10:10
The newly appointed Chief Executive of the Oxford University Hospitals Foundation Trust (OUHFT), Dr Bruno Holthof, will attend the meeting to introduce himself to the Committee and share his initial observations from his first few weeks in his new role. He will be accompanied by Andrew Stevens, Director of Planning & Information (OUHFT).
Minutes:
The newly appointed Chief Executive of the Oxford University Hospitals Foundation Trust (OUHFT), Dr Bruno Holthof, attended the meeting both to introduce himself to the Committee and to share his initial observations from his first few weeks in his new role. He was accompanied by his Director of Planning & Information, Andrew Stevens.
The Chairman made reference to the radical plan to the most recent pilot to tackle bed-blocking. A press statement and separate statement of commitment to the stakeholders had been issued that morning (copies of which were circulated around the meeting).
Dr Holthof gave his initial thoughts with regard to Oxfordshire and outlined his initial priorities. Firstly, he highlighted joint working (such as that already demonstrated with the pilot to address delayed transfer of care) as a top priority and that this will be a focus area to further strengthen work across all of the health and social care organisations. He commended the joint working already underway, to look at better ways to get patients back to their home from hospital as quickly as possible. He also stated that a priority area was to review the current activities that are undertaken at Oxford based hospital sites which could be better performed at the Horton General Hospital and other general hospitals in the broader region. Thirdly, he wanted to see the development of more highly specialised services at the John Radcliffe Hospital so that patients living in Oxfordshire, and those from further afield could be treated in Oxfordshire.
A member commented that Banbury was an area that was growing fast and, although she was very pleased that patients would be treated closer to home, she wondered if there would be sufficient care home beds to accommodate this. Dr Holthof responded that if Oxfordshire was successful in commissioning enough care home beds to be turned into intermediate care beds, as part of the ‘Rebalancing the System’ project, then that would solve the long-standing delayed transfers for care (DToC) problem in Oxfordshire. He made reference to his first interaction with the community which had been with the action group ‘Keep the Horton General’ about when it was appropriate for patients to be treated locally. He understood that travelling was an additional burden, adding that treatment at other acute trusts in, for example, Warwickshire, could also be an option, should it not be possible for them to be treated at the Horton for quality or safety reasons.
Dr Holthof was asked if placing patients into intermediate care beds in distant localities would be at the expense of the needs of the families, and might therefore result in people having to go into a home. Dr Holthof responded that the intention was to get the patients home as soon as possible, complete with sufficient care plans. Andrew Stevens added that this had been measured as part of a trial last winter that had successfully provided sufficient home care beds. Members of the Committee were keen to understand the details off this pilot including its outcomes and AGREED that David Smith, Oxfordshire Clinical Commissioning Group, be asked to report on the findings to a special meeting of this Committee in December. This meeting will consider details of the pilot, including the numbers of beds (including where) had been commissioned and what supporting services had been agreed to support the community based care, together with a full range of performance measures to help assess the success of the pilot.
A member asked if the Trust was sufficiently flexible with its rostas to ensure attractive working conditions for nurses. Andrew Stevens responded that the Trusts employed a range of contracts giving opportunities for term time working, for example. However it was better to obtain staff on a permanent basis. The Trust had increased the rates for bank staff in an endeavour to entice them in, rather than using agencies. He added that he had held discussions with GPs and other workers in healthcare on the cost of living in the county, as he believed this to be a very real issue.
In response to a Committee member’s concern that older people may have two moves, from hospital to intermediate care and from there to home, Dr Holthof informed the meeting that a small-scale trial had been carried out on two occasions during the previous year with the aim of moving patients to home rather than via an intermediate care bed. He added however, that to do this on a larger scale would require a look at nursing and care capacity within the system.
The Committee requested, and Andrew Stevens AGREED to come back to the special meeting in December with information about the localities of discharge of patients (in particular to address concerns about Thame.
A member asked about whether the international standing and global role of the Trust was a hindrance or a benefit, Dr Holthof stated that it was a benefit, explaining that many patients wanted access to the latest available therapies for cancer, for example, adding that the hospital conducted many clinical trials and its research base was an additional advantage for Oxfordshire residents.
In response to a question about medical advances which had come about as a result of technological developments, Andrew Stevens stated that there was a need for the Trust to better explain some of the benefits and efficiencies that the advances had brought the Trust and its patients.
Dr Holthof and Mr Stevens were thanked for their attendance.
It was AGREED to ask the OCCG for an explanation at a future meeting about what proportion of patients were coming into the John Radcliffe Hospital for specialist services, and how these services were funded.