Agenda and minutes

Apologies had been received from Freddie Van Mierlo, Nigel Champken-Woods, and Lesley Mclean.

Cllr Sandy Douglas declared that he had an honorary contract with Oxford University Hospitals NHS Foundation Trust.

To approve the minutes of the meeting held on 16 January 2024, and to receive information arising from them.

The minutes of the committee’s meeting on 16 January 2024 were assessed for their accuracy.

The Committee AGREED the minutes as an accurate record of proceedings, subject to a minor amendment to the spelling of Cllr Haywood’s name.

Members of the public who wish to speak at this meeting can attend the meeting in person or ‘virtually’ through an online connection.

To facilitate ‘hybrid’ meetings we are asking that requests to speak or present a petition are submitted by no later than 9am four working days before the meeting i.e., 9am on Friday 2^nd February. Requests to speak should be sent to Scrutiny@oxfordshire.gov.uk.

No requests to speak had been received.

Cllr Hanna will provide a verbal update on relevant issues since the last meeting.

There are TWO documents attached this item:

1.    A HOSC report containing recommendations from the Committee on the future of Wantage Community Hospital in light of the completion of the Wantage Public Engagement Exercise and the recommendations from the NHS’s co-produced report which were discussed during the 16 January 2024 HOSC meeting.

2.    A HOSC report containing recommendations from the Committee on the Oxfordshire Place-Based Partnership.

The Committee is recommended to NOTE the Chair’s update having raised any relevant questions.

The Committee Chair outlined the following points to update the Committee on developments since the previous meeting:

1.    The Committee had been strongly interested in developments around access to GP services, particularly in the Didcot area. The Committee had asked for urgent priority for GP provision to be enhanced in this area, and was pleased to hear of the promised GP newbuild at the Great Western Site. Didcot had a 30 percent population growth trend, and it was therefore critical that residents had access to General Practice.

2.    The BOB Joint Health Overview Scrutiny Committee had met on 24 January, during which three items were discussed including the BOB ICB’s Primary Care Strategy and the Digital and Data Strategy.

3.    The Chair and the Health Scrutiny officer had attended a BOB HOSC Working Group meeting on 17 January to collate and submit written feedback to BOB ICB on its Digital and Data Strategy.

4.    A report (containing recommendations from HOSC) had been submitted to the NHS regarding the future of Wantage Community Hospital. This could be found in the agenda papers. This report was also published in Oxford Health NHS Foundation Trust’s board papers and was discussed at the Oxford Health NHS Foundation Trust board meeting on 31 January.

5.    The Chair, Health Scrutiny Officer, Barbara Shaw, Elizabeth Poskitt, and Katharine Keats-Rohan, had attended a HOSC site visit on 30 January to the Warneford Hospital as part of the scrutiny of the Warneford hospital redevelopment project and the bids for government funding for this.

6.    A report (containing recommendations from HOSC) had been submitted to the BOB ICB Director of Place in relation to the Place-Based Partnership. This could also be found in the agenda papers.

The Committee NOTED the Chair’s Update.

Daryl Lutchmaya (SCAS Chief Governance Officer) has been invited to present a report with an update on South Central Ambulance Service’s CQC improvement journey.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

PLEASE NOTE: There are 9 documents attached to this item, the first being the main report submitted by SCAS, and the remaining 8 constitute additional supporting information documents provided by the Ambulance Service.

Daryl Lutchmaya (Chief Governance Officer, SCAS); Kirsten Willis- Drewett (Assistant Director of Operations, SCAS); Dai Tamplin (Senior Transformation Programme Manager, SCAS); and John Dunn (Head of Risk and Security, SCAS) were invited to present a report providing an update on the South Central Ambulance Service’s Care Quality Commission improvement journey.

The South Central Ambulance Service (SCAS) Chief Governance Officer informed the Committee that the Trust had an ambition to be an outstanding team, and to deliver good outcomes through innovation and partnership. The SCAS mission was that ‘the right care is delivered as best as it can’. In order to achieve these ambitions, the Trust had 4 key values which are to be:

Ø  Caring.

Ø  Innovative.

Ø  Professional.

Ø  A teamworking organisation.

The Chief Governance Officer highlighted that in order to achieve the results that the Trust was striving toward, it had formulated six strategic objectives:

Ø  High quality care and patient experience.

Ø  Partnership and stakeholder engagement.

Ø  Sustainability.

Ø  People and Organisation.

Ø  Technology Transformation.

Ø  Being well-led.

The Committee were informed that SCAS had received some assistance from the NHS National Improvement Team, who had put together an improvement plan for SCAS to work to.

The Assistant Director for Operations explained that SCAS was in a challenging position in relation to the increase in volume of workload coming through, particularly category 1 and category 2 calls (immediately life-threatening calls). The service had to declare a critical incident on the 23 January, which occurred due to the sudden increase in category 1 and 2 calls. Over the course of two or three days, these had constituted 72 percent of calls; which was an incredibly high number. Such high levels of category 1 and 2 calls would have a knock-on effect on the system, particularly the acute Trusts, as most of those patients who were calling in would require hospital admission. This also had knock-on effects in creating ambulance service handover delays.

The Committee were informed that there was good work within the system to try to keep patients away from Emergency Departments. There had been an increase, on average, in 8 patients a day who were able to be referred into other areas or departments. SCAS were grateful for the good partnership working that existed within the Oxfordshire system.

The Committee enquired as to whether there was any progress in improving structures of governance within SCAS. The Chief Governance Officer outlined that the recent CQC inspection and report rightly highlighted that there were a number of issues that were not operating appropriately. Whilst trying to address the issues of the improvement programme, a governance team was being established. The service also received support from the governance institute, which had helped the service with its risk management solutions.

The Committee also queried whether there were independent members on the SCAS governance board. It was explained to the Committee that initially, the board was comprised of executive as well as non-executive directors, which felt top heavy. The service sought  ...  view the full minutes text for item 16/24

Eileen Walsh (Chief Assurance Officer, Oxford University Hospitals NHS Foundation Trust) has been invited to present a report with an update on the John Radcliffe Hospital’s CQC Improvement Journey.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Eileen Walsh (Chief Assurance Officer, Oxford University Hospitals NHS Foundation Trust); Andrew Grant (Chief Medical Officer, Oxford University Hospitals NHS Foundation Trust); and Lisa Glynn (Director of Clinical Services, Oxford University Hospitals NHS Foundation Trust) had been invited to present a report with an update on the John Radcliffe Hospital CQC Improvement Journey.

The Chief Assurance Officer informed the Committee that the report provided an insight into how the organisation addressed the specific areas of improvements listed in the CQC report and placed them in the context of the wider strategic and operational developments that had been made.

The Committee enquired as to the level of staff and patient involvement in the development of the Trust strategy. The Chief Medical Officer informed the Committee that the strategy was developed with extensive staff and patient engagement. Staff engagement continued beyond the point of publication and adoption of the strategy in the form of regular staff listening events that included members of the leadership team, and were an opportunity to hear staff concerns.

Patient engagement had contributed to service development work in the form of patient partners and experts by experience, and individual work streams had involved patient recommendations where possible.

The Chief Assurance Officer added that the patient’s voice was kept at the heart of the strategy, and that Listening Events were held involving patients and stakeholders that had influenced the development of the strategy, as co-creation was the key platform for developing future strategies.

The Chair queried what opportunities there were for the strategic ambition of the Trust to integrate with the wider prevention agenda. The Director of Clinical Services explained that one of the Trust’s key priorities was the part that key acute providers could play in prevention. The Trust was heavily involved with early detection of cancer through the Targeted Lung Health Check Programme, that would be initiating in April 2024. The Trust worked closely with the community and partners in relation to Wantage Community hospital, and were looking to expand additional services that would meet the needs of local populations and support the demand seen in local hospitals for acute services. In order to address the demand on urgent care services, the Trust had been involved with the Integrated Neighbourhood Teams as well as the Primary Care Strategy. The Trust had also been looking at admission and attendance avoidance, and the development of same day emergency care services.

The BOB ICB Place Director for Oxfordshire explained that the Trust was trying to strike a balance between treatment and prevention. Oxford University Hospitals NHS Foundation Trust (OUH) was involved in many prevention projects, such as co-location of maternity services within ‘Flos in the Park’, the Early Lives Project, and the Hospital at Home service to support acutely sick people at home. The BOB ICB Place Director emphasised that the greatest long-term impact on prevention was to focus on children and young people, and the Community Paediatrics service was fundamental to this.

The Chief Medical Officer  ...  view the full minutes text for item 17/24

Veronica Barry, Executive Director of Healthwatch Oxfordshire will present the Healthwatch update report. The Committee is invited to consider the report and NOTE it having raised any questions arising from the contents.

The Executive Director of Healthwatch Oxfordshire explained to the Committee that Healthwatch had received feedback from patients at the John Radcliffe Hospital through online feedback reviews from October to December 2023. The online reviews provided an average of 4 stars (Good) for services at the John Radcliffe

The Executive Director also informed the Committee that between October and December 2022, Healthwatch England undertook national research to understand the extent to which mental health support had improved during and subsequent to pregnancy, and to explore whether new mental health checks were taking place at postnatal consultations. Healthwatch England had provided Healthwatch Oxfordshire with the anonymous responses of the 45 women from Oxfordshire who participated in the survey so we could analyse these responses separately. The Committee were informed that this information could be found in the report submitted by Healthwatch Oxfordshire for this item.

It was explained to the Committee that Healthwatch Oxfordshire had published reports on Community Research in Oxfordshire. These were a series of in-depth reports on both community members, system and organisational views on community research. What Healthwatch Oxfordshire heard was directly relevant to all organisations which worked with communities throughout the county, with insights as to how to meaningfully engage, listen and learn and to support development and design of services.

The Committee thanked Healthwatch Oxfordshire for their work and NOTED the report.

Ansaf Azhar (Director of Public Health) has been invited to present the Director of Public Health’s Annual Report.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Ansaf Azhar (Director of Public Health); Dr Rosie Rowe (Head of Healthy Place Shaping); and Dr Louisa Chenciner (Public Health Registrar and Academic Clinical Fellow) were invited to present the Director of Public Health’s (DPH) Annual Report.

The Committee Chair outlined that the Committee would return to this item again in the near future for the purposes of scrutinising the full DPH annual report subsequent to its publication.

It was explained to the Committee that this particular DPH annual report and its focus on climate action and health did not emerge from a vacuum, and that in late 2023, over 120 countries backed the COP28 climate and health declaration. Additionally, the United Kingdom’s (UK) Health Security Agency published reports in 2023 which outlined some of the health effects of climate change on the UK. The Committee were also informed that major journals such as the Lancet and the British Medical Journal had also highlighted the impacts of the climate crisis on health.

The DPH annual report emphasised that health was the untold story of the climate emergency, but that this was surprising given the immediate and positive health benefits for individuals, families and communities which could be delivered through climate action​. Climate action could be a means for achieving better health for all people and for all ages.

It was highlighted to the Committee that the DPH report explained the reasoning behind the focus on climate change and health; and that an elemental approach was adopted which included five domains including temperature, air, water, food, and nature. Local evidence and data would be drawn on to outline what the impact was in Oxfordshire in all the aforementioned areas.

Steps were already being taken as part of climate action which could produce health benefits for Oxfordshire’s residents. These related to the following:

1.     Creating energy efficient homes and buildings.

2.     Sustainable travel and clean air.

3.     Green Health and Social Care.

4.     Healthy and sustainable diets.

5.     Accessible green and blue spaces and nature.

The Committee were also informed that the DPH Annual Report included a set of recommended actions that revolved around two key areas including:

Actions that the Oxfordshire System could embark on including: working together for cleaner indoor and outdoor air; improving access for all residents to safe and inclusive green and blue spaces; adapting and upgrading buildings, estates and facilities; working with suppliers and the supply chain to reduce carbon emissions; support the establishment of an Oxfordshire Climate Mitigation and Adaptation Healthcare Network; build and continuously bolster community resilience.

A call to actions around national policy and funding including: reducing air pollution by investing in low-carbon and climate-resilient infrastructure; creating good, secure employment and reduce inequalities; improving resident’s health and wellbeing by upgrading peoples’ homes, healthcare facilities and schools; and boosting our physical and mental health by making it easy for people to walk and cycle.

The Committee enquired as to whether the DPH report would be explicit around the balance between any national directives around  ...  view the full minutes text for item 19/24

The Committee has received Responses as well as Acceptances for the recommendations made as part of the following items held during the 23 November 2023 HOSC meeting:

1.    Children’s Emotional Wellbeing and Mental Health.

2.    CAMHS Services Update

The Committee is recommended to NOTE the responses.

The Chair outlined that the Committee had received Acceptances and Responses to its recommendations on the following two items:

1.    Children’s Emotional Wellbeing and Mental Health Strategy.

2.    CAMHS Services.

It was explained to the Committee that one particular recommendation that was issued to CAMHS around training had been rejected. The reason behind the rejection was outlined in the response form which was within the agenda papers.

The Committee NOTED the responses.

To AGREE the Committee’s proposed work programme for the upcoming meetings throughout the remainder of the 2023/24 civic year and beyond, having raised any questions.

The Committee AGREED the forward work plan.

The Committee is recommended to NOTE the progress made against agreed actions and recommendations having raised any questions.

The Committee NOTED the progress made against agreed actions and recommendations.