Agenda item

10:20

To scrutinise the outcome of the implementation of the ‘Planning for Future Population Health and Care Needs Framework’ in the OX12 Locality.

A report from the HOSC Task and Finish Group on the roll out of the Framework will follow later as an addendum.

Julie Mabberley, Chair of the Stakeholders’ Reference Group, stated that she had circulated a letter to members of the Committee earlier.  She was disappointed in the process.  There is a wealth of data on current needs but nothing of future needs.  The report did not provide a basis for future decisions and she supported the Town Council call for it to be withdrawn.

Brian Falkenau, Clerk, Wantage Town Council, had already circulated the views of the Town Council to Members of the Committee.  He stated that the report’s contention that the area was well served was not credible.  He called for the beds to be re-opened.  The figures used to justify them remaining closed were superficial and took no account of seasonal demand.  The Town Council had not been invited to take part in the process.  They would like to participate and access the data but, in the meantime, they asked for the report to be withdrawn.  Grove Parish Council supported this request.

Maggie Swain, Save Wantage Hospital Campaign Group, noted that the only definite proposal in the report was not to re-open the beds – everything else was suggestions.  She disputed the figure of 12 beds, saying that there were 18 when she last worked in the hospital.  Given the problem with bed-blocking and shortage of care workers in the county, the hospital could assist with that problem.

Councillor Jenny Hannaby, Grove and Wantage, stated that she had agreed to go along with the Stakeholders’ Reference Group when it was proposed by HOSC, as she wanted an outcome to help with primary care in the town which had a growing population but was losing infrastructure.  She believes that Oxford Health had already decided that they wanted to close the beds and she has no confidence in any consultation process.  She asked that the report be withdrawn until there was a county-wide strategy for community hospitals.

Councillor Alison Rooke introduced the report from the Task & Finish Group.  She thanked the members of the group for their hard work, especially the Chair, Councillor Mike Fox-Davies, and the policy officers, Sam Shepherd and Martin Dyson.

The Chairman welcomed Louise Patten, CEO, to her final meeting with HOSC before she leaves her post.  He stated that she had built a very good relationship with the Committee, despite disagreeing on certain areas.  He wished her well.

Louise Patten described the background to the report.  The Framework had been agreed by the Health and Wellbeing Board after consultation with HOSC.  This report described current needs.  No decisions had been made.  The next step would be consultation.  She said that services and beds were separate issues.  There was still a lot of work to do to draw out further information on community assets.  There are no plans to close the facility – it could be adapted for other uses.

Jo Cogswell, Director of Transformation at OCCG, added that it was the first time this Framework had been used and they have learned a lot from it.  She felt that the Task & Finish Group had been a healthy challenge.  The team had met with the Stakeholders’ Reference Group to walk them through the report.  It was clear that they were disappointed and that the key question for the local community was the reinstatement of the closed beds.

Councillor Alison Rooke outlined the recommendations from the Task & Finish Group, highlighting the five points under Recommendation 14.  She added that their work was not finished and that they should continue as long as HOSC decides is necessary.

Ansaf Azhar asked if the terms of reference of the Task & Finish Group needed to be discussed if it is to continue.

Louise Patten said that she shared the frustration that this community asset is not being fully utilised at a time when Wantage is short of space for health services.  The extension for GPs has not been signed off yet.  There are different ways in which these beds could be used – either for specialised services or more general services.  More work will need to be done before consultation.

Jo Cogswell noted the criticism that their questionnaire lacked questions about people’s experiences of health services.  That will be part of the next phase.  The question of the beds remains open but this report suggests that needs are being met in other facilities.

The Chairman noted that after countless meetings, the needs assessment and recommendations from the Task & Finish Group, this meeting was having the exact same conversation as before.  He believed that a county-wide needs assessment is needed.  That would take 18 months to two years and he proposed that the money ring-fenced to deal with Legionnaire’s disease in the building be used in order to re-open the beds in the meantime.

Louise Patten stated that there was an operational strategy on how to use beds.  She believed that there was enough information to go to consultation.  This could be scoped together with the Task & Finish Group.

Councillor Laura Price noted that there had been a motion passed six years ago to have a cross-county examination of community beds.  This is still needed.  Community services have been dogged by problems with resources and staffing.  There is a big problem with Delayed Transfers of Care.  She asked if the hospital could not contribute to a solution.

Louise Patten responded that there is a lot of interest in different uses of the facility.  However, if all of these are taken up now, it would be seen as pre-empting the decision on beds.  That decision needs to be made before looking at which services should go in.

Dr Alan Cohen asked how long it would take to complete an Oxfordshire-wide community services plan in order to put the OX12 area in context.

Jo Cogswell responded that the strategic vision is there to drive solutions.  The Primary Care Network for OX12 is already using the team’s intel to help in targeting patients.

Councillor Alison Rooke asked what evidence there was to back up the suggestion to locate dialysis in the hospital.  She had only seen it mentioned in one questionnaire response.  If it was intended to service people outside OX12, the lack of public transport will be a problem.

Jo Cogswell responded that it was just a suggestion – she didn’t have detailed figures on it to hand.  They looked at much more than the questionnaires.  A business case would be needed to proceed.  Louise Patten added that it could be part of a wider network of services.

Councillor Jeanette Matelot recalled that there had been a similar debate in Thame.  They had a pilot scheme to bring in an orthopaedic surgeon which worked out well.  Louise Patten agreed that the situation was similar – a change of service was proposed which was hard for the community to accept.  There was a level of distrust but confidence is growing and the new service in Thame has the support of the League of Friends.

Councillor Laura Price expressed concern that the lack of a county-wide strategy was undermining the work done for the report.  The issue of beds in one hospital should not be dealt with in isolation.

Louise Patten proposed that they move to consultation on Wantage Community Hospital to address the question of beds – possibly including wider uses.  She was confident that enough county-wide information is there – if they find anything missing, they can move to cover that.

The Chairman summarised the situation.  They have been through the assessment with input from the Stakeholders’ Reference Group and the Task & Finish Group.  He thanked all involved.  The Committee had fought hard for the officer resource needed.

He proposed that the Committee support recommendations 1 to 13 for which a response will be required from the health system.  He also proposed that they support recommendation 14 for the Health and Wellbeing Board.

He understood the strength of feeling behind the calls to withdraw the report.  He had to balance that with the Healthwatch report on the process which indicated that all views had been aired.  He noted though that they said that they saw no tangible change and there was learning to be taken from that.

He recommended that the Task & Finish Group continue their work.  The Terms of Reference allow it to continue scrutiny until implementation.

He made a request to the CCG that if they find that they need more information by September/October and more time to research it, that they re-open the beds in the interim.  Louise Patten responded that it would be for the Health and Wellbeing Board to decide but it would consider that request.  They would have to take the financial situation into account.  The capital money is ring-fenced but service funding would still be a question.

Councillor Laura Price asked how proceeding with the consultation sat with recommendation 14 b) on the development of a county-wide strategy.  The Chairman responded that it was not a finite process.  Needs would be assessed one area at a time.  It would be an ongoing process which the Committee would continue to scrutinise.

Dr Kiren Collison, Clinical Chair at OCCG, thanked the Committee for the scrutiny and challenge.  She said that it put them in a good place for taking the Framework elsewhere.  She added that it was important to remember that research had shown that only 20% of health outcomes come from the health service while 80% relate to environmental factors such as transport, loneliness etc.

RESOLVED:

·         to agree Recommendations 1 to 14 in the report of the Task & Finish Group along with an additional Recommendation 15: In the event that, by September or October 2020, more time is needed to gather information, the Committee requests that theCCG take a Board decision that the beds in Wantage Community Hospital be re-opened in the interim.

·         that the Task and Finish Group continue to scrutinise the process.