Agenda item

10:45

A report on Intermediate Care to be considered by the County Council’s Cabinet on 15 September is attached for information at JHO7. The outcome of discussions will be submitted by way of an Addenda to this meeting.

John Jackson, Oxfordshire County Council and Oxfordshire Clinical Commissioning Group, will attend for this item.

Clive Hill of Chipping Norton Hospital Action Group urged the Committee to advise the Cabinet to suspend its plans for changes at Chipping Norton Hospital and not to make any changes until a review of whole community hospital healthcare in Oxfordshire has been conducted, which would include a properly costed and integrated plan. His view was that the OCC proposal would make the Delayed Transfers of Care (DTOC) situation worse because patient lengths of stay under OSJ was an average of 40 days compared to NHS of 27 days, at an extra cost to the NHS of £750k per annum. David Cameron had confirmed that beds were ‘sub-acute’, meaning that they should be used for a higher standard of care than planned by OCC.

It was the view of the Action Group that John Jackson had made an intimidating ‘threat’ at the last meeting - and that the proposed consultation, giving only two options, was fatally flawed. They believed that a judicial review of the process would find it in their favour.

He stated that it was the view of the Action Group that the OCC plan under OSJ would significantly downgrade the current service provided by Oxford Health. He cited a recent Care Quality Commission report on the ISIS Centre which revealed that of the five key areas evaluated at ISIS, three were rated ‘requires Improvement’ and ‘there was insufficient staff on duty to support people and meet their needs.’

Mr Hill added that the Action Group was aware that OCC had to make budget savings, but ISIS could not be the model just because it was the cheapest. They advocated instead that OCC return the commissioning of the beds to the CCG so that commissioning could fully take into account the overall impact on Oxfordshire healthcare. He added that apart from Banbury, Chipping Norton and the surrounding villages were the largest centres of population in the north of the county and that a fully functioning Community Hospital in this rural area was essential.

Mr Hill commented that the Committee could not have an overview because the wider impact of the OCC plan had not been properly evaluated and there was no integrated approach to Oxfordshire’s hospital healthcare in this proposal. He therefore urged the Committee to take a further reflection and realise that a fair and open consultation could not now take place.

David Smith, Chief Executive, OCCG, Cllr Mrs Judith Heathcoat, Cabinet Member for Adult Social Care, and John Jackson, Director for Adult Social Services (OCC) & Director of Strategy & Transformation (OCCG) attended for this item. Mr Jackson explained that meetings had been held with key organisations, ie OCC, OCCG, Oxford Health (OH), Oxford University Hospitals NHS Foundation Trust (OUHFT), Healthwatch Oxfordshire (HWO) and the Chipping Norton Action Group, adding that OUHT and OH had made it clear at their meetings that it would not be possible to continue the current arrangement for Intermediate Care to be provided through a bed-based service at Chipping Norton. Thus there was no alternative but to proceed to a public consultation setting out an affordable representation on the way Intermediate Care was provided in North Oxfordshire in the future, as set out in the report to OCC’s Cabinet.

Cllr Mrs Heathcoat referred to an email that she and all Cabinet Members had received from Mark Taylor, a director from a Nursing Home in Banbury and the response which she had given to him about the consultation. Within the response she had explained that intermediate care was about keeping people out of hospital and returning people to independent living following a spell in hospital. When referring to the facilities and management arrangements in relation to Chipping Norton Hospital, she stressed that the status quo was not an option and therefore could not be supported. She added that there was no reason for care in Chipping Norton to cost any more than in the rest of the county. Thus there had to be an equality of service provision and options had to be both affordable and sustainable in the long-term.

In response to a question from a Committee member, Mr Jackson clarified that Chipping Norton was not defined as a community hospital, and, since 2011, had not provided sub acute beds. David Smith affirmed this, saying that Chipping Norton did not have the resources to provide acute care. The model for the provision of Intermediate Care, which was in line with the County Council’s specification, had been implemented by Oxford Health since October last year.

Members of the Committee felt it was essential that the fine line between intermediate care and home care and sub acute care at Community Hospitals be made clear within the consultation. John Jackson commented that was very helpful and that he would attempt to address the issue that sub acute and intermediate care had very different processes within the consultation. He added that also that there would be a map of the county showing where people requiring intermediate care beds would be going and the same for those people requiring sub acute care.

The Chairman thanked Cllr Mrs Heathcoat, Mr Jackson and Mr Smith for their attendance.

In light of the above, it was AGREED that the results of the consultation and the recommended/agreed course of action be discussed at the next meeting of this Committee in February 2016.