Agenda item

Dan Leveson (BOB ICB – Place Director, Oxfordshire) and Lily O’ Connor (BOB ICB Programme Director Urgent and Emergency Care for Oxfordshire), have been invited to present a report on winter preparedness.

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

Lily O'Connor (Programme Director Urgent and Emergency Care for Oxfordshire), Ed Capo-Bianco (Urgent Care, Palliative and End of Life Care, Cardiovascular Disease Clinical Lead for Oxfordshire Place in BOB ICB), Ben Riley (Executive Managing Director for Community, Primary and Dental Care), Sally Steele (Service Manager Hospitals, Adult Social Services), Tamsin Cater (Head of Transfer of Care Hub, OUH), Karen Fuller (Director of Adult Social Care), Ansaf Azhar (Director of Public Health OCC), and Dan Leveson (BOB ICB Director of Place) submitted a report on Winter Planning in Oxfordshire.

The first question from the Committee focused on workforce and funding challenges for the upcoming winter. The Committee asked what measures were being taken to address these challenges in the short term. The BOB ICB Director of Place highlighted that the winter plan was essentially an urgent emergency care plan, with workforce being a significant challenge. The Director of Adult Social Care explained that across the Oxfordshire system, efforts were being made to maximise the workforce, ensuring the right people were in the right place at the right time. She mentioned an ambitious recruitment campaign that had yielded positive results, particularly in recruiting qualified social workers and occupational therapists. Additionally, work was being done with care providers to support hospital discharges and ensure a buoyant home care market.

The Committee then raised concerns about A&E and ambulance handover times. The BOB ICB Director of Place indicated that while the four-hour standard in A&E had been challenging, improvements had been made through partnerships and the establishment of urgent care centres. The performance had improved, with the target for the year being 78%. He also touched on the challenges faced by different trusts and the importance of system-wide collaboration to manage discharges and patient flow.

The Committee inquired about the confidence in reducing ambulance handover times. The Head of Transfer of Care Hub reiterated that Oxfordshire was performing well in this area, with excellent relationships with the South Central Ambulance Service. She noted that it was rare for ambulance handover delays to exceed 60 minutes, and efforts were being made to further reduce this time.

The Committee asked about the maturity of community services. The Executive Managing Director for Community, Primary and Dental Care reflected on the challenges faced due to stagnant funding despite increasing demands from a growing and ageing population. To address these challenges, he discussed efforts to streamline and consolidate services, such as implementing a single point of access for planned, urgent, and emergency care. This approach aimed to free up clinical time and improve efficiency, with some success already seen in the planned care sector.

Additionally, the Director mentioned ongoing staffing changes to make services more sustainable, moving away from short-term staffing solutions to long-term employment plans. This shift was expected to reduce costs associated with agency fees and provide more reliable staffing. He also discussed the development of hubs to bring together services from multiple locations, aiming to deliver more care closer to home.

The Committee raised concerns about primary care capacity during the winter. The Cardiovascular Disease Clinical Lead for Oxfordshire Place in BOB ICB acknowledged that GP capacity was stretched, but efforts were being made to manage demand through triage models and the involvement of multidisciplinary teams. Investments in community pharmacies and same-day emergency care units were also supporting primary care capacity.

The Committee asked about the availability of vaccines and the challenges faced in certain areas. The Cardiovascular Disease Clinical Lead for Oxfordshire Place in BOB ICB indicated that the vaccine programme had been commissioned to ensure better alignment and availability, with efforts to address any gaps in provision. The Director for Public Health reported no significant issues with vaccine availability this year, though prioritisation remained necessary. Compared to previous years, there was no notable increase in respiratory illnesses, but they would not be complacent.

The Committee inquired about the capacity for reablement services and the balance between patient flow and personalised care. The Service Manager for Hospitals in Adult Social Services explained that the discharge to assess model had been implemented to ensure decisions were made in patients’ homes, allowing for better reablement opportunities. She acknowledged the challenges but emphasised the importance of system-wide collaboration to maximise resources and support patients effectively.

The Committee AGREED to delegate to the Health Scrutiny Officer and the Chair to finalise the wording of the recommendations.