Agenda and minutes

All members were in attendance.

There were no declarations of interest.

To approve the minutes of the last meeting held on 28 September 2018             (HHOSC3) and to receive information arising from them.

The Minutes of the meeting held on 28 September 2018 (JHO3) were approved and signed as a correct record.

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

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

Keith Strangwood referred to option 5 in Appendix 5 on the long list of options that had been submitted to the September meeting. He queried why this had been removed from the current list of options. He noted that there was no mention in the papers before the committee of the loss of income from Warwickshire and South Northamptonshire. He made reference to hundreds of individual cases of mothers which had been sent to Members and he expressed the hope that they had had an opportunity to consider these. He went on to detail an individual case as an example of the experiences of mothers giving birth. He highlighted that buildings needed to be part of the consideration of options. Mr Strangwood further commented on issues within the papers and queried whether the current staffing levels at the John Radcliffe Hospital and the Horton Hospital provided a safe level of care. The Chairman responded that the information on income into and out of county was one of the areas that the Committee was expecting a response on.

2.10 pm

At its last meeting the Joint Committee asked the Oxfordshire Clinical Commissioning Group (OCCG) and the Oxford University Hospitals Foundation Trust (OUH) for the following information for consideration at this meeting:

·         A revised programme plan for addressing the recommendations of the Secretary of State.

·         A comprehensive engagement plan that demonstrates a focus on the voices of local people and gives sufficient attention to mothers in Northamptonshire and Warwickshire.

·         Further information about the approach to recruitment and retention of midwives and doctors at the Horton.

A report is attached at HHOSC5.

The Horton Joint Overview and Scrutiny Committee is asked to:

•      Confirm that in the opinion of the Committee the proposed approach and plan outlined will address the recommendations of the Secretary of State/Independent Reconfiguration Panel.

•      Confirm that the Engagement plan presented is comprehensive and allows for full engagement in the work streams and appraisal process.

•      Note and endorse the revised timeline which has extended to ensure fuller engagement throughout the work streams as requested by the Horton Joint OSC and the period of political restriction prior to the local elections.

•        Note the revised timeline would indicate that further meetings of the Horton Joint OSC for the proposed gateways should be held in February and June 2019 (previously January and April 2019)

•      Agree that the priority now is for OCCG and OUH to proceed to implement the plan.

At its last meeting the Joint Committee asked the Oxfordshire Clinical Commissioning Group (OCCG) and the Oxford University Hospitals Foundation Trust (OUH) for the following information for consideration at this meeting:

·         A revised programme plan for addressing the recommendations of the Secretary of State.

·         A comprehensive engagement plan that demonstrates a focus on the voices of local people and gives sufficient attention to mothers in Northamptonshire and Warwickshire.

·         Further information about the approach to recruitment and retention of midwives and doctors at the Horton.

The Chairman welcomed the following representatives to the meeting: -

Richard Bailey, NHS Nene CCG and NHS Corby CCG

Sarah Breton, Head of Commissioning, OCCG

Ally Green, Head of Communications, OCCG

Kathy Hall, OUH

Anna Hargrave, Chief Transformation Officer, South Warwickshire CCG

Veronica Miller, OUH

Catherine Mountford, Director of Governance, OCCG

Louise Patten, Chief Executive, OCCG

Catherine Mountford presented the report, drawing attention to the table setting out how points raised at the meeting in September were to be addressed. She also drew attention to paragraph 3.6.3 that proposed that 2 options be removed. The paper gave a more detailed scope for the work and a realistic timeline. Responding to the points raised by Mr Strangwood she clarified that the original option 5 had been omitted from the updated options list by mistake and should be included giving 10 options in all. There was specific work on finance included in the workstreams.

Ally Green presented the draft engagement plan set out at Appendix 1 which had been further developed using the useful feedback at the previous meeting. She referred to a small workgroup that had met to discuss what information was wanted from the survey. A decision on the company to deliver the survey would be made in December.

The Chairman thanked representatives for the work undertaken and the greater detail included in the paper. Referring to the timescale he noted that the final Board decision was scheduled for September 2019. He understood the need to ensure that the work was done properly but would like to see it progress quicker. He found the table useful and hoped that there would be no further delays.

During discussion the following points were made:

·                Members expressed disappointment that the review of transfer times requested for this meeting was not available and was included in a future workstream instead. This was a vital question for local residents and it was hoped that the work could be progressed and come back quickly.

·                A member queried when the CQC report of the maternity unit at the John Radcliffe Hospital (JR) would be available. Kathy Hall advised that the report was expected in January.

·                Members queried the timeline and in particular challenged the delay due to local elections. Catherine Mountford indicated that the position on election purdah was the result of clear instruction from NHS England.

·                A member who had attended the workgroup commented that it had been a good meeting looking at the patient survey. They had looked at the criteria  ...  view the full minutes text for item 14/18

3.30 pm

The Horton Joint Overview and Scrutiny Committee is asked to comment on the attached paper (HHOSC6) from OUH that summarises current and past efforts to increase recruitment of midwifes and obstetricians.

Veronica Miller presented the paper that summarised current and past efforts to increase recruitment of midwifes and obstetricians.

During discussion the following points were made:

·                     A member asked whether enough was being doing on retention and that if people recognised that it was a great place to work and live recruitment and retention would improve. Kath Hall in noting that turnover was down undertook to provide a note.

·                     Members referred to an offer from Cherwell and South Northants District Councils to put a package together and queried whether OUH had actively engaged with the councils. Kathy Hall advised that they had spoken with Cherwell District Council on recruitment fairs, for advice on housing markets and on access to affordable lettings. She undertook to go back to the District Councils to discuss this matter further.

·                     Responding to a query about recent shortlisting where nothing further had happened Veronica Miller assured members that the delay had been down to illness but that all those shortlisted were still coming to interview. None had been lost.

·                     Referring to the number of applications received, against those shortlisted and appointed a member questioned whether the correct criteria were being set. A member also queried at the drop off in the percentage of successful appointments and hoped that this was not intentional. Veronica Miller explained that nothing had changed and that it was important to appoint to set criteria.

·                     Members referred to the closure of local units in order to transfer staff to the JR and were advised that this was a normal response to demand and had happened over a number of years.

·                     Members explored the local picture on recruitment compared with the national position and noted that Oxfordshire was successful in recruiting from overseas compared to the picture nationally.

·                     A member querying whether the JR was short staffed asked for information on numbers of neonatal nurses before the closure and the number of cots and maternity nurses at JR. Veronica Miller stated that this information while not available at the meeting could be obtained. Veronica Miller added that they were running a safe unit with excellent outcomes and they were proud of the care provided.

·                     Members discussed the impact of recruitment and retention and leadership on the issue on staff morale levels and were advised that morale was a national problem.

·                     A Member highlighted a survey by Oxfordshire Healthwatch and queried whether the Committee would see that information. Kath Hall stated that there was an ongoing official NHS staff survey with results in the New Year.

In noting the paper the Horton Joint Overview and Scrutiny Committee asked for the following further information to meeting following the evidence gathering in December:

·                    An information note on retention

·                    Detailed information on numbers of neonatal nurses.

·                    Detailed analysis of the recruitment process for doctors

·                    Share the report findings – Birthrate plus

·                    Information on discussions with Cherwell District Council on a formal package of measure to attract applicants.