Agenda item

9.45

Julie Waldron, Chief Executive Oxford Health will present a report (JHO5) on the key issues relating to the Oxford Health NHS Foundation Trust’s (FT) progress with integration since the merger with Community Health Oxfordshire in April 2011.

Julie Waldron, Chief Executive, Pete McGrane, Clinical Director for Oxfordshire Community Services, Heather Rice, Divisional Director from Oxford Health Foundation Trust presented the report to the committee. The presentation highlighted the following points,

• Physical (community health) and mental health services were brought together three years ago.
• The integration of services is a three stage process: Transaction, Transition and Transformation. They are currently moving into transformation.
• Infection control has improved due to more consistency and specialists across mental health and community wards.
• There is an increasing health focus in mental heath wards
• There is a focus on leg ulcers with the aim of improving the time for healing.
• Children’s mental health is working closely with the Local Authority’s new Early Intervention and hub model.
• Children’s services have moved to be a locality based rather than a profession based service which enables better integration with other services and a single point of access to the team.
• Oxford Health is working with the Oxford University Hospitals to redesign the community nurses team.
• Oxford Health will be an early implementer of the new national health visiting approach

The item was then opened up to the committee for questions and discussion during which the following points were made,

• Oxford Health are looking for opportunities to invest in its estate as many of its inpatient facilities are in need of updating.
• Dementia is a ‘full system’ issue for action in Oxfordshire and Oxford Health are working with the County Council, Primary Care and Oxford University Hospitals to develop a joint bid for national dementia funding.  Oxford Health is already working with GPs on early referral.
• Cllr Smith noted that housing has a large impact on mental health in particular the insecurity many people face around housing. Other agreed that housing was a key factor in health and that schools should ensure that housing associations are represented at child case conferences.
• There is the ability to self refer to services, such as the talking space which is delivered in partnership with MIND.
• Health visiting service much is provided alongside schools but includes going into people’s home and includes the ability to refer straight into other services.
• District nursing service is to be reviewed in terms of structure of the service and how it links with primary care to provide the best support
• The end of life community matrons are supporting prescribing.
• Oxford Health has rolled out a single point of access to its services for GPs. Relationships with GPs are strong but more work is required to integrate with social care.
• It was noted that until now the incentives and penalities for providers were working against each other but new contracts are now better aligned and Chief Executive’s are working closely together to tackle the issue of delayed transfers of care and recruitment which is a challenge that all providers face.
• In response to Dr McWIlliam’s question whether the integration of community and mental health services has created one large Cinderella service Julie Waldron said that in bringing them together it has creating a stronger voice for these services and has enabled better use of resources and less wastage.
• There is a desire from Oxford Health to push for a different type of contract to block contracts in the acute sector as this do not reflect the range and type of work in the Community and Mental Health sector.
• The scope of the hospital at home service is for people who do not need bed based services such as those who require administration of medication which can be provided at home.
• It was noted that A+E experienced high demand in June which impacted on the delay transfers of care (DTOC).
• The reablement service is not currently working at capacity but Oxford Health reassured the committee that it is on track to meet targets that have been set.
• In summary the committee were pleased with the progress being made but felt that they would be keen to see what the outcomes are as the report had been focused on management.