Oxfordshire

Clinical Commissioning Group

South West Oxfordshire Locality Forum (SWOLF)

Notes of the Meeting

Held on

Tuesday 13October2015(10.00-12.30)

Didcot Civic Hall, the Northbourne Meeting Room, Didcot

  1. WELCOME: Shelagh Garvey, as Acting Chair, welcomed everyone to the meeting.

MEETINGATTENDEES AND APOLOGIES RECEIVED:

Organisation: / Names: / Initials
Chair: SWOLF
and Woodlands Medical Centre / Martin Tarran- Jones / MTJ
Clifton Hampden Surgery / Chris Dupond / CD
Didcot Health Centre / Lesley Powell,
Shelagh Garvey / LP
SG
Long Furlong Medical Centre / Rosemary Allan / RA
Newbury Street Practice LINK / Janet Parker / JP
White Horse Medical Centre / John Mattingley
Gene Webb / JM (2)
GW
Grove Medical Centre / Tom Thacker / TT
Visitors:
OCCG / Dasa Miklosovicova / DM
OCCG / Dr Gavin Bartholomew / GB
South & Vale Carers / John Tabor / JT
Healthwatch Oxfordshire / Jen Marks / JM
OCC / John Jackson / JJ
OCCG / Julie Dandridge / JD
NHSE / Kath Rooksby / KR
Minutes taken by:
NHS South, Central and West Commissioning Support Unit, Senior Communications and Engagement Manager /
Julia Stackhouse / JS
Apologies Received:
Alison Langton
Mary Braybrooke / Marcham Road FamilyHealthCentre
Clifton Hampden Surgery
  1. MINUTES OF THE LAST MEETING (14-7-2015)

SG asked those present to confirm the minutes as a true and correct record of the July 14 2015 meeting. The minutes were accepted and confirmed without amendment.

MATTERS ARISING:
S106 funding for Health Services;

John Jackson (JJ)Director of Adult Social Services for the OCC, and Director for Strategy and Transformation for the OCCG. JJ thanked the SWOLF for getting the issue of S106 funding for Health Services onto the OCCG agenda. He explained that:

  • He is now leading for the OCCG on this issue, assisted by Julie Dandridge.
  • That the planning rules and processes are very complex and that the negotiations are all carried out with the housing developers by the District Councils (DCs).
  • He has had an initial meeting with the South and Vale District Council, which was welcomed and went well. He is planning to meet with all the DCs in due course.
  • He has written to all the DCs requesting that they include OCCG in their S106 planning processes.
  • That the Community Infrastructure Levy (CIL) was being introduced for smaller developments.
  • That NHS England have been carrying out some work in this area, for instance by getting contributions/land agreed with the Developers of Great Western Park, Didcot for the construction of a small branch surgery. (This however is now on hold whilst OCCG/NHSE try to finalise their support plans for both the GWP and Valley Park developments totally nearly 8,000 homes).
  • That it has been proposed that the DC and OCC planners will run a workshop to bring together health and social care issues and understanding. This might include a patient representative. MTJ agreed to discuss with the LFCs once more details of this and a firm proposal was available. Action: JJ to keep MTJ informed on progress.
  • That the money available is not huge and that excessive demands from DCs for funding can delay or even stop potential house building. However, it was appropriate that Health services should be included in the negotiations. It was suggested that also high requirements for developer contributions could lead to higher house prices.

JN-P flagged up that Wantage/Grove expected 5,000 new homes to be built and that these developments should be asked to contribute to expanded Health services in the area.

The general thrust of members’ responses was that the NHS needed to be consistent and commercially minded in pursuit of S106/CIL funds.

MTJ said that he would write to JJ with further questions in due course. Action: MTJ

  • Update on Primary Care Advisory Group (PAG) – GW updated that the Primary Care Strategy has been extended to include out of hospital care. The COACH website is now live and has been for 2 weeks. GW thinks it needs more work and this is recognised by the Abingdon Practices involved

For an update on the Challenge Fund pilots go to

  • Talking Health communications and website:

MTJ said that there was still very little usage of the TH facility but it was something that we just needed to persevere with.

SG reported that she had been unable to install TH on her smartphone and had to install it on another device – Action on JS to check with Inovem. Check registration for XXXX

  • Increasing membership – SG thanked the observers who were attending the SWOLF meeting and said that their thoughts and input would be sought in due course, following the meeting. (Subsequent to the meeting no interest has been expressed by those who attended as observers).

3)Chair report

  • Update on LFCS and OCCG meeting – MTJ provided a report. He had offered to circulate the reports from that meeting and nobody has expressed an interest. MTJ has said that we are facing an unprecedented level of change both within services and how money is spent. MTJ can understand the OCCG’s vision but not how it will be carried out. Although OCCG will have a surplus this year, the overall health and social care budgets for the County are only at break-even. By 2020 £270 million of health expenditure savings must be made. The OCC Social Care budgets are being cut due to reductions in central Government contributions. He also expressed concern about the Lavender Statements’ list of over 80 items that are deemed to be of limited clinical value until they become “acute.” This list includes: Hip and knee replacements and cataract removals. He doesn’t believe that the public understand this list or the guidance provided to clinicians on how patients should be treated, suffering from these conditions. The result is that many patients are having their lives spoiled through pain and disability because their conditions are not diagnosed as being sufficiently “acute.” He believes that the NHS needs to be much more openly explaining its “rationing policies” with regard to the Lavender statements. Other consequences of this are: further pressure on carers and future pressures on the NHS as patients become more acutely ill/disabled.

Action: Invite Sharon Barrington to come and talk about the planned care projects including MSK.

  • MTJ SWOLF–will review the terms of reference, V6 in preparation for January’s meeting, so that we are in a position to elect a replacement Chair, one way or the other then. Martin asked for people to be involved in the drafting of the new TOR, and SG, JNP, MW and TT expressed an interest. Will get feedback from observers too.

4)Friends and Family Test:KR, from NHSE, provided a tabled paper which was circulated to members. (Also attached to these minutes). FFT is a mandatory patient feedback tool in all NHS services, whether that isin acute hospitals or in a GP practice. It is not compulsory and should be seen as part of the wider patient engagement opportunities. The low levels of current FFT returns are of concern and MTJ pointed out that they should not be considered as a ratio of patient numbers but of appointment numbers. JT added that higher returns were needed to access real trend data. Some practices work with the PPG to review the FFT responses. Some PPGs hand out the FFT forms at reception. KR feels that the PPG can support the practice manager with FFT, as you can change your second question on the FFT form on a regular basis to reflect current questions that need to be answered within the practice. PPGs can use FFT to engage with their patient populations. JT - more responses could be generated if the practice and the commissioners/NHSE can explain what happens with the responses. MTJ said that part of the commitment required from Practices was to display all the FFT results and details of patient comments, on a monthly basis. JN-P welcomed the FFT and presentation and thanked KR for giving PPGs ‘permission’ to be involved in their practices FFT processes. KR’s post is only funded until end of March 2016. NHSE are working with Health and Social Care students in Reading and Stroud to encourage them to work in GP practice specifically on patient engagement. NHSE developing a toolkit for practice staff as part of their development.

5)SWOL Exec/Julie Anderson Report (full report attached to these minutes).
Dr Gavin Bartholomew attended as deputy to Julie Anderson. Referring to the previous discussion on the FFT, Dr GB gave his opinion that Practice Managers’ workloads did not permit them to do justice to the FFT and that also it was not seen as a priority by GPs. GB gave an update on co-commissioning and performance targets, including cancer targets and referral to treatment times, which are both improving. The four hour standard in A&E was met over the summer but he noted that as we come into winter it could be a more challenging time. Progress has been good. GB gave an update on Townlands, acknowledging that the bed based care in community hospitals is not financially effective, as often people there should be at home. Bed based community care would be better served atplaces where people receive treatment and then go home. A discussion was had about the Townlands model, explaining that this is a preventative measure; in general people accepted the model and acknowledged that it will take time for a difference to be seen at the back end. GB confirmed that the CCG is in a healthier financial position, but the financial situation has to be seen across the whole piece, taking into account the needs of OCC and OUHT and Oxford Health. GB also highlighted that there are discussions with the SCAS on red light ambulance services in rural areas.

GB advised that the SW Locality GPs have been thinking about planning in Didcot and recently used one of their sessions to discuss with practices the housing developments in the SW. Asked the practices to think about the developments and to think about what support and plans they might have to deal with the expansion. Abingdon practices felt that they could absorb the growth. Faringdon said that they too could absorb the growth and manage its expansion for the next 5 years. Clifton Hampden is looking to Berinsfield to see if there is any future room for collaboration. Wantage/Grove didn’t have the right people in the room to discuss the issue, but there is great scope for expansion at the Wantage medical centre. (MTJ: Although Didcot wasn’t mentioned at the meeting, the 3 practices in the town have said that they can only cope with the current rates of population increase for the next 18-24 months). MTJ – How does this involve the federations?GB - they are evolving but not involved in these discussions as yet. TT raised concerns about the Wantage and grove housing expansion. He said that the Grove Practice was suffering from the loss of a GP and a struggle to get locums in. GB confirmed that locums were also in short supply.

PMCF - early visiting service is up and running, as is the COACH website and is a portal for information ( Hubs are due to start in Wantage on 27 October and the roll out has been slow due to cost. This is ongoing. Hubs for Wantage and Didcot are under consideration now.

Local initiatives include the use of dermatascopes for the use of skin lesions in practices to ensure that patients are not referred inappropriately to JR.

JT – asked for feedback on the FFT. GB said he feels that practices should be working with their PPGs and that sometimes practices are not resourced sufficiently.

6)Healthwatch Oxfordshire Update – report was circulated.No questions were put by members.

7)Patient Group updates

MTJ confirmed that Appendix B has been circulated. Dave Pluright confirmed it is up to date, but at their next meeting Dave will be standing down as Chairman and process is in place to replace him.

MTJ reported that the Woodlands’ Patient Group had conducted a survey of patients asking for their Practice services’ improvement ideas. Circa 50 responses received and 150 ideas expressed. This has been followed up with the Practice and has been distilled into a number of improvement plans on which progress will be reported to patients in April 2016.

Appendix B – people to circulate their updates electronically. JS to prompt the group to do this. MTJ said that he doubted that this would happen and that if it didn’t he would still send out the Appendix for people to update and return to him.

8)AOB

  • JT – update on South and Vale Carers, hosting a drop in at Didcot Civic Hall. Success of this will depend on whether they will roll it out. Faringdon café continues. Young Carers first aid course, very successful. Issue a newsletter in SE and SW which will go out to over 2000 carers. SWOLF are welcome to put forward inserts for this in future.
  • Call out for the NE seeking a PPG to come and talk about their experiences about PPG partnerships with their practices.
  • Need to book local venues from April 2016 onwards – action for this to be done. Action on Dasa to look at alternative venues, perhaps rotating on a quarterly basis. Requirements: Large enough to hold up to 40. Refreshments available. Car parking. Cost acceptable to OCCG.
  • GW – asked for commissioning intentions to be on the next agenda item.
  • SH – survey on Maternity services, reporting back to the maternity group to feedback and present the findings from the survey.
  1. Date of next meeting: January 12th at the Didcot Civic Centre at 10.00.

Shelagh Garvey

ActingChair

SWOLF Meeting Minutes 14/7/15Version 4 October 30th 2015

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