10:15
Representatives from the Transformation Board will update the Committee on the following:
· Consultation process, timetable and sign-off schedule
· Feedback from the pre-engagement phase
· The Sustainability and Transformation Plan itself
Minutes:
The Chairman welcomed Stewart Bell, Oxford Health (OH); David Smith, Dr Joe McManners and Damon Palmer, Oxfordshire Clinical Commissioning Group (OCCG) attended for this item.
Stuart Bell gave a presentation - the objectives for which were to:
- summarise the key messages from the public conversation regarding the case for change in transforming health and care in Oxfordshire and the emerging models of care;
- give a summary of the key messages from the public conversation;
- primary care development;
- to seek views to help inform the thinking and development of plans as part of the ongoing process of engagement.
Mr Bell pointed out that one of the key messages from the public pre-consultation was that there needed to be an interconnection between all services so that any questions relating to other services could be raised and may engender more useful work.
David Smith reported that there would be a delay in launching the consultation It was currently anticipated that the new date was early January 2017. He added that the Clinical Senate and NHS England had to sign it off primarily. He also stated that the earliest a final decision could be made was May 2017 and the implementation period would be up to 5 years.
Stuart Bell confirmed that transport matters were high on the public’s list of priorities.
The Committee asked to receive a summary of information given out at all the roadshows, as it was a useful method of informing their constituents.
Damon Palmer confirmed that the next stakeholders meeting would be on 22 September. The Chairman confirmed that she would attend this event and relay any information to all members of the Committee.
Members of the Committee urged Health representatives to give more information on the ongoing remedial work that was currently underway, for example in relation to the closure of certain GP surgeries. More flesh was needed on the bones, for example what criteria was being used to determine which were to close. Mr Bell responded that access to services was a major factor being considered. He added that the Deer Park surgery, Witney was a slightly different situation in that the provider was proposing a difference in quality. He added that the issue was how do small practices continue to make ends meet in the plans for the future integration of primary care with the hospital sector and the community services. GPs and PML were looking at the whole primary solution trying to work it out for the whole population. With regard to a question about provisions being made to transfer patients to other surgeries, the current plan was to expand other practices to enable them to take on more patients. He stressed that patient support was the key issue. In answer to a question about the sustainability of care provision via primary care providers, David Smith responded that this came back to the importance of getting as much right before the consultation began. He added that lessons learned from elsewhere had informed them that if the consultation was to start too early, the outcome might result in it having to be repeated. Furthermore, the difficulty was that each part of the system ie. voluntary care, primary care and social care was under pressure. They needed to be as clear as possible about their assumptions on what could be provided not only in the NHS, but by other providers.
Stuart Bell was asked about the long-term sustainability of care provider services funded by the County Council. He responded that traditionally the care sector had been regarded as a separate world, but the Plan recognised its importance. At a practical level, the current outreach work being provided in nursing homes had proved to be very successful because patients were helped to leave hospital quickly. Integration of social care could increase the stability of the system, for example, the rotation of staff through the whole system. Part of the work being undertaken was to ensure that this would not be exposed to problems such as that of recruitment.
David Smith responded to questions about the possible closure of community hospitals and the impact of that on villages and rural areas with no available transport; what help or incentives would be available for key workers? and would the private sector be subsidised? He advised that the OCCG could not proceed with ‘half-baked’ proposals and it was far better to conduct a proper dialogue using information that was correct. He added that if the Health system did nothing, by 2020 there would be a £200m deficit, and in the face of demand rising significantly faster than the 2% financial growth monies that Health was receiving, this was not a reality. Should there be work undertaken with other sectors, there would need to be a radical series of trade-offs and a series of choices. Dr McManners explained that the Government had requested each area to provide cuts in service provision. £5m had been top-sliced from the NHS England budget to pay to nursing homes. Furthermore, acute hospitals were starting to work on locality planning. GPs were looking at services in localities, for example, what out-patient provision could be undertaken in their area. Also the future co-location of social workers, GPs and nurses was also in the process of being discussed for each locality. Once this had been completed then discussions would begin with the public.
Cllr Doughty, local member for Witney, expressed concern about the urgent issues to be addressed at the Deer Park surgery in Witney and the need to take on board the views of the residents in relation to future plans for primary care in Witney. Dr McManners responded that there was a need to organise an urgent briefing. The Chairman made reference to a similar situation in Bicester (see Chairman’s report later in the Agenda) where members of this Committee had invited local Councillors and the local patient groups to a meeting about supporting people to transfer to other practices and the future of North Bicester Surgery.
A member asked why there had not been a road show in Abingdon, to which Stuart Bell responded that an event was planned to take place in that location during stage 2.
In response to a question about whether the possibility of more extra care housing in new developments had been considered in Banbury and other areas, David Smith informed the Committee that the OCCG’s modelling assumptions had to include the best projections for housing across the patch and activity. He stressed that there was not the same activity everywhere. Following that the OCCG would look at what primary care facilities were required.
A Councillor added his concern that Bicester had not been included within the list of sites in the emerging whole system options, making reference to the additional growth in housing in this area. He called for more forward thinking on the part of OCCG and more care given to the residents who are impacted by the closure of a GP surgery, citing as an example, the imminent closure of the surgery in North Bicester on 30 September where local residents had not had sufficient time to register with a new GP surgery. David Smith responded that Bicester was not the only area across Oxfordshire that was under pressure and the OCCG was trying to support primary care as much as possible. He added that there were specific issues that they were addressing, such as how to make some areas more attractive to GPs and how to introduce more funding into primary care to make services more sustainable.
Stuart Bell was asked how the Transformation Plan (TP) for Oxfordshire would fit into the BOB (Berkshire, Oxfordshire and Buckinghamshire) Plan (the Sustainability & Transformation Plan (SDP) and how it would feature in terms of available funding. He responded that the TP process for Oxfordshire pre-dated the STP process. He added that it had not been helpful that the STP Plans had not been published, but reassured the Committee that all the discussions taking place in this local arena were part of the STP and there would not be anything new when they were finally published. He reassured the Committee also that the Horton Hospital would be included in the pre-consultation and in the TP consultation. In response to a question, he confirmed that there would be data available on each option contained within the consultation, together with comment on whether this would be affordable or not.
The Chairman thanked Mr Bell, Mr Smith, Dr McManners and Mr Palmer for their attendance.