Agenda and minutes

Apologies for absence were received from Councillors S R Parkin, Mrs S Harrison and P Robins.

None were declared.

RESOLVED:

           That the minutes of the meeting held on 15 March 2023 be approved    as a correct record and signed by the Chairman.

Further to the announcements circulated with the agenda, the Chairman brought to the Committee’s attention the supplementary announcements circulated on 18 April 2023.

During consideration of this item, the following points were recorded:

·      The Committee welcomed the recommendation to review GP and Care Contracts within the Hewitt Review – An Independent Review of Integrated Care Systems, however concerns were raised over the impact of the review’s recommendations for Lincolnshire as a rural county.

·      Concerns were also raised over the implementation of the decision on the nuclear medicine service in Lincolnshire and views were reiterated on the arrangements leading to unnecessary travel for some residents.

·      Some Members welcomed NHS plans to reduce inappropriate prescribing of high-strength painkillers, in particular the use of opioids. However, some Members recognised the importance of ensuring opioid painkillers were still available to those who were unable to be prescribed alternative painkillers due to medical conditions.

·      The Committee raised concerns over the announced closure of the BUPA dental practice in Skegness to NHS patients and other potential closures in Lincolnshire given that there was already a lack of NHS dental provision in Lincolnshire, particularly on the east coast. The development of new ideas for the recruitment and retention of dentists through the Integrated Care Board was supported.

RESOLVED:

           That the Chairman’s Announcements on pages and the            Supplementary Announcements circulated on 18 April 2023 be noted. 

(To receive a report from Derek Ward, Director of Public Health, which asks the Committee to note the publication of Lincolnshire’s new Joint Strategic Needs Assessment. Lucy Gavens, Consultant in Public Health will be in attendance for this item)

Consideration was given to a presentation by the Public Health Consultant, which invited the Committee to note the publication of the Joint Strategic Needs Assessment for Lincolnshire (JSNA). The presentation provided background information on the JSNA; updates to the JSNA and the Life Course Approach and demonstrated the new interactive reporting mechanism. Members were advised that the JSNA would be continually updated and were encouraged to visit the Lincolnshire Intelligence Hub where data could be viewed.

Consideration was given to the report and during the discussion the following points were recorded:

·      Whilst the Committee welcomed the JSNA as a comprehensive evidence-based resource, the Committee emphasised the importance of ensuring that the JSNA was used as a mechanism to implement change within the sector, such as access to medical services, dental provision and weight loss strategies. 

·      Assurance was provided that the JSNA had been coproduced with NHS Lincolnshire Integrated Care Board (ICB) colleagues who were working towards ensuring that data was used at a strategic level and in practice to shape services.

·      The JSNA had directly influenced the dental strategy which was being produced by the ICB ensuring it targeted inequalities and areas with the greatest need. 

·      Some Members were disappointed that Lincolnshire County Council’s JSNA did not include comprehensive needs assessments including groups protected by legislation and specific needs in the way that other local authorities had. The Committee were assured that the Council had the same level of intelligence to inform the JSNA as other local authorities, but the data may be presented differently.

·      A range of services were available to support people with lifestyle changes such as weight loss, some of which was targeted within communities and with organisations connected to communities.

·      Data on the Lincolnshire Intelligence Hub was managed by the Public Health Intelligence team who were confident that online data could be kept up to date. 

·      To date, no feedback had been received on Lincolnshire Intelligence Hub, however the team were keen to ensure that data was accessible to a range of users and would monitor any feedback.

·      In relation to cancer treatment, the JSNA could be used to develop the understanding around local challenges and ensure priorities and prevention are based on local data.

RESOLVED:

           That the Lincolnshire Joint Strategic Needs Assessment be noted and    be used to support future scrutiny activity.

(To receive a report from Derek Ward, Director of Public Health, which invites the Committee to consider the joint engagement approach for the Joint Health and Wellbeing Strategy and the Integrated Care Strategy.  Alison Christie, Programme Manager, Public Health will be in attendance for this item)

Consideration was given to a report by the Programme Manager – Public Health, which invited the Committee to consider the Joint Engagement Approach – Joint Health and Wellbeing Strategy and Integrated Care Strategy, which would inform the review of the Joint Health and Wellbeing Strategy and the next iteration of the Integrated Care Strategy. The report made reference to statutory guidance, purpose and objectives, engagement with the public and the proposed process and timeframes.

Consideration was given to the report and during the discussion the following points were recorded:

• Concerns were raised that health care had become reactive and questioned the impact the strategy could have on services given the backlog of appointments and operations. The need for a more emphasis on a holistic approach was stressed given that further health care issues will be reported in future years as a result of a lack of provision now. There was strong support for prevention activity and using the JSNA evidence to develop preventative services.
• The Committee observed that information gathering would ideally lead health services in the right direction.
• Assurance was provided that stakeholder groups would be consulted should the strategy be renewed and a public consultation be carried out.
• Councillors expressed disappointment that a new strategy was not being proposed, given the significant challenges faced within the NHS in recent years.

RESOLVED:

1.      That joint engagement approach and the methodology for identifying priorities from the new joint strategic needs assessment be supported:

2.     That an item be scheduled in Committee’s work programme for 8?November 2023 on the draft Lincolnshire health and wellbeing strategy and the Lincolnshire integrated care plan, prior to their approval in December 2023.   

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider a report from the Committee’s Suicide Prevention and Mental Health Working Group)

Consideration was given to a report by the Health Scrutiny Officer, which invited the Committee to a report from the Committee’s Suicide Prevention and Mental Health Working Group, as set out at appendix A To the report.

Consideration was given to the report and during the discussion the following points were recorded:

• The Committee supported the recommendations made by the Working Group and recorded its thanks to the group for the work on this topic.
• The Committee acknowledged the increase people experiencing mental health challenges, particularly in the younger generation. The need to embed better provision to support those experiencing challenges was highlighted.
• The introduction of specific option for mental health support when contacting 111 was supported.
• Members referenced statistics which had recorded a rise in mental health issues by 20% between 1993 – 2014. A link to virtual communication and mental health was suggested.
• The link between mental health issues and drug use/dependency was emphasised. The reluctance of some organisations to acknowledge a dual diagnosis could often lead to barriers in treatment and support for individuals. It was agreed that this be considered within a future report on the link between GP and Mental Health Services.
• It was suggested that recommendation 1 from the working group be amended to ensure the Committee also consider the role of PCN’s and ICB’s and would read as follows:

1.      That an item be included in the Committee’s work programme on the mental health in GP practices and the role of primary care networks and the NHS Lincolnshire Integrated Care Board, including:
       (a) the development of dedicated mental health staffing       roles in primary care;

       (b) the views of GPs and the NHS Lincolnshire        Integrated        Care Board on the prescribing of anti-depressants for      people               with sub-threshold and mild depression.

RESOLVED:

1. That the recommendations from the Suicide Prevention and Mental Health Working Group, with the subject to the amendments proposed, be supported
2. That thanks be recorded to the working group for their work on this topic.

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

Consideration was given to a report by the Health Scrutiny Officer, which invited the Committee to consider its work programme, as set out on pages  61 – 67 of the agenda pack.

During discussion, the following suggestions were put forward for additions to the Committee’s work programme:

• The NHS 111 service
• An update on urgent treatment centres (UTCs), including the arrangements for the Grantham and District Hospital UTC; and Stamford and Rutland Hospital’s minor injuries unit becoming a UTC.
• The absence of fluoride in water systems in relation to oral health
• Update on A&E services at Pilgrim Hospital, Boston

RESOLVED:

              That the work programme be noted, subject to the suggestions put             forward by the Committee.