Agenda item

12:40

The Committee will receive an update (JHO11) from the Oxfordshire Clinical Commissioning Group and Oxford Health Foundation Trust following the recommendations put forward at the last meeting on 20 September (Minute 47/18 refers), including proposals for the resumption of services and any necessary consultation on services at Wantage Community Hospital.

Two reports are attached entitled ‘Planning for Future Population Health and Care Needs’ and ‘Planning for Population Needs – Wantage’ (JHO11).

Prior to consideration of this item the Committee was addressed by Maggie Swain (Save Wantage Hospital Campaign Group), Councillor Cathy Augustine and Councillor Jenny Hannaby, Local Member.

Maggie Swain

Maggie Swain made the following points:

·         She was a ‘passionate advocate’ of the Hospital as a result of her mother’s past employment there and also in her own capacity as a volunteer up until the time of its temporary closure. Once her mother had become ill she had attended the hospital for regular respite;

·         The campaign group agreed with the future plans by the OCCG to restore the overnight beds, which it was understood were linked directly with the pipework, but there were other facilities that could be restored without the need for the pipework to be done;

·         In recent years it was the view of the campaign group that there had been a gradual decline in the services provides. These were the removal of X ray, the stoppage of clinics such as Ear, Nose and Throat and of Physiotherapy without consultation, and the temporary closure of the Minor Injuries Unit;

·         Besides Grove, there were at least 18 villages/hamlets within a 5 mile radius, most of which had no services or transport; and there was a reliance on Wantage for them. For someone living in Letcombe Basset without transport;

·         Since the Hospital’s temporary closure in July 2016, money had been spent on the following, none of which had been of any help to the people of Wantage:

-       Securing the building due to the loss of 24 hour cover with the closure of the beds;

-       Moving Physiotherapy into the main area of the hospital, then closing it;

-       Provision of security guards to protect the building; and

-       The conversion of rooms to accommodate NHS staff that had been moved out of the Mably Way Health Centre;

In conclusion, Maggie Swain commented that the Campaign Group were aware that the OCCG had opened a dialogue with the residents of Wantage, but it appeared that nothing would be decided for a further year. This was ‘totally unacceptable’ as this meant the Hospital would have been temporarily closed for nearly 3 and a half years. There was uncertainty whether there would be a slippage again or even cancellation. A way of gaining trust was to reinstate a service which had been lost.

Councillor Cathy Augustine spoke of her concerns that Phase 1 of the ‘Big Health and Social Care’ conversation spoke to only 900 people in total, across the whole of Oxfordshire, which amounted to less than 0.5% of the population. In addition, only 46 people responded to the South West Oxfordshire Locality Plan Survey and 4 in Didcot. As a result, Ed Vaizey, MP for Wantage and Didcot also raised a concern in Parliament about the lack of consultation.

She called for the Committee to exercise its powers of independent oversight and scrutiny to challenge NHS England on the imminent Integrated Care Service on the grounds that there may be potential for one large contractor which may be private, and a myriad of sub -  contractors, which would be likely to lead to dis-integration.

Councillor Jenny Hannaby declared a personal interest as a volunteer for the League of Friends for Wantage Hospital. She made the following points to Committee:

·         Over the years monies had been spent on the hospital, but not on the pipework which had had a detrimental effect on the Hospital;

·         The statistics as set down on page 131 of the paper were ‘disgraceful for the residents of Wantage’ if compared to the admissions in other community hospitals. The beds had been temporarily closed, thus rendering the statistics to hold no meaning at all. The decision that Oxford Health was making was making, in her view, a ‘non-viable’ hospital;

·         Some people would be unable to travel farther afield to other hospitals for treatment for the reasons outlined by Maggie Swain – Community Hospitals played an important part in offering support to these people;

·         She reminded the Committee that Oxford Health and the OCCG had used the hospital from the time the legionella had been cleared up to July when it had been closed;

·         Part 2 of the Oxfordshire Transformation consultation had not appeared, which had ‘added fuel to the fire’;

·         Closure costed the taxpayer £180k per annum.

Cllr Hannaby stated that on her view the Wantage residents had been let down and urged the Committee not to support the paper, to take responsibility for mending the pipework and to make the monies available to recruit the staff one more.

This item has been included on the Agenda following the recommendations put forward at the last meeting on 20 September (Minute 47/18 refers) which included proposals for the resumption of services and any necessary consultation on services at Wantage Community Hospital. The Committee had before them two reports entitled ‘Planning for Future Population Health and Care Needs’ and ‘Planning for Population Needs – Wantage’.

The Chairman welcomed Louise Patten, Dr Collison and Jo Cogswell (OCCG), together with Stuart Bell and Peter McGrane (OH) to the table.

Louise Patten stated that the CCG had taken all comments made by stakeholders and the public into account and had produced an improved framework. Commissioners and providers had demonstrated a clear commitment to work together to meet the health and care needs of residents of Oxfordshire both now and in the future; and to plan and work alongside the public and with stakeholders in an open and transparent way. She drew the Committee’s attention to some significant work which had taken place over the past ten weeks in the form of a place profile and draft outline timetable relating to engagement and consultation, if so required. She further stated her appreciation of the fact that residents were concerned about the future of Wantage Hospital, but the work was required to identify in a quicker timeframe, what the local needs were, together with services required.

Stuart Bell stated that the Committee’s request to re-instate the pipework was taken back to his Trust Board and revised estimates had been requested. This had amounted to £450k (including vat). He explained that the problems with the plumbing had been due to various additions to the Hospital structure over the years, and therefore, legionella had grown in a haphazard manner. Stuart Bell stated that it would not be appropriate to undertake remedial works before any decisions had been made about the future of services at the Hospital site. However, there was a commitment to make the investment to replace the plumbing for whatever services were identified. He added that the Midwifery service had been kept and the Health Visitors and school nurses had been moved into the Hospital due to the need for more space for primary care. He added that the Trust was happy to continue to use the Hospital’s space until such time as it was known what to use the Hospital for in the future.

Questions from Members of the Committee and answers received were as follows:

In response to a question asking which services would not require a consultation process prior to delivery, and could thus be delivered more speedily, Louise Patten stated that if there was a significant service change then formal consultation would be required. For example, there would have to be if specifically addressing overnight bed provision. However, should there be services to which improvements would be made then formal consultation would not be required. All change had to be based on evidence, which required some analysis. The Chairman clarified for the Committee that what the NHS termed ‘engagement’, the local authorities called ‘consultation’.

A member commented that whilst she recognised the need for services in Wantage and Grove as soon as possible, it may be advantageous for members of Save Wantage Hospital Campaign Group to visit the new Townlands Hospital in Henley-on -Thames to see the more up-to – date services provided there. Stuart Bell stated that Townlands was working very well and it was his view that if a community hospital was to have a secure future, then this was the way forward, as this was the way in which services were developing. He added that he would be pleased to invite people along to see the newly developed outpatient services which included 14 specialities, with consultants from the Royal Berkshire Hospital coming out to Henley, if that would be helpful. He stated also that this Hospital was now able to provide a wider set of services and also supported the nursing home from the hospital. He pointed out that the Hospital did not start off with these specialities, this had grown.

Stuart Bell also pointed out that the beds created at Abingdon Community Hospital were dedicated for patients suffering from a stroke, in a specialist ward, giving better outcomes as a result. He added that the drive now across the world was to support patients in their own home for improved clinical outcomes, bed-based care causing more harm than good for frail, bed-based older people. Ten days in bed was the equivalent of ten years loss of muscle function.

In response to a question, Louise Patten confirmed that there would be an evaluation framework as part of the process. She added that an evaluation was also about what people felt about their services and this information would also be built in, to enable this to be shared with the system.

A member asked if the CCG felt it had a legal duty to consult when services had been temporarily closed on a long-term basis? Louise Patten undertook to circulate a legal view to the Committee.

A member commented that the public did wish to engage and thanked the CCG for this, however, there was a need for clarity about the precise locality in which the paper was directed. The paper talked about discussion with stakeholders around the locality of Grove and the surrounding villages. However, residents were concerned about the population growth in that area,which was 45k in 10 years. Louise Patten replied that work had already been done with stakeholders to establish the need for GP practices. With regard to services, there was a need to define the population needs in relation to population size and what was required. Therefore, the first tranche was about defining that particular locality. The CCG had listened to the frustrations voiced by the public about not being listened to with regard to the establishment of services in the past and was addressing that. In response to a further question asking for clarity on what population was the basis for the papers, Jo Cogswell explained that it was the CCG’s intention to work locally to determine this whilst engaging with the public and the community, and developing in a transparent manner. Louise Patten added that definitely by May 2019 the CCG would have some idea of what services could look like. The CCG was already talking to other services and looking at providers in relation to what could be done. This timetable was reasonable, especially as it was the first time the framework would be used, but there was no wish to over-promise and under-deliver.

The Chairman, responding on behalf of the Committee, stated that Members had been very disappointed to read the report, in that its request to accelerate the timescale had not shortened the proposed timeframe for decision. However, it was felt that the overall approach for health and care needs was a good one. He added that the Committee was keen that there was no further delay and so proposed, and the Committee AGREED (unanimously) the following:

(a)  that this Committee is not prepared to endorse the plan for the Wantage Locality against the current timetable and to request the CCG to come back to the next meeting of Committee with a shortened timetable;

(b)  to request the legal officers at NHS England to scrutinise their interpretation and advice in relation to the issue of purdah as a reason not to embark on the process and the impact of this on the timescales for the work to begin; and

(c)  to form a task and finish group in relation to Wantage Hospital.