Agenda and minutes

Apologies were received from District Councillor Elizabeth Poskitt, County Councillors Damian Haywood (substituted by Councillor Brad Baines), Nathan Ley (substituted by Councillor Roz Smith) and Freddie van Mierlo (substituted by Councillor Alison Rooke attending remotely).

Councillor Nigel Champken-Woods attended remotely as did the Co-opted Members Dr Alan Cohen, Jean Bradlow and Barbara Shaw.

The following non-pecuniary interests were declared:

Dr Alan Cohen as a Trustee of Oxfordshire Mind.

Cllr Jane Hanna as CEO of SUDEP Action.

To approve the minutes of the meeting held on 9 June 2022 (JHO3) and to receive information arising from them.

The meeting considered the second draft of the minutes of the meeting held on 9 June 2022 which were circulated in Addenda 2.

Two further amendments were approved:

On Item 30/22 Oxford Health NHS FT Quality Account, on the fourth bullet point

Replace

“The Trust has been successful in staff recruitment”

With

“The Trust has had some success in staff recruitment”

On Item 34/22 Healthwatch Report, replace the final bullet point with:

“The Committee thanked Healthwatch for facilitating a workshop where women from minority ethnic groups could feedback on their experiences of using maternity services in Oxfordshire.”

The minutes as amended were approved as an accurate record.

Members of the public who wish to speak at this meeting can attend the meeting in person or ‘virtually’ through an online connection.

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 ‘hybrid’ meetings 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 8 June 2022.  Requests to speak should be sent to colm.ocaomhanaigh@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 1 A4 sheet.

The following requests to speak were received:

Item 5 Oxfordshire Integrated Improvement Programme

Julie Mabberley

Councillor Jenny Hannaby

3.10pm

Ben Riley, Managing Director for Oxfordshire Health, and Helen Shute, Programme Director, Oxfordshire Community Services, Oxford Health will be presenting a report on the Oxfordshire Integrated Improvement Programme. The Committee is asked to consider the report and agree any recommendations it wishes to make in response.

The Committee received a report and presentation on the Integrated Improvement Plan from Helen Shute, Programme Director, Oxfordshire Community Services, Dr Ben Riley, Executive Managing Director, Oxford Health FT and Lily O’Connor, Oxfordshire Director for Urgent Care.  

Before discussing the papers, the Chair had agreed to the following requests to speak:

Julie Mabberley welcomed the report but wished to see timescales for the underlying projects and the objectives and outcomes of each project clearly presented.  She asked a series of clarifications on the report.  Wantage Community Hospital had been temporarily closed for minor injuries for 20 years, temporarily closed to in-patients for 6 years, maternity services had not been providing birthing services for 32 weeks and physiotherapy services had closed again without any consultation.  The local community felt that their hospital was being closed by stealth.

Councillor Jenny Hannaby, Wantage & Grove, noted that demographic information was very important in planning health and care services.  She asked if the census data by age range and postcode for 2011 and 2021 could be provided as well as growth forecasts to the end of the local plan period in 2031.

Members were reminded that the Integrated Improvement Programme aimed to provide an interconnected system of care; and in order to provide reliable, high quality care, services must function effectively together in a reliable joined up way. The programme was made up of separate initiatives, which together formed the patient journey and experience.  

Resulting from the Committee’s questions and comments the following points were noted:  

·         A data insight tool for the programme was being created in order to analyse and make use of data on population health, transport links and food deserts.  

·         Each individual part of the wider Integrated Improvement Programme had a known attached cost, which was funded by rolled-over, previous funds or additional national or regional funding which had been bid for. In cases, where funding wasn’t in place now, it was anticipated that it would be received in September.  

·         The Project Management Office function had been costed, and a finalised bid was waiting to be considered by the Integrated Care Board.  

·         Whilst some of the services under the programme would beprovided by the private sector, namely physio, homecare and services provided by the GP Federations; the majority of the services offered under the programme would be offered directly in-house. It was also noted that there was no funding for the programme from the private or voluntary sectors.  

·         There were potential concerns in respect of access to services by vulnerable people, as well as those without English as their first language. It was noted that there were well established systems of feedback, which fed into quality improvement processes and pilot schemes. The next part of the programme was a large-scale public consultation.  

·         It was asked since the Sue Ryder charity had closed its South Oxfordshire Palliative Care Hospice in Nettlebed, how many people which had been referred  ...  view the full minutes text for item 5/22

3.50pm

Catherine Mountford, Director of Governance at Buckinghamshire, Oxfordshire and Berkshire West ICB, and Amanda Lyons, Interim Director of Strategy and Partnerships, will present a response to the letter submitted by HOSC in relation to issues of consultation and engagement. The Committee is asked to note the response and agree any action it wishes to take arising from the response.

Catherine Mountford, Director of Governance, presented the Integrated Care Board’s response to the Committee’s recommendation made on Consultation and Engagement, which was published as a supplement to the agenda pack.  

The Committee was informed that if the Committee wished to make any further representations on the draft engagement strategy, it should do so by the first two weeks of September. An offer of engagement with a sub-group of the Committee in respect of the proposed strategy was also noted.  

In addition, it was acknowledged that it would be helpful in future for the Committee to be informed of any upcoming publication of national guidance in the background of the reforms.  

RESOLVED that the ICB’s response be noted.  

4.05pm

Catherine Mountford, Director of Governance at Buckinghamshire, Oxfordshire and Berkshire West ICB, and Amanda Lyons, Interim Director of Strategy and Partnerships, will introduce a presentation on forthcoming development of the ICB. The Committee is asked to note the presentation and agree any actions it wishes to take in response.

The Committee received an update on

·       the Integrated Care System development following 2022 Health & Care Act receiving Royal Assent in April

·       the System delivery plan

·       the Preparatory phase – pre-establishment for Integrated Care Partnership strategy development

From the ICB, Catherine Mountford, Director of Governance, and Amanda Lyons, Interim Director of Strategy and Partnerships, highlighted points in the presentation.  Slide 5 described the elements created by the Act.  Most of the focus so far had been on establishing the ICB to replace the Clinical Commissioning Groups.  Work was now extending more to the broader Integrated Care System and discussions had taken place on forming the ICP and Place Based Partnerships.

The following points were made in response to questions:

·       Collaboration was being encouraged where appropriate.  There will be a joint strategy with agreed outcomes but then discussions as to how best to deliver.  There may be different needs or priorities in different areas.

·       Eliminating health inequalities will be a major focus.  They will work with Directors of Public Health and Patient Care Networks to identify needs and discuss how to focus resources where most needed.

·       Oxfordshire had already done work on researching the most deprived areas.  It was also known that certain people had worse health outcomes, for example, those with learning disabilities, and particular efforts would be made to engage with those groups including through the voluntary and community sector.

·       The starting point for this year was that each provider had the same funding as last year.  Guidance will be received by the end of the calendar year when the strategy will also be in place.  The funding allocations for 2023/24 will then be decided in detail as well as more generally for a five year period.

·       Specialist services will remain the responsibility of the NHS nationally but some may be delegated to ICSs from 1 April 2023.  However, the South East Region had decided, give the complexity of these commissioning arrangements, that none will be delegated before 1 April 2024 – apart from possibly some pilots.

·       Workforce issues were being examined across the system including health and social care partners as well as the voluntary and community sector.

·       A document on the establishment of the Place Based Partnership was in development and could be shared at the Committee’s meeting in September.

·       It was agreed that the term ‘hard to reach’ communities should be avoided but there was a need to find more effective ways of engaging with certain communities – whether geographic or service-related – and there was a lot to be learned from local authorities who have experience at this.

·       The ICB was already looking at principles for prioritisation of resources.  It was agreed that there was a need to improve engagement and transparency on these decisions.

·       Local authorities and Directors of Public Health were fully involved in the discussions on the strategy representing the views from Place.

·       It was proposed that the Place Based Partnerships will initially be committees of the ICB to allow for delegation to  ...  view the full minutes text for item 7/22

4.35pm

Catherine Mountford, Director of Governance at Buckinghamshire, Oxfordshire and Berkshire West ICB, and Amanda Lyons, Interim Director of Strategy and Partnerships, will introduce a presentation on the activity to date to establish the Oxfordshire Place within the ICB, and the future road map for further development. The Committee is asked to note the presentation and agree and actions it wishes to take in response.

This report was a continuation of the reports which had been received from Oxfordshire Clinical Commissioning Group.  Given that it was a short report and MSK was to be discussed in a later item, the Chair proposed to take it as read and this was agreed.

4.50pm

Rosalind Pearce, Executive Director of Healthwatch Oxfordshire, will present the Healthwatch Oxfordshire Annual Impact Report 2021/22. The Committee is asked to note the report.

The Committee was asked to consider and note the Annual Impact Report from Healthwatch Oxfordshire for 2021-22.  Given the limited time available at this extra meeting, the Chair asked Members to send any questions or comments to Healthwatch after the meeting.

Rosalind Pearce, Executive Director, introduced the report.  She was very proud of the team and what it had achieved over the year but it could not have done so without the input from the community.  The key elements were the outcomes which were outlined at the back of the report.

5.00pm

To receive a verbal update on the outcome of the meeting held on 11^th July relating to the changes to Muscular Skeletal Services. The Committee is asked to note the update and agree any further action it wishes to take in response.

Helen Mitchell, Scrutiny Officer, gave a report on two meetings of the MSK Subgroup comprising Councillor Nigel Champken-Woods, Barbara Shaw and Dr Alan Cohen.  The group wanted to thank officers of the Integrated Care Board for the information they provided on the recommissioning of this service.

Discussions have included communications and engagement around the new service as well as the model itself.  The ICB completed a Substantial Change Toolkit retrospectively to demonstrate why they believed that it was not a substantial change.

The subgroup agreed to make three recommendations to the Committee:

·       That a group of three voting Members of the Committee, plus the Co-optees who have been involved, review the completed toolkit.

·       That an offer from the new provider, Connect Health, to meet informally be accepted - to be held when the Key Performance Indicators have been finalised.

·       That Connect Health be invited to the first available meeting of the Committee in 2023 to review how the service is progressing.

The recommendations were agreed and Councillor Jane Hanna and Councillor Nick Leverton agreed to join Councillor Champken-Woods on the subgroup.

5.05pm

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

The Committee considered its work programme for the remainder of the Council Year.  Helen Mitchell, Scrutiny Officer, noted that the main changes were to bring the item on Primary Care forward being swapped with Dentistry and also the addition of an item on the Smoke Free Strategy.

Councillor Brad Baines noted that Healthy Place Shaping was on the deferred list and asked if there was a possibility of it being taken at one of the meetings in this Council Year as it was an issue that crossed over with other scrutiny committees.  The Chair responded that the work programme was an evolving document – the September list of items was set but beyond that there was possibility of change.

The Committee agreed the Work Programme.

5.10pm

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

Helen Mitchell, Scrutiny Officer, reminded Members to respond to the offer and suggested dates from Karen Fuller, Interim Corporate Director for Adult Services, to arrange visits to care homes if they were interested in taking up the offer.

The Chair proposed forming a subgroup to collate publicly available data on waiting times for services which could be analysed by the Health Scrutiny Officer.  The group would also be available to meet with the Director of Public Health if urgent discussed was required.

The Committee agreed to the formation of the subgroup with Councillor Jane Hanna, Barbara Shaw and Jean Bradlow.

The Chair also proposed and it was agreed that Councillor Tim Bearder, Cabinet Member for Adult Social Care, be invited to present Cabinet’s response to the recommendation from this Committee that there be a local review of the Covid response.

Barbara Shaw noted that since that recommendation was made the Central Government review had been formally initiated and the terms of reference included looking at the work of local authorities and discharges to care homes.

5.25pm

Cllr Hanna will introduce her Chair’s report. The Committee is asked to note it, having raised any questions relating to its content.

The Chair highlighted a number of points:

·       It had been confirmed that physiotherapy services will be provided at Wantage Community Hospital.

·       The Committee will seek clarification whether GP surgeries in Didcot and elsewhere have closed to new patients.  This will form part of the discussion at the Primary Care workshop.

The Chair thanked Helen Mitchell for her support as Interim Scrutiny Officer noting that the permanent appointment of a Health Scrutiny Officer had taken place.