Agenda item

The new Chipping Norton Hospital is due to open later this year. It will be run on behalf of the NHS by the Orders of St John Care Trust. In 2005 and again in 2007 the PCT stated the following with regard to the employment of nursing staff at the hospital:

i.          To enable staff at the Hospital to decide which choice was better for them as individuals, they would be given the option of whether to remain as NHS employees and be seconded to the Orders of St John (OSJ) for a period of three  years or to transfer under TUPE to the OSJ

ii.                  The PCT would not indicate a preference with regard to the above options

iii.                In the event that an NHS employed staff member was to leave during the three year period, their replacement would be placed on NHS terms and conditions for the remainder of the three years.

At the end of the three years a review would take place.

The transfer of existing staff is being undertaken in accordance with the first two statements above. However the PCT has now decided that new staff employed during the three year period would be employed by the OSJ.

The purpose of this item is to help members understand why the PCT view on employment has changed and for the HOSC to consider whether any further action is required. A representative of the PCT will attend the meeting.

Copies of two letters are attached for information:

1.      From the Acting Chairman of the HOSC to the PCT (JHO6a)

2.      The reply from the Chief Executive of the PCT (JHO6b)

This item was included because in 2005 and again in 2007 the PCT stated the following with regard to the employment of nursing staff at the hospital:

i.          To enable staff at the Hospital to decide which choice was better for them as individuals, they would be given the option of whether to remain as NHS employees and be seconded to the Orders of St John (OSJ) for a period of three years or to transfer under TUPE to the OSJ

ii.         The PCT would not indicate a preference with regard to the above options

iii.        In the event that an NHS employed staff member was to leave during the three year period, their replacement would be placed on NHS terms and conditions for the remainder of the three years.

At the end of the three years a review would take place.

The transfer of existing staff is being undertaken in accordance with the first two statements above. However the PCT decided that new staff employed during the three year period would be employed by the OSJ.

Councillor Hilary Hibbert-Biles spoke to the Committee as the local member for Chipping Norton. Councillor Biles explained the issue as it appears to her and her Chipping Norton colleagues. They are concerned that if nurses are employed by the Orders of St John (OSJ) they would be seen as care staff and the hospital would eventually become a care home rather than a hospital. Councillor Biles expressed a view that the original agreements made in 2004 had already been “whittled away” with no additional consultation and that the PCT was challenging the authority of the HOSC. Members should insist that the original agreement should be upheld, i.e. that nurses employed at any time during the first three years of the hospital's life should be given the opportunity to opt for NHS employment.

Alan Webb, speaking for the PCT, first of all welcomed the fact that the new hospital is now open. He made clear that all staff at present seconded to the OSJ are NHS employees who would be deployed only in the hospital. What the PCT wanted to do was to ensure that staff employed in future would all be OSJ employees with the flexibility to employed throughout the unit. If new staff were not to be OSJ employees they would have to be employed by Oxford Health rather than the PCT and that would cause complications.

The PCT has decided that, rather than wait for three years before reviewing how the hospital was working they would undertake a review at the end of the first year of operation. The views of nursing staff would be sought monthly.

Mr Webb also referred to the “innovative model” that had been created for the First Aid Unit (FAU) whereby a paramedic from the South Central Ambulance Service would be placed on site with a triage link to Bicester Hospital. The Acting Chair of the HOSC made clear that the HOSC was happy with the FAU arrangement.

A discussion took place on the nursing issue. Mr Webb stated that the contract specification that the PCT had agreed with the OSJ would ensure that only qualified nurses would be employed in the hospital. Nurses might be deployed into the care home but not the other way around. This is a new way of working and how it is communicated to the public had to be thought through again.

Despite Mr Webb's assurances members continued to have concerns. They could not see why it was necessary to go back on the original agreement. It was important for the PCT to retain public confidence and allay fears that the hospital would be swallowed up by the care home. Adhering to the agreement would do that.

Concern was expressed that any deviation from the agreed model could also affect the hew hospitals proposed for Bicester and Henley as Chipping Norton was seen as the model for the future. There was also some anxiety that qualified nurses being deployed into the care home could lead to a loss of job satisfaction.

However some members were of the view that the PCT's assurance about the qualifications and experience requirements for staff convinced them that care standards would be maintained.

The Acting Chair summed up the discussion by stating that while there was a mix of views there were clearly a number of members who continued to have concerns about the matter. If the PCT wished to adhere to their intention that all new staff should be OSJ employees then it may be possible for the South Central Strategic Health Authority to act as mediators in the matter.

A vote took place on whether or not the Committee wished to call upon the PCT to adhere to the previous agreement that all staff employed within three years of the opening of the new hospital should be given the opportunity to opt for NHS employment. The vote resulted in a 9 to 2 majority in favour of asking the PCT to adhere to the agreement.

A further vote then took place on whether to refer the matter to the SHA. By a majority of 9 to 1 this course of action was AGREED. Roger Edwards was asked to draft a letter to the SHA to be signed by the Acting Chair.

The Acting Chair confirmed that the HOSC would retain the right to refer the matter to the Secretary of State if necessary.