Report from the County Leadership Team (CC12).

On 21 February the Cabinet considered a paper from the Council leadership team setting out the officers’ assessment of the Oxfordshire Clinical Commissioning Group’s (OCCG) proposals for the future of health and care services in the County. They agreed the following recommendation, ‘to welcome the opportunity to comment on this consultation, acknowledge the difficulties faced by NHS services locally as presented in the OCCGs case for change, but on balance not to support the proposals based on the lack of information on the impact on council services and that of the public.’

Cabinet’s views on the proposals were presented to the Oxfordshire Joint Health Overview and Scrutiny Committee (OJHOSC) on 7 March. The OJHOSC is the statutory consultee on substantial developments or variations in the provision of the health service. OJHOSC invited evidence from a wide range of organisations and will be responding to the OCCG consultation with comments and recommendations as well as meeting again to consider whether the OCCG has responded adequately to the issues it has raised.

Due to the scale, impact and interest of all members in the proposals to transform local health services Cabinet wants to give County Council the opportunity to consider the potential impact on council services and the public. These views will be collated and fed back to the OCCG as part of the consultation process.

A copy of the Consultation document can be found on the CCG web site: The Oxfordshire Big Health & Care Consultation: Phase 1 - Consultation Document

Council is RECOMMENDED to:

(a)          note the views expressed to HOSC by Cabinet on the proposals;

(b)         identify any further concerns regarding the proposals;

(c)          agree for Officers to summarise these further concerns to the OCCG as a response to the consultation;

(d)      Share these concerns with HOSC to aid their further consideration of the OCCG proposals.

On 21 February the Cabinet had considered a paper from the Council leadership team setting out the officers’ assessment of the Oxfordshire Clinical Commissioning Group’s (OCCG) proposals for the future of health and care services in the County. They agreed the following recommendation, ‘to welcome the opportunity to comment on this consultation, acknowledge the difficulties faced by NHS services locally as presented in the OCCGs case for change, but on balance not to support the proposals based on the lack of information on the impact on council services and that of the public.’

Cabinet’s views on the proposals were presented to the Oxfordshire Joint Health Overview and Scrutiny Committee (OJHOSC) on 7 March. The OJHOSC was the statutory consultee on substantial developments or variations in the provision of the health service. OJHOSC invited evidence from a wide range of organisations and would be responding to the OCCG consultation with comments and recommendations as well as meeting again to consider whether the OCCG had responded adequately to the issues it had raised.

Due to the scale, impact and interest of all members in the proposals to transform local health services Cabinet wanted to give County Council the opportunity to consider the potential impact on Council services and the public. These views will be collated and fed back to the OCCG as part of the consultation process.  According the Council now had before it the report for consideration.

Councillor Heathcoat moved and Councillor Hudspeth seconded that the recommendations set out in the report and on the face on the Agenda be adopted.

There then followed a lengthy debate in which the Council indicated its strong opposition to the proposals and rejected the consultation. The following points were raised during debate:

Members discussed the Oxfordshire transformation proposals in the wider national context of significant financial challenge for the NHS and social care. They wanted to emphasise that they understood that the situation the CCG is facing is a result of national policy. The rising demand for health services and lack of funding to address this was a huge national issue which was being played out locally to the detriment of services for local people.

Members felt that the consultation did not make clear the impact on social care and there was a lack of modelling to accurately assess this. It was felt that the proposals would benefit from a workforce plan setting out how the impact on carers would be managed. It should not be assumed that county council services would be able to absorb the impact of the changes on social care. It was also noted that the care sector is financially very fragile as recent examples of agencies becoming insolvent shows.

Members expressed frustration that no options for alternative delivery options were presented in the consultation. Some members felt this implied a ‘fait accompli’ as no alternative future arrangements were presented for consideration. It was also unacceptable to expect proposals for substantial bed closures to be agreed without any detail about proposals for the future of services in the community. These would be vital to support changes in the acute system.

There were consistent concerns about the splitting of the proposals into two phases which it was agreed had resulted in a lack of coherent vision for the future of health and care services in Oxfordshire. Furthermore rolling so many specific issues into the consultation had meant that it lacked clarity. Members agreed that the impact of the proposals on primary care would be significant but this was not discussed in this first phase of proposals and was a significant flaw.

Oxfordshire was experiencing significant housing growth and members felt that there was insufficient planning for this in the proposals. Specifically there was concern about Banbury where significant changes to the levels of service at the Horton Hospital were proposed but also in the south of the county at Didcot which was experiencing substantial growth.

Parking and access to hospitals both in Oxford and Banbury was a particular concern to local members whose constituents already experience considerable difficulty accessing appointments.

The Oxfordshire Transformation proposals did not clearly align to the regional STP process and there were concerns about what the additional impact of these proposals would be on local health services. Members felt these proposals lacked transparency.

Following debate, the recommendations, incorporating the views above was put to the vote and was carried by 55 votes to 0, with 1 abstention)

RESOLVED: (by 55 votes to 0, with 1 abstention)

Council is RECOMMENDED to:

(a)      note the views expressed to HOSC by Cabinet on the proposals;

(b)      identify further concerns, as set out above regarding the proposals;

(c)      agree for Officers to summarise these further concerns to the OCCG as a response to the consultation;

(d)      Share these concerns with HOSC to aid their further consideration of the OCCG proposals.