Agenda and draft minutes

Apologies for absence were received from Councillor Judith Edwards.

Councillor Garnett declared a personal interest as an employee of the University of Oxford, Primary Health Care Department.

Barbara Shaw declared a personal interest as Chair of Healthwatch Oxfordshire (HWO) and as a Patient Safety Partner at Oxford University Hospitals NHS Foundation Trust (OUH).

Sylvia Buckingham declared a personal interest as a Patient Safety Partner and a Trustee of Healthwatch Oxfordshire.

The Chair declared her standing interest as an employee of a national epilepsy and sudden unexpected death in epilepsy (SUDEP) charity.

No further declarations were made.

The Committee NOTED the declarations of interest.

To APPROVE the minutes of the meeting held on 29 January 2026 and to receive information arising from them.

The Committee considered the minutes of the meeting held on 29 January 2026.

The Committee AGREED that: the minutes of 29 January 2026 be amended, where necessary, following checking against the meeting recording to capture aspects of what a member of the public raised regarding eyecare services; and that the final amended version be treated as a true and accurate record once those checks had been completed.

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.

Requests to speak must be submitted no later than 9am three working days before the meeting, i.e. Monday 13 April 2026.

Requests should be submitted to the Scrutiny Officer at 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.

Three members of the public had registered to address the Committee.

Dr Andrew Johnson (retired Consultant Surgeon):

Dr Johnson spoke on maternity services at Horton General Hospital; due to technical issues he could not join live, so a written statement was read to the Committee.

He said removing consultant-led maternity in 2016 reduced local access and reassurance for families, and raised concerns about capacity and quality at the John Radcliffe, citing a CQC “requires improvement” rating. He argued workforce pressures could be mitigated by reinstating a consultant-led Horton unit using rotational staffing from the John Radcliffe, noting similar models elsewhere.

The Committee NOTED that maternity services remained an ongoing focus of the Committee’s scrutiny work.

Joan Stewart (Keep Our NHS Public):

Ms Stewart said long waits and limited theatre capacity at Oxford Eye Hospital persisted, with reliance on leased theatres and constrained consultant availability. She warned delays were driving patients to the independent sector, undermining NHS training, workforce sustainability and financial viability. She also raised concerns about a lack of data on A&E presentations with complications after independent-sector surgery, arguing this reduced transparency and effective contract management.

The Committee was asked to continue scrutinising eye care services and to investigate further.

Jane Southworth (Member of Public):

Ms Southworth described being moved onto an unexplained “virtual clinic” pathway at Oxford Eye Hospital despite longstanding glaucoma and awaiting surgery, with no in-person ophthalmologist and scans reviewed remotely weeks later. She said criteria and safeguards were unclear, the model was difficult for older/frail patients, and she requested Eye Hospital senior managers attend a future Committee meeting to explain the changes and the impact on the hospital’s teaching role.

In response, the Chair thanked Ms Southworth and confirmed that the Committee took these concerns seriously.

The Committee NOTED the public representations.

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

1.    Oxfordshire Neighbourhood Health Plan.

2.    Adults Autism and ADHD Services

The Committee is recommended to NOTE the responses.

The Committee considered written responses received to previous recommendations issued by the Committee, including responses relating to:

• Oxfordshire Neighbourhood Health Plan.
• Adult Autism and ADHD Services.

The Committee NOTED the responses to previous recommendations.

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

A request for information has been submitted on behalf of the Oxfordshire Joint Health Overview and Scrutiny Committee seeking assurance regarding the timeliness and oversight of Learning from Lives and Deaths of people with a learning disability and autistic people (LeDeR) reviews. The request was for a brief written update from the Integrated Care Board to the Committee covering:

1.    Current performance against NHS England LeDeR Key Performance Indicators (including completion timescales) and the current backlog position.

2.    Governance and accountability: where LeDeR sits in Oxfordshire/Thames Valley quality governance; and how learning/actions are tracked to completion.

3.    Capacity and resilience of the LeDeR function (local area contact/reviewer capacity; Quality Assurance arrangements).

4.    Recovery actions and milestones for bringing timeliness back on track (if applicable), and evidence of impact from learning.

The Buckinghamshire, Oxfordshire, and Berkshire West Joint Health Overview Scrutiny Committee (BOB JHOSC) convened its last meeting on 17 March 2026. Given the establishment of a new Thames Valley Integrated Care Board (ICB) with a new geography, a proposal will be submitted to all the local authorities within the new ICB boundaries to formally dissolve the BOB JHOSC and to establish a new Thames Valley JHOSC.

A letter was sent to the Chief Executive and Chair of Oxford University Hospitals NHS Foundation Trust on behalf of the Committee in relation to maternity services. The letter includes a request for clarification regarding errors in the data submitted in the report to the Committee on maternity services. This letter can be found in the agenda papers for this item.

A HOSC report containing recommendations on maternity services was submitted on behalf of the Committee to Oxford Health NHS Foundation Trust. This can be found in the agenda papers for this item.

Given that there remains one vacant cooptee post on the Committee, a formal recruitment exercise will be initiated, with the aim of recruiting a third co-optee member of the Committee by the next meeting in June.

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

The Chair provided a comprehensive verbal update on activity since the Committee’s previous meeting in January.

• The Chair advised that a report containing the Committee’s recommendations on maternity services had been submitted to Oxford University Hospitals NHS (OUH) Foundation Trust on behalf of the Committee. The report was included within the agenda papers for transparency.

• A letter had been sent on behalf of the Committee to the Chief Executive and Chair of OUH seeking clarification in relation to errors identified in data presented to the Committee at its January public meeting item on maternity. The letter had also requested further information regarding engagement with families affected by maternity service concerns. A response had since been received from the Trust’s Chief Executive, which was published as an addendum to the agenda.

• Correspondence from the Committee had continued with families affecting by OUH maternity services since January, and the Committee had taken the unusual step of offering to facilitate an initial process‑planning discussion between families and the Trust to help establish an engagement approach that might be acceptable to all parties. The offer remained open and families had also been reminded of the standard routes through which they could continue to address the Committee directly in public meetings.

• The Chair updated Members on developments relating to joint health scrutiny arrangements. She reported that the Buckinghamshire, Oxfordshire and Berkshire West Joint Health Overview and Scrutiny Committee (BOB JHOSC) had met on 17 March 2026, and that, following the establishment of the new Thames Valley Integrated Care Board on 1^st April 2026 with an expanded geography, proposals would be brought forward to formally dissolve the BOB JHOSC and to establish a new Thames Valley JHOSC. Recommendations made by the BOB JHOSC remained available to Members and the public via the published minutes of its last meeting.

• There was currently one vacant cooptee position on the Committee. A recruitment exercise would be initiated with the aim of appointing an additional co‑opted member ahead of the Committee’s June meeting.

• The Chair reported on the work of the Primary Care Working Group, which had met four times since January, including sessions with officers of the Integrated Care Board, the Chair of the Local Medical Committee, and district council officers. She highlighted that scrutiny had focused in particular on primary care estates, including progress on the Didcot Great Western Park health facility, where a developer had now been appointed. She confirmed that further scrutiny, including visits to GP practices and additional working group sessions on estates in Didcot, Bicester and Wallingford, was planned, with findings to be reported back to the Committee in due course.

• Regarding the Substantial Change Working Group focusing on the redevelopment of Wantage Community Hospital; the Chair explained that, although negative media coverage had referenced delays, the working group’s scrutiny had identified that the primary cause related to asbestos and iron issues identified during surveys. She advised that these issues had now been addressed and that completion was anticipated in late  ...  view the full minutes text for item 19/26

The purpose of this item is to address the Mental Health Motion passed by Oxfordshire County Council at its meeting on 9 December 2025. Oxfordshire County Council passed a motion requesting that the Health & Wellbeing Board (HWB) invite the Health Overview & Scrutiny Committee (JHOSC) to investigate and report on how mental health services provided by Oxford Health NHS Foundation Trust and wider system partners are addressing the rising prevalence and impact of poor mental health among adults and children in Oxfordshire.

The wording of the motion agreed was as follows:

“This Council being deeply concerned by the impact of poor mental health on adults and children in the County asks the Health and Wellbeing Board to request the Health Overview and Scrutiny Committee to investigate and report back to them and to the County Council on how Mental Health services provided by Oxford Health and other organisations are tackling this issue.

Such an investigation of issues needs to include addressing accessibility to services including:

·       Prevention

·       Assessment

·       Therapeutic support

·       Medication

·       Emergency intervention such as "sectioning"

·       Inpatient beds

How these issues impact on other public services such Community Safety, Public Health, Housing, Schools, Fire and Rescue and the Police also needs to be assessed and understood. Most of all poor mental health impacts on individuals, families, and communities around the County and this must be addressed.

Council requests that the outcome of the investigation be sent to the appropriate Secretaries of State.”

The Oxfordshire Joint Health Overview Scrutiny Committee is RECOMMENDED to:

a)    NOTE the request from the Health and Wellbeing Board for the Committee to undertake scrutiny of adults and childrens mental health services as outlined in the wording of the motion detailed in paragraph 3.

b)    AGREE that the Committee will continue its scrutiny of adults and children's mental health as outlined in its work programme, and that it will report back within its annual report to Council, details of the adults and children's mental health scrutiny undertaken

The Committee considered a report by the Health Scrutiny Officer relating to a motion passed by Oxfordshire County Council at its meeting on 9 December 2025. The motion requested that the Health and Wellbeing Board invite the Joint Health Overview and Scrutiny Committee to investigate and report on how mental health services provided by Oxford Health NHS Foundation Trust and wider system partners were addressing the rising prevalence and impact of poor mental health among adults and children in Oxfordshire.

The Chair outlined the context to the motion, explaining that it had been debated late in the Full Council agenda and had received cross‑party support, reflecting the shared recognition of the scale of mental health need locally and nationally. She advised that, due to time constraints at Full Council, it had not been possible for the Committee to explain that substantial scrutiny of children’s emotional wellbeing and mental health services had already been completed in November 2025, resulting in a detailed report with multiple recommendations, the formal response to which was still awaited.

The Chair explained that the Committee’s agreed work programme already included scrutiny of adult and older adult mental health services, scheduled for the current meeting, including consideration of transition issues between children’s and adult services. She therefore proposed that the Committee formally note the request arising from the Full Council motion, reaffirm its existing and ongoing scrutiny of mental health services across the age spectrum, and incorporate its findings into its next Annual Report to Council.

The Chair confirmed that mental health was already a recurring theme across the Committee’s work programme, and that future scrutiny items, including sessions with the ambulance service and other providers, would provide further opportunities to explore system‑wide impacts. She further proposed that, as part of its formal response to the motion, the Committee could write to the Secretary of State for Health and Social Care, summarising key findings from its scrutiny of children’s and adult mental health services and highlighting relevant national context.

Following discussion, the Committee indicated that it was content with this approach.

The Committee AGREED to:

• NOTE the request arising from the Full Council motion.
• CONFIRM that it had already undertaken scrutiny of children’s mental health services and was undertaking scrutiny of adult and older adult mental health services at the current meeting.
• Incorporate its findings and observations into its next Annual Report to Council.
• Write to the Secretary of State for Health and Social Care to highlight key findings and concerns identified through its mental health scrutiny work.

Dan Leveson (Director of Places and Communities, Thames Valley Integrated Care Board) and Rob Bale (Chief Operating Officer for Mental Health and Learning Disability, Oxford Health NHSFT) have been invited to present a report with an update on Adult and Older Adult Mental Health Services in Oxfordshire.

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

Dr Lola Martos (Consultant old age psychiatrist and Clinical Director Oxfordshire, BaNES, Swindon & Wiltshire Mental Health Directorate, Oxford Health NHS Foundation Trust); Catherine Sage (Associate Director, Adult & Older Adult Mental Health and Partnerships Oxford Health NHS Foundation Trust); Dr Rob Bale (Consultant Psychiatrist and Chief Operating Officer for Mental Health and Learning Disability Oxford Health NHS Foundation Trust); Jess Wilshire (Chief Executive, Oxfordshire Mind); Matthew Tait (Executive Delivery Officer, Thames Valley ICB); Karen Fuller (Director of Adult Social Care, Oxfordshire County Council); and Bhavna Taank (Head of Joint Commissioning Live Well); were invited to attend in order to present a report with an update on Adult and Older Adult Mental Health services in Oxfordshire.

The Chair welcomed the officers and set out the context for the item, noting that it formed part of the Committee’s agreed work programme and responded directly to the motion passed by Full Council in December 2025, requesting further scrutiny of mental health services.

The Oxford Health NHS Foundation Trust (OH) Chief Operating Officer for Mental Health and Learning Disability outlined the national and local context, explaining that adult mental health services continued to experience sustained increases in demand, rising clinical complexity, and significant workforce pressures. Referrals to adult mental health services had increased year‑on‑year, with a growing proportion of people presenting with complex trauma, co‑existing substance misuse, neurodivergence and social needs such as housing instability. These pressures had affected flow through services and contributed to challenges in meeting waiting‑time expectations in some pathways.

The Associate Director for Adult and Older Adult Mental Health and Partnerships provided further detail on community services and access. The Community Mental Health Transformation Programme had been central to current service redesign and aimed to strengthen multidisciplinary working, improve access, and embed voluntary and community sector support within neighbourhood‑based models. While investment had supported the development of new roles such as peer support workers, officers noted that recruitment and retention of experienced mental health professionals, including nurses and consultant psychiatrists, remained challenging and continued to place pressure on teams.

Members queried waiting times for assessment and treatment, particularly for adults with serious mental illness and for older adults accessing memory services and dementia pathways. The OH Consultant Old Age Psychiatrist and Clinical Director acknowledged that demand for older adult mental health services, including memory assessment, had increased substantially, reflecting demographic change and greater awareness. She advised that this had led to longer waits in some areas, but emphasised that work was under way to streamline diagnostic pathways, strengthen links with primary care, and ensure that people received meaningful support while awaiting formal diagnosis.

The Committee explored the operation of crisis services, including crisis resolution and home treatment teams. Officers explained that crisis services were under sustained pressure, with high demand and increasing acuity, but that the Trust remained committed to supporting people safely in the community wherever possible. The Executive Delivery Officer for the Integrated Care Board highlighted the importance of system‑wide coordination, noting  ...  view the full minutes text for item 21/26

Karen Fuller (Director of Adult Social Care, Oxfordshire County Council) has been invited to present a report on the ongoing development of an All-Age Autism Strategy for Oxfordshire.

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

PLEASE NOTE: The report for this item is to follow and will be published as an addenda.

Karen Fuller (Corporate Director - Adult Social Care); Bhavna Taank (Head of Joint Commissioning – Live Well – Housing, Education and Social Care); Dee Nic Sitric (Chief Executive- Autism Champions and Expert by Experience); and Matthew Tait (Executive Delivery Officer, Thames Valley Integrated Care Board); attended to present and discuss the draft All‑Age Autism Strategy for Oxfordshire and the strategy’s ongoing development.

The Chair introduced the item by noting that the strategy remained in draft and that the Committee welcomed the opportunity to provide scrutiny at this stage of its development prior to its sign off at the Health and Wellbeing Board.

The Corporate Director – Adult Social Care described the strategy as having been “on quite a journey” and stressed that, while it remained draft, it represented a significant shift in approach and language. The strategy had been co‑produced across multiple organisations and that the drafting process had required repeated pauses, reflection and revision, particularly where language and framing risked reinforcing a deficit narrative.

The Chief Executive of Autism Champions and Expert by Experience provided a detailed account of lived experience and, critically, the lived experience of participating in co‑production itself. She described co‑production as a term that was frequently used but often misunderstood, and explained that meaningful co‑production required autistic people and the autistic community to be involved from the beginning and throughout delivery, rather than being consulted at the end. The experience of attending and waiting through an extended agenda had been anxiety‑provoking even though she had supportive “anchors” in the room and prior experience of attending. Small acts of reassurance (such as being approached and acknowledged in a supportive manner by the Health Scrutiny Officer), constituted practical “reasonable adjustments” and were often more impactful than large, formal interventions.

The Chief Executive of Autism Champions and Expert by Experience then addressed the broader content and direction of the strategy. She described autism as frequently “invisible” in ways that made system engagement harder, noting that autism could not be reliably inferred by appearance and that autistic presentation varied widely across individuals. She described the challenge of engaging key stakeholders and seldom‑heard voices, particularly non‑speaking autistic people, emphasising that engaging non‑speakers required time, relational practice and specialist expertise that were often difficult to secure within tight drafting timetables and constraints.

A significant part of the discussion focused on the difficulty of system engagement during the strategy’s development. The Chief Executive of Autism Champions and Expert by Experience explained that securing the right stakeholders “in a room” had been extremely difficult and described this as a recurring barrier, despite some successful engagement activity. A major engagement session at the King’s Centre had attracted high attendance from autistic people and which had been led effectively by autistic members of the working group, but she stressed that engagement remained one of the hardest aspects of delivery because the system often struggled to understand or prioritise autism as a cross‑cutting issue.

The Committee  ...  view the full minutes text for item 22/26

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, Healthwatch Oxfordshire) was invited to present the Healthwatch Oxfordshire Update Report.

Healthwatch’s ongoing statutory role in gathering and representing patient and public experience across Oxfordshire’s health and social care system was explained to the Committee. Healthwatch’s continued engagement with a range of partnership boards and system forums was also highlighted.

Members noted the publication of a number of recent Healthwatch reports and pieces of community research. These included a report on experiences of musculoskeletal services, which identified persistent concerns around communication, appointment availability, cancellations, referral pathways and waiting times, alongside some positive feedback once care was accessed. The Committee noted that recommendations had been issued and that responses had been received from commissioners and the provider.

The update also highlighted community research activity, including work with the Sunrise Multicultural Centre in Banbury on cancer awareness and barriers to access, and engagement with rural communities as part of wider work on health inequalities. Members noted that these findings were intended to complement formal system performance data.

The Committee received an update on Enter and View activity, including visits to Katharine House Hospice and Ashurst Ward at Littlemore Hospital, and the publication of an Enter and View report relating to St Leonard’s Ward at Wallingford Community Hospital. Members noted that all reports, including provider responses, were publicly available.

Healthwatch Oxfordshire also reported on recent and forthcoming public engagement activity, including a March 2026 webinar on Oxfordshire’s work as a Marmot Place and a planned webinar providing an opportunity for public input into the Oxford Health NHS Foundation Trust strategy.

Members noted recurring themes from Healthwatch intelligence, including difficulties accessing GP and dental services, administrative barriers, and challenges navigating complaints processes. It was also noted that some forthcoming Healthwatch reports would be published after the local elections in line with Purdah guidance.

The Committee NOTED the Healthwatch Oxfordshire Update.

Ansaf Azhar (Director of Public Health, Oxfordshire County Council) and Emma Leaver (Chief Operating Officer- Community Health Services, Dentistry & Primary Care, Oxford Health NHSFT) have been invited to present a report on Health Visitor Services in Oxfordshire.

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

Donna Husband (Head of Public Health Programmes – Start Well – Public Health, Oxfordshire County Council); Mark Chambers (Head of Children’s Community Services Community Health Services, Dentistry and Primary Care Directorate | Oxford Health NHS Foundation Trust); Emma Leaver (Chief Operating Officer for Community Health Services, Dentistry & Primary Care, Oxford Health NHS Foundation Trust); and Taylor Nicola (Senior Clinical Lead for Public Health) were invited to present a report on Health Visitor Services in Oxfordshire.

Officers outlined the extent of organisational change following the establishment of the integrated 0–19 Children’s Community Public Health Service, which had brought together health visiting, school nursing, and related services within locality‑based teams operating under a single point of access. This model had been informed by learning from the COVID‑19 period, evidence on widening inequalities across Oxfordshire, and the County’s commitment to the Marmot principles.

Members questioned reported performance against mandated contacts, particularly delayed new birth and early years reviews, and sought clarity on how such delays arose and how risks were mitigated. The statutory window for new birth visits was extremely narrow and that apparent “misses” often reflected legitimate clinical and social circumstances, including prolonged hospital stays, overlapping midwifery involvement, parental choice to stay with family out of county, or non‑attendance at clinic appointments.

Officers stressed that recorded performance metrics did not fully reflect the extent of follow‑up activity undertaken by teams. Examples were provided of families who had initially failed to attend scheduled appointments but were subsequently followed up through home visits, enabling practitioners to assess both the child and the home environment. The Committee was reassured that delayed contacts did not equate to withdrawal of support and that persistence, professional curiosity, and escalation were embedded in practice.

Members expressed concern that families who did not engage might be those most at risk, particularly in more deprived or vulnerable circumstances. Officers described clear escalation policies, including structured records review, checks against GP and safeguarding databases, and liaison with other universal and specialist services. Health visitors did not work in isolation but as part of multidisciplinary arrangements designed to ensure that no child became “invisible” to services.

The Committee explored arrangements for transition from maternity to health visiting care. Officers described close operational integration with midwifery services, including daily birth notifications, shared vulnerability scoring, and regular local and strategic meetings. The introduction of improved digital systems was noted to have strengthened information flow, although challenges remained around county borders, private births, and families moving shortly after delivery.

Members were advised that vulnerability assessments were dynamic rather than static and were reviewed throughout the antenatal and early postnatal period, enabling proactive targeting of additional support where risk increased. Officers clarified that reported data focused on face‑to‑face contacts, even where telephone contact or hospital‑based engagement had occurred, creating a risk that activity was under‑represented in headline figures.

Members referred to sections of the report describing increasing acuity, safeguarding activity, and complexity within caseloads, and questioned how this was  ...  view the full minutes text for item 24/26

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

The Committee considered its Forward Work Programme.

The Committee AGREED the proposed Forward Work Programme for the June 2026 meeting, and to delegate authority to the Chair and Health Scrutiny Officer to make necessary adjustments to the programme should circumstances require changes between meetings.

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

The Committee NOTED the Actions and Recommendations Tracker.