Agenda and minutes

To elect a Chairman for the Joint Committee.

Councillor Arash Fatemian was elected as Chairman of the Joint Committee.

To elect a Deputy Chairman.

Councillor Fiona Baker was elected Deputy Chairman of the Committee.

Cllr Mark Cargill attended in place of Cllr Wallace Redford.

Cllr Sean Gaul declared a personal interest on account of his wife being in employment for an Oxfordshire Health Service employer. Cllr Arash Fatemian also declared a personal interest by virtue of his child being born at the maternity Unit at Horton Hospital.

The following requests to speak at Agenda Item 7 had been agreed:

-       Jenny Jones-Claydon – as a member of the public;

-       Keith Strangwood – as Chairman of ‘Keep the Horton General’ campaign Group

-       Cllr Andrew McHugh – Cabinet Member for Health, Cherwell District Council

Jenny Jones – Claydon

Jenny Jones spoke as an informed member of the public with more than 10 years’ experience attending meetings associated with the Horton Hospital. She stated her view that the list of options was incomplete. She stated that when the Oxfordshire Joint Health Overview & Scrutiny Committee was addressed in August 2017, she had indicated that the General Medical Council would allow each of the obstetrics trainees from the John Radcliffe Hospital to work 8 hours per week at the Horton. It was her view that no attention had been given to this by the CCG. She asked that this be included as an additional option.

With regard to the engagement plan to consider the options, it was her view that responses to questions from the public on the website contained so much ‘spin’, adding that this was not a substitute for face-to-face dialogue. She pointed out that the CPN Plan was non-statutory, asking that OUH and the CCG do not use this non-statutory status as reasons not to answer questions.

Keith Strangwood

Keith Strangwood pointed out that the obstetrics unit had now been closed for two years. He made reference to some individual cases of mothers who had given birth which he had personally sent to the members of the Committee, and stated that there were many more cases to follow.

He also made reference to certain information currently in the media that this Committee did not have the power to refer again to the Secretary of State, which was not the case, but that there would be no concrete decisions made by this Committee until May 2019. He expressed a hope that this matter be not ‘pushed into the long grass again’ as the mental stress this had caused had been substantial.

He urged the Committee to opt for option 9 in the paper, it being the only viable one in his view.

Cllr Andrew McHugh

Cllr McHugh expressed his concern that, in his view, a safe maternity service could not be delivered at the Horton on the grounds that it had proved impossible to recruit sufficient staff, this having been under threat since before 2008. He referred to the high living costs in the County and the costs of housing, albeit these were lower in the Banbury area. He made reference to a report produced by the Royal College of Nursing which suggested that the recruitment of obstetricians and gynaecologists was set to improve which should attract candidates for employment at the hospital. Cllr McHugh stated that Cherwell District Council believed that a safe and efficient obstetrics service given at the Horton Hospital would lead to a vibrant future for the hospital, whilst leaving the complex cases to  ...  view the full minutes text for item 5/18

14:10

To approve the attached Terms of Reference for the Committee (HHOSC5).

The Committee’s Terms of Reference (HHOSC6) were before the Committee for approval.

The Chairman pointed out that, by virtue of the agreed Terms of Reference, the Joint Committee held the full powers of referral to the Secretary of State without the need for the decision to be referred back to each Council for approval. In addition, substitutes had been allowed at the request of Warwickshire County Council.

In response to a question from Cllr Cargill, the Chairman explained that the numbers of representatives on the Joint Committee from each Council was in proportion to the percentage of births at the Horton Maternity Hospital for the last full year.

The Committee RESOLVED to approve the Terms of Reference.

14:20

The Chairman of Oxfordshire HOSC, Cllr Arash Fatemian, will present the background to the Oxfordshire HOSC Referral and Secretary of State and Independent Reconfiguration Panel recommendations.

The Chairman presented the background to the referral by the Oxfordshire Joint Health Overview & Scrutiny Committee and outlined the Secretary for Health and Independent Reconfiguration Panel recommendations (HHOSC7).

The Joint Committee noted the report.

14:35

Representatives from the Oxfordshire Clinical Commissioning Group (OCCG) and the Oxford University Hospitals Foundation Trust (OUH) will attend to present the report (HHOSC7).

The paper outlines the approach that Oxfordshire Clinical Commissioning Group and Oxford University Hospitals NHS Trust are proposing to take to address the outcome of the referral to the Secretary of State.  It is shared in draft form to enable the Joint OSC to ensure the Oxfordshire CCG is covering all aspects and to comment and input before presenting it to the relevant Health Boards for approval.  

The paper sets out the scope of the work, an outline timetable and the workstreams that will be established. These include:

·         Stakeholder involvement and patient experience - the purpose of this work stream is to ensure that the work is undertaken with stakeholders in an open and transparent way and to seek and use the views of women and families who have used the services since 1 October 2016

·         Service description – the purpose of this work stream is to provide the description of the full range of maternity services available to women and their families. 

·         Interdependencies – the purpose of this work stream is to describe the future vision for the Horton General Hospital and to identify what, if any service interdependencies there are which may be impacted by any decision on provision of obstetric services.

·         Activity and Population Modelling – the purpose of this work stream is to collate and analyse activity and develop activity projections that take into account population growth for areas that access services in Oxfordshire.

·         Option development and appraisal - the purpose of this work stream is to ensure that all potential options are identified and appraised openly and consistently. 

·         Addressing Clinical Senate Recommendations - the purpose of this work stream is to ensure that all of the Clinical Senate recommendations have been addressed. 

Oxfordshire CCG welcomes comments on any aspects of the plan but in particular would like the Horton Joint HOSC to:

·         Agree the scope of the work

·         Review and agree the draft engagement plan

·         Agree the approach to option development and appraisal

·         Agree to the outline timescales

·         Identify whether there are any aspects missing from the plan

The Chairman welcomed the following representatives to the meeting:

·         Chris Panel – Northamptonshire General Hospital

·         Sue Lloyd – Obstetrics/Gynaecology – Northamptonshire General Hospital

·         Anne Hargrove – South Warwickshire

·         Lou Patten, Sarah Adair, Veronica Miller and Catherine Mountford - Oxfordshire Clinical Commissioning Group

·         Kathy Hall and Sarah Randall – Oxford University Hospitals Foundation Trust

Lou Patten gave a brief overview of the situation from the OCCG’s perspective, stressing that Accident & Emergency and Paediatrics services would remain at the Horton and the OCCG was espousing a main focus on planning services, rather than buildings, in order to give a vibrant future for the Horton. The future service planning was linked to a growing population and its growing health and care needs which would lead to, over time, service change at the Horton.  She added that, at this meeting, the OCCG intended to share the draft plan and to glean the Joint Committee’s views and comments on the scope of the work and to identify if anything was missing, having learned the lessons from the Secretary of State’s comments in relation to the referral. It was anticipated that there would be monthly updates to the Committee, as well as HOSC meetings, on how work was progressing.

Sarah Adair spoke of the CCG’s plans for stakeholder involvement and a patient experience workstream, to be conducted in an open and transparent way. The CCG would be seeking the views of women and families who had used maternity services across Oxfordshire, including people in north Oxfordshire who had used the obstetric unit at the Horton. These views would be brought into a report to be used in an options appraisal to list the final options.

Veronica Miller stated that a report would be produced describing what maternity services currently look like, to include information from the ten community midwife teams, the four freestanding Midwife-Led Units, the Spires Unit alongside the John Radcliffe Hospital and the main obstetric delivery suite and the tertiary unit at the John Radcliffe Hospital. This would also include information on regional referrals across Oxfordshire, the neo-natal unit at the John Radcliffe Hospital and the transitional care facilities for families. She added that there was close working in place with Warwick Hospital, where mothers were given options for where they wished to deliver their babies. Referrals were accepted from other authorities and a border was shared with Northamptonshire. Sarah Adair added that the paediatric, urgent care team in Accident & Emergency would also be included.

Catherine Mountford added that very detailed information on activity and population modelling had been received and shared, including statistics on, for example, where mothers had given birth and, if the obstetrics service had been needed, where these mothers had come from. Analysis had not yet commenced on information received regarding housing growth for surrounding areas. The CCG aimed to have a full list of all potential options and would work with this Committee to determine the method of appraisal.

Questions asked by members of the Committee and responses received,  ...  view the full minutes text for item 8/18

15:35

To agree the dates for future meetings, having regard to the proposed process and timeline given above.

It was AGREED that the next meeting would be in November 2018, there would be an evidence gathering meeting in December 2018 and a possibility of further meetings in January and April.