Agenda and draft minutes

The following members tendered their apologies:

Cllr Nigel Champken-Woods

The following members were not able to attend in person but attended virtually (meaning they verbally participated in the discussions although were not permitted to formally contribute to decisions or recommendations made by the Committee):

Cllr Jane Hanna

Cllr Jenny Hannaby

No declarations of interest made.

To approve the minutes of the meeting held on 06 June 2024 and to receive information arising from them.

The Committee is recommended to AGREE the minutes as an accurate record having raised any necessary amendments.

The minutes of the committee’s meeting on 6 June 2024 were assessed for their accuracy.

The Committee AGREED the minutes as an accurate record of proceedings and that the Chair should sign them as such.

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 Monday 29 July 2024.  Requests to speak should be sent 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 your views are taken into account. A written copy of your statement can be provided no later than 9am 2 working days before the meeting. Written submissions should be no longer than 1 A4 sheet.

The Chair invited the registered speakers to address the Committee.

1.           Statement by Olly Glover, MP for Didcot and Wantage:

Glover expressed his concerns about the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board’s (BOB ICB) proposed reorganisation. He found the proposal difficult to follow due to its jargon-heavy nature and lack of clear diagrams. Glover focused his remarks on the needs of the Didcot and Wantage constituency, highlighting his worries about the removal of a dedicated director position for place and joint commissioning for Oxfordshire. He feared this change would dilute the focus on Oxfordshire’s specific needs and create misalignment with the County Council.

Glover also criticised the lack of proper consultation time, especially since the proposals were introduced during the summer when many people were away. He pointed out the exceptional population growth in Didcot, Wantage, Grove, and Wallingford, which had strained local healthcare services; including general practice, community pharmacy, and NHS dentistry. He praised the progress made by the Committee and the ICB Director of Place in addressing urgent care needs and prioritising projects like the new GP surgery in Didcot and the refurbishment of Wantage Community Hospital.

Glover concluded by expressing his hope that the new restructure would not undermine the promises made to local residents and urged for reassurance that efforts to protect progress in Oxfordshire would continue.

2.           Dr Michelle Brennan

Dr Michelle Brennan, Chair of the Oxfordshire GP Leadership Group, acknowledged the potential for legislative changes to provide a platform for improvement but stressed that these alone could not facilitate the necessary cultural and systemic changes. She noted that Oxfordshire had many excellent individual providers but had historically struggled with system-wide collaboration, resulting in complex and difficult-to-navigate healthcare services.

She viewed the establishment of Integrated Care Systems (ICS) and place-based partnerships as an opportunity for collaborative work to improve health outcomes, practice sustainability, and staff well-being. However, she expressed concern that the proposed operating model represented a shift towards centralisation, which she believed was contrary to the principles of subsidiarity and the current political vision. Dr Brennan feared that the hierarchical model would fail to support the transformational changes needed to meet residents' needs.

She praised the progress made by the place-based partnership, particularly the development of urgent treatment centres and integrated neighbourhood teams. Dr Brennan emphasised the importance of maintaining clinical leadership within the ICB to address local health inequalities and drive local projects. She warned that a reduction in clinical leadership and corporate knowledge posed a critical risk to the organisation's effectiveness.

Dr Brennan concluded by stressing the need for a proactive health system focused on prevention rather than a reactive one. She called for a balanced approach, with some initiatives led at the ICB level and others at the place and neighbourhood levels, to ensure the development of the ICS.

3.           Sylvia Buckingham

Sylvia Buckingham, a trustee and former Chair of Healthwatch Oxfordshire, welcomed the model's renewed emphasis on working with people and communities and the commitment to allocate more  ...  view the full minutes text for item 54/24

Nick Broughton (Chief Executive BOB Integrated Care Board) and supporting ICB officers have been invited to attend this meeting to discuss the BOB Integrated Care Board proposed new structure and operating model.

It is recommended that the Committee AGREES on:

1.Whether or not the proposed restructure constitutes a substantial change.

2. How the Committee should proceed in light of the proposed restructure.

PLEASE NOTE: Reports relating to this item are to follow.

Matthew Tate (Chief Delivery Officer), and Hannah Iqbal (Chief Strategy and Partnership Officer), attended the meeting as representatives of the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB).

The Chief Delivery Officer highlighted that the consultation process with staff was ongoing, and that partner engagement was being actively sought. He acknowledged the concerns raised by various stakeholders about the potential impact of the restructure on place-based partnerships and service delivery. He assured the attendees that the feedback received would be carefully considered and that the final proposals would reflect the input from both staff and partners.

The Chief Delivery Officer explained the context and necessity of the restructuring. He highlighted that the ICB was required to reduce its running costs by 30%, which prompted a review of their management structures. This review aimed to drive economies of scale and ensure the ICB could address strategic challenges more effectively.

The Chief Delivery Officer outlined that the initial set of structures proposed in April had received significant feedback, particularly concerning the clarity of the operating model and the potential transfer of staff to other organisations. This feedback, combined with the ICB’s need to sign off a deficit position of £60 million, led to a revised set of proposals. These new proposals aimed to strengthen internal functions, such as finance and Continuing Healthcare (CHC), to better control and understand strategic issues.

The Chief Delivery Officer acknowledged the significant progress made by the place directors and the importance of maintaining strong relationships and collaborative working at the local level. He suggested that the new model could involve different leadership arrangements, with partners stepping into some of the roles previously held by ICB staff. He reiterated the commitment to supporting place-based partnerships and ensuring that the restructure would not undermine the progress made.

The Chief Strategy and Partnership Officer added context to the partnership development and collaboration aspects. She emphasised that the changes were not about altering service priorities or collaborative intent but were focused on management structures. She acknowledged the difficulty in balancing the consultation process with staff and the engagement with partners, given the sensitivity around potential redundancies.

The Executive Director of People in Oxfordshire County Council expressed his pride in the Oxfordshire contingent and his respect for the representatives from the BOB ICB. He provided a brief background of his career, highlighting his experience in the NHS and local government, emphasising the importance of collaborative work to achieve meaningful impacts on people’s lives.

He discussed the BOB ICB’s consultation document, agreeing with the importance of ICBs and their role as system leaders. The Executive Director stressed the need to balance system-level benefits with the individuality of place. He pointed out that Oxfordshire’s integrated health and care system, supported by a significant pooled budget, was unique within the BOB footprint and required adequate resources to maintain its effectiveness. He expressed concerns about the proposals in the consultation document, questioning their alignment with the policy goals of integrated care systems.

He raised  ...  view the full minutes text for item 55/24

The Committee has received Acceptances and Responses to all the recommendations made to Oxford Health NHS Foundation Trust as part of the Trust’s Quality Account item held during our 06 June 2024 meeting.

The Committee is recommended to NOTE the responses.

The Committee had received acceptances and responses to all the recommendations made to Oxford Health NHS Foundation Trust regarding the Trust's quality account, which was discussed during the meeting on 06 June 2024. The Health Scrutiny Officer reminded the Committee that these were not merely requests for additional information to be included in the quality account, but actual recommendations directed towards the Trust.

The Committee NOTED the responses to the recommendations.

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

There is ONE documents attached this item:

1.   A HOSC report containing recommendations from the Committee on Integrated Neighbourhood Teams in Oxfordshire, which was discussed during the 06 June 2024 HOSC meeting.

The Committee Chair outlined the following points to update the Committee on

developments since the previous meeting:

·       A HOSC report containing recommendations from the Committee on Integrated Neighbourhood Teams in Oxfordshire, discussed in the June meeting, had been published in the agenda papers for this meeting.

·       The Committee had a planned site visit to the John Radcliffe Hospital, focusing on patient safety, and received detailed and interesting insights into the Trust’s steps and projects to improve patient safety.

·       The Committee received a briefing from Oxford University Hospitals NHS Foundation Trust regarding the CQC inspection of maternity services at the Horton. The topic of maternity services throughout Oxfordshire was broadly discussed and would be revisited as part of the forward plan agreed at the June meeting.

·       The HOSC working group examining the Oxford Community Health Hubs Project met with senior representatives of Oxford Health NHS Foundation Trust and discussed key progress made on the project, which was found to be extremely useful.

The Committee NOTED the Chair’s Update.

To AGREE the Committee’s proposed work programme for its upcoming meetings.

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.