Agenda item

10.50

This item will provide a report on the key issues for the CCG and outline current and upcoming areas of work including an update on gynaecological appointments and gynae-oncology services.

Prior to consideration of this item, the Committee was addressed by the following member of the public:

Bill MacKeith of Oxfordshire Keep Our NHS Public expressed his group’s concern at the proposal to merge the Clinical Commissioning Groups of Oxfordshire, Buckinghamshire and Berkshire West.  He asked how the larger CCG could be effectively scrutinised.  He urged the Committee to seek a full public consultation before any application to merge is made.

Louise Patten, Chief Executive Officer, summarised the CCG’s update report.  General Practices in Banbury continue to merge with the running of Horsefair surgery taken over by PML.  It is not anticipated that there will be any change to services for patients.

On Gynaecology services, as a temporary measure to alleviate the waiting times for Oxford University Hospital (OUH), patients were given a list of alternative hospitals if they wished to be seen sooner.  However, if they wanted OUH then they could still go there.  There were no patients waiting 52 weeks in April 2019 and by June 2019, 66% were referred within 18 weeks for benign gynaecology.  There is still more work to do.  Patients with chronic pelvic pain are continuing to be offered referrals elsewhere due to the 39-week waiting time.

Professor Meghana Pandit, Chief Medical Officer OUH, updated the Committee on Gynaecology Oncology.  The Royal College of Obstetricians and Gynaecologists were invited to review the service in January and delivered a final report in July. 

All are agreed that Oxford needs to be a centre for tertiary services and that time was needed to reorganise.  Diversions to Imperial Health will continue until a new clinical leader has developed a new team to deliver the service.  That position has been filled to start this week.

Barbara Shaw asked if patients are still being referred out-of-county for gynaecology services, how long they have to wait and if Oxfordshire patients are receiving a poorer service. Louise Patten responded that hospitals work well together anyway.  Other hospitals have shorter waits but people tend to prefer their local hospital if they are given a choice. Chronic pain is where they are asking GPs to encourage patients to go elsewhere but now for other services people are just informed of the longer wait in local services.

Councillor Hilary Hibbert-Biles asked that the Committee be kept involved in any possible changes to pathways.  Louise Patten AGREED to do this.

Dr Alan Cohen welcomed the reports showing that everything was being done to reopen the City Community Hospital but asked if there was any progress on a wider county-wide strategy for community hospitals.

Louise Patten said that all providers are reporting workforce challenges.  It needs to be tackled along with social care and she has already had discussions with the new Director for Public Health about it.  It will need to start with workforce modelling.  Louise Patten AGREED to scope the work to look at how the workforce challenges in health and social care locally limit the provision of community services.

The Chairman asked if it would not have made more sense in Banbury to merge Horsefair and West Bar surgeries as they operated in the same building.  Louise Patten responded that the previous provider for Horsefair had a number of practices outside Oxfordshire and did not have much interest but the solution arrived at keeps the providers local.

With regard to Brexit, there are seven key areas for regional and national preparations and they are working to provide a readiness plan for the potential impacts.  This is all part of emergency preparedness which the CCG does all the time.  Each organisation has to have a Senior Responsible Officer.  They work with the Local Resilience Forum.  The A&E Delivery Board is cited on plans.  Mitigation plans are being worked through.  The CCG says no significant risks have been identified.

It will all depend on behaviours which may change as we get closer.  There are regular regional and national events to share information. The three main areas are continuity of supply, reciprocal care (charging those not eligible for free services from 1 November) and communications.

Anita Higham asked if the departure of the Director of OUH would have any implication for continuity.  Meghana Pandit responded that the Chief Operating Officer, Sarah Randall, was the officer with responsibility.

Councillor Jane Hanna asked if the risk assessments that support the statement of no significant risk can be published.  Louise Patten responded that the risk assessments are subject to Freedom of Information requests anyway so she was happy to AGREE to publish them.  She also AGREED to find out if they include issues raised in Operation Yellowhammer.

Members of the Committee asked about

·         reported shortages of anti-depressants and HRT drugs;

·         potential difficulties relating to drugs for epilepsy which cannot be stockpiled;

·         who will have to pay for their care?;

·         the number of staff who are EU nationals;

Louise Patten responded as follows:

·         It is difficult to know if medicine shortages are due to stockpiling in advance of Brexit or not.  She will raise the issue of epilepsy at the next regional meeting.  Drug issues are handled at a national level.

·         Who will have to pay for services will depend on the outcome of the Brexit negotiations.

Matt Akid, Head of Communications at OUH, added that they had 1500 EU staff and they were working hard to retain them.

It was AGREED that national and local risk assessments be shared with the Committee who can then collate a set of questions for the CCG to be answered in their next report.