The Oxfordshire Joint Health Overview & Scrutiny Committee met to discuss general practice access, eyecare services, and support for adults with autism and ADHD in Oxfordshire. The committee noted responses to previous recommendations regarding musculoskeletal services, audiology, cancer services, Oxfordshire as a Marmot Place, and Oxfordshire system pressures. They also discussed the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board's (BOB ICB) neighbourhood health bid.

General Practice Access and Estates

The committee considered a report on general practice access and estates in Oxfordshire, and were invited to agree any recommendations arising from it.

Julie Dandridge, Strategic Lead for Primary Care across Oxfordshire for the BOB ICB, presented the report, which provided an update on primary care services, specifically general practice services, in Oxfordshire.

Key points from the report included:

• Appointment numbers: Appointment numbers in general practice have remained steady since 2023, with seasonal variations. Of the 374,000 appointments offered in June 2025, 48.6% were with a GP. 88% of Oxfordshire patients are seen within two weeks of contacting their practice, compared to 86% nationally. 55.5% of patients have a same-day appointment, compared to 54.3% for England.
• General Practice workforce: Data indicates that Oxfordshire has slightly more GPs per 10,000 patients than the national average, but slightly fewer nurses. The number of GPs has been slowly increasing.
• Additional Roles Reimbursement Scheme (ARRS): Oxfordshire now has 394.84 whole-time equivalent ARRS staff across 25 separate roles.
• Physician Associates/Assistants: Following concerns about patient safety, role clarity, and the rapidly expanding presence of Physician Associates (PAs), an independent review (the Leng Review) was undertaken. The numbers of PAs have not decreased in Oxfordshire as a result of the concerns and the publication of the Leng Review.
• Patient Access Survey: Oxfordshire remains above the England average for overall experience of their GP practice, although there was a slight decrease compared to 2024 survey results.
• Schemes to support general practice access: Pharmacy First schemes are being promoted to remove reliance on general practice for some health tasks, and the ICB has commissioned an Urgent and Non-Urgent Unscheduled Care Dental Access Appointments Scheme.
• Primary Care Estate: There are currently 154 practices across BOB operating out of 223 practice sites. Across Oxfordshire there are two major projects to improve primary care estate which includes a new surgery building in Great Western Park in Didcot and expansion of Bicester Health Centre into space vacated by Oxford Health NHS Foundation Trust to increase the number of consulting rooms available.

Oxfordshire Eyecare Services

The committee considered a report on eyecare services in Oxfordshire, and were invited to agree any recommendations arising from it.

Matthew Tait, BOB ICB, presented a report on eyecare services commissioned in Oxfordshire. The report detailed how eyecare services are commissioned and managed, the geographical distribution of eye care facilities, the numbers of eye care professionals, waiting times, barriers to access, protocols and guidelines, quality measurement, patient satisfaction, and referral pathways.

Key points from the report included:

• Primary care optometry services: NHS-funded sight tests are undertaken in community and domiciliary settings.
• Intermediate care/community eyecare providers: Primary Eye Care Services (PEC) provide enhanced community eye care services across Oxfordshire, including Minor Eye conditions (MEC), Glaucoma Repeat Readings service (GRRS), and Hydroxychloroquine Monitoring.
• Hospital/Secondary eyecare services: The Oxford Eye Hospital, provided by Oxford University Hospital NHS Foundation Trust and located at the John Radcliffe Hospital, provides a range of ophthalmology services. There has been an increase in the number of Independent Service Providers (ISPs) offering ophthalmology services.
• Geographical distribution: Primary Optometry and PEC services are distributed across Oxfordshire, with domiciliary services available to eligible patients. ISPs provide services from their base at Blenheim Office Park, Long Hanborough and Newmedica is located in on the Marcham Road in Abingdon.
• Waiting times: Emergency conditions are seen in eye casualty on the day. MECS provides assessment and treatment for sudden onset, minor eye problems, with patients able to be seen by a specialist within 48 hours.
• Patient satisfaction: In September 2024 Healthwatch Oxfordshire published a report setting out the experiences of patients using primary and secondary care eyecare services in Oxfordshire.

Joan Stuart, from Oxfordshire Keep Our NHS Public, had previously raised concerns about private eye clinics performing most cataract surgeries, which she felt risked NHS eye care departments¹.

Adults Autism and Attention Deficit Hyperactivity Disorder (ADHD) services

The committee considered a report on adults autism and ADHD services in Oxfordshire, and were invited to agree any recommendations arising from it.

Matthew Tait, BOB Integrated Care Board Chief Delivery Officer, presented a report on adults with autism and Attention Deficit Hyperactivity Disorder (ADHD) services in Oxfordshire.

Key points from the report included:

• Adult Autism and ADHD services in Oxfordshire are experiencing rising demand and long waiting times, and the local NHS service is paused to new referrals due to capacity limits.
• Around 11,778 adults have autism and 27,714 have ADHD in Oxfordshire, but actual diagnoses, especially for ADHD (10,528 adults), are lower reflecting underdiagnosis, particularly among females and older adults.
• Waiting lists are long, with autism assessments capped at 110 per year and over 2,200 people waiting for ADHD assessments.
• Many GPs (about 50%) are reluctant to prescribe ADHD medication, impacting ongoing care.
• The Right to Choose scheme allows patients to seek assessments from alternative providers when local services are paused, with waits ranging from a few weeks up to 18 months.
• A five-year autism strategy is in development, and the Adult ADHD Transformation Programme is underway to streamline care pathways, improve medication management, and better engage GPs.

Healthwatch Oxfordshire Update

Veronica Barry, Executive Director of Healthwatch Oxfordshire², presented the Healthwatch Oxfordshire Update report. The committee was invited to consider the update and note it, having raised any questions arising.

Key points from the report included:

• Healthwatch Oxfordshire attended Health and Wellbeing Board, Health Improvement Board and the Children's Trust Board.
• Reports published since the last meeting included: Navigating urgent and emergency care in Oxfordshire and Using women's health and emergency care services in Oxfordshire.
• Since the last meeting Healthwatch Oxfordshire made Enter and View visits to Well Pharmacy, Marston and Blue Outpatient at John Radcliffe.
• Key issues heard from the public included: GP Services - mainly around barriers access to services in a timely way, confusion for patients caused by Connect Health being absorbed into Cora Health, and issues with using the NHS App.

The report also included a document outlining the future of Healthwatch and independent scrutiny, noting that the Dash Report on patient safety published for the government in July 2025 outlines the future landscape for patient safety including rationalising pathways for patient voice, action, accountability and response.

Chairs Update

Councillor Jane Hanna OBE provided an update on relevant issues since the last meeting.

The update included two reports containing recommendations from the committee on Oxfordshire System Pressures, and on Oxfordshire as a Marmot Place.

A letter was sent to the Chief Executive of the BOB Integrated Care Board, requesting further information on a recent Oxfordshire Neighbourhood Health Bid. The application Oxfordshire Place-based Partnership recently submitted in response to the national neighbourhood health implementation programme (NNHIP) stated that:

The Oxfordshire application is intended to accelerate the benefits of neighbourhood working in Oxfordshire...Specifically, for some of the most vulnerable and deprived residents...To build on progress to date relating to care being delivered and coordinated by INTs...To further explore and mature primary care at scale delivery.

Forward Work Plan

The committee agreed to the proposed work programme for its upcoming meetings.

Actions and Recommendations Tracker

The committee noted the progress made against agreed actions and recommendations.