Agenda and minutes

The Chairman welcomed all to the meeting. In particular he welcomed Stuart Bell, Chief Executive, Oxford Health (OH) and Andrew Stevens, Director of Planning & Information, Oxford University Hospitals NHS Trust (OUHT) to the meeting, both of whom had been invited to participate in the discussion at Agenda Item 5.

Apologies had been received from Councillor Hilary Hibbert-Biles, Dr Matthew Gaw and Jim Leivers. James Drury attended as a representative from the Thames Valley NHS Commissioning Board.

Mr Drury reported that from Monday 5 January 2015, as a result from an organisational alignment and capability programme, the structure of NHS England had been reviewed. The outcome was that the seven area teams had now become four. He was now Director of Finance for the South Centre Team and Rachel Pearce had been appointed interim Director of Communications and Operations. Further appointments would be made over the next three month period.

There were no declarations of interest submitted.

The Chairman had agreed to Paul Cann, Chief Executive, Age UK, Oxfordshire addressing the meeting in relation to Agenda Item 5.

Paul Cann expressed Age UK’s support for the Oxfordshire Better Care Fund Plan 2014/15 and 2015/16. He pointed out, however, that the £9.3m funding allotted to social care as a result of this initiative was the minimum of what was needed and that the needs of 9,000 adults with social care needs were not being met, due to underfunding. He added that since 2005/6, Social Care funding had been reduced by £1.4b, which had amounted to an 18% reduction. Moreover, this was an area where the local community and voluntary services, if they were to be embedded more into the system, could work together with all involved to further the prevention aspect of the Plan, ie, to help older people stay mentally alert, to stay mobile and with a sense of purpose. He asked, therefore that prevention be not disabled, due to lack of funding, but that the local community and voluntary services be integrated into the system as an equal party in the delivery of services.

The Chairman welcomed the support of Age UK. David Smith added that implicit within the report was the ongoing work towards a future single Health & Social Care Plan for Oxfordshire and the resource which would be required for that. Reliance on the contribution of the non-statutory voluntary sector and the communities would be of paramount importance.

Following previous consideration at meetings held on 4 April 20114, 17 July 2014 and 16 September 2014, the Better Care Fund Plan 2014/15 and 2015/16 is now attached in the form of a covering report (HWB5); a narrative template including detailed schemes (Appendix A); and a qualitative template including expenditure, benefits and performance metrics (Appendix B).

Please note that Annex 2 of the narrative document will be forwarded on as an Addendum next week once all parties have had the opportunity to formally sign the document off.

The Board is RECOMMENDED to agree the Better Care Fund Plan 2014/15 and 2015/16 for submission to NHS England by 9 January 2015, subject to the inclusion of any changes following the meeting, as agreed by the Chairman and Vice-Chairman of the Board.

John Jackson, David Smith and Cllr Mrs Judith Heathcoat introduced the Plan, all commenting on the excellent progress made on the Plan between the four organisations (OCC, OCCG, OH and OUHT) since the Board’s September meeting. The Board was reminded that the £37.5m funding was not new money and that there remained financial pressures on the NHS and on Social Care but that that this was a different way of using the funding available and of using it more efficiently.

David Smith reported significant changes to the overall resources for NHS since the Board had last met in November. Instead of the expected £18m funding for 2015/16 for growth purposes (which had already been committed for routine pressures), the Chancellor had given the south east £41m for 2015/16 and a further £20m for 2016/17. He pointed out that Chief Executives from all four organisations (OCC, OCCG, OH and OUHT) were already thinking collectively about which schemes would require funding, and trying to coordinate in -year delivery in accordance with governmental processes, in line with the transformational change and integrated approach ethos.

During the course of the debate areas of discussion and views expressed comprised the following:

·         The requirement for the patient and public involvement input to be worked out in the light of the large numbers of groups of people using the services, so that any concerns and experiences could be fed into the process;

·         From a Public Health point of view, the Plan addressed the symptoms of the problems, and not the causes. For example, if nothing was done about problems such as the demographic challenge, loneliness and isolation or chronic illness arising from obesity then this would sweep away all the transformational changes made. The intention was that a single Social Care /Health Plan for Oxfordshire would address both the causes and the symptoms and therefore more work and discussion between Health and Social Care and commissioners and providers and with the residents of Oxfordshire would be needed in order to join the two together;

·         The additional monies could be spent on a prevention/intervention programme;

·         The mental health budget must not be eroded and the service needed to be treated as an equal service to others - a new set of standards were to be introduced;

·         The intention was that Integrated Centres for patients would cover the whole county and work had already started on them, with Social Care having committed to enter by a certain date. There were many issues to iron out, but Health and Social Care needs would be met within local communities where possible. Work was in train on the Outcome Based Contracting programme for Mental Health/Older People/ Community Nursing Services which included a possible need to approach requirements in slightly different ways depending upon the location. Stuart Bell warned that the transformational change should not take too long, or the benefits would not be realised;

·         Elected members needed to think about how to communicate with constituents on issues such as the correct use  ...  view the full minutes text for item 5/15