Agenda and minutes

Apologies for absence were received from Councillors T A Carter, M R Clarke and Mrs N F Clarke.

It was reported that, under Regulation 13 of the Local Government (Committee and Political Groups) Regulations 1990, Councillor N Sear be appointed as a substitute for Councillor T A Carter and Councillor Taylor be appointed as a substitute for Councillor Mrs N F Clarke, for this meeting only.

None were declared.

RESOLVED:

        That the minutes of the meeting held on 22 February 2023 be    approved as a correct record and signed by the Chairman.

The Chairman announced that on 30 March 2023 he had attended the 2022 Lincolnshire Care Awards in which 34 providers and 500 people had participated, with awards given across twelve categories. The Chairman celebrated the success of the awards and the platform they provided to showcase and recognise the work of carers across the county, and congratulated the winners and runners up for their inspirational work.

The Executive Director – Adult Care and Community Wellbeing advised the Committee that two documents had been published on 4 April 2023: the Hewitt Review – An Independent Review of Integrated Care Systems; and the Department for Health and Social Care’s ‘Next steps to put people at the heart of Care’ which followed on from the white paper on Social Care Reform.  It was agreed that both documents be circulated to the Committee and items would be added to the work programme for further consideration at future meetings.  

(To receive a report by Afsaneh Sabouri, Assistant Director - Older Adult Services and Andrea Kingdom, Head of Service - Hospitals and Special Projects, Adult Care and Community Wellbeing, which explores the issues of the impacts arising from the discharge of patients from acute hospital beds)

The Committee received a presentation from the Assistant Director – Adult Frailty and Long-Term Conditions which provided an overview of the Acute hospital Discharge Pathways including active recovery beds and Pathway 1 – Discharge to Assess and Discharge Reablement Service. 

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

·     The Committee supported the introduction of the Admission to Discharge Care Pathway and commended the valuable service which would relieve pressure on the NHS. 

·     Referrals failing to start on the day of discharge often resulted from a change in opinion on whether the patient was medically fit for discharge or families no longer wishing to use the service.

·     The Committee were reassured that the proposed reduction in beds from 60 to 40 for nine months of the year was based on evidence and was considered sufficient given analysis of the patient flow. The Committee requested a future report to analyse the number of beds taken throughout the year to ensure that there was adequate provision all year round.

·     Members were supportive of the widespread provision made available in a number of locations across the County, in particular in ensuring provision for home visits and visits from family members.  The Committee were reassured that referrals for Lincolnshire residents from out of County hospital were also supported.

·     Cases for independent living were reviewed on an individual basis, including a patient’s mental capacity. Research showed that going back home with the right support to be independent provided the best success for the person.

·     The scheme was wholly funded by the Government as part of a two-year funding agreement to alleviate acute pressures on hospital systems, however the Admission to Discharge Pathway was a Lincolnshire initiative which other regional NHS colleagues had expressed interest in adopting.

·     The importance of ensuring there was a system in place to offer support for mental health issues in the elderly population, particularly for the issue of loneliness was highlighted. The Committee acknowledged the benefits of community support to prevent loneliness. It was suggested that a report on preventative services be scheduled. 

·     Data on active recovery beds was produced by Lincolnshire County Council’s commercial team.

·     The Committee were pleased that the scheme was benefiting and contributing towards savings and better outcomes for all partners.

RESOLVED:

        That the update be noted. 

(To receive a report by Carl Miller, Commercial and Procurement Manager, which invites the Committee to consider a report on the Sexual Health Services Re-procurement which is due to be considered by the Executive on 3 May 2023. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Consideration was given to a report by the Consultant in Public Health, which invited the Committee to consider a report on Sexual Health Services Re-Commissioning which was due to be considered by the Executive on 3 May 2023, as set out at appendix A to the report.

The Committee supported the recommendations to the Executive Councillor and during the discussion the following points were recorded:

·       Although negotiations with NHS England in relation to the section 75 agreement had not concluded, this did not represent a financial risk, as the obligation to commission this service rested with NHS England, and ultimately if negotiations were to fail, the costs of the service would be borne by NHS England.

·       The ‘cross-charging’ for sexual health services, where Lincolnshire residents accessed services in North Lincolnshire and North-East Lincolnshire, was likely to cease, as part of the collaboration with those two authorities on the overall procurement arrangements.  Cross-charging would continue where residents accessed services in other counties. 

·       The Committee welcomed the proposed new structure whereby the integrated sexual health services provider became responsible for managing pharmacy sexual health provision.

·     The treatment and care elements for HIV were seen to be most effective when provided as one service provided by the NHS and funded by Public Health.

·     It was recognised that over 50-year-olds were more likely to access Sexual Health Services through their GP, whereas under 24 year olds were more likely to access through a clinic, which highlighted the importance of ensuring there was adequate access and education within GP practices.

·     Assurance was provided that there were sexual health clinics in all of the main areas of Lincoln as well as outreach services in most towns throughout the county. This would continue to be a specification for the new contract.

·     The Committee were assured that sexual health promotion be prioritised as part of the new contract to ensure clarity on the range of support services on offer.

·     Councillor K E Lee raised concerns over the financial risk posed by potential for inadequate funding to the project and therefore requested that her abstention from the vote be recorded.

RESOLVED:

1.    That the recommendations to the Executive be supported;

2.    That a summary of the comments made be passed on to the Executive Councillor as part of its consideration of this item.

(To receive a report by Emma Rowitt, Project Manager – Corporate Property, which invites the Committee to consider a report on the Specialist Adults Accommodation at Grange Farm, Market Rasen, which is due to be considered by the Leader of the Council and the Executive Councillor for Adult Care and Public Health between the 12 and 19 April 2023. The views of the Committee will be reported to the Executive Councillors as part of their consideration of this item)

Consideration was given to a report by the Senior Project Manager – Corporate Property, which invited the Committee to consider a report on the Community Supported Living for Working Age Adults at Grange Farm, Market Rasen with ACIS Group, prior to consideration by the Executive Councillor for Leader of the Council and the Executive Councillor for Adult Care and Public Health between the 12 and 19 April 2023, as set out at appendix A to the report.

The Committee strongly supported the recommendations to the Executive Councillor and during the discussion the following points were recorded:

·     The Committee supported the scheme and commended the way in which there was no exposure to financial voids.

·     The Committee requested to see the design proposals for the scheme.

·     The scheme was based on a similar model to the extra care housing unit in Sleaford which was planned to commence construction at the end of 2023. 

·     The Committee commended the work and resilience of Officers in developing the scheme and other supportive living scheme which would be in development in the coming years.

·     Members expressed an interest in attending the facility once it was in operation.

RESOLVED:    

1.    That the recommendations to the Leader of the Council and the      Executive Councillor for Adult Care and Public Health be   supported;

2.    That a summary of the comments made by the Committee be       passed on to the Leader of the Council and the Executive         Councillor for Adult Care and Public Health for consideration.

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to review its work programme)

Consideration was given to a report by the Health Scrutiny Officer, which invited the Committee to consider its work programme.

The following additions to the work programme were proposed:

·     Next steps to put people at the Heart of Care report – May 2023

·   The Hewitt Review – An Independent Review of Integrated Care Systems – May 2023

·     An update report on Hospital Discharge/Active recovery beds looking towards the Winter Plan for 2023/24 – September 2023.

RESOLVED:

        That the work programme be agreed, subject to the proposed amendments.