Agenda item

10:20

This item provides a report on the key issues for the OCCG and outline current and upcoming areas of work. This includes information on a pilot of community palliative care by Sue Ryder (JHO6).

Diane Hedges, Deputy CEO, Oxfordshire Clinical Commissioning Group (OCCG), attended to present the report JHO6. She highlighted the following:

-       The ‘exciting’ progress made that day in relation to the announcement of the Integrated Care Strategy (ICS) which was a testament to improved working between OCC and Oxfordshire NHS, together with the growing

work with the other Oxfordshire authorities also;

-       The large amount of learning which had taken place around primary care and the need to enlarge its capacity. An active piece of work had taken place in Bicester surgeries were being consolidated into one, in order to offer more services for patients. PML in Banbury were taking an active role in strengthening primary care into a more stable environment, supported by more back office structures. South Oxford Health Centre was another practice who had stepped forward to take on a pilot;

-       The pilot work being undertaken by Sue Ryder around giving care and support to more people in their own homes; and

-       The OCCG had realised a small financial surplus which would be used to improve care service.

The deputy Chairman, Councillor Sean Gaul, local member for Bicester, requested that Bicester councillors be involved in the work that was taking place in that area. In return, Councillors could offer the OCCG clarity on what would help in determining decision making. A member added that, as GPs were retiring from the service, it was vital that Councillors were involved in the decisions going forward. Diane Hedges responded that the Banbury Community Partnership Networks had been involved in the past, with which the OCCG had been very open. She reassured the Committee that talks were currently taking place with councillors and also within the public domain.

A member asked that, in light of the need to recruit more GPs, how robust was the CCG’s forward planning processes? She also made a plea that, when considering sites for the new super-surgery in Bicester, that they be accessible for patients in terms of transport to the site, including cycling routes to it, and for parking availability. Diane Hedges gave her assurances that there would be a very clear set of criteria attached to these plans which would include the input of councillors.

In response to a question asking what contingencies were in place should Sue Ryder, or any other charity involved in the new structure, withdraw? Diane Hedges responded that the ICS was a form of contingency in itself. Thought was currently being given to how integration of the voluntary organisations would be achieved, given the pressures of the increasing workforce challenge. As an example of this, there was a collective group comprising end of life, palliative care workers from OUH who were supporting the consultation which included a proposal for the introduction of certain services. She added that these were different methods of working, and in a more joined - up fashion. She added also that the way organisations were now working, meant more of an understanding for each other’s methods of working. The Sue Ryder pilot was a good example of how to facilitate ways of supporting people in new and creative ways.

A member asked that, in light of media reports of hospices not receiving the level of support from central government funding, what was the level of financial input from Sue Ryder and from the CCG; and how it would be balanced out should there be a significant drop in support for Sue Ryder. She also asked for more detail in relation to in-patient bed occupancy and bed numbers; on the scale of pressure on continuing health care and the spend; how much related to legal cases; and finally, how many self - funders there are?

Diane Hedges responded as follows:

-       The Children’s Hospital and Sue Ryder would always welcome more funding. The OCCG paid a proportion of it and donations were added. Favourable conversations were currently taking place with the Children’s Hospital with regard to elements of care which had resulted in additional money flowing in their favour;

-       The OCCG was not in a position to replace services provided by non-NHS providers. However, conversations were taking place with end of life providers to ensure their financial positions. She gave the Committee her assurance that the OCCG wished to be very open and to share its understanding of what was the NHS spend;

-       With regard to the number of beds provided, in September the OCCG planned to conduct conversations about the nature of care provision which did not include beds, intermediate care beds and those in the Hubs. She added that it was not about patients coming through the system, as care would be given at home; and

-       In relation to the cost and volume of care packages provided, she pointed out that there were more older people needing support and this aspect was going to be looked at.

A committee member asked how the OCCG managed the pressures on payment by results, other than by lengthening waiting lists? Diane Hedges responded that it had now been agreed within the Oxfordshire system to pay by creative incentives. A fixed pot of money would be given and this would be used not as a means of managing spend, but via joined up working and by utilising the different skills which were available from within the community.

A member of the Committee asked for an update on the 3 months plan to address the waiting list for gynaecological services – and would Oxfordshire be providing all the services? Diane Hedges responded that OUH had diverted referrals to a quicker service, which had resulted in an improvement and the best performance for over a year. There was also nobody currently awaiting stage 2 treatment now. There had been 459 on the waiting list at the end of May, which was a reduction of 20-25%. Most referrals had been diverted to hospitals in Reading, Swindon and Buckinghamshire. However, there were still long waits for different aspects of the service. Further work was required with the clinicians on this to ensure the right options were considered. In response to a further question asking what the plans were to bring the services back to Oxfordshire. She reported that clinicians at OUH were being given the opportunity to operate on those waiting a long time. The OCCG would continue to review it and come back to HOSC with an update when the service was back in balance. She took this opportunity to thank patients for travelling that little way further to be seen in the meantime.

The Chairman thanked Diane Hedges for her attendance and for the report.