Agenda and minutes

Cllr Hanna, was nominated by Cllr Batstone and seconded by Cllr Edosomwan.

There being no other nominations, Cllr Hanna was elected Chair for the 2025/26 municipal year.

D/Cllr Walker, was nominated by Cllr Epps and seconded by D/Cllr Keats-Rohan.

There being no other nominations, D/Cllr Walker was elected Deputy Chair for the 2025/26 municipal year.

Apologies were received from Barbara Shaw.

Sylvia Buckingham declared that she was also a Patient Safety Partner with Oxford University Hospitals NHS Foundation Trust (OUH), and a Trustee for Healthwatch Oxfordshire.

Cllr Sargent declared a personal interest as that their partner works for Adult Social Care for Oxfordshire County Council.

Cllr Garnett declared that they were employed by the Department of Primary Healthcare at the University of Oxford.

Cllr Hanna declared an interest as an employee of SUDEP Action.

To APPROVE the minutes of the meeting held on 06 March 2025 and to receive information arising from them.

The Chair requested an amendment to the minutes of the 6^th March 2025 meeting. The Committee AGREED to update the wording around epilepsy services to reflect positive changes, including the new Medicines and Healthcare products Regulatory Agency (MHRA) policy and the distribution of patient safety leaflets in 30 languages. However, it also noted the lack of progress on medication access for girls and women. Additionally, the Committee was still awaiting information on whether the capacity risks to the epilepsy service had been addressed.

The Committee APRROVED the minutes of the meeting held on 6^th March 2025, subject to the above amendment.

Members of the public who wish to speak on an item on the agenda at this meeting, or present a petition, can attend the meeting in person or ‘virtually’ through an online connection.

Requests to present a petition must be submitted no later than 9am ten working days before the meeting, i.e. Friday 23 May 2025.

Requests to speak must be submitted no later than 9am three working days before the meeting, i.e. Monday 02 June 2025.

Requests should be submitted to scrutiny@oxfordshire.gov.uk AND omid.nouri@oxfordshire.gov.uk

If you are speaking ‘virtually’, you may submit a written statement of your presentation to ensure that if the technology fails, then your views can still be taken into account. A written copy of your statement can be provided no later than 9am on the day of the meeting. Written submissions should be no longer than 1 A4 sheet.

Joan Stuart, from Oxfordshire Keep Our NHS Public, raised concerns about private eye clinics performing most cataract surgeries, which she felt risked NHS eye care departments. She cited a Sunday Times investigation revealing potential fraud, unnecessary operations, poor post-surgery care, and Accident & Emergency (A&E) visits for complications. Research indicated that private clinics funded by the NHS made significant profits, with much of the budget not spent on patient care, destabilising NHS hospitals. Joan questioned the effectiveness of the ICB's referral process and called for a full investigation into Oxfordshire's eye care services, urging the Committee to address the issue.

David Rogers discussed the Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board (BOB ICB) operating model and primary care. He emphasised funding and expanding primary care through developer contributions, especially in Cherwell, which was predicted to grow significantly. He mentioned that around £21 million could aid primary care expansion, including infrastructure and digital services. Rogers requested the Committee support the ICB by ensuring prompt consultation on local plans to secure these contributions. He stressed the importance of a plan for primary care expansion, incorporating digital systems, and the need to inform practices about available funding. He also recommended monitoring progress to ensure primary care services developed to meet the population's needs.

Jenny Hannaby, Chair of the Wantage Town Council Health Committee, expressed her appreciation for the Committee's oversight of the Wantage Community Hospital redevelopment project. She described the history of the hospital's temporary closure and the unsuccessful engagement between the Clinical Commissioning Group (CCG) and the town, leading to a coproduction effort with various stakeholders. Jenny outlined the plans for refurbishing the hospital in 2024, including digital upgrades and a £1 million investment. She emphasised the hospital's importance in addressing rural health disparities and reducing travel to Oxford City. Jenny sought the Committee's support in communicating the project's significance to OUH’s new leadership.

The Committee has received Acceptances and Responses to recommendations made as part of the following item(s):

1.    Oxfordshire Healthy Weight

2.    Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board Operating Model.

3.    Health and Wellbeing Strategy Outcomes Framework.

4.    Support for Patients Leaving Hospital.

5.    Oxford Health NHS Foundation Trust People Plan.

6.    Director of Public Health Annual Report

The Committee is recommended to NOTE the responses.

The Committee NOTED the responses to its recommendations on:

1. Oxfordshire Healthy Weight.
2. Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board Operating Model.
3. Health and Wellbeing Strategy Outcomes Framework.
4. Support for Patients Leaving Hospital.
5. Oxford Health NHS Foundation Trust People Plan.
6. Director of Public Health Annual Report.

Matthew Tait (Chief Delivery Officer- Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board) and Stephen Chandler have been invited to provide an update to the Committee on the recent and ongoing NHS reforms. These reforms include the government’s plans to integrate NHS England into the Department of Health and Social Care, and to further reduce Integrated Care Board running costs.

The Committee is invited to; discuss the implications of these developments on Oxfordshire Place; raise any relevant questions; and AGREE any recommendations arising it may wish to make.

Dan Leveson, BOB ICB Director of Place and Communities, introduced an update on the NHS Reforms. The BOB ICB Director of Place and Communities sent the apologies of Matthew Tait, BOB ICB Chief Delivery Officer.

Stephen Chander, Executive Director for People, attended to take the Committee’s questions on the NHS Reforms update, with Cllr Kate Gregory, Cabinet Member for Public Health & Inequalities, also attending online. Veronica Barry, Executive Director of Healthwatch Oxfordshire, also attended as a guest of the Committee.

The BOB ICB Director of Place and Communities announced that the government required Integrated Care Boards (ICBs) to cut costs by 50%, targeting £18 per head. He highlighted areas like strategic commissioning and population health management, reducing performance activities. Southeast’s ICBs reduced from six to four, with BOB ICB possibly merging with East Berkshire. Rapid changes were planned, with stakeholder engagement in June and July, a new model agreed by September, staff consultation in October, and formalisation by April 2026 or 2027. A transition executive oversaw the reorganisation.

The Executive Director for People acknowledged there were significant proposed changes without clear details on their impact. He highlighted Oxfordshire's strong integrated work and viewed reforms as an opportunity for a local solution. The Place Based Partnership met in July to discuss Oxfordshire's offer to the ICB, aiming to mitigate risks and identify opportunities. He emphasised understanding the impact on services and the Committee's scrutiny role.

The Chair mentioned that as the Chair of the BOB HOSC, they have requested that the BOB HOSC be convened, with all the Committees across the three-county area in place, and further actions were to be considered.

Members asked if the ICB was required to make a 50% cut in addition to the cuts made last year or if it is a 50% reduction on top of the most recent changes to the operating model. The BOB ICB Director of Place and Communities clarified that the 50% reduction was on top of the previous 30% cuts made last year. The target is to reduce the total cost to about £19 per head of population. This involves further reductions in staff and an expansion of geographical boundaries.

Members enquired whether further restructuring would reduce Place staff and if there was a commitment to a place-based convener role. The BOB ICB Director of Place and Communities noted that workforce reductions were anticipated but the exact impact on Place staff was undetermined. He affirmed the importance of Place in the new operating model and committed to collaborating with Place-based partnerships. The concept of a Place-based convener role was still being considered.

The Committee asked about the implications of changes to the provider oversight role on monitoring and evaluation. The BOB ICB Director clarified that the new model aimed to minimise duplication and emphasise collaboration. The oversight and assurance role would evolve to focus on understanding performance, evaluating needs, and reducing unwarranted variation. The central team would handle regulation and performance management, allowing local teams to concentrate on needs assessment  ...  view the full minutes text for item 35/25

Karen Fuller (Director for Adult Social Care, Oxfordshire County Council) has been invited to present a report on pressures within the Oxfordshire Health and Care System.

PLEASE NOTE: This item will encompass key pressures affecting all of Oxfordshire’s health and care system partners in general, as well as some insights into the preparations being made for the pressures of the ensuing Winter season.

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

Karen Fuller, Director of Adult Social Care, introduced the system pressures update, along with Lily O’Connor, Oxfordshire Urgent Emergency Care Director.

They were joined by:

• Cllr Kate Gregory, Cabinet Member for Public Health & Inequalities;
• Ansaf Azhar, Director of Public Health and Communities;
• Veronica Barry, Executive Director of Healthwatch Oxfordshire;
• Dan Leveson, BOB ICB Director of Places and Communities; 
• Anne Carlile, BOB ICB Head of Urgent Emergency Care Programme; 
• Jenna Gilkes, BOB ICB Urgent Emergency Care Programme Manager;
• Sally Steele, Head of Hospitals;
• Felicity Taylor-Drewe, OUH Chief Operating Officer; 
• Louise Johnson, OUH Deputy Director Urgent Emergency Care; 
• Emma Leaver, Interim Chief Operating Officer for Community Health Services, Dentistry & Primary Care;
• Sue Butt, Oxford Health NHSFT Transformation Director;
• Kirsten Willis-Drewett, South Central Ambulance Service (SCAS) Assistant Director of Operations.

The Director of Adult Social Care emphasised the early discussion of system pressures and noted strong organisational collaboration. She cited many representatives as evidence of effective urgent and emergency care efforts. The Oxfordshire Urgent Emergency Care Director stated that despite challenges, Oxfordshire performed well compared to neighbouring counties during the previous winter. She identified gaps in care pathways and highlighted initiatives to reduce duplication, improve continuity, and enhance access to same-day emergency services. Successes in Banbury and Oxford City were noted, particularly in managing patients at home to improve outcomes.

The Committee inquired about improving outcomes, redesignating minor injuries units, public engagement strategies, and primary patient outcomes. The Oxfordshire Urgent Emergency Care Director clarified that the redesignation was mainly for reporting and might not occur, with services remaining unchanged. Simplifying information for the public was emphasised to guide them based on their symptoms. Key patient outcomes included better quality of life, reduced morbidity and mortality, and continuity of care, especially in deprived areas. The Director of Adult Social Care added that understanding urgent care options was crucial for timely and appropriate patient care.

The Executive Director of Healthwatch Oxfordshire requested details on recent developments and service functions, referring to the Healthwatch report. The Urgent Emergency Care Director explained that a detailed list of services, opening times, and functions had been compiled, with plans to provide comprehensive information to the public via the Oxfordshire Live Well website and Google searches.

Members discussed the 111 service, noting delays and initial contact with non-clinical staff. The Urgent Emergency Care Director and SCAS Assistant Director of Operations described the 111 service as integrated and effective, directing patients through care pathways using a directory of services. Non-clinical staff triaged calls, escalating them to clinicians, if necessary, with the ambulance service responding if a clinical response was needed within 30 minutes.

The SCAS Assistant Director of Operations explained that ambulance delays were managed through a triage system categorising calls from life-threatening to less urgent. Patients with worsening conditions were re-triaged to higher priorities. The Oxfordshire Urgent Emergency Care Director noted that delays were caused by inappropriate calls, multiple ambulances arriving simultaneously, and ensuring safe handover. Efforts were made to free up ambulances quickly for critical cases.

Members inquired about  ...  view the full minutes text for item 36/25

Veronica Barry (Executive Director, Healthwatch Oxfordshire) has been invited to present the Healthwatch Oxfordshire Update Report.

The Committee is invited to consider the Healthwatch Oxfordshire update and NOTE it having raised any questions arising.

Veronica Barry, Executive Director of Healthwatch Oxfordshire, provided a brief summary of the Healthwatch Oxfordshire update report.

The Executive Director of Healthwatch Oxfordshire reviewed key initiatives. GP access had been a major concern due to appointment scheduling and digital access issues. An upcoming Urgent Care Report, based on feedback from nearly 200 individuals, would address urgent care navigation. A video highlighted the importance of patient involvement in prevention and primary care models. A discussion event examined the Marmot Review with around 100 community representatives expected. A menopause webinar featured an Oxford community champion. Collaboration continued with Lilly O'Connor on developing integrated neighbourhood teams. Supporting the voluntary and community sector during these changes was emphasised.

The Chair enquired about rural deprivation inclusion at Monday's event. The Executive Director clarified that the focus had been on priority urban areas since the Marmot introduction in December. Rural deprivation was being addressed through a separate initiative. The Director of Public Health mentioned ongoing work to develop a dashboard to tackle rural inequalities.

The Committee paused for lunch at 12:50, and commenced at 13:28

The purpose of this item is to approve the draft of the Annual Report of the Oxfordshire Joint Health Overview Scrutiny Committee. This report will be presented to Full Council on 08 July 2025, and summarises the key scrutiny activities and accomplishments of the JHOSC throughout the course of the 2024-2025 civic year.

There are TWO documents attached to this item:

1.    A cover report for the JHOSC Annual Report.

2.    Annex 1- The full draft and wording of the JHOSC Annual Report.

The Committee is RECOMMENDED to:  

1.1      Note the requirement for the Committee to produce an annual report.

1.2      Approve the wording of the annual report.

1.3      Delegate authority to the Health Scrutiny Officer:

1.3.1   for the design of the final report,

1.3.2   to make minor updates or amendments as required, in consultation with the Chair,

1.3.3   for publication of the final report

The Committee AGREED to the wording of the draft Annual Report, subject to any minor amendments that may be required to be completed by the Health Scrutiny Officer in consultation with the Chair.

Ansaf Azhar has been invited to present a report on Oxfordshire becoming a Marmot Place.

This is an opportunity for the Committee and the wider public to receive further insight into the work and progress to date on Oxfordshire becoming a Marmot Place.

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, and Kate Holburn, Deputy Director of Public Health, introduced the Marmot Place report and were prepared to answer questions the Committee had about the process of Marmotisation and its potential impact on Oxfordshire.

The Director of Public Health highlighted health disparities in Oxfordshire, despite its affluence, and recommended the Marmot Place initiative's system-wide approach. This initiative provided a framework for improvement, inspired by Coventry's positive results. The Deputy Director discussed using data and community engagement to address local inequalities, focusing on children's welfare, fair employment, and healthy living standards. She described the governance structure, work streams, and projects like children's services pathways, housing health assessments, and rural inequality mapping, while mentioning collaborations with universities and community engagement plans.

The Committee asked why three out of eight Marmot principles had been selected. The Deputy Director of Public Health explained these principles aligned with ongoing local work and provided a defined focus. This strategy allowed for measurable results and adhered to the Health and Wellbeing Strategy. Although the Institute of Health Equity recommended focusing on two principles, Oxfordshire selected three due to existing initiatives. These principles interconnected with others for a comprehensive approach.

Members queried if the Marmot Place initiative would involve local councils, parishes, and villages. The Director of Public Health confirmed it would, leveraging their knowledge and projects. The engagement process incorporated Committee input, ensuring thorough involvement. The Marmot team offered independent expertise to enhance initiatives and identify areas for improvement.

Members enquired if resources would assist rural groups in gathering data for the Marmot Place initiative. The Deputy Director of Public Health confirmed support for these groups, involving voluntary organisations to collect evidence through surveys, discussions, and focus groups. The Director of Public Health emphasised the need for both quantitative and qualitative data, including community insights, to address rural inequalities.

Members inquired about how rural inequalities were quantified. The Deputy Director of Public Health explained that census measures focused on household-level deprivation across employment, education, health and disability, and household overcrowding. The Director mentioned that qualitative aspects like social isolation and community insights were vital. The initiative included community engagement and lived experiences.

The Committee asked about the prevention of increasing inequalities and the measurement of intervention success. The Director noted that a hierarchy of evidence was used, including community feedback and randomised control trials, but ethical issues prevented control groups without intervention. Instead, a mix of qualitative and quantitative evaluations, including Policy Lab research, assessed intervention effectiveness.

Members enquired about collaboration and coproduction efforts, particularly with Oxford universities, and inclusive examples of patient and public involvement. The Director of Public Health and the Deputy Director of Public Health clarified that coproduction in the Marmot initiative involved community health development officers, focus groups, and partnerships with organisations such as Healthwatch. The engagement process was iterative and adapted to different communities. Regarding Oxford University Collaboration, the Policy Lab—a collaboration with Oxford University and Oxford Brookes University—was a significant component of the initiative, involving students  ...  view the full minutes text for item 39/25

Oxford Health NHS Foundation Trust has been invited to present the Trust’s Annual Quality Account for the year 2024-2025.

The Committee is RECOMMENDED to:

a) AGREE to provide feedback on the Trust’s Quality Account.

b) AGREE to finalise the wording of the feedback subsequent to and outside this meeting, and to submit the feedback to the Trust prior to the publication date for the Quality Account at the end of June 2025.

Britta Klinck, Chief Nurse, Dr Rob Bale, Interim Chief Operating Officer for Mental Health and Learning Disability, Angie Fletcher, Deputy Chief Nurse, and Emma Leaver, Interim Chief Operating Officer for Community Health Services, Dentistry & Primary Care, attended to present the quality account report.

The Chief Nurse had presented the quality account report, which was due for public release at the end of the month. The report had supplemented the annual report, highlighting quality priorities and performance. Oxford Health NHS Foundation Trust, a major provider of community and mental health care, had managed services in several regions and community hospitals in Oxfordshire. The Trust had assessed its performance over the past year, set new goals, and aligned with national directives. Despite efficiency challenges, improvements had earned them national recognition. They had prepared for the NHS 10-year plan by aligning with anticipated national priorities.

Members inquired about the Trust's strategy on clinical effectiveness, patient safety, and experience. The strategy focused on staff support, enhancing patient experience and safety, and advancing research. A board committee oversaw quality work, monitored data, and sought improvements. The Trust made progress with 68 peer support workers and established patient forums to include patient voices in decision-making. Continuously evaluating and improving care quality remained a priority.

The Committee requested evidence of measures for staff wellbeing and managing violent behaviour. The Trust implemented conflict resolution training, de-escalation techniques, trauma counselling, and formed a group to reduce violence and aggression, including racial abuse. Campaigns communicated a zero-tolerance policy towards such behaviour. In response to the cost-of-living crisis, they offered financial advice, crisis loans, and support for staff. Improved staff survey results placed the trust among the top ten mental health trusts for supporting, valuing, and engaging staff, and they conducted quarterly surveys for ongoing feedback.

Members also asked about advocating for an Oxford living wage and its recent rejection. Despite acknowledging the high cost of living, the proposal was rejected due to national pay framework constraints and political implications. Nonetheless, the Trust made strides in staffing, particularly through developing nurses from nursing associates and apprenticeships.

Members asked about the effectiveness and uptake of Keystone health and well-being hubs on community mental health. These hubs had high referral levels and were being evaluated for impact using qualitative and quantitative methods. They offered early interventions and guided people to community activities for mental health support, staffed by health professionals, partners, and peer workers who raised awareness and engaged with local communities.

Members also inquired about the Trust's efforts to enhance physical healthcare for those with serious mental illness. The Trust implemented smoking cessation programmes, annual health checks, and physical health clinics within community mental health teams, including home visits if necessary. General nurses in inpatient settings treated patients holistically, acknowledging the link between mental and physical health, and utilised their integrated structure to support both needs, especially in community hospitals.

Members queried the reasons for longer wait times for mental health services, measures taken to improve them, and alternatives for those unable  ...  view the full minutes text for item 40/25

The purpose of this item is for the Committee to receive and NOTE the update report from its Oxford Community Health Hubs Working Group. This report provides an update on the ongoing scrutiny of the Oxford Community Health Hubs Project launched by Oxford Health NHS Foundation Trust.

There are TWO documents attached to this item:

1.    The update report of the Oxford Community Health Hubs Working Group.

2.    A brief slide deck from Oxford Health NHS Foundation Trust which provides a status update of the three Community Health Hubs in Oxford City.

The Committee is RECOMMENDED to:

1.    NOTE the work of the HOSC Oxford Community Health Hubs working group around scrutinising the Community Health Hubs project for Oxford City since the working group’s establishment in April 2024.

2.    CONFIRM its support for the continuation of the working group’s existence and its ongoing scrutiny of the project to establish three Integrated Community Health Hubs in Oxford City.

3.    AGREE to the appointment of a fourth working group member given that former Cllr Michael O’Connor is no longer a member of Oxfordshire County Council.

The Health scrutiny Officer introduced the Oxford Community health Hubs working group report. Formed in April 2024, the working group group actively tracked the Oxford Community Health Hubs project's progress.

The working group's oversight since its inception was acknowledged. The Committee AGREED to:

1. The continuation of the working group's existence and scrutiny of the Community Health Hubs Project.

2. Oxford City Cllr Upton’s appointment as a new working group member, replacing former Councillor Michael O'Connor.

A site visit to Murray House (North City hub) was scheduled for 11^th June 2025, featuring a project update presentation and a building tour. Committee members were invited, and interested new members were to notify the Health Scrutiny Officer.

The Chair will provide a verbal update on relevant issues since the last meeting.

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

The Committee needs to provide written feedback to the Quality Accounts for both Oxford Health NHS Foundation Trust and Oxford University Hospitals NHS Foundation Trust. The Committee will discuss Oxford Health’s Quality Account as a public item during this meeting. In regards to the Oxford University Hospitals NHS Foundation Trust Quality Account, the Committee is RECOMMENDED to:

a) AGREE to hold a private briefing with the Trust to discuss the Quality Account.

b) AGREE to finalise the wording of the feedback subsequent to and outside this meeting, and to submit the feedback to the Trust prior to the publication date for the Quality Account at the end of June 2025.

NHS England have requested that Integrated Care Boards share the following news with local HOSCs in relation to the redesignation of Urgent Care Centres and Minor Injuries Units into Urgent Treatment Centres:

‘Oxfordshire has three Minor Injury Units (MIUs); Abingdon, Witney, and Henley. They presently report monthly in the 4-hour standard for Oxford Health NHS Foundation Trust. NHS England has requested that all these units are redesignated as Urgent Treatment Centres, otherwise they will not be able to continue to report the 4-hour standard. Before NHS England will complete the final assessment for designation, they have requested that the HOSC committee is aware of the redesignation.

Any units of this type (Minor Injuries Units and Urgent Care Centres) not to get the designation of an Urgent Treatment Centre, will have to stop reporting their activity in the 4-hour standard.

The regional and National NHS England team have requested that the HOSC is made aware of the potential redesignation of the Minor Injuries Units in Oxfordshire to Urgent Treatment Centres, to comply with full transparency.’

It has also been brought to the Committee’s attention that Professor Ben Burton (Royal College of Opthamologists) has written a letter to Stephen Kinnock MP (Minister of State for Care) in relation to Eye Care Services. The Committee will imminently receive a briefing from the BOB Integrated Care Board on the current state of Eye Care Services.

There are NINE documents attached to this item:

1.    EIGHT reports containing recommendations from the Committee on: the BOB Integrated Care Board Operating Model; the Health and Wellbeing Strategy Outcomes Framework; the Support for People Leaving Hospital; the Oxford Health NHS Foundation Trust People Plan; Audiology Services; Cancer Services; Musculoskeletal Services; the Director of Public Health Annual Report.

2.    The letter written by Professor Ben Burton to Stephen Kinnock MP (Minister of State for Care) in relation to Eye Care Services.

The Chair provided updates on several ongoing and new initiatives, including the Oxford Community Health Hubs Working Group. Volunteers were requested for the Wantage Substantial Change Working Group, with Councillor Batstone volunteering to join. The potential redesignation of minor injuries units and the ophthalmology briefing were also discussed. An ophthalmology briefing was scheduled for September due to public interest.

The Committee AGREED to provide feedback offline on the Oxford University Hospitals NHS Foundation Trust quality account, and the Chair also highlighted the importance of engaging with the new Chief Executive of the Trust.

The Committee is recommended to AGREE to the proposed work programme for its upcoming meetings.

The Committee discussed organising an online meeting to prioritise the work programme for the rest of the year. They agreed on the importance of GP access and estates, given public interest. A new working group focusing on primary care was suggested to address these issues in depth. The Committee identified GP access and ophthalmology as urgent items to be addressed at the September meeting but expressed concerns about overloading the agenda. They considered holding a workshop for a more focused discussion on primary care.

In conclusion, the Committee AGREED to GP access and ophthalmology as being items for the September meeting, and to organise an online meeting to finalise the work programme.

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

The Committee NOTED the tracker.