Agenda item

11:20

The community services strategy work has been progressing and this paper provides information on:

·         Engagement and feedback on the draft principles

·         Progress on the key focus areas of the strategy

- increasing independence and health and wellbeing outcomes for our population

- Working to make the best use of our people, systems and assets

·         Approach to option development

The Committee received a report updating on the community services strategy work including engagement and feedback on the draft principles, progress on the key focus areas of the strategy and the approach to option development.

Before considering the report the Committee heard from a speaker:

Julie Mabberley asked a number of questions around the proposed strategy including concerns at the temporary closure of maternity services at Wantage Community Hospital and when this would amount to a ‘substantial change’ requiring public consultation.

Julie Mabberley also asked if it was being considered to re-open the minor injuries unit that closed in 2002.  She described difficulties that patients had with results of procedures not being passed on to GPs – both for procedures received outside the county and in Oxford hospitals. She expressed doubts around the ability to adequately staff increased demand for care in the home when a large number of extra care facilities were operating or planned around Wantage requiring a lot of staff.

Dr Ben Reilly, Executive Managing Director for Community, Primary and Dental Care, Oxford Health NHS Foundation Trust (OH), and Diane Hedges, Deputy Chief Executive, Oxfordshire Clinical Commissioning Group, responded to Members questions as follows:

·         The use of community hospital was a core part of the strategy.  A census had been carried out to give a snapshot of how the beds were being used.  An NHS benchmarking exercise was also being carried out across the BOB (Bucks, Oxon, Berkshire West) area.

·         The intention was to use the data to create a model which would outline which patients needed in-patient care in the community and which would benefit more from other approaches.  At the next Committee meeting they intended to set out in more detail how the public and service-users would be involved in creating the model.

·         There was a need to be clearer about the definition of what is in the community strategy and then see how community beds fit into that.

·         The plan was to share the information from the workshops held recently early in the New Year.  The evidence behind decisions made will be available.

·         Oxford University Hospitals (OUH) and OH were working together on the workforce challenges recognising the shift from acute care to more care in the home.  A Community Day held recently in Abingdon Community Hospital had been quite successful and more of those were planned in other areas.

·         Some of the projects being piloted in Wantage Community Hospital may be rolled out to other community hospitals.  There was a lot of interest in expanding outpatient services.

·         People have a choice of whether to die at home or not but sometimes  there was a need for specialist palliative care input or more care at home.  There was a need for a more consistent cross-county approach as part of the strategy being developed.

·         End-of-life (EOL) care in South Oxfordshire will have a multidisciplinary team who will also be supporting people at home, in specialist beds in Wallingford and advising other community hospitals.

·         EOL care can be provided in care homes but this was less appropriate for specialist palliative care where specialist skills may be needed to be provided in these enhanced community hospital or hospice beds.  Officers will consider whether EOL care needs can be assessed as part of the JSNA (Joint Strategic Needs Assessment).

·         There were systems in place for patient and family feedback at a service level but EOL care can often span a number of services so it may be more difficult to identify.

·         There was a strong clinical component to decisions on where workforce was deployed when there were shortages and this was discussed with the commissioners.

·         BOB-ICS should make planning better particularly around examples like Thame Community Hospital which is in Oxfordshire but part of Buckinghamshire Healthcare NHS Trust.

Karen Fuller, Deputy Director for Adult Social Care, added that while families often want to be part of the care provided, it was never assumed that this was the case.  Oxfordshire Carers was set up in April this year to provide carers with independent advice.

With regard to the temporary closure of maternity services at Wantage and Chipping Norton due to staff shortages, Sara Randall, Chief Operating Officer, OUH, reported that there were weekly assessments on whether the units could reopen.  Risk assessments were carried out for those due to birth.  They were using all the resources available including hospital and community midwives to ensure as much capacity as possible.

The Chair offered the Committee’s support in shaping the engagement element of the community services strategy and how HOSC will fit into that.

Action:

Dr Ben Riley and OCCG to meet the Chair before the next Committee meeting to discuss patient engagement elements of the Strategy.