue was at their own risk. She assured the Committee that OCCG wanted this service to return to Wantage.

Louise Patten  ...  view the full minutes text for item 18/19

10:50

To consider a report from NHS England (JHO7) which gives the following:

·         an overview of the commissioning and procurement process which led to the award of the contract for the regional Positron Emission Tomography and Computed Tomography (PET-CT) scanning service to a private healthcare company, InHealth;

·         A proposal for provision of services in Oxford.

A representative from the Oxford University Hospitals Foundation Trust (OUH) will be present will be present to discuss the implications of this decision for the delivery of PET/CT scanning for cancer patients’ safety and good quality outcomes.A report is attached at JHO7.

Prior to consideration of this item the Committee was addressed and petitioned by the following members of the public:

Alan Davison presented a petition with 9,711 signatures on behalf of the ‘38 Degrees’ campaign. He stated that he had been discharged as a patient at the Churchill Hospital two years ago and was currently taking part in a long-term trial which required a number of scans. He highlighted the outrage expressed by the signatories, who resented the giving of public money to private companies; the start or creeping privatisation and the perceived secrecy behind the procedure. He asked why fragment a very good working system which was routed in co-ordinated collaboration. He also expressed his own outrage at the lack of real communication and evidence and the injury being done to a centre of excellence.

Suzy Drohan read out a statement on behalf of Annelise Dodds MP, who informed the Committee that she had been contacted by an unprecedented number of members of the public, researchers and clinicians, all concerned about the new partnership. Some of these had spoken to her regarding their concerns about the threat of legal action made by NHS England against critics of the new arrangement, on the grounds of care quality. She hoped this Committee would reject these plans for two reasons. Firstly, that it was her view that InHealth lacked the requisite staff to operate the scanner and there was no clarity about how the partnership might develop over time. Secondly, it would create a two-tier system as people from Swindon and Milton Keynes would be required to come to Oxford for treatment from a perceived, poorer quality mobile scanner – and there would be pressure on the service.

Action - The Chairman requested a copy of the letter threatening legal action.

Liz Peretz addressed the meeting on behalf of Didcot Town Councillor Cathy Augustine. She stated that, as the contract had yet to be awarded, the process needed to be halted on the following grounds:

-       In her view the process was flawed and the OUH bid had not been fairly considered. There was pressure on staff not to criticise;

-       The consultation had been conducted online, and for one month only, which, in her view, was inadequate;

-       A full consultation was required, together with an impact assessment on financial and medical grounds;

-       The full details of the plan needed to be put in the public domain, for example for who was responsible for the upkeep of the equipment, who employed and trained the staff; and who was responsible for the data. Given this lack of detail the Committee could not say what level of engagement was appropriate

She stated that there was still time for the Committee to take the above forward, adding that the OUH was where the scanner belonged.  She denounced the sub-contracting of OUH and called on the Committee to stand firm, not engage and refer the matter to the Secretary of State for Health.  ...  view the full minutes text for item 19/19

12:20

The Committee will scrutinise the provision and capacity of NHS dentists in Oxfordshire (JHO8). It will include a look at the dental health of adults and children in the Oxfordshire population, including where inequalities exist; and programmes of work to promote dental health.

Public Health will lead on this item with input from Adult Social Care to link in with the needs of people in residential/nursing care.

13:00 – LUNCH

It was AGREED that this item be deferred to a future meeting.

13:30

The Committee will receive a report on the benefits of the changes to Learning Disability services for patients. The report is attached at JHO9.

There will be representatives attending for this item from a number of organisations – from the Clinical Commissioning Group, the Oxfordshire Family Support Network, ‘My Life my Choice’, Oxford Health and Oxfordshire County Council.

It was AGREED that this item be deferred to a future meeting.

MEETING ADJOURNED FOR LUNCH: 1.30 PM

RECONVENED: 2.00 PM

14:00

Jackie Wilderspin (Oxfordshire County Council) and Dr Kiren Collison, Oxfordshire Clinical Commissioning Group) will attend to present the review of progress made (JHO10) in relation to the Health & Wellbeing Board’s Health Inequalities Commission report.

Jackie Wilderspin (Oxfordshire County Council) and Dr Kiren Collison, Oxfordshire Clinical Commissioning Group) attended to present the review of progress made (JHO10) in relation to the Health & Wellbeing Board’s Health Inequalities Commission report.

In response to questions the Committee was advised:

·                     Data collection was still a concern but it was improving. In particular the equity audit was difficult when there is no record of ethnicity in 10% of cases. However, 90% was still a significant improvement. The new GP registration recorded ethnicity and hospital statistics were also improving.

·                     Work was underway on a prevention document and the impact of poverty and resource reallocation would be part of that work.

·                     Districts were involved in the Implementation Group and there was an awareness of geographical inequalities. It was suggested by a member that the Committee should look at the Prevention Framework at a future meeting. In relation to scrutiny of the 5 principles it was thought that this could be part of the scrutiny of the Health & Wellbeing Board in June.

·                     The Implementation Group was focussed on health and health outcomes and were not considering wider implications of Growth. The Committee was advised that it could be part of a wider discussion and that the Oxfordshire Strategic Partnership still met. The Chairman suggested it could be a matter for the new Director of Public Health to take forward and that it could come back as an action to a future meeting.

·                     Responding to questions as to what the specific health needs of the BME communities were the Committee was advised that there were inequalities. By understanding the nature of the disadvantage it was possible to address them. For example there was some increased prevalence of some diseases in various communities such as diabetes or sickle cell anaemia.

The Chairman noted that the new Director of Public Health would be in post shortly and he proposed and it was AGREED that the matter be looked at again in 6 months with a Strategic Plan to consider the way forward.

.

14:30

Dr Clare Dollery (Oxford University Hospitals Foundation Trust) will attend to present the annual report on key progress against OUH stated priorities. The Committee are asked to comment (JHO11).

Dr Clare Dollery (Oxford University Hospitals Foundation Trust) attended to present the annual report on key progress against OUH stated priorities.

The Committee commented:

·                     On the cardiac arrest reduction target for 2018/19 that had not been achieved. The Committee was advised that it followed on 10% reductions in both of the previous 2 years. Over time more and more of the most well patients had received ambulatory care meaning that only the most ill patients were treated as in patients.

·                     That the layout and presentation of the information could be improved by being clear about the objectives, what was  achieved and what was to be done where targets were not achieved.

·                     That it was important to be looking at the right metrics and that they were clear.

·                     That there was little detail about HART. A member suggested the need for a radical rethink and that there were geographical challenges to be met. It was queried what involvement there had been with the County Council. Dr Dollery commented that OUH was committed to working together and that there was a better relationship following the CQC System Wide Review.

·                     That measures to address the numbers of stranded patients did not seem to be working. It was noted that although the number had reduced significantly it was still high.

·                     On the usefulness of the current process and whether it could better link to the Health & Wellbeing Board priorities. Dr Dollery explained how it worked alongside the constitutional targets and the work being done to ensure that risk was considered alongside operational matters.

Dr Dollery responded to questions:

·                     Members queried why the survival rate for 2019-20 did not show a split between men and women. Dr Dollery stated that she was unable to advise on the gender split but would take the query back.

·                     There had been 16 never events this year which was a source of real concern. This was reflected in the current priorities.

·                     Dr Dollery explained the process for setting priorities. She added that something not being a current priority did not mean that work would stop.

Dr Dollery was thanked for her presentation and attendance.

14:45

Rosalind Pearce, Chief Executive Officer of Healthwatch Oxfordshire (HWO) will be present to report on views gathered by HWO and its latest activities. (JHO12).

Rosalind Pearce, Chief Executive Officer of Healthwatch Oxfordshire (HWO) to report on views gathered by HWO and its latest activities. (JHO12).

Ms Pearce undertook to provide to the clerk for circulation to members a presentation that had been made to Health & Wellbeing Board (HWB) relating to the first Stakeholder Group meeting asked for by HWB. This was the start of the process of better engagement with the voluntary sector.

Ms Pearce responded to questions:

·                     In response to a question concerning the PET scanner service being retained at the Churchill being described by HWO as good news Ms Pearce explained the context of the remarks and the information it was based on. On the face of it was good news in terms of location. They had to focus on patients and outcomes.

·                     Referring to the first of the six monthly meetings held on 28 February Ms Pearce indicated that there had been 6 or 7 members of the Health & Wellbeing Board present. Feedback would be a regular item on HWO reports to this Committee.

14:55

The Chairman’s report is attached at JHO13. It includes and update on health and social care liaison.

15:05 Close of Meeting.

In addition to the submitted report the Committee noted a verbal update from Councillor Fox-Davies, Chairman of the Task and Finish Group on Local Health Needs Assessment in the Wantage Locality

It was AGREED to receive the Chairman’s report.