Agenda item

2:55

25 minutes

Persons responsible:           Chief Executive Officer, OCCG; Director of Finance, Thames Valley Area Team, NHS England; Director for Social & Community Services

Persons giving report:          Dr. Stephen Richards, Chief Executive Officer, OCCG; James Drury, Director of Finance, Thames Valley Area Team, NHS England; John Jackson, Director for Social & Community Services

To discuss and debate the attached papers (HWB9) which set out the budgets for commissioning from:

• Adult Social Care;
• The Oxfordshire Clinical Commissioning Group; and
• NHS England (Thames Valley Area Team and Specialist Commissioning in Oxfordshire, budgets held by Wessex Area Team).

Dr. Richards introduced the debate introducing Garth Kenworthy, Chief Finance Officer, Oxfordshire Clinical Commissioning Group. Each of the following spoke in turn making reference to their submitted papers(HWB9) and highlighting the respective financial pressures and challenges in their field:

• John Jackson – Adult Social Care
• Gareth Kenworthy – Oxfordshire Clinical Commissioning Group
• James Drury - NHS England (Thames Valley Area Team and Specialist Commissioning in Oxfordshire)
• Dr. Jonathan McWilliam – Oxfordshire Public Health

Key pressure points and challenges highlighted by each were as follows:

John Jackson

-           the challenges associated with demographic change affecting older people and children with a learning disability;

-                      the reduced central government financial settlement this year and focus now being on better integration of Health and Social Care and reducing demand via prevention and early intervention programmes;

-                      more people are requiring care this year than last year and there are also people still in the wrong bed-based setting;

-                      there is the possibility of transferring up to £20million in Oxfordshire  from Health to Social Care as part of better integration and funding reform but there is currently only half this figure identified  as available in the system to date.

Gareth Kenworthy

-                      the biggest risk and current pressure demand is continuing increases in demand;

-                      There is also pressure from limited flexibility in large acute and secondary care contracts

-                      Recently there has been a significant step up in demand for urgent care services, for example, in ambulance services;

-                      the significant financial challenges for the NHS set by Central Government amounting to savings of £30billion nationally by 2020.

James Drury

-                      reiterated those issues highlighted by Gareth Kenworthy adding that there would be a consultation processes over the coming months with a view  to reviewing the scope of Health services across the region. These would be brought to future meetings of the Board.

Dr Jonathan McWilliam

-                      Public Health were experiencing increasing demand including more sexually transmitted infections, obesity  was on the increase and there are more immunisation programmes to support.

Points raised during the debate were:

-                      David Nicholson had stated that the NHS had to be radical about how health care was to be delivered and that NHS personnel would have to be ‘brave’ about it. Equally more money was now being spent on early intervention and less on expensive forms of care and this required a different mind-set for the people delivering it;

-                      Integration was about improving and simplifying pathways of care for patients, making for a smoother service delivery. There were still many challenges along the way to achieve this;

-                      High quality information and advice was critical for helping people to arrange and manage their own care and support and supporting them to live independent lives at home for as long as possible. More linkage was required into university research etc;

-                      Finally the Board, together with its Partnership Boards, would take a common sense of purpose in discussing, scrutinising, making relationships and working together at a strategic level.