Agenda item

2.50pm

A report from the Oxfordshire Clinical Commissioning Group.

Diane Hedges summarised the report and the focus for the third phase of recovery: accelerating the return to near-normal; preparing for winter; and learning the lessons from the first COVID peak.

People are less nervous now about attending hospitals and clinics but the message really needs to get out there that it is safe to return to services.

Cancer services were greatly impacted with a dramatic drop in presentations.  Resources were being prioritised to the greatest need.  The Thames Valley Cancer Alliance was leading the recovery having developed a programme of high impact interventions.

With elective care, capacity was reduced due to COVID measures but face-to-face consultations were available when needed.  Not all services had re-opened – for example ENT (Ear, Nose, Throat).  They were working with the independent sector to help ease the reduced capacity.  Patients were offered alternatives that would mean they would have to travel further but would be seen sooner.

It was expected that diagnostics, inpatients and day cases would be back to 100% going into December.  Outpatients would be a challenge to recover to pre-pandemic levels.  Sites must be kept safe to access.  There were over one thousand people waiting more than 52 weeks and those numbers were likely to grow until about March.

General practices had been excellent in moving to total triage.  They were getting back close to normal numbers.  Community services also adapted well and were operating to a new ‘home first’ model.  It was being examined how community hospitals could support more outpatient services.  Care homes were being supported to be prepared for a second wave.

Mental Health services made great use of virtual consultation.  The 24-hour helpline that was put in place will continue since it had proven to be very valuable.  It was welcome that schools had reopened but there was a risk of more children and adults presenting with problems following the lockdown.

Two key learning points were the use of digital and the highlighting of inequalities.  Healthwatch helped greatly – particularly in getting information translated – and they continue to advise on the engagement process being planned.

Members of the Board endorsed the message that it was safe to present to services – some having had recent personal experience.  Ansaf Azhar expressed concern that there was a risk of the non-COVID mortality increasing if people did not access services.  Any local lockdown measures did not prevent people from accessing, even for routine appointments.

District Councillor Andrew McHugh noted that increasing breast screenings were already a red flag on the performance reports and asked how the backlog could be reduced when there was less capacity.  Diane Hedges confirmed that they were working to reduce the backlog including Sunday working.

City Councillor Louise Upton expressed concern that the lack of face-to-face contact would be particularly difficult for those with mental health problems and asked if there had been any increase in cases and how telephone services were coping with that.

Nick Broughton responded that there had been a gradual increase in referrals since the end of lockdown.  The numbers now were similar to one year ago.  They were seeing more urgent cases, more people in crisis and more new patients presenting in crisis.

Video consulting was a very efficient way of delivering care but they needed to be sure that it was delivering high quality care.  This was being researched by the University of Oxford.  It worked for some but others really miss the face-to-face, so they try to facilitate them.

Due to the reduced occupancy of wards in order to keep patients safe, some have had to be placed out of area – about 15 to 20 patients across Oxon and Bucks.

Tracey Rees wanted to flag that the resumption of contact between Patient Participation Groups (PPGs) and GPs had been inconsistent and asked if some messages around this could be included in OCCG’s engagement plan.  In particular she believed that the PPGs run by GPs themselves had been slow to restart.

Diane Hedges agreed that the PPGs had an important role to play including helping the public to understand the way in which GPs were working now.  OCCG had provided some resources to Healthwatch to help the PPGs to engage.  While there was a requirement for GPs to engage with PPGs, she wanted to emphasise to them the benefits of doing so in terms of sharing best practice.

Councillor Upton asked if the long-term effects of COVID on patients was most likely to be handled at home or in hospital.

Diane Hedges responded that this was something that they were still learning about and said that she would come back to it at a future meeting.  Kiren Collison added that there was a good website dealing with this https://www.yourcovidrecovery.nhs.uk/

Yvonne Rees praised the exemplar partnership approach in Oxfordshire.  This was now driving the recovery.  There was strong governance in place to ensure escalation when appropriate.  The Health Protection Board had been a high performer supported by a multi-agency operational cell.

She urged caution that over enthusiasm might cause some duplication of effort.  It was important that everyone kept to the structures that are there to ensure the appropriate responses to any outbreaks.  She was proud of the system and believed that it bodes well for the partnerships going forward.

The Chairman reiterated the message that everyone had done very well so far but there was no room for complacency.