Agenda and minutes

An apology was received from Councillor Jane Hanna OBE.

There were no declarations of interest.

To approve the minutes of the meeting held on 8 July 2010 (JHO3) and to note for information any matters arising on them.

The Minutes of the meeting held on 8 July 2010 were approved and signed, subject to the word ‘two’ being amended to ‘ten’; in Minute 44/10, page 6, line 1 and Councillor Pressel being added to those who attended the meeting with Sir Jonathan Michael, Chief Executive, ORH, as noted in Minute 47/10, page 12.

With regard to Minute 44/10, first bullet point, page 6, Dr McWilliam reaffirmed his hope that spending on family support would be an ongoing topic of interest for the Committee. He added that he had requested data from Linda Watson, Chief Executive, Oxfordshire Rural Community Council, in a bid too tease out types of deprivation, whether that be of a poverty nature, or housing, rural access to services etc.

The Chairman had agreed to a request from Councillor Larry Sanders to address the Committee at Agenda Item 5.

10.30 am

The recent White Paper and other related consultation papers set out a whole series of radical proposals for change to the NHS. The White Paper is now out for consultation with responses required by 11 October 2010. The proposals can be grouped together under three main headings:

Consideration of the White Paper will be in three parts:

Adult Social Care –  A paper by the Director of Social & Community Services entitled ‘Health White Paper’ is attached at JHO 5(a).

Public Health

A report by the Director of Public Health is attached at JHO 5(b).

Implications for Oxfordshire County Council and the Implementation of the Proposals – to include the implications for the Oxfordshire Joint Health Overview & Scrutiny Committee and for the Health & Well Being Partnership Board – current and future. A report by the Health Scrutiny Advisor is attached at JHO 5(c).

A wide range of speakers from Health, the County Council and other interested organisations have been invited to address the Committee on the issues raised by the proposals.

Members of the Committee will be asked to consider their response to the consultation.

A copy of the White Paper entitled ‘Equity and Excellence: Liberating the NHS’ is enclosed together with two associated consultation papers entitled ‘Liberating the NHS: Commissioning for Patients’ and ‘Liberating the NHS: Local democratic legitimacy in Health’.

The recent White Paper and other related consultation papers set out a whole series of radical proposals for change to the NHS. The White Paper was now out for consultation with responses required by 11 October 2010.

For the purposes of this Committee, consideration of the White Paper was addressed in relation to three major areas:

Adult Social Care  - A paper by the Director of Social & Community Services entitled ‘Health White Paper’ was circulated (JHO5(a));

Public Health – A paper by the Director of Public Health was circulated (JHO5(b));

Implications for Oxfordshire County Council and the Implementation of the Proposals – to include the implications for this Committee and for the Health & Well Being Partnership Board – current and future. A paper by the Health Scrutiny Adviser was circulated at JHO5(b).

A wide range of speakers from Health, Oxfordshire County Council and other interested organisations had been invited to address the Committee on the issues raised by the proposals. The speakers are listed as follows:

·                    Councillor Arash Fatemian (Cabinet Member for Adult Services – Oxfordshire County Council (OCC));

·                    John Jackson (Director of Social & Community Services - OCC);

·                    Joanna Simons (Chief Executive – OCC);

·                    Fred Hucker (Chair, Oxfordshire Primary Care Trust (PCT) Board);

·                    Sonia Mills (Chief Executive – Oxfordshire PCT);

·                    Dr John Galuszka (Acting Medical Director – Oxfordshire PCT);

·                    Dr Jonathan McWilliam (Director of Public Health);

·                    Dr Peter Von Eichstorff (Practice Based Commissioning consortia representative);

·                    Dr Paul Roblin (Local Medical Council (LMC) representative);

·                    Mark Ladbrooke (Secretary – Oxfordshire Unison – health branch);

·                    Dermot Roaf (Oxfordshire Link); and

·                    Olga Senior (SHA Director of Communications & Corporate Affairs).

Prior to the above business, Councillor Larry Sanders addressed the meeting prior to the above as follows:

-           His view that the overarching themes of the White Paper would create risks and his hope that these would be minimised in Oxfordshire;

-           The ongoing ‘Keep our NHS Public’ campaign had aired their concerns about the ‘privatisation and fragmentation’ of the NHS;

-           He advocated that there should be one sole commissioning consortia for Oxfordshire, adding that it had only been a short while ago that 5 PCTs had been reduced to one and the ensuing costs had been substantial;

-           In the past, similar PBC consortia had proved very expensive to run. He asked what would be the consequences if they should run into financial difficulties;

-           He warned of the alleged ‘power and unscrupulous working practices’ of the private sector;

-           He asked what would happen if a Foundation Trust  should run into financial problems. The Government had indicated that any organisation could bid for services and expressed a hope that a cautious stance be taken with regard to outsourcing any commissioning responsibilities.

John Jackson  – introduced his paper (JHO5(a)) informing the Committee that the Cabinet deadline for responding was 5 October and for its supplementary papers was 12 October. He added that the OCC response would focus on a package which was intended to be part of  ...  view the full minutes text for item 53/10

12.00 noon

The Better Healthcare Programme for Banbury and the surrounding area has been a major community engagement project. With the advent of the White Paper, and talk of a ‘Big Society’, how can lessons learnt locally help to ensure that health services are designed and delivered with, and for, patients and the public? Julia Cartwright, Chair of the Community Partnership Forum, will share insights into the benefits of, and barriers to, collaborative working.

A copy of Julia Cartwright’s presentation entitled ‘Lessons from an IRP Review: The Importance of Community Engagement’ is attached at JHO 6.

LUNCH

The Better Healthcare Programme for Banbury and the surrounding area has been a major community engagement project. With the advent of the NHS White Paper, and talk of a ‘Big Society’, the Committee has wondered how can lessons learnt locally help to ensure that health services are designed and delivered with, and for, patients and the public? Julia Cartwright, Chair of the Community Partnership Forum, will share insights into the benefits of, and barriers to, collaborative working.

The Committee had before them a copy of Julia Cartwright’s presentation entitled ‘Lessons from an IRP Review: The importance of Community Engagement’ is attached at JHO6.

The Committee thanked Julia Cartwright, Chairman of the Community Partnership Forum, for attending the meeting and for her insights to their questions on lessons which could be drawn from the IRP review in relation to community engagement, in light of the White Paper and talk of a Big Society. They congratulated her once again for her excellent leadership skills and the exemplary role she and members of the Forum played in co-ordinating the community response to the Horton proposals.

13:15 pm

The Chief Executive of the Nuffield Orthopaedic Centre will speak to the Committee on the Centre’s present position and its possible future position.

Jan Fowler, Chief Executive, Nuffield Orthopaedic Centre (NOC), together with Sarah Randall, Director of Operations & Performance, had been invited to speak to the Committee on the Centre’s current position and its possible future.

Jan Fowler made the following points:

·                    She had been in discussion recently with the Chairman of this Committee and Roger Edwards;

·                    The last time she had attended the Committee it had been to discuss the underlying issues relating to a shortfall of £8.5m. Since then and significant amount of work had been undertaken and high levels of performance had been delivered;

·                    The Board had considered what would constitute the best clinical and financially sustainable service in the future which was most unique to the NOC, but also wide reaching;

·                    The decision  to merge with the ORH  to form a new acute organisation for Oxfordshire had been taken within the context of the NHS White Paper and its inherent financial pressures;

·                    There would be a new name, which was symbolic of the new organisation, but individual sites would retain the same name;

·                    The change was not about changing services – they would continue to be delivered from the present site – but there would be better resilience for the service;

·                    A new business case was now being developed which would be signed off by the Trust Boards at the beginning of next year. It would then need further approval by the SHA and finally by the DoH;

·                    A new Foundation Trust application would hopefully be submitted in 2012/13;

·                    The merger would be likely to happen in mid 2011;

·                    The NOC Trust Board had decided to run a public consultation from September to the end of November, even though the SHA had advised that this was not required. The NOC had very strong stakeholder support. The Chairman commented that whilst this Committee did not require the NOC to hold a public consultation, it required continuous informal consultation.

Questions asked, and issues raised by the Committee and responses received were as follows:

-                      What savings would be made by the merger? (response) There would be one Board. The NOC were already cross working with the ORH looking at opportunities to deliver improvements within a larger organisation – the merger would enable them to be provided more cost effectively. The NOC’s contribution in the face of huge financial pressures have been made very clear to staff;

-                      What would you be consulting on? (response) Plans to create a clinical division within a bigger organisation which would work in a semi-autonomous way. An exploration of what it would look like and what is important to the clinicians;

-                      By merging, will the patients be seen quicker? (response) We will be working with the JR to support more complex cases. There will be a requirement to be confident that there is a strong clinical infrastructure in place. We will be streamlining trauma cases with the JR, giving better access for patients;

-                      Do you envisage sharing staff with the ORH? (response) Specialist staff  ...  view the full minutes text for item 55/10

13:45 pm

Representatives from Patient Voice, (a group of members of the former Oxfordshire Radcliffe Hospitals Trust (ORH) Patient & Public Involvement Forum),  will present their report, which was been commissioned by the Oxfordshire LINk, on Discharge Procedures. They will be accompanied by a representative from the Oxfordshire LINk Steering Group.

Copies of the papers submitted by Patient Voice are attached at JHO 8.

Representatives from Patient Voice ( a group of members of the former Oxfordshire  presented their report, which had been commissioned by the Oxfordshire LINk, on Discharge Procedures. Copies of the papers submitted by Patient Voice were attached at JHO8.

The Committee thanked the representatives from Patient Voice and from the Oxfordshire LINk for attending to present their report on discharge procedures from acute hospitals. They also thanked Susan Brown, Communications Manager for the ORH for her input to the discussion.

It was noted that the LINk were keen to revisit  the recommendation in Spring, 2011 to ascertain whether the plans, systems and implementation had taken place. The LINk had also requested Patient Voice to carry out some research with regard to the quality of food, the appropriateness and presentation of food, and the enablement to eat accorded to patients, in an acute setting.

2.15 pm

An update of the latest Oxfordshire LINk activity is attached at JHO 9.

Adrian Chant presented an update of the latest Oxfordshire LINk activity (JHO9).

The Committee thanked Adrian Chant for his report.

2.30 pm

The Chairman will report on the meetings he has attended since the last meeting.

The Chairman reported on a number of meetings which he, the Deputy Chairman and Mr Edwards had attended. These included meetings with the Chief Executives of the Nuffield Orthopaedic Centre, the Oxford Radcliffe Hospitals Trust and the Oxfordshire Primary Care Trust.