Agenda and minutes

Venue: Committee Room One, County Offices, Newland, Lincoln LN1 1YL

Contact: Katrina Cope  Senior Democratic Services Officer

Items
No. Item

44.

Apologies for Absence/Replacement Members

Minutes:

An apology for absence was received from Councillor T Boston (North Kesteven District Council).

45.

Declarations of Members' Interest

Minutes:

Councillor Mrs P F Watson advised the Committee that she was currently a patient of United Lincolnshire Hospitals NHS Trust.

46.

Minutes of the meeting of the Health Scrutiny Committee for Lincolnshire held on 8 November 2017 pdf icon PDF 178 KB

Minutes:

RESOLVED

 

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 8 November 2017, be approved and signed by the Chairman as a correct record.

47.

Chairman's Announcements pdf icon PDF 260 KB

Minutes:

The Chairman advised that further to the announcements circulated as part of the agenda, the following supplementary information was circulated at the meeting for the Committees consideration:-

 

United Lincolnshire Hospitals NHS Trust Grantham and District A & E Department – Additional Information

 

That the United Lincolnshire Hospitals NHS Trust (ULHT) Board was meeting on 15 December 2017 to consider a report on the opening hours of Grantham and District Hospital's A & E Department, which was currently closed each night between 6.30pm and 8.00am.  The Committee was advised that further information had been published on 12 December 2017, which included reference to the details as shown below:-

 

Decision of ULHT Board on 7 November 2017

 

On 7 November 2017, the ULHT Board had agreed that it wanted to re-open Grantham and District Hospital A & E Department overnight, pending an independent review of staffing by NHS Improvement, the national regulator of provider trusts.  NHS Improvement asked the East of England Clinical Senate[1] to undertake a safety review for all ULHT's A & E Departments and to see whether the opening hours of Grantham and District Hospital A & E Department could be extended. 

 

Recommendations of the East of England Clinical Senate

 

In order to undertake the review, the East of England Clinical Senate had appointed a Clinical Review Panel, whose report had been published and contained the following five recommendations:

 

Recommendation 1

 

·         The Panel does not support the reopening of the 24/7 A & E department at Grantham Hospital on the grounds of potential adverse impact on patient safety at A & E Departments at all three United Lincolnshire NHS Trust Hospitals.

 

·         The Panel strongly recommends, on the grounds of patient safety, United Lincolnshire Hospitals NHS Trust Board reconsider its proposal to extend the current A & E service opening hours at Grantham and District Hospital.

 

·         The Panel recommends that the Trust should continue to provide an A&E service at Grantham and District Hospital on the current opening hours of 08.00-18.30, seven days a week until a more definitive long term urgent and emergency care plan was developed and agreed.

 

Recommendation 2

 

The Panel recommends that in order to make it clear for patients and the public the type of service available at Grantham and District Hospital A & E Department, the Trust look to re-labelling or re-naming the department, and ensure that it communicates that widely. The panel further recommended that the terminology ‘A & E Centre’ is not applied to Grantham and District Hospital in any further model.

 

Recommendation 3

 

The Panel recommends that the Trust should move to a single A & E team with a focus on standardised clinical pathways and processes across the three sites, removing any unnecessary variation and providing enhanced training opportunities.

 

Recommendation 4

 

The Panel recommends that the Trust and CCG have clear alignment with the Lincolnshire STP, developing a system approach to urgent and emergency care, and planned care for patient and the public. The Trust and STP should move to public consultation on an agreed  ...  view the full minutes text for item 47.

48.

Alternative Provisions to the Lincoln Walk-in Centre pdf icon PDF 155 KB

(To receive a report from Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West Clinical Commissioning Group, which provides an update on the progress in implementing plans to enhance primary care services and its public awareness campaign as to the alternative provisions to the Lincoln Walk-in Centre; and invites the Committee to review and comment on these plans) 

Additional documents:

Minutes:

The Chairman welcomed to the meeting Dr Sunil Hindocha, Chief Clinical Officer, Lincolnshire West Clinical Commissioning Group (LWCCG), Sarah-Jane Mills, Chief Operating Officer LWCCG and Wendy Martin, Executive Lead Nurse and Midwife – Quality and Governance LWCCG.

 

The Chief Clinical Officer, LWCCG advised the Committee that a Push Doctor App had been promoting its online 'walk-in centre' services to patients in the Lincoln area.  Confirmation was given that this was not a service that had been commissioned by LWCCG; and that LWCCG had had no interaction or conversations with the company behind the App.  The Committee noted that a statement to this effect had been released.

 

During their joint presentation, Officers from the Lincolnshire West Clinical Commissioning Group updated the Committee on the following issues:-

 

·         Background – The Committee was reminded that on 12 June 2017, the Lincolnshire West Clinical Commissioning Group (LWCCG) had launched a public consultation on the future of the Walk-in Centre, this had concluded on 18 August 2017.  Then, at the Governing Body meeting held on 27 September 2017, a decision had been taken to keep the Walk-in-Centre open over the winter period; and close only when the governing body was satisfied with the evidence based reviews.  The first evidence based review had been presented to the Governing Body on 29 November 2017; and a further review was due to be presented to the Governing Body meeting on 24 January 2018.  It was highlighted that the ten week public consultation had been extensive and had engaged patients, the general public; public bodies, key stakeholders including health care partners and the third sector; 

·         It was reported that attendance to the Walk-in-Centre had significantly reduced, and that October 2017 had seen a reduction of 26.8% from the previous year; and that the September attendances had been the lowest monthly attendances at the Walk-in-Centre for over two and a half years.  The LWCCG had supported a targeted communications and engagement initiative by the University practice, during freshers' week to encourage students to register with a GP.  As a result of the initiative, the Committee was advised that the University practice had seen a net increase in registrations of 3,150 students;

·         Alternative provision – Page 22 of the report presented provided the Committee with a list of ongoing plans to strengthen alternative provisions in six key areas; and Appendix A to the report provided details of the status of the alternative provision plans.  Other alternative provisions mentioned included GP same day access, arrangements for urgent need; skype access at the University practice; additional community pharmacists; GP Out of Hours; 111 supplemented by Lincolnshire Clinical Assessment Service; Neighbourhood Team implementation progression (Gainsborough and the South of Lincoln areas).  The Committee was also advised that GP practices had confirmed that arrangements were in place to support any potential increase in demand.  It was noted that on average there was approximately 3 - 10 additional appointments per practice per day.  The Committee noted that as a result of  ...  view the full minutes text for item 48.

49.

Non-Emergency Patient Transport Service for NHS Lincolnshire CCG's - Thames Ambulance Service Limited (TASL) pdf icon PDF 100 KB

(To consider a report from Lincolnshire West Clinical Commissioning Group on the Non-Emergency Patient Transport Service in Lincolnshire.  Lincolnshire West Clinical Commissioning Group is the lead commissioner for these services, and Sarah-Jane Mills, the Chief Operating Officer, and Tim Fowler, the Director of Commissioning and Contracting, will be in attendance from the CCG.  In addition, Sue Flintham, North Regional Director, Tracy Hodgkiss, Improvement Director, and Blanche Lentz, Interim Chief Operating Officer from the Thames Ambulance Service Ltd are due to attend and present information to the Committee)

Additional documents:

Minutes:

The Chairman welcomed to the meeting, firstly presenters from Thames Ambulance Service Limited (TASL):- Sue Flintham, North Regional Director, Graham Briggs, Director of Corporate Services and Workforce, Blanche Lentz, Acting Chief Operating Officer and Tracy Hodgkiss, Improvement Director and then secondly, the presenters from Lincolnshire West CCG, Sarah-Jane Mills, Chief Operating Officer and Tim Fowler, Director of Commissioning and Contracting.

 

The Committee had received a report from the Lincolnshire West Clinical Commissioning Group, which formed part of the agenda, which advised of the actions the LWCCG was taking to ensure that TASL were making the necessary improvements in the quality of services being provided to patients.  A subsequent supplementary report from TASL had then been circulated to Committee by email, which advised of the actions TASL were under taking to make the necessary changes to deliver the contract performance, and to improve the patient experience of the service being provided.

 

In their presentation to the Committee, TASL advised that they had been awarded the NHS contract for delivery of Non-Emergency Patient Transport for the four CCGs following a competitive procurement process.  The five year contract had commenced on 1 July 2017, (with the potential for an extension for a further two years).  Details of the contract were shown on page two of the supplementary report.

 

The report highlighted that since the 'go live' date there had been issues relating to performance in line with the contract pertaining to journey planning, and significant delays in answering calls, which had resulted in patients not arriving on time, or not being collected in a timely manner on discharge.  The Committee was advised that the service in Lincolnshire had been adversely affected by the distraction of management capacity to support the commencement of patient services in Leicestershire, and that the TASL Executive had agreed not to bid for any further work until performance in current TASL contracts were at a required level.

 

Following the issue of a formal Contract Performance Notice by the Lincolnshire CCGs on the 17 November 2017, the Committee was advised that in accordance with the contract TASL had submitted a Remedial Action Plan to the LWCCG.  The Committee was advised further that work was ongoing with LWCCG to improve service provision.  A list of the changes to enable TASL to work towards the Remedial Action Plan was shown on page three of the supplementary report.

 

As well as the changes detailed in the report, the Committee noted that TASL had implemented a new management structure which had commenced in August 2017, which had incorporated a regional devolution process, which would provide more control to the local team.  The Committee was also advised that as a result of ill health, the Chief Executive Officer had recently resigned; and that the process of external recruitment for the post had commenced. 

 

The Chairman invited members of the Committee to posed questions to TASL. The following issues were raised:-

 

·         Whether TASL had had experience of the rural nature  ...  view the full minutes text for item 49.

50.

Winter Planning pdf icon PDF 131 KB

(To receive a report from Ruth Cumbers, Urgent Care Programme Director, which updates the Committee on planning for Winter Pressures across the Health and Care Economy in Lincolnshire)

Additional documents:

Minutes:

Consideration was given to a report from the Lincolnshire East Clinical Commissioning Group (LECCG), which provided an update on planning for winter pressures across the health and care economy in Lincolnshire.  The Committee was also asked to give consideration to a report from the Council's Executive Director of Adult Care and Community Wellbeing, which provided the Committee with details relating to the performance on Delayed Transfers of Care.

 

The Chairman welcomed to the meeting Samantha Milbank, Accountable Officer, Lincolnshire East Clinical Commissioning Group and Lynne Bucknell, County Manager, Special Projects and Hospital Services.

 

In guiding the Committee through the report, the Accountable Officer, LECCG advised that it was essential that a 'whole system' approach was taken to anticipating how and where in the system increased demand was likely to present, and to the planning of appropriate inter-agency responses to ensure that no part of the system was overwhelmed or unable to function.

 

The Committee noted that the A & E Delivery Board had effective leadership and that the draft winter plan had been submitted to regulators for review and assurance prior to 7 August 2017.  The Plan had been assured by the Regulators, NHS England and NHS Improvement, and had been signed off by the Lincolnshire A & E Delivery Board on 14 November 2017.  A summary of the various areas involved in the plan was detailed within the report presented.

 

The County Manager, Special Projects and Hospitals Services provided on page six of the supplementary report, details relating to Delayed Transfer of Care (DTOC) Targets.

 

A table on page seven provided data relating to all hospitals adult care delayed days over a six month rolling period.  The graph demonstrated that there had been very low Adult Care delays over the last six months across the acute hospitals.  It was reported that Adult Care had continued to meet local Better Care Fund Delayed Transfer of Care Targets.

 

During discussion, the Committee raised the following points:-

 

·         Some of the members felt that the report should have been presented to the Committee earlier in the year.  Officers noted the request and agreed to ensure that the Committee had sight of the report at an earlier stage of the process;

·         Lack of beds – The Committee was advised that the flexible system approach was to avoid admission where possible by moving the patient to primary care;

·         The need to include the provision of transport in future years plans;

·         The reduction in elective work during the winter period, to give better capacity to the system as a whole;

·         Promotional Campaigns – Encouraging people to 'Stay Well this Winter';

·         That the majority of DTOC's were as a result of NHS issues.  It was highlighted that 79.35% of DTOC's were achieved at Lincoln County Hospital, where as Grantham Hospital was achieving 96.13% of the four hourly wait figure.  Officers advised that the A & E waiting at Boston and Lincoln Hospitals was different.  There was streaming at Boston and Lincoln as there was a higher  ...  view the full minutes text for item 50.

51.

Congenital Heart Disease Services - Decision by NHS England pdf icon PDF 258 KB

(To receive a report from Simon Evans, Health Scrutiny Officer, which provides the Committee with an update on the decision made by NHS England Board on 30 November 2017 in relation to the future of Congenital Heart Disease Services)

Minutes:

The Committee gave consideration to a report from Simon Evans, Health Scrutiny Officer, which advised the Committee of the decision taken by NHS England on 20 November 2017 relating to the future of Congenital Heart Disease Services, in particular its decision to continue to commission Level 1 Congenital Heart Disease Services from the University Hospitals of Leicester NHS Trust (UHL), conditional upon UHL achieving full compliance with the standards in line with UHL's own plan and demonstrating convincing progress along the way.

 

Pages 81/82 of the report provided the Committee with details of the milestones to be achieved by UHL.

 

During a short discussion, the Committee paid tribute to former Health Scrutiny Committee for Lincolnshire Chairman, Councillor Mrs C A Talbot, for all her hard work supporting the continuation of congenital heart surgery in Leicester.

 

RESOLVED

 

That the Committee note the decision of NHS England on 20 November 2017 relating to the future of Congenital Heart Disease services, in particular its decision to continue to commission Level 1 Congenital Heart Disease services from the University Hospitals of Leicester NHS Trust (UHL), conditional upon UHL achieving full compliance with the standards in line with UHL's own plan and demonstrating convincing progress along the way.

52.

Health Scrutiny Committee for Lincolnshire - Work Programme pdf icon PDF 177 KB

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider and comment on its work programme)

Minutes:

Consideration was given to a report from Simon Evans, Health Scrutiny Officer, which enabled the Committee to consider and comment on the content of its work programme to ensure that scrutiny activity was focussed where it could be of greatest benefit.

 

Appendix A to the report provided the work programme from 17 January 2018 to 16 May 2018.

 

The Committee was advised that Grantham A & E would be added to the agenda for the 17 January 2018 meeting, as would the Non-Emergency Transport Service for NHS Lincolnshire CCG's.  The Committee agreed that the 17 January 2018 meeting should be an all-day meeting due to the number of items for consideration.

 

RESOLVED

 

That the work programme as detailed in Appendix A be received, subject to the inclusion of the items listed above.

 

 

 
 
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