Agenda item

2:35

This report was presented to a meeting of Buckinghamshire, Oxfordshire, and Berkshire West CCGs (BOB) Governing Bodies Meetings in Common on 10 June and gives an update on the current status of NHS Recovery from the pandemic.

This Board had before it a report that had been presented to a meeting of the BOB Clinical Commissioning Groups (Buckinghamshire, Oxfordshire, and Berkshire West) giving an update on the current status of NHS recovery from the pandemic

Diane Hedges, Deputy Chief Executive, Oxfordshire Clinical Commissioning Group (OCCG), emphasised that the key was in getting people’s confidence back in services and also in getting people to use the services available in the right way.  During the peaks of the pandemic those needing urgent care or who had cancer were prioritised over elective surgery.  This had led to people with less urgent need having to wait longer than anyone would want.

There has been a need to use all resources more efficiently, for example theatre productivity in Oxford University Hospitals the previous week had exceeded 90%.  Although national funding was available, there were issues around staff resources especially in relation to breast screening.

Very few specialties remained closed.  Since the last Board meeting, Ophthalmology had reopened apart from for cataracts.  They have worked with the independent sector too to increase capacity and people were encouraged to use other services if they could.

The overall Oxfordshire waiting list had dropped by 2,300 and the number waiting over 52 weeks had reduced by 900 to 3,500.  As outlined in the report, those on the waiting lists were reviewed regularly in case there was any need to be given higher priority.

In relation to breast screening, people may wait longer at the front end but once they were in the system the expected timelines were being met and the one-stop-shop approach was supported by the Thames Valley Cancer Alliance.

Urgent care was coming under a lot of pressure with increased demand and increased acuity.  Partners were working well together to find ways to support people nearer to their home.

In Mental Health, the system was really only seeing the start of the increase in demand that was expected.  The helpline continued to provide support and the services were there but in some cases could only respond to urgent referrals.

Sylvia Buckingham asked about communications with patients, especially those on waiting lists, and for acronyms to be avoided or explained in public documents.  Diane Hedges accepted the point on acronyms and assured that those on waiting lists were contacted regularly and checked in case their condition had changed.  Wider communications changed over time – for example, at one time they had to assure people that it was safe to present at the Emergency Department but now ED was under pressure and there was a need to ensure that the 111 service was sufficiently resourced before encouraging more people to go there.

Kevin Gordon emphasised that children’s mental health was not all about CAMHS (Child and Adolescent Mental Health Service) but there was very good work being done in schools and youth settings too.  The traditional approach could not deal with the level of demand that was expected.  A broader emotional, mental health and wellbeing strategy was needed.  There was now an integrated commissioning structure for children’s mental health.

Kerrin Masterman asked about the stored-up problem with referrals being held by GP practices, if it was reasonable for some services to be still closed 18 months later and what strategy there was for the waiting lists for Ear, Nose and Throat in particular.

Professor Jonathan Montgomery responded that there were referral options other than Oxford University Hospitals (OUH) as they managed the demand across the Integrated Care System.  If a harm review identified that a patient may have experienced harm, then this information was shared with them under a duty of candour.  They do not want to have a situation where they re-open a pathway but patients have to wait so long that they would be better off being managed within the system.

Diane Hedges added that they were aware of a built-up latent demand especially for Ophthalmology.  OCCG were working with OUH and Primary Care on a new model involving optometrists, triage and additional diagnostics to increase capacity.  Those services that remained closed were reviewed every two weeks and they were working as fast as they could to re-open safely.  They were looking at the learning from other counties to adopt methods that work there.

Councillor Jenny Hannaby asked in relation to staff shortages if there was any evidence that staff were leaving to work for private contractors that we contract to.  She also asked about the situation with dementia services and CAMHS where she was aware of a child waiting for 2 years to be seen.

Diane Hedges responded that she was not aware of any evidence of staff moving to private contractors.  Dementia services had reopened but the demand was very high.  The number of referrals to CAMHS was well above national expectations but waiting times were coming down.  There was a particular problem with waits for autism diagnoses.

Councillor Liz Brighouse expressed concern about the long-term effects of Covid-19 on a whole generation of young people.  There was a problem with CAMHS across the country which made one question whether the model was right.  She believed that GPs must be dealing with a lot of the mental health issues.

Sylvia Buckingham asked for more information on the key worker pilot mentioned on Agenda Page 27 and on screening for people with disabilities.  Diane Hedges offered to find the information and circulate afterwards.

It was agreed that children’s mental health services should be a full agenda item at the next meeting.