Agenda item

Oxfordshire Clinical Commissioning Group Update



This item will provide a report on the key issues for the CCG and outline current and upcoming areas of work. Including an update on Chipping Norton First Aid Unit and the CCG Annual Reports.


Clive Hill stated that he did not see why the award-winning Chipping Norton First Aid Unit (FAU) needed to be moved into the GP surgery.  He asked that if it was not a cost problem, if paramedics will not take on primary care work, if the FAU will be commissioned separately and operate independently and if patient records can be accessed in the hospital, why does the FAU need to be moved to the GP surgery?  He said that he understood that the SCAS paramedics could be used to help less qualified surgery staff.


He asked the committee to instruct OCCG to either cancel the proposed change or conduct a full public consultation before any change is implemented.  People see the proposed move as a major backward step and a significant downgrade of the Community Hospital based services.  In addition, this change must not be forced through in a hurry because after the General Election there will be a new Government and policies could well change.


Louise Pattern, CEO, responded that NHS national guidance in 2017 stated that everything must be either an urgent treatment centre or primary care.  OCCG did not want to lose the FAU which was working well so asked for more time to consider the options.


Being a reactive service there can be a lot of down time but by placing paramedics with other clinicians there can be a better utilisation of staff.  The FAU will not be under the GP practice.  It will be commissioned separately but will not operate in a silo.  She AGREED to come back and report on the benefits.


Councillor Laura Price questioned if the decision made sense being taken in isolation from the community hospital issue.  Louise Patten replied that the FAU has to be part of the primary care hub.  Services in Chipping Norton are a wider issue which could include consideration of digital solutions.


Barbara Shaw asked if medics were overstretched and their mental health was being considered.  Louise Patten said that paramedics were often the most stressed staff but that opportunities to work on something different can be helpful.  Staff were in favour of working together.  They had felt isolated.  Councillor Nadine Bely-Summers asked if there were records of the staff feedback.  Louise Patten AGREED that she would see what was available to share.


Councillor Jane Hanna asked when there would be a strategy for community hospitals.  Clarity was needed around community beds especially in areas of expanding population such as OX12.


Louise Patten described how some community hospitals are part of a network such as for stroke rehabilitation.  Some have specialisms.  But local services out of hospital need to be considered as well as social care.  One third of beds are social care funded.


Members agreed that they were not ready to agree that the re-location of Chipping Norton FAU is not a “substantial change”.  The Chairman asked that the toolkit be revised to take account of the wider issue of the viability of the Community Hospital.


Louise Patten stated that there was a commitment to the Community Hospital in the Health and Wellbeing Board’s (HWB) planning but that decisions cannot be made without understanding the overall health and social care needs.  She AGREED to flag the Committee’s concerns at the HWB.


On the Winter Plan, Barbara Shaw asked if interim performance data could be provided at the February Committee meeting.  Louise Patten AGREED to provide this.


Councillor Laura Price noted that there seemed to be some inconsistencies from year to year.  It was reported last year that appointing the Winter Director was impactful but yet it is not being done this year.  The Committee received a paper outlining how the appointment of trusted assessors was crucial but it seems that the OCCG cannot recruit all of the posts needed.  The focus seemed to shift each year and yet the high numbers of Delayed Transfers of Care (DTCs) remains.


Louise Patten responded that plans had to be flexible because things inevitably change during the winter.  For example, the Australian flu was expected this year but has not made an impact yet.


The Chairman asked if trend data for DTCs over the years can be shared with the Committee.


Councillor Jane Hanna stated that it was recorded in the minutes of the last meeting that the risk assessments relating to Brexit would be published.  She had not seen them.  She asked to see on what basis the OCCG had concluded that there was no significant risk, which she said was out of line with the general view – especially regarding the impact of a no-deal Brexit.


Louise Patten responded that any risk assessments that are available are at a national level.  The opinion of local partners that there was no significant risk was their interpretation of the national risk assessments.  The Chairman stated that in his opinion the links already circulated were satisfactory.


Dr Alan Cohen stated that he had repeatedly called for an example audit from Healthshare on quality of outcomes.  He asked that the clinical lead demand this.


The Chairman questioned why the report was briefer than usual with purdah being cited as the reason.  He noted that hospital waiting times can be published during purdah and that should inform OCCG’s interpretation.  He said that he will bring this up with legal officers.


Louise Patten responded that the NHS gave them clear guidance on this and she would welcome their interpretation being challenged.


The Chairman reminded Members that the draft minutes of the previous meeting are included in the agenda published eight days before the Committee meeting and it was open to all participants to request amendments, not just councillors.


Supporting documents: