Members of the public who wish to speak at this meeting can attend the meeting in person or ‘virtually’ through an online connection.
To facilitate ‘hybrid’ meetings we are asking that requests to speak or present a petition are submitted by no later than 9am four working days before the meeting i.e., 9am on Friday 17 November. Requests to speak should be sent to omid.nouri@oxfordshire.gov.uk and scrutiny@oxfordshire.gov.uk
If you are speaking ‘virtually’, you may submit a written statement of your presentation to ensure that your views are taken into account. A written copy of your statement can be provided no later than 9am 2 working days before the meeting. Written submissions should be no longer than 1 A4 sheet.
Minutes:
The Chair invited the registered speakers to address the Committee.
1. Statement by Cllr Stefan Gawrysiak
Cllr Gawrysiak highlighted that in December, 7 short stay Hub beds (SSHB) were being removed from Chiltern Court Henley on the Townlands health Campus. This was part of a reduction across the county from 97 SSHB to 63. A further cut to 40 was to happen in April and that this removal by OCC had been done without any consultation with GPs and the local community. These beds were currently fully occupied and were supervised by the Bell and Hart Surgeries.
This meant that the whole of South Oxfordshire was without any SSHB. South Oxfordshire comprises 140,000 residents. These were not Henley beds, these were beds that served postcodes RG9, RG4, OX10, OX9 and OX39.
A frail elderly person, with frail elderly relatives who was discharged from the Royal Berkshire Hospital would be placed in a care homes 20miles and a 2hr Bus journey away. This could not be good for their recovery.
Cllr Gawrysiak highlighted that all local GP’s were against this because the burden would fall on them. Also, it was to be noted:
Ø that even though they run the service they had not been consulted.
Ø Henley Town Council, Patient Groups as well as himself (Cllr Gawrysiak) as County Councillor had not been consulted.
Cllr Gawrysiak concluded by asking HOSC to investigate and ask the following questions:
2. Statement by Henley Town Council Cllr Ian Reissmann:
Cllr Reissmann outlined that he was speaking in his capacity as Chair of the Townlands Steering Group; a community-based committee which invited a wide range of community representatives including 15 Parish Councils from the South of Oxfordshire. The group had also been active for 20 years in the subject of health and social care, and had met a week prior to the HOSC meeting to discuss the closure of the SSHB in Henley. Cllr Reissmann shared Cllr Gawrysiak’s concerns outlined in the previous public statement, and that he was concerned that the determining factor behind the closure of the beds may be cost-driven as opposed to being based on patient need. It also seemed inappropriate that South Oxfordshire, which had a population of 140,000 residents, would have no SSHB. Cllr Reissmann also expressed concern regarding the ways in which the care pathways would work under the proposed reductions of SSHB. The GPs had clarified that they provided the care for the patients occupying the SSHB, and that these beds were fully utilised. Cllr Reissmann added that he had been informed that the beds had only been occupied by patients who experienced delays in being discharged home by Adult Social Care due to capacity issues.
However, not all patients that occupied these beds were doing so specifically for that reason alone. In order for the community, patients, as well as GPs to be reassured, there would have to be confirmation on the figures around the usage of these beds over the last 2 years.
Cllr Reissmann also stated that the lack of public engagement with the community over the closure of the beds had also been a cause of concern amongst residents as well as GPs. Cllr Reissmann also called for the deferral of the closure of the SSHB in Henley pending satisfactory levels of community engagement.
The Health Scrutiny Officer made a statement highlighting that at the point in time of the meeting, the Committee was not in a position to declare the closure of the SSHB as a Substantial Change for two reasons:
1. The current guidance around declaring Substantial Changes indicated that such declarations could only be made over NHS services, and not on services that may be exclusively commissioned by a County Council.
2. If it was determined that prior to commissioning these beds, the intent was for these to be interim and not permanent beds, then declaring their closure as a Substantial Change would not be appropriate.
However, the Health Scrutiny Officer outlined that this did not mean that HOSC did not have the prerogative to scrutinise such closures and to examine the impacts of such closures on local residents.
The Chair outlined that the Committee will be looking into this matter of the closure of the SSHB further, and that a decision on how to proceed would be made in the Chair’s update item.
3. Statement by Vale of the White Horse District Council Cllr Dr Debra Dewhurst:
Cllr Dewhurst explained that Cllr Hayleigh Gascoigne and herself were the Vale of White Horse District Councillors for Blewbury and Harwell – which covered the parishes of Blewbury, Harwell, Chilton, Upton and the newly formed parish Western Valley (the Vale portion of Great Western Park).
Cllr Dewhurst raised the issue of Primary Care provision in Didcot and the surrounding area, in particular the planned GP practice for Great Western Park (GWP). It was explained that this was an important issue for their residents and one that was brought up with them regularly. All health centres and GP surgeries in the Didcot area were currently oversubscribed and many had closed their books to new patients. With 4000 new homes due to be built in the area imminently, this was a problem that needed to be solved urgently.
Cllr Dewhurst further explained that the ICB had delegated powers from NHS England to be the commissioner of Primary Care Services in Oxfordshire. Consequently, the ICB was charged under these delegated powers to ensure appropriate primary medical services were available across Oxfordshire. The ICB therefore oversaw these Primary Care Services and, as the reimbursing body of Primary Care estate rent, effectively decided which premises those services operate from.
A site of 0.2 hectares within the GWP District Centre, currently owned by Taylor Wimpey, had been set aside for primary care provision in the GWP S106 Agreement dated 18 July 2008, together with a health centre financial contribution; but the site was still currently empty/derelict. Cllr Dewhurst added that the S106 was in place to improve infrastructure to mitigate the impact of the development and yet the GWP estate had been fully occupied for some time, adding some 6000-7000 additional residents. Cllr Dewhurst explained that they were aware that the Vale of White Horse District Council was working with Taylor Wimpey and the ICB to have the land and the money transferred to the ICB and to modify the S106 agreement.
Cllr Dewhurst outlined that given the urgent nature of primary healthcare provision in the Didcot area, was there anything holding up this process? It was also enquired as to what the timescales were for having a health centre on GWP. As with all S106 agreements, the money available was time-limited. It was urged that residents were to be given reassurance that this much needed health centre would be built. It was also asked as to what the next step in the process was? Cllr Dewhurst concluded by stating that they all wanted to see the GP surgery being built and put to use as soon as possible.
The Committee Chair highlighted that the issue of capital and builds for Primary Care estates was something that the Committee was concerned about, and referred to a Primary Care Workshop that the Committee had previously held, where the Didcot Estate was the case study that was actuality utilised given the particular scenario Didcot was facing. The Chair also referred to the agenda papers for this meeting which contained a letter with recommendations on Primary Care that was submitted to the Secretary of State for Health. It was also highlighted that recommendations around some of the aforementioned challenges had been made by the Committee to the ICB previously.
The BOB ICB Oxfordshire Place Director highlighted that the Didcot project was progressing, and that the ICB were working with Local Authorities as well as Primary Care at the local level. Delays had been around affordability, where the ICB had to approve the Value for Money, as it had to go above the District Valuer amount for rental agreements. It was emphasised that a detailed response was to be provided to the Parish.
The Committee urged for a timely resolution on the district valuation, given the urgency of need in the Didcot area.