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Agenda and minutes

Venue: Rooms 1&2 - County Hall, New Road, Oxford OX1 1ND. View directions

Contact: Colm Ó Caomhánaigh, Tel 07393 001096  Email: colm.ocaomhanaigh@oxfordshire.gov.uk

Items
No. Item

1/20

Apologies for Absence and Temporary Appointments

Minutes:

Apologies were received from the following Committee Members:

 

Councillor Mike Fox-Davies

District Councillor Sean Gaul

Councillor Hilary Hibbert-Biles (substituted by Councillor Nick Carter)

District Councillor Neil Owen

 

Apologies were also received from Tracey Rees, Chair of Healthwatch.

 

2/20

Declarations of Interest - see guidance note on the back page

Minutes:

Dr Alan Cohen declared a personal interest as a Trustee of Oxfordshire Mind.

3/20

Minutes pdf icon PDF 243 KB

To approve the minutes of the meeting held on 21 November 2019 (JHO3) and to receive information arising from them.

 

For ease of reference when considering the Matters Arising from the minutes, a list of actions is attached at the end of the minutes.

 

Additional documents:

Minutes:

The minutes of the meeting on 21 November 2019 were approved and signed with the following amendments:

 

Items 64/19 and 67/19: replace “NHS Private” with “NHS Public”

 

Item 67/19, Agenda Page 6, fourth paragraph: replace “Laura” with “Louise”

and second last paragraph, replace “David Bretherton” with “Paul Barrow”

 

4/20

Speaking to or Petitioning the Committee

Minutes:

The Chairman had agreed to the following requests to speak at this meeting:

 

Agenda Item 6 OX12 Planning for Future Population Health and Care Needs Framework

Julie Mabbeley, Chair, Stakeholders’ Reference Group

Bill Falkenau, Clerk, Wantage Town Council

Maggie Swain, Save Wantage Hospital Campaign Group

Councillor Jenny Hannaby, Grove and Wantage

 

Agenda Item 7 OCCG Update

Liz Peretz, Oxfordshire Keep Our NHS Public

Councillor Stefan Gawrysiak, Henley-on-Thames

Town Councilllor Ian Reissmann, Henley-on-Thames

 

It was agreed to take two of the speakers on Item 7 at this point.

 

Councillor Stefan Gawrysiak stated that there had been no consultation with the community over the closure of the Sue Ryder hospice at Nettlebed.  He asked the Committee to support his view that this was a major change of service requiring a statutory consultation period.  Alternatively, the Committee must ask the CCG to look at providing alternative hospice care.

 

Town Councillor Ian Reissmann added that the hospice had been rated “Outstanding”.  He believes that it needs to be explained to the public how the needs of the area will be met.  He also believes that this change in service required a public consultation process, as services for people in the area were moving location to the Royal Berkshire Hospital.  He called on the CCG to engage with the community and HOSC on the matter.

 

5/20

Forward Plan pdf icon PDF 238 KB

10:15

 

The Committee’s Forward Plan is attached for consideration.

 

Minutes:

The forward plan was agreed.

 

6/20

OX12 Planning for Future Population Health and Care Needs Framework pdf icon PDF 284 KB

10:20

 

To scrutinise the outcome of the implementation of the ‘Planning for Future Population Health and Care Needs Framework’ in the OX12 Locality.

 

A report from the HOSC Task and Finish Group on the roll out of the Framework will follow later as an addendum.

 

Additional documents:

Minutes:

Julie Mabberley, Chair of the Stakeholders’ Reference Group, stated that she had circulated a letter to members of the Committee earlier.  She was disappointed in the process.  There is a wealth of data on current needs but nothing of future needs.  The report did not provide a basis for future decisions and she supported the Town Council call for it to be withdrawn.

 

Brian Falkenau, Clerk, Wantage Town Council, had already circulated the views of the Town Council to Members of the Committee.  He stated that the report’s contention that the area was well served was not credible.  He called for the beds to be re-opened.  The figures used to justify them remaining closed were superficial and took no account of seasonal demand.  The Town Council had not been invited to take part in the process.  They would like to participate and access the data but, in the meantime, they asked for the report to be withdrawn.  Grove Parish Council supported this request.

 

Maggie Swain, Save Wantage Hospital Campaign Group, noted that the only definite proposal in the report was not to re-open the beds – everything else was suggestions.  She disputed the figure of 12 beds, saying that there were 18 when she last worked in the hospital.  Given the problem with bed-blocking and shortage of care workers in the county, the hospital could assist with that problem.

 

Councillor Jenny Hannaby, Grove and Wantage, stated that she had agreed to go along with the Stakeholders’ Reference Group when it was proposed by HOSC, as she wanted an outcome to help with primary care in the town which had a growing population but was losing infrastructure.  She believes that Oxford Health had already decided that they wanted to close the beds and she has no confidence in any consultation process.  She asked that the report be withdrawn until there was a county-wide strategy for community hospitals.

 

Councillor Alison Rooke introduced the report from the Task & Finish Group.  She thanked the members of the group for their hard work, especially the Chair, Councillor Mike Fox-Davies, and the policy officers, Sam Shepherd and Martin Dyson.

 

The Chairman welcomed Louise Patten, CEO, to her final meeting with HOSC before she leaves her post.  He stated that she had built a very good relationship with the Committee, despite disagreeing on certain areas.  He wished her well.

 

Louise Patten described the background to the report.  The Framework had been agreed by the Health and Wellbeing Board after consultation with HOSC.  This report described current needs.  No decisions had been made.  The next step would be consultation.  She said that services and beds were separate issues.  There was still a lot of work to do to draw out further information on community assets.  There are no plans to close the facility – it could be adapted for other uses.

 

Jo Cogswell, Director of Transformation at OCCG, added that it was the first time this Framework had been used and they have learned  ...  view the full minutes text for item 6/20

7/20

Oxfordshire Clinical Commissioning Group Update pdf icon PDF 171 KB

12:00

 

This item will provide a report on the key issues for the CCG and outline current and upcoming areas of work. Including an update on

 

·         Sue Ryder Joyce Grove Hospice

·         Winter Plan

·         Horsefair Surgery

 

 

Minutes:

Liz Peretz, Oxfordshire Keep Our NHS Public, stated that winter pressures were leading to long queues and early discharges.  Some people discharged under Home First have been sent back to the hospital queue because they are not assessed at the hospital but at home.  Although 10 more reablement staff are being recruited, she asked if it will be possible to recruit them or if they will end up being agency staff?  She urged the Committee to review the system in three months.

 

 

Sue Ryder Joyce Grove Hospice

 

Louise Patten stated that the hospice had reported the number of requests had reduced significantly leaving them with empty beds and staff that could be better used in Hospice at Home.  It was a decision of the Governors to close. The CCG was working with them to identify alternative beds.  There is capacity at the Duchess of Kent Hospice in Reading.  The CCG will monitor the situation going forward with full transparency.

 

Councillor Laura Price asked about the advice line and day services run by the provider.  Louise Patten responded that the CCG is still in active dialogue on those points.

 

Barbara Shaw asked if the reduction in hospice need was related to slow discharge from hospital.  Louise Patten responded that it was a challenge getting patients out of hospital.  The final stages are funded by Continuing Healthcare.  The numbers are relatively low.  The CCG will look at this with Sue Ryder.

 

Councillor Alison Rooke noted that not all care homes are equipped for hospice care and asked how many were.  She also asked how many in the Home First programme were re-admitted to hospital.

 

Louise Patten responded that the report is referring to where a care home is treated as a person’s home.  Hospice at Home is more appealing to clinicians and therefore easier to recruit to.  On Home First, there is an assessment before discharge.  People can be disempowered in hospital but gain more independence at home.  She didn’t have the figures for re-admissions but it is monitored.

 

The Chairman accepted that it was the charity’s decision to close and there was no requirement for a formal consultation.

 

It was AGREED that the Committee needs to look at hospices and how they are funded.  This was timetabled for the June meeting.

 

 

Horsefair Surgery

 

Councillor Mark Cherry asked for assurances that everything is moving in the right direction and the crisis situation will not happen again.

 

Louise Patten stated that the contract has transferred to a local provider with a strong reputation.  The action plan is progressing and the CCG continues to monitor.

 

MSK Services

 

Alan Cohen thanked her for the information provided on Healthshare’s quality of care.  He noted though that there was little data on improvement.  He asked if an independent review would be helpful.  Louise Patten responded that she would consider it and that a conversation outside of the meeting could assist with determining how best this could be achieved.

 

 

Winter Plan

 

Barbara Shaw noted information on  ...  view the full minutes text for item 7/20

8/20

Mental Health pdf icon PDF 172 KB

13:15

 

To follow an item at a Performance Scrutiny meeting on the 4th of February.

 

A report has been written on the council’s mental health activity and spend which covers:

 

a) The Section 75 Partnership agreement between OHFT and OCC covering the delivery of social work and the outcome of the transfer of the Older Adult Mental Health Team back into the council. It also includes team performance, the number of people supported and an overview of s. 117 funding.

 

b) The Mental Health Outcomes Based Contract between OHFT and OCCG (OCC contribute funding to this contract) covering the delivery of all mental health support to people with particular conditions, including inpatient care, community support, wellbeing and employment support, housing, and Care Act assessed social care needs to include:

 

• How are mental contracts being fulfilled and delivered

• The outcomes being delivered for the people of Oxfordshire

 

Additional documents:

Minutes:

Stephen Chandler, Corporate Director for Adult Services, summarised the reports.  He introduced Karen Fuller, Deputy Director for Adult Social Care, who is on the Joint Management Group that has oversight and provides assurance on the budget.

 

The report includes an overview of S117 funding which relates to aftercare for people who have been detained in hospital under the Mental Health Act.  Responsibility rests with the psychiatrist who consults with the Multidisciplinary Team.  Performance has been mixed with some cases not reviewed for several years.  Under a joint protocol, Oxford Health is ensuring that reviews are conducted regularly and the LAS system is up to date.

 

Councillor Liz Brighouse, Chair of the Performance Scrutiny Committee, gave a summary of that Committee’s discussion on the same issues.  The Committee welcomed the wider overview of mental health partnerships.  It heard about the clarity being given to individual cases that may come under S117 and/or NHS funding.  The Committee was also pleased to see that health issues are not being moved over to the Adult Social Care area.

 

There was discussion of Looked After Children (LACs) including concern at the numbers and that many may involve mental health issues of the parents.

 

On the Outcomes Based Contract (OBC) the Committee welcomed greater Council engagement, especially to ensure that young people with autism receive appropriate services.  The discussion highlighted the extent of reliance on the voluntary sector – something many Members were unaware of until last year’s budget discussion.

 

The Committee discussed the two-year extension of the contract and is keen that the Council plays a role in ensuring greater scrutiny and transparency.  They were pleased to hear of the improved processes being followed to ensure that the system was not so reliant on individuals.

 

Councillor Liz Brighouse added that investment in mental health was less than what was needed – all of the money is being used to avoid crisis point.  Any extra money needs to be matched by the NHS.  Directors and councillors need to be involved in reviewing to discuss funding issues and clarify management costs.

 

Stephen Chandler stated that, while the contract has been extended for two years, there will be a review which will involve both Council and CCG officers.  The budget about to be discussed by Full Council includes three items under mental health: one-off support; transformation work and the reversal of the reduction to the mental health staffing contribution.

 

Louise Patten stated that the review was agreed along with the two-year extension.  It is important that goodwill is not lost in advance of negotiations on the next contract.

 

Alan Cohen noted that the delivery of some statutory services was dependent on the voluntary sector which often struggles to raise funds.  He recalled hearing in a briefing in February 2019 that more funding was expected from the NHS.  He asked if that had happened and if it went to statutory services.

 

Louise Patten responded that a benchmarking exercise indicated that services were underfunded.  The CCG is in contractual discussions  ...  view the full minutes text for item 8/20

9/20

Director of Public Health Annual report pdf icon PDF 3 MB

14:30

 

An Annual Report is a statutory duty of the Director of Public Health and it is a duty of the County Council to publish the report.  The Director of Public Health for Oxfordshire will present a draft of his Annual Report for 2018/19.

 

He will also present an update on the 2017/18 recommendations for 2018/19.

 

Additional documents:

Minutes:

Ansaf Azhar presented a draft of his annual report.  It is a statutory requirement for the Director of Public Health to deliver an annual report by the 31 March.  Traditionally this has been a rich set of data but this year he is taking a different approach and using the report to signal a new direction – a focus on inequalities.

 

While across Oxfordshire most performance indicators are green, if you look at the ten wards that contain areas that are among the most deprived in the country, you see a lot of red ratings.  There is a 15-year life expectancy gap in some cases.

 

The new approach will be driven by a prevention framework.  This year the Joint Strategic Needs Assessment (JSNA) will take the three most deprived wards and create a ward profile which will include health data, community insight and mapping of community assets.  This will help identify solutions particular to that area.  The first to be profiled will be Banbury Ruscote and then Blackbird Leys.

 

The Chairman thanked the Director for his presentation.  He noted the success of the FAST Card in Banbury which is encouraging more physical activity in areas where this was lacking.  Ansaf Azhar added that the card’s success has led to it being expanded to Bicester and Kidlington.

 

Councillor Alison Rooke asked how progress will be measured.  Ansaf Azhar said that there are recommendations from various bodies on what to measure and these will be included in the plan.

 

Councillor Nadine Bély Summers asked if Littlemore will be included in the ward profiles.  Ansaf Azhar responded that the second area may not be just Blackbird Leys but all of the Leys.

 

Councillor Mark Cherry said that he looked forward to meeting the Director in Banbury Ruscote.  The difficulties there included a lack of social housing and educational attainment.  Ansaf Azhar agreed that they needed to take the community with them.  This would involve culture change.

 

Barbara Shaw stated that they need to work closely with education to get the message out, to change the aspirations of people who currently have to focus on living day to day.  She asked how the plan would be rural-proofed.

 

Ansaf Azhar responded that they would work with Town Councils to understand the problems in their areas.  He also believed simply walking around the areas was very useful.

 

District Councillor Paul Barrow welcomed the development of healthy new towns but asked how existing communities can be ‘retrofitted’.  Ansaf Azhar responded that every place had a different solution.  It’s about community activation.

 

Councillor Alison Rooke asked if there was any duplication between the ward profile work and the needs framework as used on OX12.  She also noted that tangible changes of this kind can take a long time – perhaps 10 or 20 years.

 

Ansaf Azhar gave the example of Banbury which, as a town, is not much different from the national average.  However, at ward level there are big differences.  He believed that there were some  ...  view the full minutes text for item 9/20

10/20

HWB Voluntary Sector Network pdf icon PDF 276 KB

15:10

 

Healthwatch Oxfordshire present the findings of a review on how effective the Oxfordshire Wellbeing Network (OWN) network is at feeding in views to the Board.

 

Minutes:

Rosalind Pearce reported on the network meeting.  Over 100 people attended from 75 organisations.  The issues that most affect wellbeing emerged as being: isolation, transport, access and information.

 

The event was not as successful as hoped at reaching communities that are seldom heard.  The next event will be in Blackbird Leys and will be more community focused.  Healthwatch is engaging with community groups to plan the event.  In the meantime contacts continue electronically and by phone.

 

District Councillor Paul Barrow asked if district councillors were invited.  Rosalind Pearce confirmed that they were and a few attended.

 

Alan Cohen asked about voluntary organisations at risk.  Rosalind Pearce responded that they were doing a lot of good work but are coming under pressure to deliver more.  The problems are not unique to Oxfordshire.

 

Barbara Shaw noted that fundraising was becoming more difficult and local authorities need to think carefully about their reliance on the voluntary sector to deliver services.  Many organisations are running on deficits.

 

The Chairman AGREED that this issue is something the Committee needs to find time to discuss in its packed agenda.

 

11/20

Healthwatch Report pdf icon PDF 242 KB

15:40

 

Report on views of health care gathered by Healthwatch.

 

Minutes:

Rosalind Pearce summarised the report.  Their report on Mental Health will be published by March 2020.  They compiled a lot of information from users and staff in services under the Mental Health Partnership.  The report on boaters and bargers will be published by the end of February.  They continue to monitor Healthshare and plan to visit in March.  Social care and pharmacists will be the focus next year.

 

Councillor Alison Rooke asked where professional scrutiny is with pharmacists, to ensure that they are giving good advice.  The Chairman AGREED to request a report on that.

 

Barbara Shaw asked about work with the Traveller community.  Their health outcomes are among the poorest.  Rosalind Pearce responded that they had tried a few years ago.  It is their intention now to focus more on communities lthat are harder to reach.

 

12/20

Chairman’s Report pdf icon PDF 519 KB

15:50

 

To include updates on

·         Horton HOSC

·         Child and Adolescent Mental Health Services (CAMHs)

·         Muscular Skeletal Services (MSK)

·         Process and learning around suicide

 

Additional documents:

Minutes:

Barbara Shaw stated that she was impressed with the responses on CAMHS.  She noted the increasing levels of mental health needs among children and expressed concern that this was eventually going to feed through to higher demands on adult mental health services which are already stretched.

 

The Chairman responded that it was unclear whether there was really an increase in mental health problems or whether more issues were emerging because people are more comfortable talking about their mental health now.