Agenda item

11.20

John Jackson, Director of Adult Social Services, OCC will provide an implementation update on the Henry Cornish Centre, Chipping Norton following the report to the September 2015 Committee (JHO7).

Prior to consideration of this item, the Committee was addressed by Cllr Hilary Hibbert-Biles, in her capacity as Local Member for Chipping Norton, and Dr Jonathan Moore, GP at the Chipping Norton Health Centre. The major points of their addresses were as follows:

Cllr Hilary Hibbert-Biles

·         The 2011 contract had made clear that the beds were defined as ‘sub-acute’ intermediate care status. The change constitutes a down-grade;

·         In her view, this Committee had not supported the residents of Chipping Norton in relation to this issue;

·         Nursing staff did not wish to TUPE over to the Orders of St. John;

·         There was concern that the Unit was not accepting referrals for people who had known clinical needs during the transition. This constituted a waste.

Cllr Hibbert-Biles called for the Committee to consider this as a substantial change in service, consultation for which had not occurred, and asked that it refer it to the Secretary of State for Health as a consequence. She also called for the Unit to be included in the forthcoming community hospital review.

Dr Jonathan Moore

·         Expressed his appreciation for the large investment made in 2011 when the old hospital centre had closed down. The Hospital now had a Maternity Unit, a Minor Injuries Unit, Physiotherapy services, Outpatients and X ray facilities.. To complement these facilities, a sub-acute unit had always been expected and it had been disappointing to GP staff, in particular to a new GP with an interest in hospital care, to find that the Community Hospital had been downgraded without sufficient consultation;

·         There had always been a need for sub-acute beds and there had been no alternative model of care provided; and

·         The numbers of beds were shrinking and as a result there was an inadequate background provision of care in the community.

The Committee had before them a briefing on the implementation of the new arrangements at the Henry Cornish Care Centre ICU. On 26 January 2016, the County Council’s Cabinet had approved Option A for the ICU which involved the ICU continuing, the full 14 bed service being provided by the Orders of St John Care Trust (OSJCT). The paper addressed the staffing issues, including the TUPE transferred staff, implications for service users and the plan moving forward.

Due to difficulties in recruiting staff in the west Oxfordshire area, a transition plan had been put in place that involved staffing the ICU with a combination of transferred nursing staff and Health Care Assistants, agency nursing staff and OSJCT care staff. All community and urgent care services would be available as usual during the transition period and there would continue to be medical and therapy cover available to the Unit at the same level as currently provided. The transition plan would focus on providing the service to those predominantly with rehabilitation needs. The service would therefore not be accepting referrals of people during the transition period who had known clinical needs, as it was essential that safe care was provided. The timescale for achieving these aims depended on the recruitment of nursing staff and it was envisaged that it would take approximately 3 months to recruit staff and a further period of 1 – 2 months to fully mobilise the nursing led service.

The Chairman welcomes Sara Livadeas, Strategy Director and Patsy Just, Assistant Operations Director, OSJCT; and John Jackson, Director for Adult Social Services, OCC.

John Jackson introduced the report about an issue which had been discussed on a number of occasions at this meeting and the Committee had previously asked for an update report on implementation. Mr Jackson asked to respond to a number of points made by Cllr Hibbert-Biles and Dr Moore. These were as follows:

·         OCC Cabinet had already made the decision on 26 January 2016 on the process of implementation;

·         Points had been made during the consultation which had directly addressed the allegation made by Cllr Biles and the Steering Group that the service had been down-graded. No person had written to his department specifically concerning the allegations. He invited a response to it, stating that the consultation information was still in place on the OCC website;

·         Improvements to the Intermediate Care Unit had been made by OCC alongside considerable investment made by the NHS into the other facilities offered, as set out above. He paid credit to the efforts made by OSJCT to provide a full complement of nurses in the implementation time-scale.

Sara Livadeas stated that the Unit had only been open for just over 2 weeks and thus it was only very early days. The OSJCT had not been able to begin the recruitment process until after the consultation had ended and the decision made. She pointed out that 3 part-time nurses had transferred from Oxford Health to OSJ and 80 hours of cover would be provided from Health Care Assistants. Whilst she understood any concerns, the nurses on duty would provide a stable staff group, aided by an agency nurse, to give cover at all times to those patients reliant on services available other than clinical nursing care.

A member of the Committee asked why OSJCT had not started a dialogue with OCC regarding staffing during the course of the consultation. Sara Livadeas responded that it had been decided not to do this in a bid not to want to pre-empt the outcome of the consultation.

Points made and views expressed by members during debate were as follows:

·         The people of Chipping Norton had been promised a ‘sub-acute’ service which would be run by the NHS. Now it was not the case and recruitment had proved difficult. There should have been a plan put in place for what may happen and then contracts could be adjusted accordingly if necessary;

·         The mapping of the ICU facility, staffed by OSJ nurses, should be mapped against other provision to ensure transparency.

John Jackson responded that, as part of the communications about the new service, OCC had published a large amount of information on the OCC website. Detailed information had also been given on the specifications of both NHS and OSJ provision, and had been compared with each other. He added that it had proved particularly difficult to recruit nurses in the west oxfordshire area due to it being predominantly rural and housing prices and rents being relatively high. He referred to a crisis in the recruitment of nurses which, he warned, might become an emergency in the future, if something is not implemented nationally.

Committee accepted the need to recruit additional permanent nursing staff for the 3 month transition period.

In addition, Members received confirmation from the Director of Adult Social Services that the Intermediate Care commissioned beds would be included within the county-wide Transformation consultation to be undertaken in the autumn of this year, as set out on page 3 of the Transformation Plans report.