Agenda and minutes

To elect a Chairman for the municipal year 2016/17.

Cllr Yvonne Constance was elected Chairman for the forthcoming municipal year 2016/17.

To elect a Deputy Chairman for the municipal year 2016/17.

District Cllr Nigel Champken-Woods was elected Deputy Chairman for the municipal year 2016/17.

Apologies for absence were received from Cllr Kevin Bulmer and District Cllr Monica Lovatt.

There were no declarations of interest.

To approve the minutes of the meeting held on  21 April 2016 (JHO5) and to receive information arising from them.

The Minutes of the meeting held on 21 April 2016 were approved and signed as a correct record subject to the following amendments:

Minute 23/16 – public address made by Cllr Hilary Hibbert-Biles – bullet point 1 – to delete the words ‘and did not have’ to read:

‘The 2011 contract had made clear that the beds were defined as ‘sub-acute intermediate care status.’

and in bullet point4  - to delete the words ‘staff expertise’  to read:

‘This constituted a waste’.

The Chairman had agreed to the following speakers:

Maggie Swain (Secretary of the Wantage Hospital League of Friends and a member of ‘Save Wantage Hospital Campaign Group’ and Julie Mabberley a member of ‘Save Wantage Hospital Campaign Group’; and Cllr Jenny Hannaby as local member for Wantage – all in relation to Agenda Item 12 – Chairman’s Report; and

Joan Stewart ‘Oxfordshire keep our NHS Public’ – in relation to Agenda Item 8 ‘Health & Care Transformation in Oxfordshire Update’.

Maggie Swain and Julie Mabberley, speaking together, stated that, in their view, there had been much misinformation about the status of Wantage Hospital and wished to make the following points in addition to the facts already known:

·         The Hospital was scheduled to close its doors to in-patients the next day. Staff and patients appeared to be unaware of the closure and it also appeared to be the imminent closure that the Trust had stated it was trying to avoid;

·         Nearly 10,000 people had signed a petition and over 400 people had marched through Wantage Town Centre recently to demonstrate support for keeping the hospital open;

·         Although bacteria had been present in the water system last year, action had been taken and no bacteria had been detected this year – there was currently no risk to patients. The bacteria was eradicated in January without moving the patients;

·         In their view Legionella bacteria had been detected in other hospitals within the Trust, but there had been no other imminent closure;

·         Although the Trust had stated that they would that they would keep Physiotherapy and Maternity services at the Hospital open, the doors of the Physiotherapy services ‘were locked and the lights were out’;

·         In their view, because of the lack of maintenance in the Hospital over the years, there was a large amount of remedial work that needed to be done to the building; and it would be easier and cheaper to do this at the same time as replacing the water pipes. The Trust had informed them that the £300k that it was believed would be the cost of the renovations, was currently available;

·         They believed that the handling of the situation had been ‘badly managed’, staff were worried about their jobs and without sufficient staff the Trust would seek to close the facilities.

They asked the Committee to confirm that there was no imminent risk to the patients and therefore no reason to close the hospital on safety grounds. They asked that the Hospital be kept open to in-patients until the results of the consultation were known.

Cllr Jenny Hannaby, local member for Wantage, referred to the letter from this Committee sent to Oxford Health following discussion at the February 2016 meeting, seeking clarification on a number of areas. The letter, Oxford Health’s reply and their subsequent press release was attached the Agenda as part of the Chairman’s report (Agenda Item 12). She stated her belief that the Committee had not devoted sufficient time to scrutinising the associated issues  ...  view the full minutes text for item 36/16

10:10

A draft Forward Plan is attached for consideration (JHO7).

The Committee had before them the draft Forward Plan (JHO7).

It was AGREED that business for the 15 September 2016 meeting be as follows:

·         Rebalancing the System – Pilot Evaluation

·         Transformation – Consultation Outline and next steps

·         Director of Public Health’s Annual Report and observations

·         Quality of and Availability of Care in Private Care Homes

It was noted that the item on travel and access to Hospitals would be postponed to November to take account of the County Council’s travel plans which were due to be published in the Autumn.

10:15

Stuart Bell, Chief Executive of Oxford Health and Chair of Oxfordshire’s Transformation Board, will give a presentation on the development of system-wide Transformation Plans that will cover:

·         The case for health and care transformation in Oxfordshire;

·         Key messages from the Oxfordshire, West Berkshire and Buckinghamshire five year Sustainability & Transformation Plan;

·         Emerging work streams in the Transformation Programme;

·         Plans for public consultation and engagement on the proposed future models of health and care in Oxfordshire.

The Chairman welcomed Stuart Bell, Chief Executive, Oxford Health & Chair of Oxfordshire’s Transformation Board to the meeting. He was accompanied by:

·         Dr Joe McManners, Clinical Chair, Oxfordshire Clinical Commissioning Group (OCCG);

·         Damon Palmer, Transformation Programme Director, OCCG;

·         Dr Barbaria Batty, Dr Shelley Hayles and Dr Kiren Collison, OCCG (leads for the work on Urgent & Emergency care, Planned Care and Maternity, respectively).

Andrew Stevens, Director of Planning & Information, Oxford University Hospitals NHS Foundation Trust (OUT) was also in attendance.

Stuart Bell gave a presentation entitled ‘Health & Care Transformation in Oxfordshire, copies of which were attached to the Addenda for the meeting. Also attached was the ‘Oxfordshire Health & Care Transformation Communications & Engagement Strategy 2016 – 2017.’ He emphasised that there was a need for a proper discussion with stakeholders about how the consultation was to be undertaken before a formal consultation was embarked upon. Moreover, that the OCCG, who represented formal leadership of the Plans, recognised this also. There was also a need to secure the support of NHS England to the Plan, whose role it was to take a clinical view across the whole of the Thames Valley region.

The Chairman noted that the Transformation Programme, as presented in June, was now on the web. Damon Palmer undertook to circulate the web link to members of the Committee.

Following the presentation, members asked a number of questions.

Stuart Bell noted a plea for the consultation to be undertaken in a properly transparent manner, using clear, jargon - free language and any specifics to be clearly bullet-pointed in the final report also. Stuart Bell explained that it was the intention to make clear the options at the outset and the specifics would then follow. He welcomed suggestions on running the consultation and that an impact assessment would be completed. Furthermore, that the engagement of hard-to-reach communities and minority ethnic communities had been considered as a critical part of the consultation process.

A Committee member commented that sufficient transport networks to accessible venues for consultation meetings were also of great importance, particularly in light of reduced bus services. A member also advocated that the Team should go into schools to demonstrate the use of smart phones, particularly for use by young people suffering from mental health problems. To make the consultation more comprehensible to the public, it was suggested that the consultation could include visits to GP/Hospital waiting rooms, where people could be informed of the plans (a very simplified version) and asking for views together with any problems encountered. Specific instances could then be added to the consultation.  Stuart Bell agreed that consultation in waiting rooms and schools had been recognised as a good idea and had been put forward previously.

A member commented that it was paramount that the public understand the need for cultural change, and it was also crucial to bring with it the trust of the public by being open and transparent. Any swell of public opinion needed to be listened to. Mr Bell responded that in  ...  view the full minutes text for item 38/16

11:45

A presentation will be given by representatives from NHS England on Representatives from NHS England on healthcare in prisons and Immigation Removal Centres (IRC) in the county. A report is also attached entitled ‘Health & Justice Commissioning for Oxfordshire Prisons and IRC in Oxford (JHO9).

The Chairman welcomed Sue Staddon, Head of Health & Justice Commissioning, NHS England South. She was accompanied by the following representatives:

Nikki Luffingham, Deputy Director of Health & Justice Operations and Delivery, NHS England

Victoria Kurrein, Regional Service Manager, Thames Valley Prisons Cluster, IRC & SARCs – Care UK

The Committee had before them a report (JHO9) entitled ‘Health & Justice Commissioning in Oxfordshire Prisons & Immigration Removal Centres (IRC) in Oxford.’ Sue Staddon gave a presentation on healthcare in custody in Oxfordshire. At the end of the presentation the meeting was opened out to questions from members of the Committee.

A member asked whether smoking had been banned generally in prisons to bring them in line with the ban on smoking in public places, in light of concerns raised about passive smoking. Sue Staddon responded that there had been a move to implement a non-smoking policy in prisons, but there had been concerns expressed by staff with regard to how it would impact on some priority prisoners.

A member asked what the flashpoints were in terms of assessment for vulnerable prisoners released back into the general population, for example, older prisoners, and prisoners with a learning disability. It was explained that the County Council commissioned and was responsible for the social care of prisoners. Victoria Kurrein stated that it was a challenge to get prisoners assessed for their physical needs. However, on their release, they would have been assessed prior to their release.

In response to a question asking who was responsible for the scrutiny of NHS England delivery, it was explained that this was undertaken by Public Health England, the Home Office and the Ministry of Justice. A national Board regulated the Partnership Board of South and London. There were regular contact meetings with providers to look at performance, key performance indicators and Health Justice performance indicators. A national Quality workstream in NHS England paid regular quality visits. Inspections were undertaken by HMI of Prisons, and Care Quality Commission inspectors who worked with the Independent Monitoring Board (IMB).

A member asked what constituted success in judging how much health care to give a person, particularly to those in Bullingdon prison, and what constraints were there in commissioning care and support for people with a mental health condition, for example. Sue Staddon responded that people in prisons were entitled to exactly the same health care as a people outside of the service would receive. For example, there was strong scrutiny given in the event of a death of a prisoner. A probation report was commissioned, as was a clinical review. The aim was to reduce deaths whilst in prison and good health outcomes were looked for. She also stated that it was about keeping offenders safe but the reality was to try to provide the best environment possible within the constraints. Moreover, the specification was set nationally and was very strong in its emphasis on the same measurement of primary and secondary care for prisoners. She added that some care such as  ...  view the full minutes text for item 39/16

12:45

Officer representatives from the Health & Wellbeing Board will attend to provide an overview of their Strategy for 2016/2017 (JHO10).

The Chairman welcomed Jackie Wilderspin, Public Health Specialist, OCC and Ben Threadgold, Policy & Performance Service Manager, OCC to the meeting. The Committee had before them a proposed, revised draft for 2016 of the Joint Health & Wellbeing Strategy for Oxfordshire (JHO10) which was scheduled to be considered at the 14 July 2016 meeting of the Oxfordshire Health & Wellbeing Board. The views of the Committee were sought.

Following discussion it was AGREED that the following comments be conveyed to the Board:

·         The Board consider a major revision of the Strategy next year (2017-18). The Strategy was first agreed in 2012 and had been reviewed on an annual basis;

·         There were examples of repetition within the document;

·         Consideration needed to be given to the wider impact of wider changes, for example, the impact of changes to bus services on the likelihood of people being lonely, the effect of funding changes to housing related support, or the result of changes to Children’s Centres;

·         The information on reablement was likely to be incomplete as it did not include people who were self-funding their care;

·         Some proposed outcomes appeared to be reducing the level of ambition – including some topics where proposed targets were lower that they were last year;

·         The Delayed Transfers of Care target appeared to be too low;

·         It would be helpful for an Executive Summary to be included for ease of reference. In addition a full summary of the previous year’s performance be included within the strategy document so that the context for the proposed outcomes could be more fully understood;

·         There was too little detail on who implemented the work to meet the outcomes and how they were held to account;

·         It was unclear what the plans were to meet the ambition/targets;

·         There was no information on how the Strategy linked to the Sustainability and Transformation Plan;

·         There was insufficient information on why some targets were not met last year, for example, smoking cessation, drugs treatment; and

·         The narrative on physical activity did not refer to active travel, though there is a cross reference within the Local Transport Plan proposals. This should be cross referenced.

13:15

An update report on Healthwatch Oxfordshire activities is attached at JHO11.

The Chairman welcomed Carol Moore, Chief Executive of Healthwatch Oxfordshire up to the table. The Committee had before them the latest update report on Oxfordshire Healthwatch activities (JHO11).

With reference to HWO’s report on their work with refugees at source and the proposal, which had been refused, to expand it to include detainees, a member encouraged the Committee to work with HWO in order to assist in the collation of information.

The Committee thanked and congratulated Carol Moore, who was leaving HWO, for all her much appreciated work in bringing some very important information to the Committee and wished her well for the future.

The Committee AGREED to:

(a)  thank HWO for the report; and

(b)  request HWO to follow up with the OCCG whether the work of  outreach workers for the gypsy traveller sites was picked up either by temporary staff or by health visitors, in the event of long term sickness and how much emphasis was given to public health issues for children living in the private sites.

13:25

The Chairman will update the Committee on meetings attended since the last meeting (JHO12).

The Committee received the update from the Chairman on meetings attended since the last meeting (JHO12).

Members took this opportunity to both welcome a new member to the Committee, District Cllr Jane Doughty, representing West Oxfordshire District Council, and to thank Hannah Iqbal, Policy Officer, who had since left the County Council, for all her hard work for the Committee and wished her well in her future employment.

The Committee is briefed on the following (JHO13):

·         Health Inequalities Commission – briefing – there will be a substantive item on the November meeting’s Agenda;

·         Oxford Health NHS Foundation Trust: Striving to Improve Care - briefing.

The Committee noted the following:

·         Oxfordshire Health Inequalities Commission – Briefing; and

·         Oxford Health NHS Foundation Trust: Striving to improve care briefing 2016