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Agenda and minutes

Venue: County Hall, New Road, Oxford OX1 1ND

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

Link: video link: oxon.cc/OJHOSC24062021

Items
No. Item

24/21

Election of Chair for the Council Year 2021-22

Minutes:

Councillor Jane Hanna was nominated by Councillor Nathan Ley and seconded by Councillor Charlie Hicks.

 

Councillor Jane Hanna was elected Chair for the Council Year 2021/22.

 

25/21

Election of Deputy Chair for the Council Year 2021-22

Minutes:

City Councillor Jabu Nala-Hartley was nominated by Councillor Charlie Hicks and seconded by District Councillor Andy Foulsham.

 

Councillor Jabu Nala-Hartley was elected as Deputy Chair for the Council Year 2021/22.

 

26/21

Apologies for Absence and Temporary Appointments

Minutes:

Apologies were received from:

 

Councillor Nigel Champken-Woods (who was to be substituted by Councillor Nick Field-Johnson but he had to give apologies on the day of the meeting)

 

District Councillor Paul Barrow (substituted by District Councillor Andy Foulsham).

 

City Councillor Amar Latif (substituted by City Councillor Jabu Nala-Hartley)

 

27/21

Declarations of Interest - see guidance note on the back page

Minutes:

The following declarations of personal interest were noted:   

·         Councillor Charlie Hicks as a Flexible Healthcare Assistant at Oxford Health NHS Foundation Trust and a family member who is a GP in Oxfordshire.

·         Dr Alan Cohen as a Trustee of Oxfordshire Mind

·         Jean Bradlow whose husband is a consultant rheumatologist at the Royal Berkshire NHS Hospitals Trust.

·         City Councillor Jabu Nala-Hartley as a member of the Socialist Health Association.

·         Councillor Jane Hanna as Chief Executive Officer of SUDEP Action.

 

28/21

Minutes pdf icon PDF 412 KB

To approve the minutes of the meeting held on 22 April 2021 (JHO3a) 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 (JHO3b).

 

Additional documents:

Minutes:

The minutes were approved subject to amendments being agreed by the Monitoring Officer and Chair on Items 20/21 and 21/21.

 

On Item 18/21, System-wide Update on Covid-19, the Chair thanked the Director for Public Health for circulating statistics on comparable counties.

 

On Item 20/21, OX12 Task and Finish Group Report, it was agreed that the Chair discuss with the Monitoring Officer the serious concerns of the Task and Finish Group before any further scrutiny proceeds.

 

On Item 21/21, Community Services Strategy, the Chair noted that an offline discussion had been proposed regarding the difficulty of items going to the Health and Wellbeing Board before this Committee has had a chance to discuss them.  This discussion had not taken place as there was no Chair for the Committee between the election and this meeting.  This was something the Committee still needed to discuss.

 

The Chair also noted another action that did not appear to have been taken forward: “That Drs Broughton and Riley of Oxford Health address the issue that keeping the inpatient beds in Wantage Community Hospital closed for so long was essentially predetermining their future.”  She asked that this be followed-up.

 

Action: The Chair to discuss with senior officers the concerns of OX12 Task and Finish Group and sequencing of this Committee’s meetings and the Health and Wellbeing Board meetings.

 

29/21

Speaking to or Petitioning the Committee

Currently council meetings are taking place in-person (not virtually) with social distancing operating in the venues.  However, members of the public who wish to speak at this meeting can attend the meeting ‘virtually’ through an online connection.  Places at the meeting are very limited due to the requirements of social distancing.  While you can ask to attend the meeting in person, you are strongly encouraged to attend ‘virtually’ to minimise the risk of Covid-19 infection.

 

Please also note that in line with current government guidance all attendees are strongly encouraged to take a lateral flow test in advance of the meeting.

 

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 18 June 2021 Requests to speak should be sent to colm.ocaomhanaigh@oxfordshire.gov.uk .  You will be contacted by the officer regarding the arrangements for speaking.

 

If you ask to attend in person, the officer will also advise you regarding Covid-19 safety at the meeting.  If you are speaking ‘virtually’, you may submit 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. Written submissions should be no longer than 1 A4 sheet.

 

Minutes:

The following speakers had been agreed:

 

Item 7, Forward Plan:

Julie Mabberley

 

Item 9, Oxfordshire Clinical Commissioning Group Update:

Maggie Winters

 

Item 12, Community Services Strategy:

Julie Mabberley

Cllr Jenny Hannaby

30/21

Forward Plan pdf icon PDF 247 KB

10:20

 

The Committee’s Forward Plan (JHO7) is attached for consideration.

Minutes:

The Committee had before it for consideration a forward plan of items for future meetings.  It had been agreed to take the following speaker for this item.

 

Julie Mabberley requested that the Committee add In-patient beds in Wantage Hospital as a specific topic in the Forward Plan.  She outlined the background to the issue which first arose in 2016 when Oxford Health decided to close in-patient facilities temporarily on health and safety grounds.  They remained temporarily closed and at the Health and Wellbeing Board recently Diane Hedges reported that the community strategy timeline indicated that any decision on beds being reopened would not be known until the end of 2022.  At the last Committee meeting the Chairman pointed out that they had asked the Clinical Commissioning Group and Oxford Health to reopen the beds many times and that this had still not happened.  She asked the Committee to add this topic in the work plan urgently.

 

Dr Alan Cohen noted that on Agenda Page 20, item title “The First Thirty Days”, there were actually two separate papers – one by himself with Barbara Shaw and one by District Councillor Paul Barrow.  He asked that they be scheduled as separate items.

 

Councillor Charlie Hicks proposed a discussion for the next meeting on the role of the Committee, how the Committee, the health partners and accountable officers viewed the question of accountability and how issues could be escalated if the system was going in a different direction from that desired by the Committee.

 

The Chair noted that this was a time of massive transformation in health and social care services given the immediate and long-term effects of Covid-19.  She acknowledged all the work by officers in putting together the Forward Plan but noted that she had not had a chance to input, having only been elected at this meeting.  She proposed to have a meeting with officers and the Deputy Chair to understand the background to the plan and the resources available.

 

The Chair invited Members of the Committee to send their suggestions to the Committee Secretary.  She expected that there would be a lot of issues to discuss and that an extra meeting would be needed.

 

City Councillor Jabu Nala-Hartley suggested a discussion on the powers of the Committee.  The Chair responded that there was a need to look at training and some of the issues coming down the line such as the BOB-Integrated Care System (Bucks, Oxfordshire and Berkshire West) and legislation aimed at limiting power of Health Overview and Scrutiny Committees.

 

Anita Bradley, Monitoring Officer, suggested a need to prioritise the issues that would come forward as it was unlikely the Committee could deal with all of them.  She recommended using a scoring system.

 

District Councillor David Turner noted that there were 12 items on the plan that were marked ‘to be confirmed’.  He asked that target dates be set for every item to avoid drift.

 

The Chair noted that the Committee could request any health partner to come  ...  view the full minutes text for item 30/21

31/21

System-wide update on Covid-19

10:25

 

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

Minutes:

The Committee had asked for a presentation on the latest data on Covid-19, vaccinations and elective recovery plans.  Ansaf Azhar, Director for Public Health, started a presentation with the very latest figures on case rates.  These had been rising in Oxfordshire, standing at 61 per 100,000 up 50% on the previous week.  Cases among over 60s were not high.  The main increase was in the 20-29 age group.

 

The Delta variant was more transmissible but thanks to the vaccination programme the increases were not as serious as they had been in December and January.  He stressed the importance of asymptomatic testing which had picked up 151 cases in the previous week.

 

Hospital admissions were still low.  Vaccination with two doses had been shown to be 80% effective against infection and 98% effective against hospital admission.  Oxfordshire had seen no deaths from Covid-19 for 5 weeks but sadly two had been reported in the previous week.

 

Jo Cogswell, Director for Transformation, Oxfordshire Clinical Commissioning Group (OCCG), presented the slide summarising the uptake of vaccine in the various age groups.  It was now being offered to everybody over 18.  They were looking at how to make vaccination more accessible for young people and setting up centres in places with greater concentrations of young people.

 

Jo Cogswell encouraged Members to be part of the communications push by encouraging everyone to get the vaccine.  Thousands of volunteers had been an essential part of the programme and a thank-you event had been organised for them.

 

Tehmeena Ajmal, Operations Director Covid, Oxford Health, outlined measures to improve the uptake of the vaccine in areas where it had been low to date, including the use of sprinter vans.  She thanked the universities for their cooperation.  The target was to have the second dose delivered to two-thirds of adults by 19 July when the Government planned to ease restrictions.

 

Councillor Charlie Hicks asked for more comparative information on hospitalisation rates and on hesitancy to take up the vaccine.  He believed that the messaging around the importance of fresh air to minimize airborne transmission was not really getting across.  He had not seen much messaging on vaccination in social media and asked what was being done there.

 

City Councillor Jabu Nala-Hartley asked if partners were aware of the work being done to encourage vaccine take-up in BAME (Black, Asian, Minority Ethnic) communities.  She asked for more information on staffing levels, if there were any compliance problems with national and privately run track and trace companies and if employers were doing enough to support their employees.

 

Ansaf Azhar responded that the take-up had been low nationally among young women due to inaccurate information about fertility concerns but they had overcome that with targeted communications.

 

Jo Cogswell noted that they had updated the information campaign to include the importance of fresh air.  They had also improved the messaging to BAME communities following feedback that previous campaigns had been received negatively.  It was now focussed more on the positive messages around  ...  view the full minutes text for item 31/21

32/21

GP workloads pdf icon PDF 592 KB

12:00

 

The paper (JHO10) aims to provide the Oxfordshire Joint Health and Overview Scrutiny Committee with an update on:

 

1.    General Practice workloads and appointment data

2.    The delivery of services through the pandemic and vaccination programme

Additional documents:

Minutes:

The Committee considered a paper on General Practitioner workloads and delivery of services through the pandemic and vaccination programme.

 

Jo Cogswell, Director of Transformation, Oxfordshire Clinical Commissioning Group (OCCG), introduced the item.  In response to questions submitted in advance, she clarified that the appointments information in her report related to appointments offered in general practice, not just appointments offered by doctors of general practice, and that appointments for vaccinations were not included.

 

Dr Rahman Nijjar, Chair of the Local Medical Committee (LMC), emphasised that GP practices were open and trying to manage demand.  Their role in the biggest vaccination programme ever had taken them away from routine GP practice.  Everyone wanted to have face-to-face appointments where one could build relationships but for now access depended on clinical demand.

 

Dr Nijjar stated that recent government guidance had been quite hurtful and damaging.  He emphasised that GPs were putting patients’ health above their own.

 

The Chair asked about the situation with regard to health problems for which one would expect a physical examination and how that was being handled in the triage system.

 

Councillor Charlie Hicks asked if there was any data on staff and patient satisfaction with the digital platforms and if there were plans to roll them out further.

 

Dr Alan Cohen asked what had been put in place to support the welfare of GPs and staff coping with enormous workloads and if there were implications in relation to long-term planning.

 

Barbara Shaw noted that experience of the ease in getting face-to-face appointments and the ease of use of GP websites appeared to vary greatly from practice to practice.  She asked if that had been seen to be the case in their feedback.

 

District Councillor Andy Foulsham noted the number of programmes that required additional work by GPs and asked if the capacity was there to meet these.

 

Dr Rahman Nijjar responded that the triage service collected a lot of information before making a judgment on whether a face-to-face appointment was required.  Triage also gave advice on what to do should the patient’s condition deteriorate.

 

Feedback on services varied across the county – the majority were pleased but a minority had access problems and their feedback was regularly reviewed to improve the systems.

 

Jo Cogswell recalled that the Committee received a report on feedback from the public in September 2020.  She offered to provide an update when the data was refreshed.

 

Dr Sam Hart, North Network Clinical Director at OCCG and a practicing GP in Islip, noted that we had seen the same changes in health services as in all other walks of life during the pandemic – a shift from face-to-face to virtual.  This had shown that there were potential efficiencies in the new systems.  Generally, ninety percent plus of the information required to make a diagnosis was in the patient’s history.  There would be a low threshold for judging if there was a clinical need for a face-to-face appointment.

 

GPs had done their best to look after  ...  view the full minutes text for item 32/21

33/21

Future of Adult Palliative Care in Oxfordshire pdf icon PDF 563 KB

12:30

 

A presentation to update the Committee.

 

 

13:00

 

LUNCH

Minutes:

The Committee had before it a presentation on the new partnership between Katharine House Hospice and Sobell House.

 

Chris Cunningham, Divisional Director, Surgery, Women’s & Oncology Clinical Division, Oxford University Hospitals (OUH), introduced the item.  He stated that the partnership had the full support of OUH and will deliver greater resilience for patients, families and staff.

 

Professor Bee Wee, Clinical Lead and Consultant in Palliative Medicine, OUH and National Clinical Director for Palliative and End-of-Life Care, NHS England, gave the presentation and illustrated the new arrangements with an example case.  She also described how the local arrangements fitted in with the national system.

 

The increase in demand for palliative care had already reached the level of need that had been projected for 2040.  It was now expected that there will be a 42% growth in numbers due to people living longer with cancer and dementia.

 

Partnership working during the pandemic demonstrated the value in working together to improve access, quality and sustainability.

 

Lydia Brook, described the Living Well and Supportive Care Service for which she was the Lead at OUH.  The aim was to meet the wellbeing, rehabilitation and holistic support needs of their case load.  She also outlined a project to develop a strategy on Equality, Diversity and Inclusion.

 

Councillor Charlie Hicks spoke about feedback he had received from front line care staff who felt a lack of empowerment and that they could do more to assist patients if given the appropriate training.  He believed that palliative care could play a greater role in the health system.  He asked what was being done to address these concerns.

 

Professor Bee Wee responded that the integrated approach being taken in Oxfordshire enabled them to do more in terms of education and training.  For example, training to allow front line staff to have conversations about long-term planning to help avoid having to make on-the-spot decisions.

 

Councillor Hicks added that he would like to see data on the number of people who died who had care plans written more than one month before they died and the number who die in their normal place of residence, as well as feedback from next of kin on their experience.

 

Councillor Nathan Ley asked officers, if they could have what they wished for going forward, what it would be.  Professor Wee responded that they needed to see how much care could be delivered at home before increasing the number of palliative care beds available.  She believed that the balance between the two would be dynamic rather than following any trajectory.

 

Jean Bradlow asked how the funding implications were going to be met.  Professor Wee replied that there would be a combination of NHS funding and charitable fundraising.  The community aspects of the integrated system would be key in ensuring community awareness of the services and therefore maintaining the income from charitable fundraising.

 

The Chair thanked the contributors for their presentation and responses to questions from Members of the Committee.

 

34/21

Community Services Strategy pdf icon PDF 269 KB

13:30

 

A presentation from Dr James Kent and Dr Nick Broughton.

Additional documents:

Minutes:

The Committee had received a presentation and supporting document updating the Committee on work towards a Community Services Strategy.

 

The following speakers had been agreed:

 

Julie Mabberley stated that most of the proposals for Wantage Community Hospital in the update related to out-patient appointments but the hospital had very little parking.  Out-patient appointments would be much better placed at the Health Centre but all promises by the NHS to extend the building (first given in 2012) had, so far, come to nothing.

 

They had yet to see the metrics which showed that care at home (with current staffing levels) provided better patient outcomes for reablement than the community hospital used to.  It also used to provide palliative care and there was no mention of where or how this service was currently provided.

 

Based on current NHS plans, the in-patient facility was likely to remain temporarily closed for about 7 years.  She asked that it be reopened without further delay regardless of any strategies for future services in the community.

 

Councillor Jenny Hannaby recounted the history of the closure of in-patient beds at Wantage Hospital for new members of the Committee.  She blamed the closure in 2016 on a lack of maintenance by Oxford Health.  She praised the hard work of the local community in campaigning for the hospital and participating in the work of the stakeholder group.

 

Councillor Hannaby, as new Cabinet Member for Adult Social Care, stated that she was well aware of the excellent work supporting people in their homes but she believed that there was still a place for Community Hospitals and she asked that a strategy be implemented and not just talked about.

 

The Chair noted that the Committee had been unable to progress discussions on how the community services strategy would be scrutinised as it had been without a Chair since the election until this meeting.  She therefore proposed that the Committee should just note the reports and have an extra meeting to give the subject the detailed examination that she believed it deserved.

 

Dr James Kent, Chief Executive, Oxfordshire Clinical Commissioning Group (OCCG), introduced the item. He stated that the proposals built on the spirit of partnership across the system that had worked well in dealing with the pandemic.  It was anticipated that legislation would require more partnership working.  Both he and Dr Broughton had only taken up their positions last year. They were well aware of the history but were keen to look forward to what could be achieved.

 

It had been agreed to look at community services in the round and comprehensively.  Work had started in collecting information on what was currently available.  They were not proposing a strategy at this stage but a path towards a strategy.  It was expected to be an 18-month process but they had taken on board the need for more and earlier engagement.  The presentation outlined the fail-safes and checkpoints that the Committee had asked for.

 

Dr Nick Broughton, Chief Executive, Oxford Health NHS Foundation Trust  ...  view the full minutes text for item 34/21

35/21

Oxford University Hospitals Quality Report pdf icon PDF 831 KB

14:15

 

A presentation by Professor Meghana Pandit, Chief Medical Officer.

Minutes:

The Committee received a report from Oxford University Hospitals NHS Foundation Trust (OUH) to demonstrate how they performed against their own objectives for 2020-21.  The Committee’s response to the report will be communicated to the Trust in writing.

 

Professor Meghana Pandit, Chief Medical Officer, OUH, introduced the report and outlined the values and priorities as defined in their Strategic Framework 2020-25 which was adopted last year.  The fact that many of their priorities had been achieved despite all of the extra work through the pandemic was testament to the hard work of their staff.

 

While planning for the recovery after Covid, they were mindful that the workforce was very tired and rest for them will be part of the recovery programme.  Professor Pandit said that she was happy to take comments at the meeting or in writing afterwards.

 

Councillor Freddie van Mierlo asked for more detail on the partial achievement of Action 1 under Psychological Medicine (Agenda Page 72) improving access to psychiatry for in-patients at Horton Hospital.

 

Professor Pandit responded that OUH was unique in delivering holistic physical and mental health care, working in collaboration with Oxford Health.  They had enhanced the tele-psychiatry service for all in-patients including the Horton.  Any actions that had only been partially achieved in the last year will continue to be tracked and reported to the Board.

 

Councillor Charlie Hicks asked about OUH’s contribution to more preventative, upstream approaches to mental health.  Professor Pandit responded that OUH was working with all the partners across the system on a population health approach which included issues like education and housing.  Their researchers were also examining the impact of multimorbidity on secondary care and surveying long Covid.

 

The Chair expressed the gratitude of the Committee to all staff at OUH for their work, in particular through the pandemic, and thanked Professor Pandit for coming to the Committee at such a busy time.

 

Action: The Chair to write to the Trust with the Committee’s response to the reports.

 

36/21

Oxford Health Quality report pdf icon PDF 2 MB

14:30

 

Annual Quality Account 2020-21 from Oxford Health NHS Foundation Trust.

 

Minutes:

The Committee had before it a report from Oxford Health NHS Foundation Trust to demonstrate how they performed against their own objectives for 2020-21.  The Committee’s response to the report will be communicated to the Trust in writing.

 

Britta Klinck, Deputy Director of Nursing, Oxford Health, introduced the report.  Due to the exceptional year it had not been possible to achieve many of the quality priorities however progress had been made in a number of domains and work continued.

 

Staff wellbeing was a priority and it was fair to say that staff had been somewhat traumatised and needed time for recovery and reflection.  In response to the need to work differently, a number of new services had been introduced including a direct help telephone number for mental health crises and delivering over 170,000 digital appointments.

 

Another lesson learnt through the pandemic was the importance of empowering staff, and staff and patient feedback will be an important element in the priority to implement quality improvement.  It had only been possible to close one objective as being achieved.  The others will be rolled over into the following year.

 

Councillor Charlie Hicks asked about measures to tackle sleep loss as a therapeutic goal for mental health patients.  Britta Klinck responded that a pilot project to gather information from patients at night without disturbing their sleep had been shortlisted for an award as outlined on Agenda Page 95.

 

Councillor Hicks also asked about research suggesting that the adolescent brain should be redefined as 10-24 years of age and if she agreed that this reinforced the importance of new services for 18-25 year olds.  Britta Klinck replied that she concurred with this.

 

The Chair thanked all the staff at Oxford Health for their hard work, particularly amidst an escalating demand for mental health services.

 

Action: The Chair to write to the Trust with the Committee’s response to the reports.

 

37/21

Oxfordshire Clinical Commissioning Group Update pdf icon PDF 165 KB

11:40

 

The paper (JHO9) aims to provide the Oxfordshire Joint Health and Overview Scrutiny Committee with an update on:

 

1.    Specialist in-patient palliative care and Henley RACU

2.    ICS development and new ways of working

3.    OCCG Annual Report

4.    Thank you to volunteers

5.    Botley Health Centre

 

 

11:55

 

Comfort Break

Minutes:

The Committee had received an update report from the Oxfordshire Clinical Commissioning Group.

 

The following speaker had been agreed:

 

Maggie Winters on behalf of Keep Our NHS Public Oxfordshire referred Members to their report entitled “Preventable Hearing Loss in Oxfordshire”, which described the lack of a properly resourced service for ear wax removal.  Most Oxfordshire GPs had withdrawn the service.   Patients were now having to pay to have wax removed privately at a cost of anything between £55 and £100. 

 

OCCG were procuring a new ear wax removal service but this will apply only to over 55 year olds whose hearing loss is not due simply to the blockage of the ear canal caused by wax build up.  KONHSP believed ear wax removal was best done at the GP surgery.  They asked the Committee to hold OCCG to account for the shortcomings in provision, the potentially discriminatory impact of its procurement policy, its failure to consult with patients and the loss of service for large numbers of people.

 

Diane Hedges, Deputy Chief Executive, OCCG, introducing the report, emphasised that she wished to make a decision on item 1 in the report on palliative care before the next meeting of the Committee, subject to the outcome of the public meeting to be held on the issue and the substantial change toolkit being completed.

 

Councillor Charlie Hicks asked, with regard to item 2 in the report on the Integrated Care System (ICS), about the role of Primary Care in population health management given that it held the only registered lists of population.  Diane Hedges responded that the latest guidance was quite clear on the importance of Primary Care and she recognised its pivotal role.

 

It was agreed that, due to pressure of time, questions could be sent to the Secretary for answer later.

 

Councillor Freddie van Mierlo asked for more information on ICS as he believed that what was in the report was quite light.  Diane Hedges responded that the guidance had not been received when the report was written.  They now had guidance on what has to be done and what can be decided locally.  An engagement plan was being developed.

 

The Chair asked if there was a distance that would be regarded as too far for somebody to travel, for example for palliative care.  Diane Hedges replied that there was no specific distance for any service but they had to balance the need for local against the need for quality. 

 

District Councillor David Turner added that distance to care was a significant issue in rural areas.  Where there was no public transport, voluntary groups were often organised to provide help.  He asked if any grants were available for such services.

 

Diane Hedges responded that there was a patient transport service for those with a medical need but that they would look to neighbourhood support, voluntary sector and work with local authority partners in regard to public transport for anything beyond that.

 

Councillor Charlie Hicks asked about OCCG’s approach to deprivation,  ...  view the full minutes text for item 37/21

38/21

Oxfordshire Adult Eating Disorder Service pdf icon PDF 1005 KB

15:00

 

A briefing from Oxford Health NHS FT

Minutes:

Members considered a briefing from Oxford Health NHS Foundation Trust.  Dr Rob Bale, Clinical Director, invited questions on the report.

 

Dr Alan Cohen noted that there were 47 high risk patients waiting over 18 months for treatment.  He asked if a harm reduction assessment had been carried out.  He also asked about the appointment of a psychiatrist to the service and if it was fair to expect already overworked GPs to contribute to the service.

 

Dr Bale agreed that patients were waiting longer that he would want but that £480,000 was being invested in the current year to address the problem as soon as possible.  The previous psychiatrist had been a part-time appointment whereas the incoming psychiatrist will be full-time.  A start date had yet to be agreed.

 

With regard to the involvement of GPs, guidance was provided on how to identify when urgent action was required and on how to act in those circumstances.

 

Councillor Charlie Hicks asked about services for 18 to 25-year-olds and the IAPT psychotherapy service.  Dr Bale responded that prevention work was a priority.  They were working on identifying pathways and staffing for services for children and adolescents.  It was recognised that the needs of young people were different and the aim was to provide more help at home and avoid hospital admissions.

 

Barbara Shaw recalled that services to those with lower acuity were closed in 2019 due to high caseloads for staff.  She asked when they would be reopened following the increase in staff numbers.

 

Dr Bale responded that the staff needed to be upskilled and he could not give a timeline.  A digital support service was also being developed to provide advice on self-help but this was still in its early days of development.  He was happy to update the Committee at a later date.

 

District Councillor Andy Foulsham noted that up to 35% of those with eating disorders were on the Autism spectrum.  He asked if their pathways were under Dr Bale or CAMHS (Child and Adolescent Mental Health Services).  Dr Bale replied that he was responsible for all the teams but worked closely with CAMHS to develop the different skills required.

 

The Chair asked about support for schools as those in her area had told her that they do not feel that they get enough.  Dr Bale responded that they had mental health support teams in schools as part of the CAMHS transformation and that these teams also feedback their learning to him.

 

The Chair thanked Dr Bale for the report and taking questions and reiterated the request for an update in the future.

 

Action: Officers to arrange a future update on the digital support service.

 

39/21

Healthwatch Report pdf icon PDF 253 KB

14:45

 

Healthwatch Oxfordshire will report on the views gathered on health care in Oxfordshire.

Minutes:

The Committee received an update from Healthwatch Oxfordshire on its findings.  Rosalind Pearce, Chief Executive, took the report as read and, given the new membership of the Committee, offered to give a briefing on Healthwatch’s role at a training session or in writing or in meeting individual Members.

 

Rosalind Pearce offered some comments on issues that arose throughout the meeting:

 

·         More messaging was needed on what people who are unregistered with a GP need to do to get the Covid vaccine.  She thanked the Luther Street Medical Centre for their assistance with this.

·         Messaging also needed to be clearer on the triaging of calls to GPs and the criteria for deciding if face-to-face consultations were needed.

·         What impact have the Primary Care Networks had on GP practices and have the new staff helped to reduce GP workload as anticipated?

·         Research had shown that 30% of people would not have considered going to the pharmacy first so more communication was needed on that but also consideration of the impact on community pharmacies if this messaging was successful.

·         It needed to be clarified if the statement that there were enough palliative care beds in those being provided by Katharine House and Sobell House applied to the county as a whole or just to the North and City.

·         Healthwatch had received the Quality Report from the South Central Ambulance Service but noted that it was not on the agenda for this Committee meeting.

 

District Councillor David Turner asked about ear wax removal which was no longer available free but cost anything from £50 to £150 from the private sector.  Rosalind Pearce responded that Healthwatch and the Oxfordshire Clinical Commissioning Group were aware of the problem which was another health inequalities issue.  Healthwatch currently had a survey on their website on this issue and would use that information in discussions with OCCG.

 

Councillor Charlie Hicks and Barbara Shaw asked about Healthwatch research on digital services as these had all taken a huge step forward under the pandemic.   Rosalind Pearce replied that digital exclusion was a priority for them and agreed that quality of design was an important factor.  She noted that as a rural county not everyone in Oxfordshire had good access to the internet.  She hoped that Primary Care Networks could help GP practices to standardise websites.

 

The Chair asked about general awareness of the new data sharing proposals and the ability to opt out.  Rosalind Pearce agreed that information on this had a low profile and was not easy to follow.  The opt-out form was available on the Healthwatch website.

 

District Councillor Jill Bull asked if the satisfaction data on dentistry was broken down by district.  She was aware of people in West Oxfordshire being sent to Swindon for the nearest NHS service.  Rosalind Pearce agreed to provide a response after the meeting.