Agenda item

12:45

This paper provides the final report of the OX12 Task and Finish Group and the response to that report by Oxfordshire Clinical Commissioning Group (OCCG) on behalf of the Oxfordshire health and social care system.

13:00 LUNCH BREAK

Before considering the report and the response from the Oxfordshire Clinical Commissioning Group, the Committee heard from the two following speakers.

Julie Mabberley, Chairman of the OX12 Stakeholder Reference Group, welcomed the final report but expressed disappointment that the Task and Finish Group had not met with the Stakeholder Reference Group since May 2019 and made no comment on the detailed project evaluation submitted by the Group.

She endorsed the final conclusion of the report that the OX12 project failed because of the poor management of the project, together with a poor level of engagement and communication with the residents of the OX12 postcode.

She believed that Wantage Community Hospital used to provide very good rehabilitation for patients and that these facilities were still required. Furthermore, the former Day Care Centre could provide supplementary services for those patients able to return home.

Julie Mabberley called on the Committee to ensure that OX12’s health and care needs were provided locally and effectively using all local health and care facilities including the Hospital, the Health Centre and the Day Care Centre going forward.

Councillor Jenny Hannaby supported the comments from the previous speaker and thanked the members of the Task and Finish Group and support officers for their work and thanked the Committee for its support over the years.  Wantage Town Council’s Health Committee had again called for the re-opening of the beds at the community hospital by whatever means it takes.  They believed that the hospital was much valued by residents for the professional care it gave for rehabilitation, enablement and end-of-life care.

The Committee considered the final report of the OX12 Task and Finish Group and its recommendations.  District Councillor Paul Barrow, Chair of the Group, summarised the report.  He stated that it had been sent to OCCG in January with a request to respond by the end of March.  They had instead sought to cover the OX12 issue under the broader Community Services Strategy but that paper was only circulated two days before this meeting.

The Task and Finish Group had thought that the needs assessment framework was essentially a good idea.  However, they believed that the way in which it was carried out was wholly inadequate as outlined in the report.  In their view such a framework should only be repeated once the criticisms of the Task and Finish Group have been taken on board.

Councillor Barrow asked the Committee to support the recommendations in the report and that the Committee’s previous call to reopen beds in Wantage Community Hospital be acted upon now.

Diane Hedges, Deputy Chief Executive, OCCG, responded that everyone was agreed that they needed to work towards achieving the highest possible footfall for Wantage Hospital but that there was disagreement on the best range of services to achieve this.  She was disappointed to hear the views of the Task and Finish Group that the framework had not worked.

Diane Hedges noted that the Joint Strategic Needs Assessment had identified that there was not enough reablement available to get people home from hospital.  The evidence was clear that long stays in bed were harmful for patients in terms of muscle wastage and there was a need for services to be reshaped to reduce the need for hospital beds and get people into their own home.

Diane Hedges concluded saying that they needed to focus on the Community Services Strategy where all of the partners were working closely together.  She recognised the need to describe how it would be evaluated and resourced.  They had also included a second paper on how the strategy would relate to the issues around OX12.

The Chairman expressed disappointment that OCCG had not responded to the OX12 report within the eight weeks they were given and that the response when it came was only two paragraphs.  He was further unhappy that the Community Services Strategy paper was only made available two days before this meeting.  He did not feel that this was in line with the “no surprises” approach that partners had agreed on.  The Chairman asked if OCCG had any objections to the points outlined under recommendations 2 and 3.

Diane Hedges responded that she had brought many of the points relating to running an effective programme into the Community Services Strategy.  Noting that Councillor Barrow had additionally asked that the beds be re-opened, she stated that they could not do that but that they would examine the issue of beds across the county.

The Chairman noted that the recommendations from the report had been proposed by Councillor Barrow.  Councillor Mike Fox-Davies seconded the proposal.

The Chairman added that he wanted to take the beds issue under the next item.  He thanked the councillors and officers who had worked on the committee over the course of its work.

RESOLVED:

In respect of the shortcomings of the Population Health Care Needs Assessment Framework and its implementation.

1.    The project plan:

a.    Evaluation should be an integral part of the project plan, and a project should not be signed off by the Health and Well-being Board (HWBB) without an evaluation plan in place.

b.    A clear project plan should be made available which describes the time required, the workforce needed, the skills and equipment needed, and the costs of such a project 

c.    The project plan should set out the process for the programme of work, so that it is clear to all those involved

2.    The Process led by CCG:

a.    Innovations Paper: Any review of the innovations and best practice must be detailed and comprehensive.

b.    Assets Evidence:

                  i.    A review of workforce issues, and how these might impact on service developments including re-opening in-patient beds, GP and community nursing staff, is needed.

                ii.    A review of GP premises for an increasing population is needed.

               iii.    Greater clarity is required on how the detailed information provided by the population questionnaire will be used to formulate solutions

c.    Health Needs Evidence:

                  i.    The link between the JSNA and the local data sources including district planning and housing data should be strengthened.

                ii.    Information gathering and analysis methods should be reviewed including the use of more sophisticated software for data analysis and future projections.

d.    Synthesis:

                         i.    It is recommended that the local framework fits into wider county-wide and national policies on community health and social care (in-patient beds/domiciliary care, etc).  This should also include Oxfordshire Health and Wellbeing Strategy, and other place-based documents.

                        ii.    Greater clarity is required on how the three separate sections of the Framework are combined and used to formulate conclusions.

e.    One of the major specific issues discussed within the project was the future of Wantage Hospital. We reiterate our earlier recommendation to HOSC that any decision made on the future of in-patient beds should be evidence-based and include the pros and cons of bed closures and of alternative provision and include consideration of Wantage Hospital within the proposed wider county strategy and not be based on the CCG report. We endorse the decision of the County Council (8^th December item 15) that a comprehensive plan for OX12 by the system be completed which is acceptable to the local population and forms a significant part of, or acts as a pilot for, the county-wide review of community health service provision.

3. We recommend that HOSC requests that the operation of the scrutiny function be part of a County Council Constitutional Review. We recommend priority to the value of transparency and openness to ensure the public is aware of the challenges faced in scrutiny of the whole system.