Agenda and minutes

Apologies were received from Cllr Edosomwan. Apologies were also received from co-optee member Slyvia Buckingham.

Barbara Shaw declared that she was the chair of Healthwatch and a patient safety partner.

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 05 June 2025, and to receive information arising from them.

The minutes of the meeting held on 05 June 2025, were APPROVED as a true and accurate record.

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 speak must be submitted no later than 9am three working days before the meeting, i.e. Friday 05 September 2025

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

Olly Glover MP expressed concern about the continued absence of a GP surgery at Great Western Park in Didcot, emphasising that this had increased pressure on existing surgeries and affected healthcare access for nearby villages. He acknowledged earlier engagement with the ICB but noted the lack of recent public updates since planning permission was granted, and he called for an update to ensure progress towards building the new facility so residents could access primary healthcare as needed.

Roseanne Edwards noted Banbury’s growing population and criticised the reduction of services at Horton Hospital, warning the John Radcliffe Hospital could not meet future demand. She called for a review of the Horton’s downgrade and urged improved planning and collaboration to address local healthcare needs.

Joan Stuart shared concerns that NHS eye departments are under-resourced, risking patient sight, and criticised the impact of private providers on the Oxford Eye Hospital. She urged a review of private sector involvement in NHS cataract surgery and backed the Royal College of Ophthalmologists’ call for action.

Graham Shelton raised concerns about abolishing Healthwatch Oxfordshire and Councils of Governors, warning this would weaken local patient voice and accountability. He urged the committee to oppose these changes due to their impact on public oversight.

Stella Hornby warned that unchecked growth in private cataract surgery could destabilise NHS ophthalmology by diverting funds, impacting staff, and jeopardising training and emergency services. She called for an urgent review of private sector involvement to protect the Eye Hospital’s future.

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

1.    Musculoskeletal Services in Oxfordshire

2.    Audiology Services in Oxfordshire

3.    Cancer Services in Oxfordshire

4.    Oxfordshire as Marmot Place

5.    Oxfordshire System Pressures

The Committee is recommended to NOTE the responses.

The Committee NOTED the responses to HOSC recommendations to:

1.    Musculoskeletal Services in Oxfordshire

2.    Audiology Services in Oxfordshire

3.    Cancer Services in Oxfordshire

4.    Oxfordshire as a Marmot Place 

5.    Oxfordshire System Pressures

Members noted ongoing concerns about musculoskeletal services, stressing that rheumatology faces the greatest need and longest waits. They requested future responses focus more on rheumatology, rather than orthopaedics.

Julie Dandridge (Strategic Lead for Primary Care across Oxfordshire -Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board) has been invited to present a report on General Practice Access and Estates in Oxfordshire.

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

Julie Dandridge (Strategic Lead for Primary Care across Oxfordshire - Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board) was invited to present a report on General Practice (GP) Access and Estates in Oxfordshire.

Also in attendance to support the Committee and answer their questions were Matthew Tait (BOB ICB Chief Delivery Officer), Dr Michelle Brennan (GP and Chair of the Oxfordshire GP Leadership Group), Rachel Jeacock (Primary Care Lead), Veronica Barry (Executive Director of Healthwatch Oxfordshire), Peter Burke (Chair, Thames Valley Faculty Board, Royal College of General Practitioners), Ansaf Azhar (Director of Public Health at Oxfordshire County Council), and Karen Fuller (Director of Adult Social Services at Oxfordshire County Council).

The Strategic Lead for Primary Care highlighted progress through new approaches and increased GP recruitment. She acknowledged persistent challenges with primary care estates, such as inadequate premises and limited funding, though some expansion projects were in progress. The Strategic Lead for Primary Care also stressed that strengthening general practice was key to future neighbourhood health plans, with further improvements still needed.

The Chair of Thames Valley Faculty Board echoed concerns about estate resources, referencing the Ten-Year Health plan and Leng review. He stressed prevention, evidence-based screening, and the vital role of primary care amid rising demand and insufficient GP growth in Oxfordshire.

Members raised the following questions and concerns:

• How widely the Modern General Practice Model had been adopted across Oxfordshire’s 64 practices. Officers indicated that the model had been implemented as a national programme, not by local GP choice, and that practices had adopted omni-channel access, though the communication to patients about these changes could have been improved.

• What strategies were in place to maintain or improve the current rate of 88% of patients being seen within two weeks. The response explained that maintaining or improving the 88% rate of patients being seen within two weeks depended on continuously adapting systems and being agile, but was fundamentally limited by the finite number of appointments GPs could offer each day due to staffing and estate constraints. The introduction of additional roles through the reimbursement scheme had helped improve access, yet the lack of physical space in practices restricted further expansion. It was described as a "chicken and egg scenario," with improvements in access reliant on both workforce and estate capacity, and while some progress had been made, significant further improvement would require addressing these underlying resource limitations.

• While the patient survey showed above average ease of contacting practices by phone, some practices had as low as 21% reporting easy access, indicating wide variation. The Strategic Lead for Primary Care explained that the ICB supported practices with lower scores by deploying a team to help improve access, sharing successful approaches from higher-performing practices, and introducing cloud-based telephony systems to better manage call queues and reduce complaints about long waits.

It was also discussed and noted that national efforts, such as the red tape challenge and recommendations from the NHS Confederation, aimed to clarify which administrative tasks should remain with hospital clinicians  ...  view the full minutes text for item 50/25

Matthew Tait (Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board) has been invited to present a report on Eyecare services in Oxfordshire.

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

Matthew Tait (BOB ICB Chief Delivery Officer) was invited to present a report on Eyecare Services in Oxfordshire.

Also, in attendance to support the Committee and answer their questions were Hannah Mills (Director of Delivery UEC and Elective), Sharon Barrington (Associate Director Acute Provider Collaborative), Ansaf Azhar (Director of Public Health at Oxfordshire County Council), and Karen Fuller (Director of Adult Social Services at Oxfordshire County Council).

Stella Hornby (Consultant Ophthalmologist at the Oxford Eye Hospital who initially spoke as a public speaker) also joined the Committee upon the Chair’s invitation.

The BOB ICB Chief Delivery Officer confirmed support for sustainable secondary care, highlighted challenges between NHS and private providers, and stated adherence to national policy on provider choice and tariffs. The Director of Delivery emphasised equal application of the national tariff and ongoing work in ophthalmology. The Associate Director explained that the single access model improved patient choice, cited responses to Healthwatch Oxfordshire recommendations on eyecare services, and listed enhancements in information, accessibility, and engagement.

Members raised the following questions and concerns:

• How did the ICB ensure consistency, quality, and good value across primary, intermediate, and secondary eyecare services, and what was the approach to procuring new services and reviewing contracts. Officers explained that the ICB held regular meetings with providers, monitored patient feedback and activity, and relied on national accreditation standards for clinical consistency and safety. It was noted that value for money checks were conducted when procuring new services or reviewing contracts, with more influence over local intermediate services, while national tariffs applied to acute and private providers.

• What mechanisms were in place to ensure that private eyecare providers adhered to the same rigorous standards as the NHS; as well as what contractual authority were exercised over private suppliers, and the processes for addressing instances of provider failure and patient complications.

The Director of Delivery stated that private providers were subject to the NHS standard contract and accreditation checks, with quality monitored through contractual mechanisms and feedback. However, it was acknowledged that when the ICB did not hold a direct contract, oversight was weaker, and there was no systematic way for NHS hospitals to report or track complications arising from private providers. Where incidents were reported, the ICB’s quality teams investigated and, if necessary, conducted multi-agency reviews for recurring issues.

• There were concerns raised about the destabilising impact of independent service providers (ISPs) on NHS ophthalmology pathways and training. It was explained that the growth of ISPs providing low complexity cataract care had reduced the number of suitable cases for NHS trainees, leading to the loss of trainees and affecting the quality of training.

Efforts were being made to arrange joint training opportunities with ISPs, but challenges remained, such as limited frequency of training lists and ISPs preferring more experienced trainees. It was noted that Oxford had been particularly hard hit, with training quality and appeal reduced, and that national work was ongoing to address these issues.

Members pushed further about how NHS trainees in eyecare were  ...  view the full minutes text for item 51/25

Matthew Tait (BOB Integrated Care Board Chief Delivery Officer) has been invited to present a report on Adults Autism and Attention Deficit Hyperactivity Disorder services in Oxfordshire.

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

Matthew Tait (BOB Integrated Care Board Chief Delivery Officer) was invited to present a report on Adults Autism and Attention Deficit Hyperactivity Disorder services in Oxfordshire. Niki Cartwright (Director of Delivery, BOB ICB – Mental Health, Learning Disability, SEND and community), and Dee Nic Sitric (Chief Executive of Autism Champions) also attended to support the Committee and answer their questions.

The BOB ICB Chief Delivery Officer introduced the Adults Autism and ADHD services item by highlighting the significant pressures on access and waiting times, the complexity of the market, and the financial challenges, noting that these issues were not unique to Oxfordshire.

The Director of Delivery explained that Autism and ADHD services were paused due to high demand and noted plans for transformation programmes with input from those with lived experience. The Chief Executive of Autism Champions supported the involvement of lived experience in service design, praised the collaborative ADHD programme, but raised concerns over limited progress and engagement in the autism strategy.

Members discussed the following questions and concerns with officers:

• What immediate steps could be taken to reduce the waiting lists for adults autism and ADHD services. The BOB ICB Chief Delivery Officer responded that there were no specific short-term measures available to rapidly reduce the waiting lists, explaining that while the right to choose market had improved access, the exponential increase in demand meant waiting times would likely not decrease quickly. He emphasised that the solution lay in a long-term transformation programme, improved contractual frameworks, and national support, rather than any quick fixes.

• Why Autism assessments had been capped at 110 per year and whether any modelling had informed this figure. The BOB ICB Chief Delivery Officer explained that the cap reflected the level of activity that could be provided within the existing contract funding, rather than being based on modelling, and the Director of Delivery confirmed it was determined by what the provider could deliver within the financial envelope, noting that this approach might need to be reconsidered as demand increased.

• What support and communication available to people with Autism and ADHD was provided while services were being developed. The Director of Delivery explained that people were signposted to a range of local voluntary sector services and that a future community offer was being developed to provide accredited support options.

She added that communication with those on waiting lists had been limited until there was clear information to share, but ongoing engagement workstreams would address this. The Executive Director of Autism Champions also highlighted the importance of moving away from a purely diagnostic approach and focusing on meeting needs, suggesting that the ADHD transformation pathway considered how to support people without requiring a formal diagnosis.

• Concerns were raised about the Shared Care Fund for ADHD, how well it was working, and the rate of GP engagement. The Director of Delivery explained that the new Shared Care protocol had only recently been signed off, with increased annual funding and plans for advice, guidance, and training to help  ...  view the full minutes text for item 52/25

Veronica Barry 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.

There are TWO documents attached to this item:

1.    The main Healthwatch Oxfordshire Update report.

2.    Appendix 1: A document developed by Healthwatch Oxfordshire, outlining the future of Healthwatch and independent scrutiny.

Veronica Barry (Executive Director of Healthwatch Oxfordshire) was invited to present the Healthwatch Oxfordshire Update report. The BOB ICB Chief Delivery Officer also attended to support the Committee and answer any questions.

The Executive Director of Healthwatch Oxfordshire introduced the Healthwatch item by highlighting recent issues, such as problems with school transport for children with autism, and explained the broad and unique role Healthwatch played in bridging the gap between the public and the health and care system, including signposting, engagement, and scrutiny. The Chair responded by emphasising the value of Healthwatch’s contributions to scrutiny and decision-making in Oxfordshire, noting the strong support for its continued function following recent national announcements about its future.

District and County Council members of the Committee highlighted their support for Healthwatch Oxfordshire, and praised the valuable insight they provide.

The BOB ICB Chief Delivery Officer stated that his organisation valued Healthwatch highly, especially its role in the place-based partnership, and shared concerns about the direction of travel regarding its future. He confirmed that they were keen to work with Healthwatch Oxfordshire across the region to design a future model that retained its expertise and independence, acknowledging that independence was a real issue in any redesign.

The Committee discussed recommending that system partners safeguard and develop the Healthwatch function, ensure meaningful consultation with local stakeholders, and allow the Committee to review any local decisions before implementation. They also considered writing to local MPs about concerns, supported the core characteristics of public voice outlined by Healthwatch, and emphasised the need for independence and local relevance in any future arrangements.

The Committee AGREED to issue the following recommendation:

1. For system partners to safeguard and develop the Healthwatch function within Oxfordshire, and to engage and meaningfully consult with all local stakeholders, to ensure the local delivery of national reforms at Place or neighbourhood level best meet patient and community need. It is recommended that the Oxfordshire JHOSC has an opportunity to scrutinise any local decisions on this before they are made.

Cllr Garnett left the meeting at this stage.

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

There are TWO reports in the agenda papers for this item, containing recommendations from the Committee on: Oxfordshire System Pressures, and on Oxfordshire as a Marmot Place.

A letter was sent on behalf of the Committee to the Chief Executive of the BOB Integrated Care Board, requesting further information on a recent Oxfordshire Neighbourhood Health Bid.

There are TWO documents attached to this item:

1.    The letter that was sent to the ICB Chief Executive on behalf of the Committee.

2.    The application Oxfordshire Place-based Partnership recently submitted in response to the national neighbourhood health implementation programme (NNHIP).

The response received by the Committee is as follows:

“The Oxfordshire application is intended to accelerate the benefits of neighbourhood working in Oxfordshire:

Ø  Specifically, for some of the most vulnerable and deprived residents:

Ø  To build on progress to date relating to care being delivered and coordinated by INTs.

Ø  To further explore and mature primary care at scale delivery.

The application required sign off from a wide variety of statutory organisations including CEOs from both the ICB and OCC. We also including other non-statutory organisations like Healthwatch and OCVA organisations hopefully demonstrating the extent stakeholders involved in developing the application.

For the purposes of the application, resident involvement was limited due to a short turnaround time in holiday season.  However, Oxfordshire has held multiple neighbourhood health and care workshops with broad representation (including statutory organisations, Healthwatch, VCFSE orgs, Patient Participation Groups. The full impact on primary care is unknown at this stage, but the Oxfordshire Neighbourhood Health Steering Group is chaired by the Chair of Oxfordshire GP Leadership Group, with further representation form GPLG and PCNs. The broader neighbourhood agenda is intended to further enhance primary and community care.

Planning guidance has recently been published, this will help inform local processes that will of course require input across sectors, organisations and residents. Dr Ben Riley is senior responsible officer for the ICB and we expect neighbourhood working to be driven and delivered large by collaborations at Place. All 3 Places in BOB have applied and we expect to hear back which proposal will be taken forward towards the end of this month. Oxfordshire’s proposal focussed on Oxford City and part of Banbury and Bicester covering areas we already have developed Integrated Neighbourhood Teams and 9 out of the 10 most deprived wards in Oxfordshire.”

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

The Chair updated the Committee that, following the unexpected government announcement about the future of Healthwatch, she and the Health Scrutiny Officer had met regularly with the Executive Director of Healthwatch Oxfordshire to stay informed and provide support. The Chair also brought a motion to the County Council, which received unanimous backing, emphasising the importance of maintaining the Healthwatch function to support the independent patient voice in Oxfordshire.

The Chair highlighted the value of Healthwatch’s contributions to scrutiny and decision-making, noting that its involvement strengthened the committee’s work and benefited system partners. She reiterated the commitment to ensuring the continuation of Healthwatch’s functions and the independent patient voice, regardless of any national changes.

The following points were also highlighted by the Chair:

The Committee NOTED the update.

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

The Committee AGREED to set up an online meeting to review the work programme, including integrating the GP working group and planning for a focus on children at the next public meeting in November.

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 the action and recommendation tracker.

The Health Scrutiny Officer clarified that some outstanding items on the tracker remained on the tracker as further updates were expected.