Agenda and draft minutes

Apologies for absence were received from Cllrs Levy and Nala-Hartley.

Cllr Rooke attended in place of Cllr Levy

Cllr Hanna noted her position as Chief Executive of SUDEP Action.

To approve the minutes of the meeting held on 22 September 2022 and to receive information arising from them.

The minutes of the HOSC meeting held on 22 September 2022 were AGREED as an accurate record subject to the following:

Min No. 62/22 – Chair’s Update

It was advised that advice had been sought by the Principal Scrutiny Officer regarding the ability of the committee to make submissions to the Covid inquiry with regard to the reports that had been produced in respect of care homes. The advice was such that the committee could not do this on behalf of the council. However it was agreed to amend the minutes to reflect the Committee’s wishes.

The request to Cllr Bearder that the council be actively involved in any inquiry be included in the minutes.

Members of the public who wish to speak at this meeting can attend the meeting in

person or ‘virtually’ through an online connection.

Requests to speak must be submitted by no later than 9am four working days before

the meeting i.e.. 9 am on Thursday 17 November 2022. Requests to speak should

be sent to simon.wright@oxfordshire.gov.uk  

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 one A4 sheet.

The following requests to speak were received:

Item 6 Integrated Care Programme for Oxfordshire

Julie Mabberley

Councillor Jenny Hannaby (statement only)

10.20am

To receive a report from Julie Dandridge and Dan Leveson, on behalf of the Integrated Care Board, on Primary Care and Population Growth within Oxfordshire.

This report should also be read in conjunction with the report by the Health Scrutiny Officer on the findings from the recent HOSC Primary Care  Workshop. 

To Committee is expected to consider various recommendations in respect of this item.

The Chair welcomed Julie Dandridge and Dan Leveson to the meeting who presented a report which summarised the key challenges and opportunities in respect of the provision of Primary Care in Oxfordshire. An additional report from the Health Scrutiny Officer summarised some of the key findings from the HOSC Primary Care Workshop session which highlighted the strains on demand and capacity in Primary Care as well as the opportunities for the ICB and local Councils to work closer together in regard to Primary Care Estate.

Members raised a number of issues in respect of the following:

·         Capacity of the estates and funding being in place. In response it was acknowledged that this could always be improved but the necessary expertise and skills were in place.

·         Data for wait times to see a GP. It was clarified that the wait time and number of patients at practices varied widely. In particular, it was noted that practices that dealt with students had seen a significant drop in numbers. Overall Oxfordshire practices saw 85.2% of patients within two weeks compared to a national average of 82%. It was further advised that many practices did have allocated ‘on the day’ appointments. GP patient lists were regularly reviewed to help identify issues.

·         Levels of workforce in primary care settings and the recruitment and retention of staff. In response, it was explained that £10m had been allocated to Oxfordshire in this regard but training of staff took a long time so the benefits could be some time away. It was emphasised that increased use of technology and self-management could also help.

·         In respect of GP retention it was noted that a number of schemes were in place and were proving effective in the county.

·         The importance of the One Public Estate initiative was highlighted as an example of public organisations working together to deliver health services. Local hubs where a variety of services were available was given as an example. It was anticipated that such schemes would take time to establish but could help reduce demand on primary care services. The monitoring would be undertaken through the Joint Strategic Needs Assessment and Health and Wellbeing Strategy.

The challenges relating to an ever-growing population in Oxfordshire and its effect on Primary Care Provision was detailed in the ICB’s report and drawn out during the committee meeting. It was acknowledged that, whilst the Oxfordshire Primary Care Estates Strategy highlighted the areas where additional general practice capacity would be needed because of housing growth, there were specific areas of exceptional population growth outside of Oxford City, such as in Didcot, where it was advised that the expected population growth was approximately 30% over the next 10 years. As a result, it was felt by members of the Committee that whilst the existing Estates Strategy provided good, strategic direction as to the provision of primary care estate in Oxfordshire, the strategy needed adjusting to reflect some of the stark population growth in some areas of the county.

From the Workshop  ...  view the full minutes text for item 68/22

11.40am

To receive a system progress update led by Lily O’Connor, Director of Urgent Care, on the Integrated Care Programme with a specific focus on the metrics around outcomes as discussed at the June Committee Meeting.

The Chair introduced the item and made reference to the participation earlier in the meeting and the interest the committee had in the issue.

Lily O’Connor, Director of Urgent Care, gave an update on the Integrated Care Programme with a specific focus on the metrics around outcomes as discussed at the June Committee Meeting.

Members highlighted the following:

·         The pausing of the Oxfordshire Way initiative and the impact on work already undertaken. In response it was confirmed that whilst work had been paused until October 2023 finance was available for digital initiatives and so work would continue on this. However work on Adult Social Care and Safeguarding would not be advanced at this stage.

·         It was noted that meetings were ongoing with the Department of Health & Social Care and matters relating to the future of the project would be kept under review in the background with a view to progressing them.

·         The use of technology and impact for customers. It was explained that the Virtual Ward initiative which involved partners such as GPs, Age UK and Adult Social Care working with clients on their care provision. In addition there were a number of contracts with Age UK to provide social prescribing in the community.

·         The closure of beds and lack of consultation with HOSC. It was noted that urgent decisions had been made regarding the closure of some short stay beds.

·         The change in culture and challenges this could present. The concern was acknowledged and it was confirmed that a co-ordinated approach was needed and challenge was very important in this regard and would be facilitated. It was agreed that this could be very staff intensive and provision was being made in this regard with a view to maximising resources across partners, reducing inefficiencies and providing training to allow staff to take on increased roles.

·         The provision of home care, with community support, and whether this was always appropriate. It was acknowledged that the wishes of the client would be respected and appropriate provision put in place as needed.

·         The strategic positioning of care beds and lack of consultation with HOSC in respect of closures. It was noted that some of the information was commercially sensitive and there was a need to address recruitment issues. It was noted that the overall number of beds had not decreased but consultation was needed.

·         It was agreed that a glossary of terms should be developed to allow better public understanding of the language used.

The Chair summarised the debate and a number of recommendations were proposed and agreed.

Resolved:

1.    Matters in respect of the Community Services Strategy continue to be looked at by the Integrated Improvement Programme Sub- Group;

2.    That further work by the committee on the urgent care be not pursued in the short term but that there be an annual review by the committee;

3.    That the temporarily closed services within the county including the midwifery led units at Wantage and Chipping Norton and the inpatient unit at Wantage  ...  view the full minutes text for item 69/22

The Committee adjourned at 12.50pm and resumed at 1.25pm

1.00pm

To consider a report by Katrina Anderson, Oxford Health, considering current service provision and opportunities for service improvement for residents with serious mental illness vulnerable and often marginalised group.

The Chair welcomed Katrina Anderson (Service Director, Oxfordshire,

BaNES, Swindon & Wiltshire Mental Health) and Dr Rob Bale (Clinical Director, Oxfordshire, BaNES, Swindon & Wiltshire mental Health

Directorate – Oxford Health) to the meeting.

The speakers presented a report outlining capacity and demand issues, recruitment and the development of a framework to develop services in the community rather than at crisis point. Work would be undertaken with community volunteers and primary care services. It was anticipated that three pilot hubs would be in place to deliver the service.

The clinical role was explained and the importance of developing services with users was paramount when introducing significant changes.

In response to members questions it was:

·         Confirmed that the scheme was being developed and delivered in partnership. It was advised that the first hub was in Blackbird Leys with a further two proposed in Abingdon and Banbury once estates issues had been resolved. There was also the possibility of virtual hubs.

·         In respect of performance monitoring it was indicated that using indicators was difficult as each case was unique. There was however work being procured to look at evaluation methods. The scheme was nationally funded with Oxfordshire getting a percentage of the money.

·         It was acknowledged that the scope of the work on prevention services could be expanded to include other outreach services such as drugs but this would need further discussion.

·         Confirmation was given that the specialist practitioners were in place until the end of the financial year with primary care funding. It was acknowledged that some groups were particularly disadvantaged and support above primary care level may be needed in those cases.

·         It was advised that patient feedback was essential when looking at outcomes and this involvement should reduce need for crisis intervention.

·         In respect of the growth in referrals between April 2019 and August 2021 it was advised that data was still to be fully assessed so the impact of the pandemic was not clear. There was an identified increase in young people accessing services during this time however.

·         The set up of the Blackbird Leys hub was outlined and it was clarified that this had been expedited as a third party had premises available and it was an area of high demand.

·         Further to this, confirmation was given that the Frank Bruno Foundation was not working in partnership with Oxford Health or providing services at the hub; instead the foundation had just leased space to the hub. This was after concern of Committee members in respect of the selection of the 3^rd sector organisation and its suitability in respect of those who had significant learning disabilities.

·         Confirmation was given that the framework for such schemes was in place and there was a process for working with voluntary services to deliver support. This involved ensuring due diligence and ensuring that partners had the necessary skills.

·         It was agreed that other services such as debt advice could also be included in hubs.

The Chair summarised the discussion and acknowledged  ...  view the full minutes text for item 70/22

1.45pm

To review the Committee’s work programme for the remainder of the 2022/23 municipal year.

A report updating on the Committee Work Programme was considered.

It was noted that data from the Ambulance Service would be presented at the next meeting and that the palliative care item was to be deferred to April 2023 as that would be one year into the project.

Reference was made to the ICP strategy and the consultation process on this was to be clarified.

Resolved:

That, the report be noted.

1.50pm

To review progress against the Committee’s agreed actions and recommendations.  The Committee is asked to note progress made and agree any actions arising.

The updated actions and recommendations tracker report was received.

In respect of the substantial change toolkit in relation to the SARC in Bicester it was reported that this was not considered to be a substantial change and a response from the commissioner was awaited.

It was confirmed that following the cessation of the Wider Access Fund this had been raised with partners and alternative funding sources could be looked at.

In respect of the amendment to the minutes agreed earlier in the meeting it was noted that further advice would be sought.

It was noted that members were looking at further care homes to visit.

Resolved:

That the report be noted.

2.00pm

To receive a report from Oxfordshire Healthwatch.

Consideration was given to the written report from Healthwatch.

It was agreed that if members had any questions regarding the report that they forward to officers.

Resolved:

That the report be noted

2.15pm

To receive an update from the Chair of the Committee.

The Committee received the Chair’s report updating on a number of issues.

Reference was made to a recent Oxford University Hospitals maternity services stakeholder event. It was explained that this would help in developing a new strategy going forward and a request would be made to see the final document.

In respect of the Covid 19 Sub-Group it was requested that trend data from the hospital trust be bought forward for consideration.

Resolved:

That the update report be noted.