Agenda and minutes

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

Contact: Katrina Cope  Senior Democratic Services Officer

Items
No. Item

63.

Apologies for Absence/Replacement Members

Minutes:

There were no apologies for absence received.

 

 

64.

Declarations of Members' Interest

Minutes:

Councillor Mrs K Cook advised the Committee that in respect of agenda item 7, she was a Lincolnshire Partnership NHS Foundation Trust Governor; and a Lincolnshire Partnership NHS Foundation Trust service user.

 

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

65.

Minutes of the meeting of the Health Scrutiny Committee for Lincolnshire held on 17 January 2018 pdf icon PDF 218 KB

Minutes:

The Chairman highlighted that Councillor A Stokes had been omitted from the list of councillors attending the meeting as observers.

 

The Committee was also advised that the STP Project Plans and additional information on the Dental Services would be circulated to members of the Committee when they were available.

 

RESOLVED

 

That the minutes of the meeting of the Health Scrutiny Committee for Lincolnshire, held on 17 January 2018, be agreed and signed by the Chairman as a correct record, subject to Councillor A Stokes being added to the list of councillors attending the meeting as observers.

66.

Chairman's Announcements pdf icon PDF 204 KB

Minutes:

The Chairman referred to the announcements circulated within the agenda pack which included the following areas:-

 

·         Grantham and District Hospital – Overnight Closure of Accident and Emergency Department;

·         Lincolnshire's Community Maternity Hubs; and

·         Director of Public Health – Derek Ward.

 

A set of supplementary Chairman's Announcements was tabled at the meeting for members of the Committee to consider.  The supplementary information provided the Committee members with an update relating to:

 

·         Grantham A & E Overnight Closure;

·         Extended GP Hours in East Lindsey;

·         Hospital Waiting Times – South West Lincolnshire CCG Area;

·         Winter Pressures: Temporary Change of Use of Rochford Unit, Pilgrim Hospital, Boston; and

·         Winter Pressures: Hospitals Alerts (Operational Pressures Escalation levels) in Hospitals in Neighbouring Counties.

 

The Committee was also advised that the two additional papers circulated at the meeting relating to:

 

·         Information relating to A & E attendances at Lincoln County Hospital for the first two weeks of February 2018, which related to the Walk-in Centre Item;

·         A revised performance table for the Thames Ambulance Service item.  The sheet provided a replacement for the table shown on page 76 of the agenda pack and included validated figures for KPI16a (Renal Patients); and a new column with week 7 figures.

 

RESOLVED

 

That the Chairman's Announcements presented as part of the agenda on pages 19/20; and the supplementary Chairman's Announcements tabled at the meeting be received.

67.

Alternative Provisions to the Walk-in Centre pdf icon PDF 113 KB

(To receive a report from Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West Clinical Commissioning Group, which provides the Committee with on update on the progress made in implementing plans to enhance primary care services and the CCG's public awareness campaign as to the alternative provisions to the Lincoln Walk-in Centre)

Additional documents:

Minutes:

Pursuant to Minute Number 48 from the meeting held on 13 December 2017, the Committee gave consideration to a report from the Lincolnshire West Clinical Commissioning Group (CCG), which provided an update on the progress that had been made in implementing plans to enhance primary care services and the CCG's public awareness campaign as to alternative provisions to the Lincoln Walk-in Centre.

 

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

 

The Chief Clinical Officer introduced the report and advised the Committee that NHS Lincolnshire West CCG's Governing Body had met on 29 November 2017 and 24 January 2018 to consider the details on the progress of the alternative provision plans.  The alternative provision plans addressed six key areas: GP appointments and access; Urgent Care Provision; Clinical Advice and GP Access for Children; University of Lincoln Practice Plans – Students; Homeless and Vulnerable Patients and Communication and Engagement Plans.  It was highlighted that at the 24 January 2018 meeting, the Governing Body had been assured and had agreed to support the recommendation to close the Walk-in Centre by the end of February 2018; but retain weekend opening only during the month of February 2018.

 

Attached to the report for the Committee's consideration were the following Appendices:-

 

Appendix 1 – Lincoln Walk-in Centre - Alternative Provisions Plan 2017;

Appendix 1A – Lincoln Walk-in Centre Consultation 2017 - Alternative Provisions Description;

Appendix 2 – Lincoln Walk-in Centre Consultation 2017 – Alternative Provisions Communications Review;

Appendix 3 – Lincoln Walk-in Centre Consultation 2017 – Alternative Provisions Engagement Plan;

Appendix 4 – Lincoln Walk-in Centre Consultation 2017 – GP Practice Case Study Summary; and

Appendix 5 – Lincoln Walk-in Centre Consultation 2017 – A & E (Lincoln) Activity Summary for Lincolnshire West CCG Patients.

 

In presenting the report to the Committee, the Executive Lead Nurse and Midwife - Quality and Governance, provided an update concerning the alternative provisions which made reference to the following:-

 

·         GP Optimisation – It was reported that GP Workflow Optimisation had been implemented across the CCG's Practices to ensure the most effective use of primary care resources;

·         The extension of clinical skills in the Primary Care team.  It was highlighted that many practices were employing community pharmacists.  It was highlighted further that four additional pharmacists had been employed, whose roles would be developed to enable them to see patients, which would release GPs to see patients who really need to see a GP;

·         Same Day Access for Urgent Need The Committee was advised that same day access for Urgent Need was currently available at all practices.  Clarification was given that same day access for urgent need would happen when a patient was unable to get an appointment the same day, but considered that their need was urgent, then either a nurse or GP would call the  ...  view the full minutes text for item 67.

68.

Non-Emergency Patient Transport Service for NHS Lincolnshire CCGs - Thames Ambulance Service Limited (TASL) pdf icon PDF 797 KB

(To receive a report from Thames Ambulance Service Limited (TASL), which provides the Committee with an update on service provision, and an overview of the actions being taken by the Lincolnshire West Clinical Commissioning Group (CCG). Sue Flintham, Regional Director, Thames Ambulance Service (TASL); Blanche Lentz, Chief Operating Officer, Lincolnshire, TASL; and Mike Casey, Manager, Lincolnshire, TASL will be in attendance)

Minutes:

Pursuant to Minute No 49 (2) from the meeting held on 13 December 2017, the Committee gave consideration to a report from the Thames Ambulance Service Limited (TASL), which provided the Committee with an update on service provision, and an overview of the actions being taken by Lincolnshire West Clinical Commissioning Group.

 

At the meeting held on the 13 December 2017, the Committee had recorded a vote of no confidence in relation to the non-emergency patient transport service provided by the Thames Ambulance Service Limited.  The Committee had also requested that performance reports should be received on a monthly basis, and that such reports should include any available comparative information on the service provided by Thames Ambulance Service Limited in other areas.

 

The Committee had received a revised table to replace page 76 of the circulated agenda.  The revised information included validated figures for KPI6a (Renal Patients); and a new column with week 7 figures.

 

The Chairman welcomed to the meeting the following presenters from TASL, Mike Casey, Interim Manager for Lincolnshire, and Chris Miller.

 

The Interim General Manager advised that he was aware of the concerns and the vote of no confidence agreed by the Committee at their meeting on 13 December 2017; and reference was also made to the concerns raised with TASL (Risk Summit) led by NHS England on behalf of Lincolnshire, Leicestershire and Northamptonshire Clinical Commissioning Groups.  Details of the main concerns raised were detailed on page 74 of the report presented.

 

It was reported that the Lincolnshire West Clinical Commissioning Group (LWCCG) was continuing to work very closely with the management team at TASL.  The Committee were advised that following the issue of a Contract Performance Notice on the 7 November 2017, TASL had been issued with an Exception Notice for failure to achieve the agreed trajectory in the Recovery Action Plan (RAP) in January 2018, in line with the NHS Contract. 

 

The Committee was advised that TASL was determined to drive change within its organisation to ensure continuous improvement to service delivery.  The Committee was advised further that TASL wholeheartedly recognised the current organisational pressure they were under with regards to service delivery and contractual commitments.  Some assurance was given that the appointment of a new management structure, including a new Chief Executive, the current recovery action plan, and support from the parent company HTG, TASL were expecting improvements to service delivery to be seen in the first few weeks of 2018, to continue and become more sustainable to deliver the contracts KPIs from April 2018.

 

There was a recognition that TASL had expanded too quickly in a short space of time without having robust processes and systems in place to accommodate the increased workload.  The Committee was advised that there had been significant involvement from the Parent Company of TASL, HTG.  This involvement had included the provision of a stronger internal governance structure, and direct support for the leadership of the organisation.

 

The Committee noted that  ...  view the full minutes text for item 68.

69.

Lincolnshire Sustainability and Transformation Partnership: Mental Health Priority pdf icon PDF 218 KB

(The Health Scrutiny Committee is focusing on four of the seven priorities being delivered as part of the Lincolnshire Sustainability and Transformation Partnership (STP).  One of the four selected priorities is mental health and this item is focusing on recent progress and strategic activity in for the delivery of Mental Services in Lincolnshire, as part of the Lincolnshire STP.  Representatives from both commissioners and the main provider, Lincolnshire Partnership NHS Foundation Trust, are due to attend)

Minutes:

The Committee gave consideration to a report from the Lincolnshire Sustainability and Transformation Partnership and Lincolnshire Partnership NHS Foundation Trust, which provided information relating to recent progress and strategic activity in relation to the NHS direction for delivery of Mental Health Services in Lincolnshire.

 

The Chairman welcomed to the meeting John Brewin, Chief Executive, Lincolnshire NHS Partnership Trust, Ian Jerams, Director of Operations, Lincolnshire Partnership NHS Foundation Trust, Andrew Rix, Chief Operating Officer South Lincolnshire CCG and Rachel Redgrave, Head of Commissioning for Mental Health, Autism and Learning Disability, South West Lincolnshire CCG.

 

The Chief Executive, Lincolnshire NHS Partnership Trust in his introduction advised the Committee that Lincolnshire Partnership NHS Foundation Trust (LPFT) was the specialist, regulated NHS Mental Health Care Provider for Lincolnshire, providing a range of mental health crisis, inpatient and community services over a range of services in over 56 locations in Lincolnshire to over 65,000 patients per year. 

 

Paragraph 2 of the report listed provided a list of successes to date that had been delivered/planned through the Sustainability and Transformation Partnership. 

 

Appendix A to the report provided the Committee with Lincolnshire's position against future Mental Health and Learning Disability Service ambitions for 2018/19.

 

It was highlighted that the Lincolnshire Sustainability and Transformation Partnership was facing the challenge of finding investment for the purposes of nationally directed mental health development and transformation of new services, within a Lincolnshire health system with a collective forecast deficit of circa £110m.  A further additional pressure for LPFT funding was from regulators concerning the standard of mental health estate.  It was reported that the Care Quality Commission had recommended that the Trust work towards the replacement of inpatient facilities, which still offered dormitory bedroom accommodation.  It was noted that the cost of meeting this recommendation was estimated to be up to £30m.  It was noted further that capital monies had been spent on the introduction of the Psychiatric Intensive Care Unit, which had resulted in significant system financial savings as well as a quality benefit to patients, carers, and families.

 

It was reported that the current national profile of Mental Health and Learning Disability services was unparalleled, particularly with a recent Royal profile.  It was noted that the Lincolnshire system had a great opportunity to implement the proposals detailed in the report, and that recent NHS Planning Guidance for 2018/19 had re-emphasised the need for systems to ensure services were in place in the timescales described.

 

A discussion ensued, from which the following issues were raised:-

 

·         Some members indicated that they would like to see more detail than that contained in the report.  The Committee was urged to look at Appendix A which provided more information.  In response to an observation that limited detail had been included as to how services had improved and whether targets had been achieved.  It was noted that some services were new and performance information was still to be received;

·         Older Adult Transformation Plans at Pilgrim Hospital, Boston – The Committee was advised  ...  view the full minutes text for item 69.

70.

Joint Health and Wellbeing Strategy Update pdf icon PDF 315 KB

(To receive a report from David Stacey, Programme Manager Strategy and Performance, which asks the Committee to comment on the proposed approach to, and the findings from the engagement from the Health and Wellbeing Board for Lincolnshire as part of developing the next Joint Health and Wellbeing Strategy for Lincolnshire)

Minutes:

Consideration was given to a report from Derek Ward, Director of Public Health, which asked the Committee to comment on the proposed approach to, and the findings from the engagement by the Health and Wellbeing Board for Lincolnshire, as part of developing the next Joint Health and Wellbeing Board Strategy for Lincolnshire.

 

Appendix A to the report provided the Committee with details of the proposed structure and governance arrangements for the new Joint Health and Wellbeing Board Strategy.

 

David Stacey, Programme Manager Strategy presented the report to the Committee and made reference to the following issues:-

 

It was reported that the purpose of the JHWS was to set the strategic commissioning direction for the next five years for all organisations who commissioned services in order to improve the health and wellbeing of the population and reduce inequalities.  It was highlighted that the current JHWS produced by the Health and Wellbeing Board for Lincolnshire was due to end in 2018, and the Health and Wellbeing Board for Lincolnshire had been engaged on the development of a new JHWS based on the evidence included within the newly refreshed JSNA for Lincolnshire.

 

It was highlighted that there had been a high degree of commonality across the different engagement stages and the overall emerging priorities identified from the engagement were:-

 

·         Adult Mental Health

·         Mental Health and Emotional Wellbeing (Children and Young People)

·         Housing

·         Carers

·         Physical Activity

·         Dementia

·         Obesity

 

The Committee was advised that the Health and Wellbeing Board for Lincolnshire at its 26 September 2017 meeting had agreed that further work would be undertaken on the priorities, which had included consideration of the thematic areas as well as the Joint Strategic Needs Assessment priority areas.  It was noted that the Health and Wellbeing Board had supported the need to include safeguarding as a cross cutting theme based on the opportunity for the JHWS to also act as the Children and Young People Plan for Lincolnshire; and had also agreed to the governance arrangements required for further developing the final JHWS and its subsequent delivery. 

 

During discussion, the Committee raised the following issues:-

 

·         That the consultation events should have been more evenly spread across the county, particular reference was made to the fact that an event had not been held in Boston.  The Programme Manager Strategy confirmed that this would be taken on board for future engagement sessions going forward.  One member extended congratulations to officers for the interactive event held in Lincoln;

·         One member enquired whether there had been engagement with the health service and social care.  The Committee was advised that the Health and Wellbeing Board membership comprised of representatives from health and social care.  Confirmation was also given that there was continued overlap between the two areas.  The Committee was advised further that the issue of Delayed Transfers of Care (DTOCs) was an item that was considered by Adults and Community Wellbeing Scrutiny Committee; and

·         One member enquired as to how the plans Sustainability and Transformation Partnership could be influenced  ...  view the full minutes text for item 70.

71.

Health Scrutiny Committee for Lincolnshire - Work Programme pdf icon PDF 176 KB

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites the Committee to consider and comment on the content of 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 focused where it would be of greatest benefit.

 

Detailed within the report were populated work programmes up to 18 April 2018 meeting.  Pages 99/100 also provided a list of items to be programmed.

 

Items put forward from the Committee included the following:-

 

·         Dentistry;

·         Specialised Commissioning;

·         Adult Immunisation;

·         Developer and Planning Contributions for NHS Provision;

·         Winter Pressures – reflection on 2017/18; and

·         ULHT Update – Double Special Measures.

 

RESOLVED

 

That the work programme as presented be agreed subject to the inclusion of the items mentioned above. 

 

 
 
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