Agenda item

(To receive a report from Lincolnshire Partnership NHS Foundation Trust (LPFT), which provides the Committee with a general update on services.  Chris Higgins, Director of Operations, LPFT will be in attendance for this item)

Consideration was given to a report from Lincolnshire Partnership NHS Foundation Trust (LPFT), which provided the Committee with a general update on services.

The Chairman advised that this item had been requested by the Committee at its meeting on 21 February 2024, in response to some developments being reported, including progress with removing legionella from the Hartsholme Centre and the expansion of the Adult Eating Disorder Support Service.

The Chairman invited the Director of Operations, LPFT, to present the item to the Committee.  The Head of Communications and Participation, LPFT was also present to observe to meeting.

In guiding the Committee through the report, reference was made to: Temporary Closures, Service Reviews; New Services; Recruitment and Retention; and Waiting Times.

(Note: Councillor S R Parkin joined the meeting at 10:13 am)

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

·       The Committee noted that if three consecutive sets of tests for Legionella showed levels that were safe for the Hartsholme Centre, then the unit would safely open. If however, this was not the case then an enhanced flushing method would be undertaken.  It was noted that the other option the Trust would consider was a possible refit of the pipe working system;

·       Confirmation was given that the NHS 111 Mental Health Option would be available for anyone to contact for advice.  The Committee was advised that the Trust was working with NHS England regarding the advertising of the new Mental Health 111 service, and that it was thought there would be a soft launch initially to test the system, followed by a nationally driven initiative by NHS England.  It was noted that the 111 Mental Health line would be staffed with a combination of registered specialist professionals and non-registered specialist professionals, and that at any time on duty there would be a combination of the two types of professionals; 

·       Confirmation was provided that funding was yet to be approved to develop the memory assessment pathway.  The Committee noted that if funding was not forthcoming this time, a further bid would be made for the following year’s funding round, and that in the meantime the service would look to see what could be done differently within the resources available. Healthwatch offered their support for the development of the business case;

·       Details relating to staffing numbers, structure and grades would be made available to members of the Committee.  The Committee noted that the Trust was confident that staff numbers would continue to increase, but there was recognition that there were some harder to recruit posts, such as psychologists;

·       In relation to Autism diagnosis, the Committee was advised that prioritisation was done from the information received from the conversation at the initial triage. It was noted the professional and the multidisciplinary professional team took into consideration what was happening in the person’s life and a range of other different factors which would indicate whether somebody would benefit more than somebody else from an early diagnosis. For example, if somebody needed to get a diagnosis to be able to seek reasonable adjustments to continue in their employment;

·       The Committee noted that the Langworth ward had beds available and was not overwhelmed.  It was noted further that this was because the Dementia Home Treatment Team had been effective in keeping people at home with their families or in residential care, which had reduced the need for inpatient beds;

·       What measurements were being done to assess the impact on patients no longer being inpatients at the Manthorpe Unit.  It was reported that there was a range of measures in place, one being the impact of patients in hospitals, as the impact of dementia could change considerably when someone was taken out of a familiar environment, and that moving someone into a hospital could also significantly impact an individual’s level of confusion and understanding.  It was highlighted that a patient just being at home was generally deemed a better outcome, and that feedback from family members, carers and from staff had indicated that caring for people in their own home seemed to support this. It was reported that alongside this was a clinical indicator.  The Committee noted that the Trust thought it was doing a good job, but the independent review by the Clinical Senate would be able to verify what was being done was the right thing.  It was hoped that the home working model would be successful as the Trust thought it was and that going forward there would not be the need to reopen the Manthorpe ward.  Confirmation was provided that the model was in essence a hospital at home model, with individuals having the same range of professionals available to them.  Clarification was also given that the Manthorpe ward was a dementia ward not a medical ward and that model had been replicated to support people at home;

·       The Committee was advised more information about the autism service was available in the virtual autism hub;

·       It was reported that the Right Care Right Person initiative was a police force led initiative to change the way the police responded to mental health issues.  A suggestion was made for a police representative to come and talk to the Committee regarding this initiative.  The Committee noted that the Trust was also looking at different ways to configure their crisis teams and other areas to make sure that there was a multi-agency response to ensure that the right resources were in place to avoid any person being missed;

·       There was recognition that the waiting time of 35 weeks for children and young people’s mental health service was not acceptable.  The Committee noted that it was the intention of the Trust to get to the four-week waiting target.  It was noted further that the Trust had seen a reduction in the number of young people waiting over twelve weeks.  It was also highlighted that anyone waiting for services received a contact at least once a month to monitor any change and share useful guided self-help resources. Once member highlighted that from personal experience young people were not being contacted on a monthly basis.  The representative agreed to look into the issue of lack of contact outside of the meeting;

·       With regard to talking therapies, the Committee was advised that the Trust was monitored on access to the service.  It was noted that the talking therapies service was a step model.  Those coming into the service at the lower end were seen very quickly, but those with more complex needs (step two) was where there was a waiting list.  It was highlighted that the Trust was currently trying to recruit additional staff to help deal with the demand, and that there had been an outsourcing of some treatments to external providers to support reducing the waiting time.  Some clarity was sought as to the percentage quoted in the report relating the 75% of patients commencing treatment within six weeks.  The Committee was advised what the report was saying was that a number of people accessing first level treatment found that this was enough to meet their needs, and that some people were then waiting some considerable time for some specific treatments.  The representative offered the Committee a more detailed report regarding this matter to a future meeting;

·       The Committee received an explanation concerning the Dementia Home Treatment Team. It was noted that people were referred to the team via other health professionals, or community mental health teams and that it was not open access to the community;

·       Reassurance was provided that young people waiting for mental health services who became teenagers would continue on their journey in children’s services.  It was noted that there was an arrangement that the service could keep individuals up to the age of 25 within the young people’s services;

·       The Committee noted that with regard to the review of the Vales at Discovery House, all staff teams would be contacted as would patients, and families of patients using the service;

·       It was reported that the Trust had worked hard to minimise the number of people placed out of area.  It was noted that there was a pressure on the availability of beds nationally and that the Trust currently had people in Nottingham, Essex and further afield.  It was highlighted that in all cases the Bed Management Team were in constant contact with these individuals, and that everything was done possible to make sure these people were brought back into Lincolnshire as soon as possible. Reassurance was provided that the out of area care was provided by good providers.  It was noted that when the Hartsholme Centre re-opened there would be enough capacity to support acute and intensive needs;

·       The Committee was advised that information would need to be provided following the meeting regarding the number of people it was expected the expanded Adult Eating Disorder service would treat in the coming year;

·       Reassurance was provided that the Trust had the right levels of staff to be able to maintain current services.  It was however highlighted that the east coast was a harder place to recruit to generally; and

·       The Committee was advised that the National Timewise Accredited Scheme was a programme open to all public sector organisations in which organisations had to demonstrate that they were offering different ways of flexible working, and that the recruitment and retention strategies of the Trust were defining different ways of working making LPFT a great place to work by offering flexible working arrangements whilst meeting service needs.

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

RESOLVED

1.      That the planned expansion of the Trust’s Adult Eating Disorder Support Service; the launch of the Virtual Autism Hub and the improvements to the recruitment and retention across the Trust be welcomed.

2.      That consideration be given to any service changes arising from the Dementia Home Treatment Teams pilot and the review of the Vales at Discovery House at an appropriate future date.