10.10 am
In August this year, the County Council/NHS Pooled Budget Joint Management Group had decided to end a contract for short term Intermediate Care beds at Watlington Care Home. Following that, the County Council and the PCT had received a number of objections to the decision. In response to the objections, the Joint Management Group had decided to suspend the decision to end the contract, pending a review of the joint Intermediate Care Strategy.
The review will report its findings and recommendations to the next Joint Management Group on 12 November. The Joint Management Group will then decide how to proceed in respect of intermediate care in general and the Watlington beds in particular.
Paul Purnell, Head of Adult Social Care, Oxfordshire County Council, will attend for this item and members of the Committee will have the opportunity to scrutinise the policy decision and rationale.
Minutes:
In August 2010 the County Council/NHS Pooled Budget Joint Management Group had decided to end a contract for short term Intermediate Care beds at Watlington Care Home. Following that, the County Council and the PCT had received a number of objections to the decision. In response to the objections, the Joint Management Group had decided to suspend the decision to end the contract, pending a review of the Joint Intermediate Care Strategy.
The review was due to report its findings and recommendations to the next Joint Management Group on 12 November 2010. The Group would then decide how to proceed in respect of intermediate care in general and the Watlington beds in particular.
The matter had created a great deal of concern in Watlington and its surrounding area and the Chairman had received a number of letters including one from John Howell MP in which he had requested the Committee to support a proposal that a decision on the beds ‘remains suspended until a proper consultation has taken place with local residents and until the impact of the additional funds for the NHS and for social care announced in the Comprehensive Spending Review can be properly assessed against a strategy for the need of intermediary care beds’.
Mr Edwards advised the Committee that while the beds were provided by the County Council, they were in an NHS setting and medical care was provided by Community Health Oxfordshire. Therefore, it was an NHS service and any plans for closure would be subject to the same rules which state that any substantial service change should be subject to full public consultation.
Prior to consideration of this item the Committee heard addresses from Councillor Roger Belson and David Turner, each of whom raised a number of points relating to the closure of 13 beds at Watlington Hospital:
Councillor Roger Belson
- The much valued care home had opened 6 years ago following a vigorous campaign by the community who had raised £1.5m;
- The number of intermediate care beds had increased recently from 13 to 15;
- During recent months the level of dependency, due to mental health problems, had increased. The Care Home was well placed to cope with this, given the level of skills held by staff;
- The level of satisfaction from patients was ‘very high’;
- Local GPs were very supportive, their premises being adjacent to the Hospital site;
- Patient costs amounting to £700 per week were relatively low compared to those charged for acute care;
- Bed occupancy was 86%, which had reduced recently due to the inefficiencies of the referral system and the known pressures of delayed discharge;
- The ORH valued the beds;
- Could beds be offered to bordering counties to alleviate the need to reduce costs?
- Any change to policy should take place following detailed consultation with patients and local residents; and
- He urged the Committee to ensure that it considers the review carried out by the OCC/NHS Pooled Budget Joint Management Group.
Councillor David Turner
- When the much valued Cottage Hospital had closed, the NHS had promised a transport budget for its replacement. This had not materialised;
- Due to extensive and resourceful fund raising efforts on the part of the local community, a package was put to Sanctuary Care, a ‘not for profit’ organisation, a part of which was 3 beds for local residents who were unable to afford a nursing care bed;
- OCC had agreed to fund more beds and it was therefore a shock to receive the news from the Chalgrove GP Surgery about the bed closures. Local members should be kept informed about issues of such significance and not to do so constituted a breakdown in members’ rights. This had been emphasised recently at full Council;
- He asked if it would be possible to attend the Joint Management Group meeting which was due to take place the next day.
The Committee had invited Paul Purnell, Head of Adult Social Care, Oxfordshire County Council to attend for this item to enable Members to scrutinise the policy decision and the rationale behind it. He made the following points:
- There was great demand for home – based and bed based community intermediate care and it had proved very effective to date. The Government was advocating it strongly;
- Different forms of rapid response service were also being developed within Oxfordshire. Getting the mix right was not an easy task and Marie Seaton, Joint Head of Commissioning, and her staff were currently working on a plan of what would be the best mix;
- A particular variant being worked on by the Government, and so in Oxfordshire, was called ‘Reablement’ which was a special form of intermediate care. It required a whole pathway, with ongoing care;
- At the end of a course of treatment, if the ongoing care was not available, then patients could become ‘stuck’. Cases of Delayed Discharge in Oxfordshire had increased since the summer months and one of the solutions to this was to improve the Reablement pathway;
- In the meantime the contract with the Watlington Care Home in relation to bed-based intermediate care was coming to an end;
- It had been the intention to proceed down the route of re-tendering for the 21/22 beds, but then it had been realised that the re-ablement pathway could provide a solution to the Delayed Discharge problem, particularly in relation to Domiciliary Care;
- The Joint Management Group, whilst suspending any decision pending the review, had progressed the planning process for re-ablement intermediate care at the Care Home;
- Marie Seaton had submitted a request to the Joint Management Group on 12 November that the current contract be rolled out to March 2011 in order for her to plan a comprehensive picture, as historically it had arisen on a haphazard basis;
- If the Joint Management Group decide to roll out the contract until March 2011, work on the re-ablement facility would have to cease and Government funding would be lost; and
- He concluded by reassuring the meeting that the Care Home was a very important local resource and that it should be protected. He understood the local concern and expressed his willingness to listen to the views of this Committee.
The Chairman asked Paul Purnell if members could attend the Joint Management Group meeting the next day. He explained that it was an officer meeting working within a legal framework which dictated that it was not a public meeting. He undertook, however, to take back the general issue of public engagement. He added that two service user representatives attended the meetings.
Following a further discussion it was AGREED to:
(a) thank Councillors Roger Belson and David Turner for their addresses and Paul Purnell, Head of Adult Social Care for his attendance;
(b) to note the reasons why the decision to close 13 intermediate care beds was made, but to request Mr Purnell to inform the Joint Management Group at their meeting on 12 November that this Committee considers that the bed closure constitutes a major service change and that therefore a full public consultation process should be undertaken as soon as possible; and
(c) to remind the Joint Management Group that a form of public consultation must take place on the future plans for Watlington Hospital once the review has been completed.