Apologies were received from Councillor Alison Rooke (Councillor Jane Hanna substituting) and City Councillor Nadine Bely-Summers.

The following declarations of interest were noted:
Dr Alan Cohen is a Trustee of Oxfordshire Mind

Jean Bradlow’s husband is a consultant rheumatologist at the Royal Berkshire NHS Hospitals Trust.

Councillor Mark Cherry is registered with the Windrush Surgery.

To approve the minutes of the meetings held on 4 February 2021 (JHO3a) and 12 March 2021 (JHO3b) 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 (JHO3c – To Follow).

The minutes of the meetings on 4 February 2021 and 12 March 2021 were approved.

This meeting will be held virtually in order to conform with current guidelines regarding social distancing. Normally requests to speak at this public meeting are required by 9 am on the day preceding the published date of the meeting. However, during the current situation and to facilitate these new arrangements we are asking that requests to speak are submitted by no later than 9am four working days before the meeting i.e. 9 am on Friday 16 April 2021. Requests to speak should be sent to colm.ocaomhanaigh@oxfordshire.gov.uk together with a written statement of your presentation to ensure that if the technology fails then your views can still be taken into account. A written copy of your statement can be provided no later than 9 am 2 working days before the meeting.

Where a meeting is held virtually and the addressee is unable to participate virtually their written submission will be accepted.

The Chairman had accepted the following requests to speak:

Item 8 Community Services Strategy

Julie Mabberley

Bill Falkenau

Cllr Jenny Hannaby

Item 9 OX12 Task and Finish Group Report

Julie Mabberley

Cllr Jenny Hannaby

It was agreed to take Item 9 before Item 8.

10:15

The Committee’s Forward Plan is attached for consideration.

The Forward Plan was agreed.

10:20

A presentation to update on the key issues for the Oxfordshire system on the COVID-19 pandemic.

The Committee received a presentation on the system-wide response to the COVID-19 pandemic.  Ansaf Azhar, Director for Public Health, presented slides on the latest data which demonstrated a continuing drop in the number of new cases.  This he attributed to a combination of the vaccination programme, widespread testing, lockdown, social distancing and COVID-secure regulations.

The numbers in hospital from COVID had come down dramatically but there was still pressure on hospitals due to the long waiting lists that had built up for non-COVID issues.  The system was ready to respond if there should be another surge.

Ansaf Azhar responded to questions as follows:

·         Workplaces were the most common sources of new cases but numbers were low.  The return to school was well managed and there was only a small effect.

·         There was currently no intervention available that was guaranteed to achieve zero-COVID and the costs to people’s general wellbeing and the economy in trying to achieve that would be significant.

·         There was no measurement to document how many people were suffering from Long-COVID.  It was being studied closely but we were still learning about it.  Maintaining a healthy lifestyle was still the best way of recovering from COVID.

·         The number of new cases was back to where it was last summer but it never got down to zero then.  There were new more transmissible variants around this time and it was important that people continued to following guidelines and carry out the regular testing being offered.

·         The data was available on whether those who tested positive had been vaccinated but he couldn’t comment on specific cases.  The vaccine did not completely prevent infection but it would ensure that, if infected, the need for hospitalisation would be avoided.

·         In terms of excess deaths – which was a useful way to compare different regions – Oxfordshire was comparable to the national average in the first wave and below average in the second.

It was agreed to provide statistics comparing Oxfordshire to other counties that Public Health England group with us as similar counties.

Testing

Ansaf Azhar presented data on testing showing that the numbers of PCR tests were dropping as fewer people were presenting with symptoms.  There were now more sites open for LFD asymptomatic testing and kits could be collected from centres, including around 100 pharmacies.  The number of positive tests was very small but it was still important to detect them to stop the spread.

Ansaf Azhar responded to questions on testing:

·         The purpose of asymptomatic testing was to detect positive cases rather than give assurance from a negative result.  The figures showed that LFD tests, although less reliable, had detected 70 cases in Oxfordshire in one week.

·         Up to April 9 asymptomatic testing was focussed on the workplace but from that date the general public were encouraged to get tested twice a week.  He noted the feedback that this message was not widely understood and would look at new ways of communicating it.

·         Asked about people being reluctant to  ...  view the full minutes text for item 18/21

11:35

The paper aims to provide the Oxfordshire Joint Health and Overview Scrutiny Committee with an update on:

1.    Transfer of services provided by Oxfed

2.    Re-procurement of MSK services

11:50 BREAK

This had been a regular item on the Committee’s agenda but had been suspended while focus was on the pandemic.  The Committee had before it an update which included the transfer of services provided by Oxfed and the re-procurement of the MSK (Musculoskeletal) services.  It was agreed to take the report as read and invite questions.

Jean Bradlow noted that while individual professionals in MSK services were doing very good work, communications between different aspects of the service were poor – especially across county boundaries.  Since the commissioning of the new services was over a year away, she asked that this issue be addressed urgently.

Diane Hedges, Deputy Chief Executive, OCCG, accepted that there had previously been problems which had been discussed in the HOSC and had mainly been addressed but was not aware of any specific cross-boundary issues and asked for more information on that to be sent to her.  She added that one of the aims of the re-procurement was to put in place a more integrated service.  She accepted an offer from Dr Alan Cohen to go through the learnings of the prior Task and Finish Group and how these related to the new procurement.

12:45

This paper provides the final report of the OX12 Task and Finish Group and the response to that report by Oxfordshire Clinical Commissioning Group (OCCG) on behalf of the Oxfordshire health and social care system.

13:00 LUNCH BREAK

Before considering the report and the response from the Oxfordshire Clinical Commissioning Group, the Committee heard from the two following speakers.

Julie Mabberley, Chairman of the OX12 Stakeholder Reference Group, welcomed the final report but expressed disappointment that the Task and Finish Group had not met with the Stakeholder Reference Group since May 2019 and made no comment on the detailed project evaluation submitted by the Group.

She endorsed the final conclusion of the report that the OX12 project failed because of the poor management of the project, together with a poor level of engagement and communication with the residents of the OX12 postcode.

She believed that Wantage Community Hospital used to provide very good rehabilitation for patients and that these facilities were still required. Furthermore, the former Day Care Centre could provide supplementary services for those patients able to return home.

Julie Mabberley called on the Committee to ensure that OX12’s health and care needs were provided locally and effectively using all local health and care facilities including the Hospital, the Health Centre and the Day Care Centre going forward.

Councillor Jenny Hannaby supported the comments from the previous speaker and thanked the members of the Task and Finish Group and support officers for their work and thanked the Committee for its support over the years.  Wantage Town Council’s Health Committee had again called for the re-opening of the beds at the community hospital by whatever means it takes.  They believed that the hospital was much valued by residents for the professional care it gave for rehabilitation, enablement and end-of-life care.

The Committee considered the final report of the OX12 Task and Finish Group and its recommendations.  District Councillor Paul Barrow, Chair of the Group, summarised the report.  He stated that it had been sent to OCCG in January with a request to respond by the end of March.  They had instead sought to cover the OX12 issue under the broader Community Services Strategy but that paper was only circulated two days before this meeting.

The Task and Finish Group had thought that the needs assessment framework was essentially a good idea.  However, they believed that the way in which it was carried out was wholly inadequate as outlined in the report.  In their view such a framework should only be repeated once the criticisms of the Task and Finish Group have been taken on board.

Councillor Barrow asked the Committee to support the recommendations in the report and that the Committee’s previous call to reopen beds in Wantage Community Hospital be acted upon now.

Diane Hedges, Deputy Chief Executive, OCCG, responded that everyone was agreed that they needed to work towards achieving the highest possible footfall for Wantage Hospital but that there was disagreement on the best range of services to achieve this.  She was disappointed to hear the views of the Task and Finish Group that the framework had not worked.

Diane Hedges noted that the Joint Strategic Needs Assessment had identified that there was not  ...  view the full minutes text for item 20/21

12:00

An update on the Community Services Strategy.

Before receiving the presentation, the Committee heard from the following three speakers:

Julie Mabberley welcomed the document but noted that the timetable and actions looked very similar to those outlined at HOSC in September 2018.  She asked if the governance was now in place and if resources had been made available.  The Oxfordshire A&E Delivery Board urgent care work, due to be completed by the end of April, needed to be set alongside this to ensure completeness.

She noted that the timetable showed a period of 17 months and hoped that they would not have to wait that long for services to be brought to OX12.  She described the role that the community hospital had played before closure in helping patients through the transition from acute hospital to home.  In looking forward to the community involvement in this strategy, she reported that members of the stakeholder group would be happy to be involved.

Bill Falkenau, Clerk of Wantage Town Council, reminded the Committee that he had previously spoken at the Committee meeting in February 2020 and had asked on behalf of Wantage Town and Grove Parish Councils that the OX12 Report be withdrawn and that the beds temporarily closed at Wantage Community Hospital be reopened.  The concerns expressed at the time had been fully justified by the report of the Task and Finish Group that was considered under Agenda Item 9.

He believed that the Community Services Strategy paper had merit but appeared to have the effect of kicking the issue of the inpatient beds in Wantage further into the “long grass” for a prolonged period which was unacceptable.  The Legionella risk had been dealt with since last September and he believed that there was now no legal justification for the beds to remain closed.  He called for the reopening of the beds prior to work on the Community Services Strategy proceeding.

Councillor Jenny Hannaby referred to Page 5 of the presentation in Addenda 2:  where it recognised that OX12 residents needed to have confidence in their access to effective rehabilitation whether in hospital or at home.  She said that the question was “what hospital?” – Wantage or having to travel across the county?

Councillor Hannaby asked for the evidence that safe services can be provided long-term at home, free at the point of need.  She noted that during the pandemic, patients who were not yet well enough to go home were put in a hotel with agency staff when they could have been looked after in Wantage Community Hospital.

Councillor Hannaby asked how much developer funding had been drawn down since OCCG took over primary care commissioning.  She believed that there was £1.2m currently held by planners and suggested that some of that could be used to fund the proposed strategy.

Councillor Mike Fox-Davies noted that the strategy appeared to be very similar to one which was presented to a meeting in Didcot in late 2018.  He drew attention to Page 6 of the presentation which  ...  view the full minutes text for item 21/21

13:30

Report on views of health care gathered by Healthwatch Oxfordshire.

The Committee had received its regular report from Healthwatch Oxfordshire on the views of the public on health and social care services.  Rosalind Pearce added some comments on the issues that had arisen at this meeting:

·         Agreed that the message on regular COVID testing had not been widely received and was happy to work with the Director for Public Health on that.

·         Agreed that the plans to deal with treatment waiting lists need to be seen.

·         While patients may be given the option to go out of county for treatment, there may barriers to that.  It would be helpful if there was support with travel costs and if they could be assured that the next appointment will be local.

·         They are still receiving some negative feedback on MSK services and will look for patient involvement in the commissioning of the new service.

·         With regard to the 17 month timeframe for the Community Services Strategy, she noted that the move to one CCG over the BOB area (Bucks, Oxon, Berkshire West) was due in April 2022 and the Committee should seek assurances that decisions on the strategy will still be taken locally.

·         A recent Healthwatch report identified that some GPs’ websites were asking for proof of identity in order to register which was clearly not allowed under the NHS guidance.

Rosalind Pearce responded to members’ questions as follows:

·         She stated that she was happy to send all Healthwatch Oxfordshire reports to the Committee Secretary for circulation to members.

·         They had not yet done work on experiences of self-isolating.  She believed that the issue of digital exclusion would be important in that, given how health services are asking patients to go online more.

·         She agreed to do some work to identify which GP practices have no Patient Participation Group (PPG) or an inactive PPG and then consider how to support these cases.  Existing and active PPGs are supported with advice and webinars.

·         Healthwatch England was participating in a working group on the government’s coming White Paper on Integrated Care Systems.  She believed that there was a commitment to local engagement in the BOB region but the challenge would be in the integration part of their work.

The Chairman and members of the Committee thanked Rosalind Pearce for the report.

13:45

To include an update on:

·         Buckinghamshire, Oxfordshire and Berkshire West (BOB) Health and Overview Scrutiny Committee (BOB HOSC)

·         Scrutiny of the Community Services Strategy

·         Committee briefings and communication

The Committee considered the Chairman’s Report on developments and communications since the last Committee meeting.

Barbara Shaw noted that the commissioning of the MSK service, which will operate across the BOB (Bucks, Oxon, Berkshire West) region, will be an in interesting test on how processes will work at that level and what input this Committee will have.

The Chairman thanked members for their work over the previous four years.  In particular, he wished Councillor Mike Fox-Davies well, as he was the only elected member of the Committee not seeking re-election.