Agenda and minutes

Councillor Jenny Hannaby attended for Councillor Alison Rooke and apologies were received from Dr Keith Ruddle and Mrs Anne Wilkinson.

There were no declarations of interest.

To approve the minutes of the meeting held on 17 September 2015            (JHO3) and to receive information arising from them.

The Minutes of the meeting held on 17 September 2015 (JHO3) were approved and signed as a correct record.

The Chairman had agreed to the following members of the public addressing the Committee:

·         County Councillor Pete Handley in relation to Agenda Item 5 - ‘Oxford University Hospitals Foundation Trust (OUHFT)’

·         Mr Keith Strangwood in relation to Agenda Item 8 ‘Chairman’s Report and Forward Plan’ (to speak prior to discussion of the item)

Councillor Pete Handley addressed the Committee questioning the amount of funding from the OUHFT being put into research in a climate where, in his view, waiting lists for operations were long and the NHS was not funding  expensive drugs for cancer treatments. He added that, in his view, the monies received from higher college tuition fees should be put towards relieving the backlog of operations.

Dr Stuart Bell, CBE, Oxford Health NHS Foundation Trust, responded that any funding received for research was in addition to that received for services. Thus, a centre for the provision of specialist services, as the OUHFT was, would benefit the local population for having those services locally.

10:40

Representatives from the Transformation Board including David Smith, Chief Executive, Oxfordshire Clinical Commissioning Group, and colleagues from Oxford University Hospitals NHS Foundation Trust, Oxford Health and Oxfordshire County Council will give a presentation on progress in respect of the emerging system-wide plans for transformation of the way in which Oxfordshire’s health and social care will be delivered to address population growth, demographic demands and pressures on available resources now and in future years (JHO6).

The Committee are invited to comment on the proposed approach and emerging vision.

Stuart Bell MBE, Chief Executive, Oxford Health NHS Foundation Trust, gave a powerpoint presentation on progress in relation to the emerging system-wide plans for transformation of future delivery of Oxfordshire’s health and social care. The plans would address population growth, demographic demands and pressures on available resources for now and in future years (JHO6). Mr Bell was accompanied for this item by Dr Bruno Holthof, Chief Executive, Oxford University Hospitals Foundation Trust (OUHFT), Dr Joe McManners, Chair, Oxfordshire Clinical Commissioning Group (OCCG) and John Jackson, Director for Adult Social Services (Oxfordshire County Council) (OCC)) and Director of Strategy & Transformation, Oxfordshire Clinical Commissioning Group (OCCG)).

The Chairman thanked Stuart Bell for the presentation and invited questions from the Committee.

A member asked for assurance that the correct number of properly trained care workers would be available at the right time in order to meet the requirements of the Plan. Dr McManners responded that there were various initiatives coming from Government that might prove helpful relating to recruitment and retention in primary care. He commented also that the high cost of living and the house prices in the region were an obstacle. Dr McManners explained that the new models of care were crucial to the ways in which GP practices were being, and would be organised, adding that more resource for prevention would hopefully lead to more care in the community. He commented also that the high cost of living and the house prices in the region was an obstacle.

John Jackson stated that new providers of social care would have to be registered with the Care Quality Commission, adding that there was also a need to ensure organisations were well managed and staff well trained. Work on a workforce strategy had been undertaken, some of it resourced by Health Education England. Values based recruitment was also a factor, for example, looking for potential candidates who would gain the most satisfaction from the nature of the work. He added also that there had been changes to the national living wage which would increase pay in the care sector, but this could be a problem if workers chose to go to work in other sectors.

A member expressed concern about the possible increased risks for the field of domiciliary home care, suggesting that people liked to be reassured that there would not be a large scale shift in public sector providers. Stuart Bell responded that this was not emerging as a problem, but a feature that was being communicated strongly was the value of partnerships operating the system together as one team, such as the acute sector and the voluntary sector working together with GPs in the localities. There had been no assumption made that a large proportion of the care would shift to the independent sector.

A member commented that the proposals were being set against the challenge of the possible removal of gateways as part of the budget cuts, such as cuts to children’s centres. Stuart Bell agreed, saying  ...  view the full minutes text for item 111/15

10:10

The newly appointed Chief Executive of the Oxford University Hospitals Foundation Trust (OUHFT), Dr Bruno Holthof, will attend the meeting to introduce himself to the Committee and share his initial observations from his first few weeks in his new role. He will be accompanied by Andrew Stevens, Director of Planning & Information (OUHFT).

The newly appointed Chief Executive of the Oxford University Hospitals Foundation Trust (OUHFT), Dr Bruno Holthof, attended the meeting both to introduce himself to the Committee and to share his initial observations from his first few weeks in his new role. He was accompanied by his Director of Planning & Information, Andrew Stevens.

The Chairman made reference to the radical plan to the most recent pilot to tackle bed-blocking. A press statement and separate statement of commitment to the stakeholders had been issued that morning (copies of which were circulated around the meeting).

Dr Holthof gave his initial thoughts with regard to Oxfordshire and outlined his initial priorities. Firstly, he highlighted joint working (such as that already demonstrated with the pilot to address delayed transfer of care) as a top priority and that this will be a focus area to further strengthen work across all of the health and social care organisations. He commended the joint working already underway, to look at better ways to get patients back to their home from hospital as quickly as possible. He also stated that a priority area was to review the current activities that are undertaken at Oxford based hospital sites which could be better performed at the Horton General Hospital and other general hospitals in the broader region. Thirdly, he wanted to see the development of more highly specialised services at the John Radcliffe Hospital so that patients living in Oxfordshire, and those from further afield could be treated in Oxfordshire.

A member commented that Banbury was an area that was growing fast and, although she was very pleased that patients would be treated closer to home, she wondered if there would be sufficient care home beds to accommodate this. Dr Holthof responded that if Oxfordshire was successful in commissioning enough care home beds to be turned into intermediate care beds, as part of the ‘Rebalancing the System’ project,  then that would solve the long-standing delayed transfers for care (DToC) problem in Oxfordshire. He made reference to his first interaction with the community which had been  with the action group ‘Keep the Horton General’ about when it was appropriate for patients to be treated locally. He understood that travelling was an additional burden, adding that treatment at other acute trusts in, for example, Warwickshire, could also be an option, should it not be possible for them to be treated at the Horton for quality or safety reasons.

Dr Holthof was asked if placing patients into intermediate care beds in distant localities would be at the expense of the needs of the families, and might therefore result in people having to go into a home. Dr Holthof responded that the intention was to get the patients home as soon as possible, complete with sufficient care plans. Andrew Stevens added that this had been measured as part of a trial last winter that had successfully provided sufficient home care beds. Members of the Committee were keen to understand the details off this  ...  view the full minutes text for item 112/15

11:40

Rachel Coney, Chief Executive of Healthwatch Oxfordshire will give her update (JHO7) on recent projects which includes the newly launched Dignity report. This is also attached at JHO7.

Members are asked to comment on the findings of the Dignity report.

The Chairman of Healthwatch Oxfordshire (HWO), Eddie Duller OBE attended the meeting to respond to questions in Rachel Coney’s absence. He reported that the Dignity in Care report which was attached for the attention of the Committee was at that moment being presented to Healthwatch England by HWO’s Head of Projects team.

He introduced the recurring themes contained within the report which were in brief:

·         Unsatisfactory communication models;

·         People being afraid of complaining in case it would have a bearing on the care they were receiving;

·         25% of people interviewed did not know the processes for making a complaint;

·         11% of people in home care said that they had witnessed abuse or been abused themselves.

adding that early commitments to the recommendations had already been given by the Trusts.

A Committee member asked about the numbers interviewed, to which Mr Duller responded that it was approximately 200 in a series of localities such as care homes and hospitals. He added that in circumstances where people were in their home or care situation, HWO had taken advice to ensure that the questions were appropriate. Dr McWilliam reminder members that this type of report shows general ‘drifts’ based on soft information rather than hard evidence (given the relatively small number of responses).

In response to concern about the national problem of inadequate advocacy and the necessity of providing a strong practical and whole system approach, Mr Duller assured the Committee that HWO were taking it very seriously and it featured high in their forward plan.

A Committee member asked how the Loneliness and Isolation database and how the Community Information network was operating, particularly in Oxford City. Mr Duller stated that meetings were planned with providers and commissioners and that HWO would be returning with a further report in 4/5 months.

John Jackson agreed with the Committee that the Dignity in Care report was a good report, having attended its launch and been part of the discussions, with responsibility for adult safeguarding issues in Oxfordshire, as overseen by the Oxfordshire Adult Safeguarding Board. He stressed that any stated worries around the impacts on the quality of care were welcomed and organisations were committed to addressing any problems encountered. He added that this had been recognised as an issue and there was a genuine wish on behalf of all organisations to do as much as possible to address it. Mr Duller added that, as one would expect, the people they talked to tended to be more open with them than with the ‘authorities’ .

A suggestion that, in the way of feedback, the public be asked to state one good thing about their care and one thing that could be done in a better way, was welcomed by John Jackson as helpful. He stated also that the ‘Families and Friends’ test was operated by the hospitals. Moreover, Social & Health care workers made a point of talking to staff and users on their own. New techniques were continually being sought to gain information and  ...  view the full minutes text for item 113/15

12:00

Attached at JHO8 is a report produced by the Chairman updating the Committee on meetings she has attended and matters addressed since the last meeting.

The Forward Plan is attached at JHO8. Members are asked to prioritise items for the next meeting and issues to be scheduled in the future.

12:15 – Close of Meeting

Mr Keith Strangwood, Chairman of ‘Keep the Horton General’ requested that the Committee look at access to Oxford hospitals from Banbury in its forward plan to include statistics of patients travelling to Oxford from the north of the county. As an example, the endoscope had been suspended at the Horton Hospital and the South Central Ambulance Service had to travel to Oxford, through the roadworks, with their patients on board.

The Chairman acknowledged that this issue had been mentioned at a number of meetings with hospital managers. She agreed that the Committee would ask for assurance that this matter was being addressed and would ask for a report to be produced for the Committee. The report would encompass areas affected by roadworks in other parts of the county. Members of the Committee asked that information on parking at the Horton and the John Radcliffe Hospitals be included, together with information on how parking monies were used.

The Committee reviewed the current Forward Plan (JHO8) for the coming year.