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.
Minutes:
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 resources to support this aim. Sylvia highlighted the importance of closer communication and engagement with the public and patients, as well as clearer information from BOB ICB to enable effective support and navigation of healthcare services.
She stressed the need for transparency and accountability in decision-making and noted that while the ICB's role and purpose were positive and clear, there was less emphasis on building relationships and supporting integrated care. Sylvia called for clearer communication pathways into BOB ICB for Healthwatch and other organisations to fulfil their roles in supporting the patient voice.
She emphasised the importance of resourcing relationships at the place level and praised the significant progress made by the Oxfordshire Place-based Partnership in integrated working. Sylvia expressed concern that the proposed model's shift towards centralisation and the potential loss of local place directors would undermine local working and the ability to tackle healthcare inequalities. She concluded by advocating for strong relationships to support health and care systems at the neighbourhood level and warned against the detrimental impact of centralising functions previously managed at the place level.
Contributions from Absent Speakers
Two contributions were read out from individuals who could not attend:
1. Laura Price
Laura Price, representing the joint Oxfordshire Voluntary, Community and Social Enterprise (VCSE) sector, expressed concerns about the proposed changes to the BOB ICB operating model. She highlighted that these changes would significantly impact the relationship that VCSE organisations in Oxfordshire had built with the ICB.
Laura emphasised the importance of the role of the Director of Place for Oxfordshire, noting that this position had been crucial in fostering rapid progress in relationship building and collaboration. She cited examples of successful initiatives, such as the whole system approach to physical activity, which had reached 12,000 people and saved 8,100 GP appointments, and the Well Together programme, which had funded over 75 grassroots community groups.
She acknowledged the need for financial sustainability and the benefits of working across a wider geography but stressed that for local residents and community organisations, the term “BOB” was meaningless. Laura argued that without a local voice at a strategic level, it would be impossible for the VCSE sector to find a route into the system, and the ICB would struggle to unlock the potential of the sector to co-produce solutions to health service challenges. She urged the ICB not to dismantle the role of the place-based director, warning that it would undermine the progress made in Oxfordshire.
2. Doctor Simon Morris
Dr Simon Morris, representing Wallingford Primary Care Network (PCN), expressed concerns about the proposed changes to the ICB operating model. He highlighted the potential negative impact on primary care estate improvements, particularly for Wallingford Medical Practice, where he is a full-time GP and partner.
Dr Morris emphasised the dire state of the current premises, which were significantly undersized and inadequate to meet the growing demand due to local housing developments and an ageing population. He noted that the practice had already ceased some services due to space constraints and was operating out of converted storage rooms. He stressed the importance of the ongoing plans to relocate to a new building, which had made significant progress, including securing a valuable site from a local developer and support from various stakeholders.
He warned that the proposed ICB changes could stall these improvements, which would be harmful to primary care provision and negatively impact patient health and welfare. Dr Morris urged that any restructuring should not make it more difficult to improve primary care estate, highlighting the critical need for investment in this area to ensure the sustainability and quality of services.