15:30

The OCCG will give an update the Committee on the transition of Learning Disability services from Southern Health to Oxford Health which took place in July 2017 (JHO14).

Following the transfer of specialist learning disability health services from Southern Health Foundation Trust to Oxford Health in July 2017, Sula Wiltshire, the OCCG’s Director of Quality and Lead Nurse attended to present an overview report (JHO14) of the transition which included a consideration of whether lessons had been learned. She was supported by Chris Walkling, Senior Commissioning Manager for Mental Health at the CCG and the co-chairs of the Oxfordshire Transforming Care Partnership Board, Gail Hanrahan (Oxfordshire Family Support Network) and Paul Scarrott (My Life My Choice).

She introduced the report by stating that the OCCG had undertaken this piece of work at the request of this Committee, its focus being on quality and safety from the users and carers’ perspective. She informed the Committee that this had been very much a shared piece of work with Southern Health, Oxford Health and ‘My Life My Choice’.

Paul Scarrott informed the Committee that he had sat on the Board during its consideration of the transition and its view was that the transition had gone smoothly, with no staffing problems encountered. The Oxfordshire Family Partnership Network had been successfully embedded within the process which had involved families and users in the process. It had also co-chaired the Board. The Network had been part of the whole of the process, for example, viewing and commenting on, if necessary, letters to families prior to despatch. This had been very good from the Network’s perspective.

The Chairman stated that this information was very reassuring and positive, asking if Oxfordshire was the only place who had experienced this level of involvement. Gail Hanrahan explained that this had been a difficult process to be a part of initially, given the mistrust from families following Conor Sparrowhawk’s death. She added that it had been a risk of reputation for their organisations to be a part of the process. She added however that there would always be a mistrust of the NHS, given the recent Leader’s report and the Mazar’s review. A benefit had been the learning for the NHS that the involvement of families was required when changes were made to a service. As a result of this involvement there was now more trust in the process and knowledge that the views and input of families were required to create a more level playing field.

A Committee member thanked Gail Hanrahan and Paul Scarrott, on behalf of the Committee stating that there was a need for more of this method of involvement within the NHS when difficult changes were proposed. Sula Wiltshire was asked if there had been any interaction the ongoing health inequality work within the County. She responded that, as a result of the Mazar’s report, a joint report had been undertaken between the OCCG and OCC’s Safeguarding Adult Board. As a result, a sub-committee had been created reviewing mortality and morbidity. This had been set-up prior to the formal requirement to look at it. She reiterated the importance of learning lessons. For example, it had been found that people with a learning disability and/or autism were not invited to breast/bowel screening examinations. In general, hard work was in progress with local providers and there was a passion to improve the lot for these people, as they were the most vulnerable in our society. She added that it was about how to strengthen services around it and create a bigger footprint. As the services were quite specialised, the Safeguarding Board was working with colleagues in Buckinghamshire and Berkshire looking at how to strengthen the expertise of providers in this area. She added that the Chair of the Health Inequalities Steering Group had also taken up the offer of help and co-operation in this regard. She was unsure about whether Professor Griffiths had taken evidence from for the Commission report, but undertook to find out.

A Committee member commented that more funding had been made available by the CCG for the transition of the service and asking whether the contract value had been increased. Sula Wiltshire responded that that the local authority held the contract for Southern Health and it was clear where these resources would like to be placed. It was about ensuring that when and where investment was received, the desired outcomes were realised. Chris Walkling added that the contract would include a secure learning disability service as there was concern in the whole of southern England that patients often stayed longer in medium secure services with nowhere to go on to. Discussions were ongoing about developing the medium secure service locally on the same site, in order to increase provision.

A member asked if out of area placements were more expensive and logistically more complicated? Chris Walkling responded that a ‘lift and shift’ approach had been taken as part of the transfer. There were no local beds at the point of transfer and then, as part of the Transforming Care Programme, they were looking at developing services. Negotiations were in progress with a Hertfordshire NHS Trust in relation to out of area beds and specialist learning disability beds moving closer geographically, with Oxfordshire looking at developing short stay admissions. Numbers were relatively small for short stay, but no necessary lengths of stay were being reduced.

Gail Hanrahan reported that the Oxfordshire Family Support Network had been in contact to ask how the beds were being used, to ensure that an independent advice and support network was in situ. She added that currently they were working with two families alongside colleagues at Oxford Health in the Intensive Support Team. Parents were working with Oxford Health to ensure that any move back home was smoother. There had been some difficulty encountered in relation to where they would go when they returned. She added her view that there was a need for other services in Social Services and Social Housing to work together on this matter.

Paul Scarrott commented that a friend was experiencing difficulty in seeing their daughter in a home in Birmingham. However, now that she was back living closer, communication had been much improved. Chris Walkling responded that they were working more closely with family carers – and families went out to other areas to view what was being provided.

In response to a question about what additional help and support could be made available, Gail Hanrahan stated that the development of new services needed to be in equal partnership with families and carers. Her membership of the Board, together with that of Paul, had resulted in them feeling valued. They had been paid consultancy rates in recognition of their huge expertise as parents. The Board could not make any decisions unless they were present. Paul Scarrott added that it had been an excellent experience, in particular the experience gleaned when working with other people with a learning disability, and bringing what was learned back to the Board. A Member suggested that perhaps this was a learning experience which all needed to take on board when working with patient groups. HOSC ought to be asking why others were not using this valuable experience.

Sula Wiltshire was asked when the CCG would be moving on to the evaluation of the impact on patients. She responded that this was part of the improvements to the service, for example, the work ongoing in relation to access to health checks and inclusion as part of the screening programme to detect illnesses at an earlier stage. The CCG intended to track this via the Transforming Care Partnership.

The Committee AGREED to request the CCG’s return, at a later date, to the Committee’s Forward Plan in order to review the evaluation of the changes.