Agenda item

Appointed members of the HOSC met on 20 April 2023 with Dan Leveson, Place Director for BOB HOSC, Ben Riley, Executive Director for Oxford Health NHS Trust, Kerry Rodgers, Director of Corporate Affairs, Oxford Health NHS Trust, Karen Fuller, Corporate Director of Adults and Housing, Oxfordshire County Council to discuss the substantial change form submitted in relation to the loss of community hospital beds. The agreed outcome of the meeting was that the planned process for engaging with the community in Wantage around how the hospital will be used in the future be made available to HOSC members prior to any further decision being made.

Dan Leveson, Ben Riley, Kerry Rogers and Karen Fuller are invited to present this item. Having listened to the presentation and discussion the Committee is recommended to AGREE its next steps.

NB This document is still currently in draft and publication will be delayed to allow greater coordination between stakeholders. A supplement to the agenda is to follow and is expected to be issued on Friday 05 May.

Following the meeting held by the Wantage Hospital Substantial Change sub-group on 20 April 2022 Dan Leveson, Place Director for BOB HOSC, Ben Riley, Executive Director for Oxford Health NHS Trust, Kerry Rodgers, Director of Corporate Affairs, Oxford Health NHS Trust, and Karen Fuller, Corporate Director of Adults and Housing, Oxfordshire County Council attended the meeting to present the agreed outcome of the Working Group meeting – a planned process for engaging with the community in Wantage around how the hospital will be used in the future.

Dan Leveson introduced the plan, which represented a process to re-engage the local community and stakeholders in order to resolve the future provision of services at Wantage Hospital. The process would be based on co-production, with an aim to develop a report based on consensus views across stakeholders developed primarily through an all-day co-production workshop. Details of the timing and membership of this workshop were still under discussion. The HOSC would have an opportunity for comment formally on the proposals in the report over the summer, following which public consultation would occur, with the expectation of a final report being put forward in November. The need to work with communities and avoidance of NHS commissioners presenting a fait accompli was reiterated. Resources to support this work were already in place, with Transformation Director Susannah Butler heading up a team with responsibility for this.

In response, the Chair summarised key points agreed from the discussion at the Wantage Hospital Substantial Change sub-group.

-        It was recognised by all present that, approaching seven years after the announcement of the temporary closure of hospital beds at Wantage Hospital, the closure had ceased to be temporary. It was important for members of the public to have a clear understanding around timelines over what would be happening next.

-        That there is a reconfiguration of the way services are delivered in Oxfordshire generally, which goes beyond Wantage on its own

-        That it is necessary to match up the fact that people in Wantage should be able to have their say on how services are delivered locally, but that must also feed in to the broader strategy. Consequently, engagement and co-production between system representatives and the local community is vital in achieving this balance.

-        The working group requested a timeline for that engagement and co-production be put to the Committee.

-        No decision was taken in relation to whether to make a referral to the Secretary of State.

The Chair also requested that the timeline presented to members of the HOSC also be shared with Wantage Town Council, which was agreed.

Issues addressed by the Committee and discussions held included the following:

-        The importance of ensuring a broad section of the community who made use of Wantage Hospital were involved in the co-production exercise, including those in the villages beyond the town of Wantage who would nevertheless be using Wantage Hospital. It was committed that, when agreed, the list of stakeholders would be circulated to HOSC members and feedback welcomed.

-        The importance of enabling community stakeholders to participate by providing sufficiently detailed information to make informed decisions around their preferences for clinical provision at the hospital. This was committed to.

-        For the community to trust the process being put forward it would be necessary and clear that NHS stakeholders would not be involved in discussions having pre-determined the outcome.

-        The degree to which there would be equality of provision across different areas of Oxfordshire. To this, it was assured that NHS colleagues had been considering this issue already for a number of years, working with colleagues across both the health and social care systems to identify the models which would most effectively deliver provision in Oxfordshire in the much-changed health and social care landscape since the original closure, particularly post-Covid. Recent work had been undertaken with Public Health to understand health inequality information at local levels, to allow for matching of provision to need in order to maximise positive health outcomes.

-        Recognising that in the seven years since the bed provision at Wantage Hospital was suspended, originally on a temporary basis, there had been multiple undertakings by health colleagues which had not been met. Although it was noted that the personnel currently involved were not necessarily those who had made those undertakings, it was suggested that a shared, owned history would be valuable in helping all stakeholders move from focusing about issues which had taken place in the past to planning for what would be best for residents in the future.  The Committee noted the size of the area which would use Wantage Hospital, and recognised that if beds were to be lost at Wantage Hospital the community would expect something new to be provided to those people in return.

-        Feedback was provided to NHS colleagues that there was a public expectation that formal consultation would need to be undertaken in light of the substantial change which had taken place, but that it was the Committee’s view that if the level of co-production and engagement with the community planned was indeed delivered beforehand this consultation need not be excessively onerous.

The following actions were AGREED:

1)    That the HOSC would provide a history of the Wantage Hospital closures to NHS colleagues as a stepping-point for stakeholder discussions on the future provision

2)    That any decision to refer to the Secretary of State would be deferred pending the progress made at the planned co-production stakeholder event, and that there would be an extraordinary meeting in late June to consider views on this.