Agenda item

12:30

At its last meeting the Committee received a brief paper on the work being undertaken by Oxfordshire Clinical Commissioning Group to develop outcomes based contracting for mental health and older people’s services.  The Committee asked for further clarity and detail in a number of areas.  This paper addresses the issues raised and is the basis for further discussion (JHO9).

Catherine Mountford and Barbara Battie of the Oxfordshire Clinical Commissioning Group will attend to present the item and respond to questions.

At its last meeting, the Committee had looked at the work undertaken by the OCCG to develop outcomes based contracting (OBC) for mental health and older people’s services. The Committee asked for further clarity and detail in a number of areas.

The Committee had before them a paper (JHO9) which addressed the issues raised and which would form the basis for further discussion.

Catherine Mountford and Barbara Batty, from the OCCG attended the meeting to present the item and to respond to questions.

Prior to discussion, the Committee were addressed by Councillor Jenny Hannaby and it was noted that she had recently attended a OCCG Governing Body meeting and she had been concerned to learn that 25% of patients who were classed as delayed transfers of care would have to leave Oxfordshire hospitals within the month.

Barbara Batty was asked to respond to the concerns of Councillor Hannaby. She stated that there was a recognised need to maintain people within the community but that it was also recognised that patients leaving hospital would require more care when they came out. All organisations were working together trying the relieve pressures on the system and to ultimately meet the targets set.

A member of the Committee asked how the outcomes would be measured. Barbara Batty and Catherine Mountford responded that there were four high level outcomes. Other outcomes, beneath them were being developed to support them. A starting point was agreed and the level of improvement which was expected year on year. The outcomes were currently subject to negotiation and once the contracts had been signed, they would be in the public domain. The Mental Health contract was due to start on 1 April 2015 until 1 April 2016. Each area had very specific indicators. They added that the older people contract was more complex and the service scope was currently under discussion with the providers. The outcomes put forward by the most capable providers were under consideration and would not be agreed for 2015/16.

When asked how it was intended that Committee should engage with the process, Catherine Mountford explained that when the mental health contract was signed, then this would give the Committee the opportunity to talk it through. Members felt that it was unacceptable that the Committee will not get to know the detail until after it had been signed, particularly if it would make major changes to the service. Catherine Mountford and Barbara Batty responded that no service change would be implemented without it being consulted upon and that this stage was only an indication to providers that their model was liked. No implementation or money would change hands until outcomes had been agreed upon.

Dr McWilliam commented that there were pros and cons to the process. Scrutiny will need to scrutinise whether the outcomes have been successfully achieved and also whether the process has proved satisfactory from the patient and public point of view. There would be a need to stay much more closely with provider and voluntary services and scrutinise them as they come. Providers and commissioners will be scrutinised at the same time.

Barbara Batty informed the Committee that Cambridgeshire and Peterborough were a few steps ahead on OBC and there was information on their CCG website on clinical outcomes.

A member commented that contracts would be let for a longer period and therefore very regular reviews would need to be put in place.  Barbara Batty agreed that this is what the CCG wanted to happen. Catherine Mountford added that as well as outcomes the CCG would be building service implantation programmes into the contracts.

It was AGREED that Councillors Thomson and Bulmer and Moira Logie would look at the Mental Health contract before it was signed to ascertain if there was a process whereby the Committee could get involved before signature; and report back to the next meeting.