Agenda item

11:25

Ian Wilson, Interim Chief Executive, Oxfordshire Clinical Commissioning Group (OCCG), will give a presentation on  Oxfordshire’s CCG Strategic and Operational Plan. A link to the Plan appears below:

http://www.oxfordshireccg.nhs.uk/wp-content/uploads/2014/04/OCCG-5-2014-2019-strategy-and-2014-2016-plan.pdf

For ease of reference, a copy of the ‘Plan on a Page’  is attached at JHO8.

The regular update from the OCCG is also attached at JHO8.

Ian Wilson, Interim Chief Executive, OCCG, gave a presentation which invited the Committee’s views on the OCCG’s strategic and Implementation Plan. For ease of reference a copy of the ‘Plan on a Page’ was attached at JHO8. He stressed that the objectives did sound a little aspirational but as the OCCG and Social Care moved towards an even more integrated service, and practices becoming integrated, it made the plans realistic. He added that the Plan centred on the premise that care should be in the community and not in hospital if at all possible. He agreed that issues remained concerning access to GPs which needed addressing in spite of efforts being made in the last two years.

In response to a query asking why the OCCG had less spent on patients per head compared to CCGs in other parts of the country, Mr Wilson responded that the amount spent depended upon the health of Oxfordshire’s demographic. Oxfordshire was deemed quite a healthy county compared to most.

In response to a question about how the overall waiting times for planned hospital care would be improved, Mr Wilson explained that issues had emerged in the last quarter and it was the CCGs intention  to bring them back. There were 67 specialities counted within the 18 weeks referral time for treatment and he had received assurances from the Oxford University Hospitals NHS Trust that all but 6 of these would be back on track very soon; and the remaining 6 were working hard to be back by July. He added that Oxfordshire’s statistics in this area were comparable with the best in the country.

In response to concerns expressed about the continuing Delayed Transfers of Care problem, Mr Wilson commented that a downward trend had begun to manifest itself for the first time in 4 years due to the multi - agency approach bearing fruit. This had the effect of bringing a focus to it and there was a determination on all parts to solve the problem. He added that statistics showed that rural areas tended to be higher than those of the rural areas. Realistically then, next year’s targets aspired to getting out of the bottom quartile and thereafter to continue the improvement.

A Committee member commented that this was a very commendable but ambitious Plan and its financial sustainability would depend upon achieving the targets it has set. One which would require much focus and a great deal of capability. On being asked if there was a multi – agency contingency plan, Mr Wilson responded that a project management structure  would be put in place which would take a much tougher approach to business cases, the testing of them and the driving and implementation of them. He added that generally  Plans were much more realistic now and lessons had been learned during the first year of operation. The likelihood of Plans not being drawn to a conclusion was small. Mr Wilson stated that it would prove very difficult to have an entire contingency plan but the work structure would ensure that risk registers were completed, together with plans to mitigate those risks if they should arrive. With regard to the current financial deficit, the deficit was now thought to be substantially less than previously thought.

A Member asked how far the CCG had progressed with their plans for a 7 day a week health service. Mr Wilson informed the Committee that a significant amount of progress had been made on this in Oxfordshire as it was deemed to be a very important issue to patients and their relatives. For example, changes were being made to contractual arrangements with providers and with Social Care to enable week-end discharge, when convenient for the families and carers.

Mr Wilson was asked how the CCG were approaching the difficult task of reducing Accident & Emergency activity over the next five years. He advised that three substantive reports had been completed on the subject within Oxfordshire. It had been recommended that one third of patients attending would be dealt with and diagnosed within the community, via, for example, same day GP appointments and via increased use of patient transport. He undertook to send Members links to the reports.

A Member expressed his concern about the downward trend of the statistics relating to the Ambulance Service based on his own personal experience. He also pointed out that if there were concerns, then it would be necessary for stringent performance measures to be put in place quickly. Mr Wilson responded that in his experience that there was a need for non-adversarial confidence and support to be given in such an event and that it would only be a final sanction to put financial penalties in place. With regard to comments regarding the Ambulance Trust, he stated that he had found the Trust to be highly professional and of a high quality adding that it was a difficult challenge for the Trust to provide a prompt response for patients living in rural areas. The Chairman commented that this issue had been included on the Committee’s Forward Plan as a matter of concern and would be looked at again in a future meeting.

It was AGREED to thank  Mr Wilson for his presentation and to note the regular update from the OCCG (JHO8).