Agenda and minutes

Apologies for absence were received from Councillor Mrs L Hagues (North Kesteven District Council), D Rodgers (West Lindsey District Council), G Scalese (South Holland District Council), S Welberry (Boston Borough Council) and Liz Ball (Healthwatch Lincolnshire).

It was noted that Councillor J Pessol (North Kesteven District Council) had replaced Councillor Mrs L Hagues (North Kesteven District Council) for this meeting only.

An apology for absence was also received from Councillor S Woolley (Executive Councillor NHS Liaison, Integrated Care System, Registration and Coroners).

Councillor R J Kendrick wished it to be noted that he was one of the Council’s representatives on the Lincolnshire Partnership NHS Foundation Trust – Council of Governors Stakeholders Group.

Councillor T J N Smith declared a non-pecuniary interest in relation to agenda item 6, as a member of the East Midlands Veteran Advisory and Pension Committee.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 8 November 2023 be approved and signed by the Chairman as a correct record.

Further to the announcements circulated with the agenda, the Chairman brought to the Committee’s attention the supplementary announcements circulated on 5 December 2023, which referred to the following:

·       The outcome of the consultation of Paediatric Services at Pilgrim Hospital, Boston. The Committee noted that the NHS Lincolnshire Integrated Care Board had approved the service change; and

·       Primary Care System Level Access Improvement Plan.  The Committee noted that the document (found on pages 29 -78 of the agenda) had been approved by the NHS Lincolnshire Integrated Care Board on 28 November 2023.

During consideration of this item, some support was extended to the investment being made into a national prostate screening trial. One member enquired as to how much funding would be allocated to Lincolnshire.  The Health Scrutiny Officer agreed to forward any available information on to members of the Committee.

RESOLVED

That the supplementary announcements circulated on 5 December 2023 and the Chairman’s announcements as detailed on pages 17 to 20 of the report pack be noted.

(To receive a report from the NHS Lincolnshire Integrated Care Board (ICB), which provides the Committee with an overview of current GP practice delivery; an update on mental health care provision within primary care; and progress on local delivery of the Primary Care Access Recovery Plan.  Sarah-Jane Mills, Director for Primary Care, Communities and Social Value NHS Lincolnshire ICB and Nick Blake, Programme Director - Primary Care NHS Lincolnshire ICB will be in attendance for this item)

Consideration was given to a report from the NHS Lincolnshire Integrated Care Board (ICB), which provided the Committee with an overview of current general practice care delivery and provided an update on mental health care provision within primary care, and summarised progress on local delivery of Primary Care Access Recovery Plan.

(Note Councillor S R Parkin joined the meeting at 10.05am).

The Chairman invited Nick Blake, Programme Director, NHS Lincolnshire Integrated Care Board and Sarah-Jane Mills, Director of Primary Care, Community & Social Value, NHS Lincolnshire Integrated Care Board, to remotely present the item to the Committee.

Attached to the report at Appendix A was a copy of the Lincolnshire Primary Care System Level Access Improvement Plan for the Committee to consider.

In conclusion, the Committee noted that GP care across Lincolnshire continued to be good and reflected the hard-work and dedication of GP’s, their practices, and Primary Care Networks.  It was noted that progress had been made regarding access, but there was more to do to ensure that people could get the care they needed.

It was reported that the development and implementation of the System Level Access Improvement Plan would improve patient access and experience and help to mitigate some of the pressures on GP practices.

During consideration of this item, some of the following comments were noted:

·       Clarification was sought regarding the methodology in place to tackle the 8am rush and to the statement that patients would no longer be asked to call back another day to book an appointment.  The Committee was advised that if a patients need was clinically urgent it would be assessed on the same day by a telephone or face-to-face appointment.  If a patient contacted a practice in the afternoon, they might be assessed the next day, where clinically appropriate.  If a patients need was not urgent, but it needed a telephone or face-to-face appointment, then this would be scheduled within two weeks.  It was also noted that where appropriate, patients would be signposted to self-care or other local services.  Some members observed that they had not experienced any improvements in the 8.00am access to GP practices issues;

·       The Committee was advised that receptionist training was down to each GP practice, as each practice had slightly different operating models, and receptionists had different roles within each practice. It was highlighted that support was available through the system to support a practice support their staff including the receptionists, which included care navigation support.  The Committee noted that the 8.00am rush was really supported by the expertise of those at first point of contact.  It was noted further that there was a national training programme, funded through the Primary Care Access Recovery Plan, for staff to develop their skills and expertise.  Some support was also extended to the service provided by care navigators as their expertise and guidance was crucial in a GP practice;

·       It was reported that that some practices had not received a Care Quality Commission (CQC) inspection for some time, but it  ...  view the full minutes text for item 53.

(To receive a report from Lincolnshire Partnership NHS Foundation Trust (LPFT), which provides the Committee with an update on the learning disability and autism services provided by LPFT in the county and the specialist mental health services available for armed forces veterans. Chris Higgins, Director of Operations LPFT and Eve Baird, Director of Operations – Specialist Services LPFT will be in attendance for this item)

The Committee considered a report from Lincolnshie Partnership NHS Foundation Trust (LPFT), which provided the Committee with an update on the learning disability and autism services provided by LPFT in the county and the specialist mental health services available for armed forces veterans.

The Chairman invited Chris Higgins, Director of Operations ULHT and Eve Baird, Associate Director of Operations for Specialist Services ULHT, to remotely present the item to the Committee.

During consideration of this item, the following comments were noted:

(Note: Councillor R J Kendrick left the meeting at 11.30am).

·       Thanks were extended to the increase in the amount of signposting for patients requiring specialist mental health services in Lincolnshire;

·       The Committee was advised there had been significant improvements in the autism waiting list, but in was noted that some people were waiting up to a year for assessment.  There was recognition that this was not acceptable, the Committee was advised there had been a recurrent funding increase to increase capacity within the diagnostic team, and that outsourcing and additional partners were helping to reduce the waiting list to a more manageable level. The Committee noted that the 18-month trajectory plan was for no-one to be waiting more than 12 weeks for an assessment;

·       In terms of the gap for 16 to 18-year-olds, the Committee noted that a piece of work was being led by the Integrated Care Board (ICB) in collaboration with the Autism Partnership Board to look at the autism diagnostic pathway across the age range;

·       The Committee noted that the virtual autism hub would offer the same level of navigation and support to individuals who believed they might be autistic or were waiting for a diagnosis, or believed they were autistic but did not want to go through a diagnostic process, but still wanted the support that the hub might be able to offer;

·       In terms of the Op COURAGE, the Committee was advised that this programme allowed for the service to step into the space of lead provider, across health and social care.  The Committee noted that the programme was specially commissioned to provide specialist care and support for service personnel, reservists, armed forces veterans, and their families.  The Committee noted further that there was currently a gap in who provides that holistic care, and that steps were being undertaken by the ICB to look at health and social care to mirror what happens in the children and young people service, as veterans required a whole system commitment.  The Committee was advised that self-referrals and referrals from professionals were accepted, with consent of the individual;

·       The Committee was advised that the average waiting time for accessing speech and language therapy was within eighteen weeks, but it was noted that this was too long, and the service was working towards a four week wait.  The Committee noted that cases with a dysphagia element would tend to be prioritised, and those individuals would be seen within a week for urgent cases or four weeks for non-urgent referrals;  ...  view the full minutes text for item 54.

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider a draft response to the Humber and North Yorkshire Integrated Care Board consultation: Your Health, Your Hospital – Let’s Get Better Hospital Care, which has been compiled on the basis of the comments made at the 8 November 2023 meeting)

Consideration was given to a report from Simon Evans, Health Scrutiny Officer, which invited the Committee to consider a draft response, and subject to any further amendments approve the draft response as the Committee’s final response to the Humber and North Yorkshire Integrated Care Board Consultation entitled Your Health, Your Hospital – Let’s Get Better Hospital Care, which had been compiled from the comments made at the 8 November 2023 meeting.

The Committee were reminded that the Humber and Lincolnshire Joint Health Overview and Scrutiny Committee (H&LJHOSC) was the statutory consultee for the purpose of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny Regulations) 2013.  It was highlighted that a meeting of the H&LJHOSC was scheduled to be held on 18 December, at which its response to the consultation was due to be finalised.

Thanks were extended to the Health Scrutiny Officer for capturing the comments raised by Committee during debate of this item at the meeting held on 8 November 2023.

During consideration of this item, the Committee highlighted their dismay at the overall consultation process, and the potential impact of some of the proposals for residents in Lincolnshire, the impact on neighbouring trusts, and transportation implications.  As a result of the Committee’s concerns, there was agreement that the tick boxes would not be used and that text boxes inserted in the document should remain. It was also suggested that local MP’s affected by the proposals should be made aware of the Committees concerns.  Members of the Committee were reminded that the Committee was only responding as a non-statutory consultee.

RESOLVED

1.      That the response (as circulated as Appendix A) be approved, as the Committee’s final response to the consultation on Your Health, Your Hospitals – Let’s Get Better Hospital, being undertaken by NHS Humber and North Yorkshire Integrated Care Board.

2.      That the Committee’s response to the consultation be shared with the Humber and Lincolnshire Joint Health Overview and Scrutiny Committee, with a view to it being considered for inclusion in the Joint Committee’s response.

3.      That a copy of the Committee’s response to the consultation be passed onto the RT Hon Sir Edward Leigh MP and the Rt Hon Victoria Atkins MP, as their constituencies would be mostly affected by the proposals.   

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

The Chairman invited Simon Evans, Health Scrutiny Officer, to present the report, which invited the Committee to consider and comment on its work programme, as detailed on pages 97 and 98 of the report pack.

Attached at Appendix A to the report was a schedule of items covered by the Committee since the beginning of the current Council term, May 2021.

The Health Scrutiny Officer briefed the Committee on the items for consideration at the 24 January 2024 meeting.

The Committee also considered the list of items to be programmed and guidance was sort regarding:

·       Item 2 - NHS Planning for Demographic Change.  It was noted that most of the demographic modelling was undertaken by NHS England who used the latest available Office for National Statistic projections to factor in population changes into their models.  It was noted that at a strategic level the responsibility for funding lay with the government, who set out the levels of funding for each government department, including Health and Social Care. Each department then agreed their priorities, which then brought in resource allocations for NHS England and ultimately for each Integrated Care Board (ICB).  It was then up to each ICB to determine its strategy to use the resources allocated to best meet the health needs of the local population.  The Committee noted the Lincolnshire Acute Services Review had evaluated projected activity growth over the next five years for the services forming part of that review.  The Committee was advised that evaluation had been done on an individual basis, and it was therefore suggested that the Committee might want to have such information when items were presented, rather than have an overall item.  A suggestion was made for further information relating to the older persons demographics across the county.  It was also highlighted that the east coast had a large concentration of caravans and that this impacted health provision along the coast, and therefore needed to be included within the demographics; 

·       Item 4 - Third Sector Support for the NHS. The Committee was advised that as this topic was so extensive, a suggested approach was for the Committee to request an overview from the Lincolnshire Voluntary Engagement Team, which was a collective of voluntary groups and organisations who had an interest in working with health and care partners to develop and deliver services. One member advised that voluntary groups were struggling and that an overview would be useful for the Committee to consider; and

·       Item 5 – Local Strategic Planning of Integrated Health Provision.  The Committee was advised that two items focusing on strategies were scheduled for the 21 February 2024 meeting.  It was further clarified that the request for an item on Local Strategic Planning for Health Provision related to strategic planning at a Primary Care Network level.  It was requested that further information be provided either as part of the two items in February or subsequently as to how the strategies worked at a Primary Care Network level, in particular on  ...  view the full minutes text for item 56.