Agenda item

12:30

The final report from the Committee’s Task & Finish Group on Musculo – Skeletal (MSK) services will be presented (JHO10).

This will be jointly presented by the CCG and this Committee.

Prior to the consideration of this item the Committee was addressed by Town Councillor Cathy Augustine. She expressed her disappointment that after initially accepting the report, the CCG was now, in her view, distancing itself from parts of it. As a Didcot Town Councillor, she was concerned that the Didcot Physiotherapy Unit did not become over-stretched due to closures of similar units nearby, and also in terms of service levels and information provided. She added that patients were still reporting long waits and poor information. She concluded by stating that, as far as the residents of Didcot was concerned, this was not a task and finish group, but an ongoing issue.

Councillor Jenny Hannaby stated she had asked why services were not being brought back to Abingdon and Wantage. She reported that she had spoken to the Chief Executive of Oxford Health about Wantage Hospital not being allowed to take over facilities and he, as a result, contacted the CCG to offer the service at Wantage. Unfortunately, by this time, Healthshare had made other arrangements for the service to be provided at Faringdon. She hoped that Abingdon would receive the Service. Councillor Hannaby thanked the Committee for convening the Task & Finish Group, which in her view had opened the public’s eyes to the situation.

Sharon Barrington, Ally Green and Diane Hedges (CCG) and Rob Walker, Healthshare were invited up to the table.

Councillor Monica Lovatt, Chairman of the MSK Task & Finish Group introduced the report (JHO10) from the Group. She paid tribute to her fellow Group members, Councillor Laura Price, Dr Alan Cohen and policy officer Sam Shepherd for all their hard work. She emphasised that the report presented was the culmination of eight meetings which had taken place between June 2018 to January 2019, to hear the views of interested parties, in response to concerns raised to this Committee by residents and patients. She stated that the recommendations made by the Group had been designed to be constructive in nature. They were intended to support and encourage performance improvements and solutions where needed. On behalf of the Group, she thanked all the people who came forward to give their views and the following organisations for their openness and co-operation:

Healthshare (Oxfordshire), Healthwatch Oxfordshire, Oxfordshire Local Medical Committee, OUH and the clinicians who participated in the process, OH and OCC.

She commended the recommendations to the Committee.

Councillor Laura Price echoed all that Councillor Lovatt had said, stating also that the recommendations were not the end for this Committee. There had been some very serious performance issues contained within it and the Group now wanted to see some plans put in place to resolve these issues.

Dr Cohen echoed all that Councillors Lovatt and Price had stated commenting that the Group had thought hard on the performance issues and had found the lack of outcome data for Healthshare disappointing. The way identified information was being collected was incorrect.

Rob Walker stated that the findings of the Task & Finish Group were very helpful, adding that Healthshare was always willing to learn. He stated that Healthshare had always collected and reported person-related outcomes to the CCG since the start of the contract – and, as a result, Healthshare had not found it necessary to alter the way these were looked at.

Questions from members and responses received were as follows:

-       Why was the service in Chipping Norton not operating from the Hospital rather than the Health Centre? Diane Hedges responded that space was not available at the Hospital and the upstairs of the Health Centre had been given over to non-GP related services. The Service Level Agreement for all sites was subject to agreement of terms of use. A request had been made, and, as a result the Hospital had set accommodation aside for other purposes;

-       In response to a question asking what savings could be achieved (page 24 of the report). Diane Hedges explained that at the outset, the target set for orthopaedic support and risk was at £20 per head. The CCG had to ensure that it focused this spend on people receiving the maximum amount of care in order to avoid an intervention in the form of an operation. The CCG had underestimated what was needed, which was £1.6m and £3m had been set aside;

-       When asked about what quality assurance was in place, Rob Walker assured the Committee that Healthshare was satisfied that the levels were as one would expect;

-       A member asked how and why had the target figures been changed? Sharon Barrington responded that there was only a certain amount of money available in Oxfordshire – and due to the 30% increase to make the contract viable, it had been important to benchmark the service against others in order to ascertain which areas could be more flexible. The contract team had agreed it and it had been signed off by the Director of Finance;

-       A member asked if, going forward, the service now had the right balance in place to improve the service, as there were many people who could be in considerable pain if there was a delay in their treatment. Rob Walker stated that this was a very large service, the biggest in the country. The CCG had given Healthshare very definite targets, and he was confident that some would be within the key performance indicators. He added that more staff had been brought into the service and it had a 91% answering rate, which compared favourably with the national survey undertaken for the GP service which was 75%.

Diane Hedges made reference to the changes to the narrative of the report, where some of the more emotive language had been taken out. She also felt that there had not been sufficient recognition of the real efforts being made and lessons learned. She added that the CCG was working through how self - referrals to the service would work – and these points made would be picked up. She was asked if it could be run by a different organisation. Diane Hedges responded that the commitment was to work as one NHS and Social care system.

The Committee AGREED to:

(a)  thank the Task & Finish Group for the report and the representatives from Health for their attendance at the meeting; and

(b)  receive the report and to request all to return to the June 2019 meeting when an Action Plan was to be produced for consideration by Committee.