Agenda item

14:10

The Chairman’s report is attached at JHO10.

Prior to consideration of this item, a statement produced by Jane Southworth on behalf of Deer Park Medical Centre Patient Participation Group (PPG), was read out by the Committee Officer, Julie Dean in her absence.

The statement made the following points:

·         The Deer Park PPG felt duty bound to again voice their objections to the failure by the OCCG to properly implement the recommendations of the Independent Reconfiguration Panel (IRP). It was their view that the work the OCCG was currently undertaking on the wider Locality plan for West Oxfordshire (related to Phase 2 of the Oxfordshire Transformation Plan), had nothing to do with the plan envisaged by the IRP, following the referral of the of the closure of the Centre to the Secretary of State. This was to produce a separate plan for primary care in Witney and its surrounds;

·         The need to produce a separate plan for primary care in Witney and its surrounds, in accordance with the IRP report, was highlighted by this Committee at its 14 September 2017 meeting, the Chairman requesting the OCCG to produce a plan or ‘roadmap’ of the actions it was taking and timeframes, which would be a separate piece of work from the detailed locality work. The Committee had agreed to the setting up of a working group to do this. She asked if the working group had met;

·         The PPG called upon the Committee to enforce the OCCG’s duty to implement the IRP’s recommendations fully and correctly. Despite the OCCG representative assuring the Committee that they would do it as a separate piece of work, it had not happened. She pointed out that the OCCG had been recommended by the IRP that the public and patients be ‘at the heart’ of this project ‘in assessing current and future health needs, understanding what the options are and co-producing the solutions’. The public and patients of Witney had not been involved in producing this plan, to date, within the six-month timeframe as envisaged by the IRP. Furthermore, the PPG remained concerned that no independent person had been appointed to oversee and review the OCCG’s compliance with the IRP plan;

·         OCCG had declined to meet with the Deer Park PPG to enable it to share their proposals for the reconvening of GP services at or near the Deer Park Medical Centre. The IRP had recommended that this possibility should not be precluded;

·         She also made reference in the statement to the two locality planning workshops held recently in Witney and Carterton which the PPG would not regard as ‘public open events’. People were required to pre-book and as a result of it being fully booked, some people had been turned away. There was also a change of both venues, causing confusion. The ‘round table’ format of both events was not agreed with the patient forum groups with no patient group input as to its format; and

·         She stated that in her view there was public mistrust of the OCCG and public dissatisfaction with the level of GP service in Witney which she stated was already overstretched (with significant housing growth already in progress and a reported 6 week waiting period for a GP appointment at a Witney surgery).

The Chairman, on behalf of the Committee, commented on the statement agreeing that the situation had continued for far too long but that, for reasons of patient safety, the surgery needed to remain closed. He also made reference to the fact that Northamptonshire CCG had agreed to use Oxford Health as a referral for 111 services. He also informed members that he had personally written to Northamptonshire’s HOSC pointing out that the public would have to travel 20 miles to see a doctor. No response had been received as yet.

Diane Hedges, OCCG, attended for this item. She stated that the IRP had requested the OCCG to provide a plan for Witney and its surrounds in six months. This was in the course of production to a deadline of the third week in January 2018. She added that the primary care plan needed to cut across the county, looking at the needs of each locality and taking the emerging plans for that locality and supporting them with resources. She stated that the OCCG was meeting its requirements, was taking forward the plans for Witney and its surrounds, within the proper timescale; but was taking account of the whole system and available resources. She reported that there were a number of events planned, including a meeting with Witney Town Council that evening and a meeting with Deer Park PPG.

The Chairman asked if there had been any developments with regard to the appointment of the independent person from NHS England. Diane Hedges responded that they still awaited an allocation and as soon as this had taken place the OCCG would convene a working group.

The Chairman pointed out that the Committee had asked the OCCG to review the process followed during the closure of the Surgery, including engagement and availability, and this had not yet been carried out. Diane Hedges responded that the lesson learned was to expect the unexpected in the procurement process, adding that the OCCG should have expected the problems and further reflection was now needed on the fundamental issues to get right each time.

A member of the Committee commented that OCCG’s reaction to the spirit and letter of the IRP’s recommendation on the nature and engagement of the public was disappointing. Early and continuous engagement with the public and patients was required. Moreover, it was doubtful that public meetings held in November on the locality plans constituted early engagement. Diane Hedges responded that there was a significant amount of engagement being carried out. In respect of the Deer Park PPG, she expressed her fear that they would be disappointed because the level of engagement was not about the Deer Park Medical Centre alone. The OCCG had to plan for a population of 80k patients and it was not possible to find viable providers for such a small population. It would cause extra pressure on the GP population in light of the growing need in Witney and in light of the high level of GPs thinking about retirement. There was a need to think creatively across the practices in Witney. She wondered whether HOSC’s view on engagement was reasonable, stating that more round table events had taken place in a bid to develop that level of co-production. This showed that the OCCG was in this mindset. She reminded the Committee that a decision had already been taken about Deer Park surgery and that the OCCG would be interested to hear about any solutions that the Committee may have to this situation.

The Chairman commented that the issue was not about the number of meetings that had taken place, and he appreciated the efforts that had gone into arranging extra meetings. It was more about making the process followed a priority. The impression that the OCCG was giving was that engagement was not a priority, that the work had been done and the timescale had lapsed.

A member pointed out that there appeared to be a contradictory process for each of the Deer Park and Banbury Health Centre presentations, asking what process was being followed for patients in the Banbury location. Diane Hedges responded that discussions were taking place in the north locality, as had happened for Witney and its surrounds, emphasising that each locality had a different set of circumstances.

Ros Pearce, was asked for a HWO viewpoint. She responded that the process of engagement on the part of the OCCG regarding locality planning for primary care appeared to be going well. She added that the meeting between the OCCG and the Deer Park PPG had now been arranged, which was what the IRP had asked for.

In response to a report from a member of the Committee that the midwives in the midwife-led unit at the Horton General Hospital were not being permitted to ask anybody at the Hospital for assistance with mothers who were presenting with complications, Diane Hedges advised that reference to clinical policy was needed which stated that these patients had to go to the John Radcliffe Hospital as soon as possible.

On the conclusion of the discussions with was AGREED that:

(a)  the Chairman’s report be noted; and

(b)  in respect of Deer Park, the Chairman would write to the OCCG giving the Committee’s views on the situation and asking for an urgent response.