Agenda item

11:25

An update from Oxfordshire CCG including development of the Integrated Care System and engagement on improving Community Health and Care Services

Comfort Break

12:00

The Committee received a report from OCCG updating on a range of issues.  Before considering the report, the Committee heard from two speakers:

Julie Mabberley welcomed the report on the plans for the extension to the Wantage Health Centre but given the housing growth in the area and the fact that this extension was first promised by NHS England in 2012 it was long overdue.  She noted that a range of new health services for adults and children will be piloted at Wantage Community Hospital but asked how this related to the project on improving community care for older people?

Patients requiring physiotherapy/MSK services had been directed away from local services because the wait for an appointment at Wantage was three times longer than in other parts of the county.  Maternity services in Wantage hospital had been closed since the middle of August because of staff shortages across the system and were unlikely to reopen before the end of October.

Oxford Health Trust had suggested that the minor injuries unit could be one of the services returned to the hospital. She was sure that would be welcomed by everyone in OX12.  With regard to the plans to strengthen palliative care inpatient support in the South of the County, she pointed out that Wallingford is about as far from OX12 as the JR and even more difficult to get to.

Councillor Ian Reissmann sent his apologies as he was unable to attend.

Councillor Stefan Gawrysiak, County, District and Henley Town Councillor, noted that the closure of the Sue Ryder Hospice had increased pressure on end-of-life palliative care in the south of the county.  He asked the Committee to examine the OCCG funding for palliative care as he believed it should be higher.

He also suggested that the Committee ask to see the contract for the Sue Ryder Hospice at Home service as he did not understand why it did not include the prescription of drugs and organising of blood tests which put a lot of pressure on local GPs.

Councillor Gawrysiak also asked the Committee to examine the data behind the assessment that two beds at Wallingford were sufficient to cover an area with a population of 140,000.  He believed that at least six beds were needed.

Dr Alan Cohen referred to Agenda Page 22 and the last paragraph where there was a reference to locally determined representatives.  He asked who would decide those representatives.

Matthew Tait, Director of CCG Transformation, responded that there was no national prescription on that.  It was to be worked out locally between the NHS and local authority.  He noted that they would like to see a mix of local stakeholders including the voluntary sector.

Diane Hedges, Deputy Chief Executive, OCCG, responded to the questions on palliative care.  The Sue Ryder Hospice had provided two beds and there had been concern that the low number had dampened demand.  However, with the introduction of the new service at home it was not anticipated that demand would rise.  The new model for palliative care involved a range of providers across the county and there was flexibility in the system in terms of bed numbers.

Diane Hedges emphasised that this was about specialist palliative care.  There were no fixed boundaries within the county.  There were beds available in the south, city and north and they would provide whatever best suited the patient.  She was happy to share the data on which the decisions were based.  The Chair asked for this to be circulated to the Committee.

With regard to prescriptions and blood tests for the Hospice at Home service, this had been discussed at the meeting of the Governing Body and their response would be published shortly.  The OCCG was working with local GPs on this.

District Councillor Paul Barrow asked about the engagement process for the Community Services Strategy.  Diane Hedges responded that they were engaging on the principles.  Three public meetings had been arranged, information was sent to stakeholders and equality groups.  They were using Facebook to promote it and information was available on the OCCG website. 

In response to the questions raised by Julie Mabberley, Diane Hedges stated that the community strategy may be more about older people than anyone else but it was not exclusive.  It was important to understand reablement and how we use beds – why people need beds, which could be a mental health reason in some cases.

The staffing shortage related to the closure of the maternity unit was a national issue but she was optimistic it would reopen quickly.  She was unaware of the issue with MSK services and would check into that.

Decisions had to be made to respond to workforce challenges.  On the elective side there was a clear methodology for prioritisation but with other services the scrutiny committee could feedback as to whether the right choices were being made.

The Chair asked for information on the new arrangements for ear wax removal.  Diane Hedges stated that it had been added to the Any Qualified Provider contract and would take effect from 1 December.  This was never a commissioned service but was provided by some primary care practices.  Many have decided that they can no longer provide it given the pressures they are under.

District Councillor David Turner described his personal experience where he was referred to a website to apply for the service and was faced with a questionnaire for which he was unable to answer some of the questions.  He believed that this would put people off applying.  The Chair noted that people would also be put off by having to pay for a private service that many could not afford.  It was agreed to consider under the work programme discussion whether to come back to this issue at another meeting.

Actions: Diane Hedges to provide information for circulation to the Committee on-

·         specialist palliative care bed numbers

·         MSK services