Agenda and minutes

Apologies for absence were received from Councillor R J Kendrick, S Welberry (Boston Borough Council), C Morgan (South Kesteven District Council) and Liz Ball (Healthwatch Lincolnshire).

The Committee noted that Colin Warren (Healthwatch Lincolnshire) had replaced Liz Ball (Healthwatch Lincolnshire), for this meeting only.

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

None were declared.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 13 September 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 3 October 2023.

The supplementary announcements referred to:

·       The new Macmillan Psychological Support Service launching in Lincolnshire;

·       The re-opening of the Hartsholme Centre – Lincolnshire’s Male Psychiatric Intensive Care Unit;

·       Proposed engagement on the Potential Development of a Female Psychiatric Intensive Care Unit in Lincolnshire; and

·       The revised Dementia Strategy for Lincolnshire – What Matters to You.

During discussion, the following comments were noted:

·       Some concern was expressed to another dental practice closure (Item 6 of the Chairman’s announcements on page 17 of the agenda pack).  It was highlighted that the Committee had previously written to local MPs expressing their concerns regarding the lack of dental provision in some parts of Lincolnshire and asking for support for the provision of a dental college to help Lincolnshire grow its own. There was also recognition that dental contracts needed to be reviewed. It was highlighted that the contract had not been an issue with this specific dental practice closure.

Note: Councillor J Makinson-Sanders wished it to be noted that she had been a patient at the North Somercotes Dental Practice.

RESOLVED

That the supplementary announcements circulated on 3 October 2023 and the Chairman’s announcements as detailed on pages 15 to 17 of the report pack be noted.

(To receive a report from the NHS Lincolnshire Integrated Care Board, which provides the Committee with an update on urgent and emergency care, including details of the actions being taken locally in response to the national Delivery Plan for Recovering Urgent and Emergency Care Services.  Clair Raybould, Director for System Delivery and other representatives from the NHS Lincolnshire Integrated Care Board, will be in attendance for this item)

Consideration was given to a report from the NHS Lincolnshire Integrated Care Board, which provided the Committee with an update on urgent and emergency care and the actions being taken locally in response to the national Delivering Plan for recovering Urgent and Emergency Care Services (January 2023).

The Chairman invited Clair Raybould, Director for System Delivery, NHS Lincolnshire Integrated Care Board and Julie Frake-Harris, Chief Operating Officer, Lincolnshire Community Health Services NHS Trust, to present the item to the Committee.

The Committee were advised of the National Recovery Plan and the Local Response; the Lincolnshire Winter Plan 2023/2024 development; System coordination in Lincolnshire; Pre-Hospital Care; Virtual Wards and Urgent Care response; the inclusion of frailty in the 2023/2024 Urgent and Emergency Care Programme; Urgent Treatment Centres in Lincolnshire; NHS 111 and Lincolnshire Clinical Assessment Service; Accident and Emergency; Ambulance Handovers; and the importance of Discharge and Flow.

Appendix A to the report provided a copy of the Delivery Plan for Recovering Urgent and Emergency Care Services (Department of Health and Social Care and NHS England – January 2023) for the Committee toIto consider.

In conclusion, the Committee noted that despite a challenging summer period, and continuing industrial action, a considerable amount of work had been achieved and plans were in place to support the system during the winter period.  It was highlighted that the urgent and emergency care system programme delivery would ensure that Lincolnshire’s ambitions were realised to transform and improve safety and experience across urgent and emergency care services for the residents of Lincolnshire.

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

·       That virtual wards in Lincolnshire covered six specialty areas: cardiology, frailty; respiratory; complex neurology, acute medicine, and hospital at home.  The virtual wards were specifically for patients where it had been agreed that they could be treated and supported outside of an acute hospital setting.  It was noted that virtual wards worked well, particularly for primary care being able to step a patient into a virtual ward rather that moving them straight to the Emergency Department.  There was recognition that connectivity was a challenge, but it was highlighted that not all monitoring had to be done through technology, as members of the community team linked in regularly with patients. It was highlighted that currently 150 patients were being supported through virtual wards, and that this was taking the pressure of acute providers having to find inpatient beds.  It was noted that virtual wards were also used to help patients step out of acute care quicker;

·       Some concern was expressed as to what was being done to prevent issues happening for example falls; and how the Council was working with health trusts in this regard.  The Committee was advised that the Council had a falls response service commissioned via LIVES, which was an interface with urgent and emergency care.  The service ensured that people were got too quickly, freeing up ambulance capacity. The service ensured that the patient was fit and well  ...  view the full minutes text for item 37.

(To receive a report from the NHS Lincolnshire Integrated Care Board, which invites the Committee to consider the steps being taken to deliver the NHS England requirements and ongoing development and delivery of the Lincolnshire system winter plan.  Clair Raybould, Director for System Delivery and other representatives from the NHS Lincolnshire Integrated Care Board will be in attendance for this item)

Consideration was given to a report from the NHS Lincolnshire Integrated Care Board, which invited the Committee to consider the steps being taken to deliver the NHS England requirements and ongoing development and delivery of the Lincolnshire System Winter Plan.

The Chairman invited Clair Raybould, Director for System Delivery, NHS Lincolnshire Integrated Care Board to present the item to the Committee.

The Committee was advised that the winter plan was still in the development stage, and it was hoped the winter plan would be presented to the Partnership Board later in the week.

The Committee was advised of the background to the winter plan; the Adult Social Care Winter Letter 2023/2024; additional national and regional areas of focus; the NHS England Winter 2023/2024 Planning Assurance; System Partner Roles and Responsibilities; and next steps.

In conclusion, the Committee noted that the plan would be shared once it was approved hopefully at the end of the week.

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

·       Confirmation was given that there was an allowance in the plan for increased hospitalisation for people with Covid-19.  It was noted further that predictions were that Covid-19 was not expected to be any worse than it had been in the previous year;

·       The Committee was advised that a lot of operations and procedures were being cancelled because of industrial action, but hospitals were seeing as many patients as they could; and

·       In terms of weather, it was hoped it would be a mild winter, as a severe winter caused extra problems including logistics, staffing and increased respiratory issues and falls.  Reassurance was given that planning had been managed around the worst weather conditions.

The Chairman on behalf of the Committee extended his thanks to the presenter.

RESOLVED

That the actions undertaken by the NHS and other partners in the preparation for winter 2023/2024 be supported.

(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 remotely present the report, which invited the Committee to consider and comment on its work programme as detailed on pages 98 to 100 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, as well as details of planned works for the coming months.

The Health Scrutiny Officer advised the Committee of the items scheduled to be considered at the 8 November 2023 meeting.

RESOLVED

That the work programme presented on pages 98 to 100 of the report pack be agreed, subject to the inclusion of the suggestion put forward by the Committee at minute number 37(3).