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Agenda and minutes

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

Contact: Julie Dean, Tel: 07393 001089  Email: julie.dean@oxfordshire.gov.uk

Items
No. Item

1.

Welcome by Vice - Chair, Dr Kiren Collison

Minutes:

The Vice-Chair welcomed all to the meeting. She thanked Christine Gore for her services to the Board, as she had stood down from her membership. Yvonne Rees was now representing both Oxfordshire County Council and all the District Councils.

2.

Apologies for Absence and Temporary Appointments

Minutes:

Jo Cogswell attended for Louise Patten, Kathy Hall for Dr Bruno Holthof and Councillor Mrs Judith Heathcoat for Councillor Ian Hudspeth. Apologies were received from Councillor Steve Harrod, Councillor Lawrie Stratford and David Radbourne.

3.

Declarations of Interest - see guidance note opposite

Minutes:

Dr Ben Riley declared a personal interest on account of his position as Director of OXFED and as a GP in Oxford.

4.

Petitions and Public Address

Minutes:

There were no requests to address the Board or to receive a petition.

5.

Note of Decisions of Last Meeting pdf icon PDF 339 KB

To approve the Note of Decisions of the meeting held on 14 March 2019 (HWB5) and to receive information arising from them.

 

 

Minutes:

The Note of Decisions of the last Meeting held on 14 March 2019 was approved and signed.

 

Professor George Smith listed a number of issues which he had raised over a number of meetings where no decision had been made. The following issues were referred on to the appropriate body to consider:

 

·         Safeguarding of Children receiving home education – Children’s Trust Board

·         Safeguarding of children excluded from school – Children’s Trust Board

·         More facilities needed to enable new homes to become Lifetime Homes and to ensure care could be provided, if needed, such as stronger ceiling joists to withstand hoists; – this was an issue for the new joint Housing Officer

·         Initiatives and practical solutions which could be implemented at local level, for example, ensuring podiatry service was available to encourage older people to become more active. Also, local shops to be encouraged to provide chairs for older people to be seated – Older People Strategy Implementation

 

With regard to Matters Arising from the Decisions List, the Board welcomed the idea of an Action Log to be provided to each meeting of this Board, in order to report back outcomes. Professor Smith was reminded that it had been decided at the last meeting that his proposal for a long-term, strategic vision of a five-year rolling plan would be taken to a future Board workshop for consideration.

6.

Oxfordshire Healthwatch Report pdf icon PDF 150 KB

2:10

10 minutes

 

To receive the regular update from Oxfordshire Healthwatch (HWB6).

 

Minutes:

Professor Smith presented the latest update from Healthwatch Oxfordshire (HWO) (HWB6).

 

He highlighted a number of additional issues not contained within the report:

 

·         Further to Healthwatch Oxfordshire’s support to Patient Participation Groups (PPG’s), it was his view that these should be developed at Primary Care Network (PCN) level to enable discussion on any issues they had in common;

·         Healthwatch Oxfordshire was calling for a systematic review of Community Hospital provision across the county;

·         He concurred with the Oxfordshire Joint Health Overview & Scrutiny Committee’s (HOSC) and OUH’s concern regarding the PET/CT scanner at the Churchill Hospital.

 

It was noted that as the issue of the PET/CT scanner was being addressed elsewhere, these were not matters for discussion at this Board.

 

On the topic of work with the armed forces community, Councillor Mrs Heathcoat suggested that Healthwatch officers could contact SSAFA or the County Council Officer who led work on the Armed Forces Covenant.

 

Louise Patten, in response to Professor Smith’s comments, stated that the CCG had agreed with the Oxfordshire Joint Health Overview & Scrutiny Committee and OCC Performance Scrutiny Committee to look to scoping ‘out of hospital’ services, physical assets (buildings), bed-day equivalents and challenges to the workforce.

 

The Board AGREED to thank HWO for the report. 

 

 

7.

Performance Report pdf icon PDF 207 KB

2:20

10 minutes

 

The Board to monitor progress on agreed outcome measures (HWB7).

Minutes:

The Board agreed to move this item to Agenda Item 12 in order to consider it prior to discussion on the reports from the Partnership Boards.

8.

Presentation: Health and Care System Strategy Development pdf icon PDF 1 MB

2:30

20 minutes

 

To inform the Board of strategic developments and seek views on the draft strategic framework (HWB8).

Minutes:

Kathy Hall, Director of Strategy, OUH, gave a presentation which informed the Board about strategic developments across the county and at a wider level, inviting requests from the Board for in-depth reports on specific elements. Comments were then invited from Board members.

 

-       In response to comments from Professor Smith, Kathy Hall confirmed that strategic, annual planning was the intention. He stated that he would await specified targets for each successive year, together with target indicators and an annual review to take account of the rapid changes occurring in Health and Social Care;

 

-       Professor Smith raised his concern about travel into Oxford’s John Radcliffe Hospital, and the parking problem, which in his view, was aligned with the centralisation of services in Oxford, as against that of care closer to home. Kathy Hall explained that a variety of ways of solving the parking situation were being considered including digital means and parking for those attending planned visits around appointments. She stated that the option of a multi – storey car park had not been included. It was also noted that moving care into the community, away from the hospitals and the work of Primary Care Networks would also eventually be part of the solution;

 

-       The Board considered the pros and cons of seeking an Oxford weighting for NHS staff, which was raised by Councillor Louise Upton. Board members were generally positive about this but felt that there were mitigating factors aligned with it, for instance, a weighting could pull staff way from other public services if salaries could not then be matched.

 

The Chair thanked Kathy Hall for the presentation commending all organisations for working together on its development.

 

 

9.

Developing Our Primary Networks in Oxfordshire pdf icon PDF 627 KB

2:50

20 minutes

 

To update the Board on recent developments in forming Primary Care Networks in Oxfordshire (HWB9).

 

Minutes:

Dr Collison introduced the report (HWB9) which updated the Board on recent developments in forming Primary Care Networks (PCN) in Oxfordshire. Dr Riley gave a presentation which provided an overview of the key points; how the network would be set up in Oxfordshire; and how it would evolve.

 

Members of the Board were asked to receive the report for information and for their consideration. Comments and input from Board members to steer the direction of travel at this very early stage were invited.

 

Councillor Andrew McHugh declared an interest on account of his past employment as a GP primary care manager and also in relation to his involvement in setting up a NOxMed network (PML Federation – a collaborative group of GPs in north Oxfordshire). It was his view that contractual arrangements were needed to reduce barriers to GPs working together, for example in delivering services to nursing homes.

 

Louise Patten stated that each individual GP practice would retain their own contract. Groups of GPs within the PCNs would then hold additional contracts for the network. She added that the result would look almost like the healthy towns concept, with a much wider social cohesion. Dr Collison concurred, adding that the PCN had the potential to be very local in nature and to become a natural community, aligned with local leisure centres, schools, libraries etc. Moreover, patient engagement would be sought and community groups would be empowered to develop their own groups.

 

Stuart Bell reported that he had attended a workshop that morning on the future of integration of PCNs. The speed of developing PCNs to date had tended to focus attention on contracts, but now the emphasis could be on contributions from as many different organisations as possible, as these may have very valuable contributions to make.  He likened this to the Healthy Abingdon work. Yvonne Rees added that it could also join/link up with Health Place-shaping, and with the Growth Board, taking Oxfordshire as one large locality, with joined-up working. It was her view that proactive conversations needed to take place with members of this Health & Wellbeing Board, who had a significant part to play in this. To this end she proposed that this matter be brought to a future Board workshop.

 

Professor Smith added HWO’s support to this also, asking however that participants should ensure that it delivered benefits for the patients themselves. He believed that there was a need to understand how social prescribing could be delivered, and how it could be joined up with voluntary organisations, as practically as possible. Professor Smith also suggested that good use of the in-services training between GP and consultant level in the teaching hospital could be made.

 

Louise Patten responded that, to date there had been a registration process for PCNs, which had been very light touch, to ensure full coverage. She added that there was a need at the present time to concentrate on the delivery of all the outcomes that were currently being required to be delivered.  ...  view the full minutes text for item 9.

10.

Care Quality Commission (CQC) Action Plan pdf icon PDF 589 KB

3:20

10 minutes

 

To receive a presentation (HWB10(a)) and highlight report (HWB10(b)) on the QCQ Action Plan.

 

Additional documents:

Minutes:

Lucy Butler gave a presentation (HWB10(a), on the CQC Action Plan whilst highlighting the report from the CQC (HWB 10(b).

 

Following a discussion, the Board AGREED that good progress had been made and that the remaining actions needed to be regarded as business as usual, embedded in the work of the whole system. This was because they had become a way of working and therefore did not need to be in a separate action plan. This way of working would be possible due to strong relationships between the partners represented on the Board with open processes and accountability.

11.

Prevention Framework pdf icon PDF 327 KB

3:30

10 minutes

 

To receive a summary of the draft framework for prevention and to update on progress (HWB11).

 

Minutes:

Dr Collison presented a summary of the draft Prevention Framework and also gave an update on progress (HWB11). She spoke of the large overlap between prevention and health inequalities and reported that she had been seeking the views of various people about what the next steps should be and what the approach and focus(s) could be. She sought the views of the Board members in relation to this.

 

Views expressed by members of the Board were as follows:

 

-       Yvonne Rees – expressed the view that prevention was fundamental to the way forward and it should therefore be embedded in all thinking across local authorities. She invited Dr Collison to the next Chief Executive’s meeting to discuss this. She also stated that there was a fundamental and very important core link in relation to health inequalities with housing support and leisure. She believed that this could be achieved in Oxfordshire given the power and strength of relationships within Oxfordshire;

 

-       Councillor McHugh offered some case studies which had been prepared at Cherwell District Council on their ‘Families Active, Sporty Together’ programme. Val Messenger responded that joining up with district councils was very positive, adding that everyone around the table was a champion for prevention in some manner or another; Kathy Hall stated that, as part of the OUH Strategy, there was a focus on prevention within the population. She also stated that she would welcome prioritisation to enable the whole system to work on common issues for prevention simultaneously;

 

-       Professor Smith highlighted the importance and practicality of what could be achieved within available resources. He gave loneliness as an example of a preventable condition and the value of voluntary groups and community groups in helping with specific initiatives to combat it. In addition, he highlighted the cost-effectiveness of the treatment of toenails, corns and bunions to aid mobility in older people; and respite support for carers; and

 

-       Dr Riley commented that lists of registered patients at each GP practice could be used to identify groups of people who were not engaging and Val Messenger stated that there were tools for health improvement which could be accessed in primary care.

 

All were thanked for their input.

12.

Reports from Partnership Boards pdf icon PDF 183 KB

3:40

20 minutes

 

To receive updates from the Children’s Trust, the Health Improvement Partnership Board, the Joint Management Groups and the Integrated Strategic Delivery Board (HWB12):

 

(a)          Report from Children’s Trust;

(b)          Report from Better Care Fund Joint Management Group;

(c)          Report from Health Improvement Board;

(d)          Report from Adults Joint Management Group;

(e)          Report from Integrated Systems Delivery Board.

 

 

 

Close of meeting – 4:00 pm

Additional documents:

Minutes:

The Board received updates from the Board’s Partnership Board (HWB12). The following was drawn to the attention of the Board:

 

Children’s Trust – Lucy Butler reported the following:

 

-       Oxfordshire Youth had taken the lead for the whole of the ‘be supported’ programme, the ‘Children Missing out on Education’ project had been very successful;

-       A Statement of Action for children with SEND would be submitted to a future meeting of this Board; and

-       A significant amount of thought was going into the new model family safeguarding model which would be reported in more detail at a future meeting.

 

Councillor Upton asked whether the £5.4m funding for children on the CAMHS programme was sufficient. Lucy Butler explained that this was a specific piece of work to support schools. She added that it had been started in Oxford City, where the greatest need was, and it was hoped it would be rolled out to the whole county.

 

Louise Patten added that nationally there had been an unprecedented rise in  referrals to CAMHS and demand had continued to rise. A significant amount of funding had been devoted to this.

 

Joint Management Groups for Adults

 

Ele Crichton, Lead Commissioner, reported, highlighting the following:

 

-       HART services – OUH was leading on the development of an improvement plan;

-       Work was taking place in relation to supporting capacity in home care; on a home care commissioning strategy; and on urgent care planning for the winter; and

-       Engagement was also taking place on the co-production of an Adults Strategy with partners. This would be brought for comment to a future meeting of this Board.

 

Health Improvement Board

 

Councillor Andrew McHugh, Chairman, highlighted the following:

 

-       Significant progress had been made on the production of a Domestic Violence Strategy;

-       There was concern over a drop in the take up of MMR vaccinations. As a result the HIB had requested a performance report from NHSE;

-       In relation to social prescribing, the Board was in the process of scoping a workshop on this subject.

 

 

Integrated System Delivery Board (ISDB)

 

Louise Patten reported that the key priorities of this officer group was to both oversee and enable any issue that prevented Chief Executives from developing an integrated agenda. She reported that it was now viewed as having an integrated agenda and also seen as an equal partner with Berkshire and Buckinghamshire. Progress had been speedy towards getting everything aligned. The next step was to develop it into an Integrated Care Partnership Board and encouraging the involvement of other people.

 

Professor Smith re-iterated an issue voiced by some which was that the ISDB was a ‘closed shop’. In response to this, Yvonne Rees defined it as a place where conversations took place which then enabled decisions to be made in the public domain. Officer conversations were required as part of the process, without this informed decision-making would suffer. She suggested that perhaps ‘network’ was a better description than ‘Board’.

 

Professor Smith suggested that engagement with staff  ...  view the full minutes text for item 12.