Agenda item

12.15

To evaluate the Winter Plan 2018/19 and plan for Winter 2019/20.

Diane Hedges, CEO OCCG, gave a presentation.  She described the learning from last winter.  A number of aspects showed improvement: shortened hospital stays and reduced waiting.  Schemes that need new staff struggle.  The 'home first' approach is important - avoiding someone going into hospital in the first place.  They are integrating mental health into the planning.

Sam Foster, Chief Nursing Officer OUH, said that a key aim is to reable more quickly and release capacity.  She emphasised that health was not just about hospital beds and that there was no “Winter Ward”.

The Chairman noted that last year a commitment was made to send weekly updates but none were received.  He asked for a commitment again and that it be followed through.  He also asked for clarification on the target for the Home Assessment Reablement Team (HART).

Benedict Leigh, Deputy Director Commissioning OCC, responded that the target for HART Contingency Hours was 600 and the actual outcome was 447.  These are hours that HART can use to support people to leave hospital quickly while a longer term solution is found.  So a reduction in the hours needed is a positive indicator.

Diane Hedges apologised for the absence of weekly briefings last year and AGREED to provide them this year.  They will need to discuss what is most useful to include.

Councillor Mark Cherry asked how they were set up to cope with any heavy snow fall, for example how will patients be transferred?

Ross Cornett, Head of Operations Oxfordshire, South Central Ambulance Service, responded that they have a 4x4 but could not have a whole fleet of them based on the need for a few days of the year.  They would get assistance from the local resilience forums and through the County Council prioritising roads around hospitals for gritting.

Councillor Laura Price asked with the trusted assessor model if private providers are being asked to do an assessment and if their assessments can be believed?  She also asked if the £1.4m fund included the Better Care Fund and Improved Better Care Fund.

Benedict Leigh said that short-term beds would be sourced from private and voluntary sectors.  They have brought together the various schemes to create a more coherent offer.  It was a much clearer way of buying short-term beds and being supported by multi-disciplinary teams.  They are asking all to trust the assessments of other people and developing relationships between those in the system.  He AGREED to circulate more detail through a briefing around this next week.  He confirmed that the BCF and iBCF are not included in the £1.4m.

Dr Alan Cohen said that the Section 136 figures looked extraordinary. He asked if the planning on beds was with or without the Fulbrook Centre and if there would be an impact on the strategy for community beds.

Diane Hedges AGREED to come back on the section 136 numbers to explain them.  On Community Hospital beds, they have made the same assumptions as last year.  With short term beds, throughput will be different to acute beds.

Pete McGrane, Clinical Director OH, said that there would be recommendations next week on the City Community Hospital.  They gave a commitment to reopen it through recruitment. Winter planning excluding CCH is for 140 beds and he thought they will open more beds than that.

Barbara Shaw noted that families often underestimate the amount of unpaid care needed. She asked what they are doing to ensure right levels of care and not over-reliance on unpaid care and for the number of readmissions.

Sara Randall, Chief Operating Officer OUH AGREED to provide readmissions numbers.  Sam Foster added that they use a clinical assessment in the home with the family to determine how much support people need. Readmissions are not always a bad thing.

Councillor Jane Hanna raised a number of issues:

·         She asked to see a list of all the acuities to see where the pressures are coming from.

·         Does the £1.4 million include Brexit?

·         When will the Emergency Medical Unit will be live?

·         What is the latest on the temporary closure of Wantage Community Hospital?

Diane Hedges AGREED to provide a list of acuities and an update on the EMU.  It has been agreed to have an Urgent Care Leader.  Sam Foster is writing the scope to ensure there are structures in place.

With regard to Wantage CH, patients are moved to where the bed is most appropriate, irrespective of where they live, in order to get the best outcome. They are looking at the blend of services and beds needed.  Workforce problems make it difficult to keep beds open.

The Chairman noted the commitments to provide information on trusted advisors, winter weekly updates, section 136 growth, readmissions data, EMU and risk assessments.  He asked for them all to be circulated within two weeks of the meeting.