Agenda and minutes

Apologies for absence were received from County Councillors C E H Marfleet and District Councillors Mrs R Kaberry-Brown (South Kesteven District Council) and C Macey (East Lindsey District Council).

There were no declarations of Members' Interests at this stage in the proceedings.

The Chairman welcomed everyone to the meeting and advised the Committee of the following items: -

i)          Lincolnshire Community Health Services NHS Trust

On 24 September 2014, the Chairman had attended the 'Celebrating Success' Awards which had been organised by Lincolnshire Community Health Services NHS Trust.  The awards had recognised exceptional service of individuals and teams within the Trust. The Chairman was privileged to present the Volunteer of the Year Award. 

On 16 October 2014, the Chairman had met with Dr Don White (Chairman) and Andrew Morgan (Chief Executive) of Lincolnshire Community Health Services NHS Trust.  As a result of their discussions the Committee would be considering an item on the Trust's clinical strategy on 14 January 2015. 

ii)         County Council Constitutional Change – Referral to the Secretary of         State for Health

On 26 September 2014, the County Council had approved a change to its Constitution which enabled the Health Scrutiny Committee for Lincolnshire to make referrals directly to the Secretary of State for Health.  This provision applied to consultations by commissioners of NHS-funded services on substantial variations or developments in health care, where the Committee and the relevant commissioner could not agree on a way forward. 

The Chairman thanked Councillor T M Trollope-Bellew for proposing the recommendation at the meeting of County Council.

iii)        New Appointment to Peterborough and Stamford Hospitals NHS     Foundation Trust

On 30 September 2014, it was announced that Dr Miles Langdon, the Chairman of the Governing Body for South Lincolnshire Clinical Commissioning Group, had been appointed as the Clinical Director for Medicine and Emergency Care at Peterborough and Stamford Hospitals NHS Foundation Trust.  Dr Langdon would take up this part time position from December 2014 and would step down from the role as Chairman of the Governing Body for the Clinical Commissioning Group (CCG).  Dr Langdon would continue with his general practice in the St Mary’s Surgery in Stamford.

iv)        Lincolnshire West Clinical Commissioning Group

On 7 October 2014, the Chairman had met with Richard Childs (Chairman) and Dr Sunil Hindocha (Chief Clinical Officer) of Lincolnshire West CCG.  The Committee would be receiving an update from the CCG at its next scheduled meeting on 19 November 2014, which would cover the developments that the CCG was taking forward.  The item would also refer to 'co-commissioning', whereby CCGs and NHS England would be jointly responsible via a 'committee in common' for the commissioning of primary care services. 

v)         Burton Road GP Surgery, Lincoln

On 7 October 2014, the Leicestershire and Lincolnshire Area Team of NHS England had announced the outcome of their consultation exercise with patients at Burton Road GP Surgery in Lincoln.  NHS England had received 491 responses to the consultation, which represented a response rate of 21%.  A total of 472 patients (96% of respondents) had supported the option whereby NHS England would see if anyone would be interested in providing a GP service to Burton Road Surgery patients.  As a result, NHS England would be undertaking a procurement exercise,  ...  view the full minutes text for item 43.

RESOLVED

That the minutes of the meeting held on 17 September 2014 be agreed as a correct record and signed by the Chairman, subject to the following amendment being made to Minute 32:

It was noted that the Chief Executive, having received a notice under Regulation 13 of the Local Government (Committees and Political Groups) Regulations 1990, had appointed Councillor A M Austin, as a replacement member of the Committee in place of Councillor S L W Palmer, until 1 January 2015.

(To receive a report by Alison Christie (The Business Manager for the Lincolnshire Health and Wellbeing Board), which provides the Health Scrutiny Committee for Lincolnshire with an update on the progress being made to deliver the outcomes defined in the Joint Health and Wellbeing Strategy and details the actions agreed by the Health and Wellbeing Board on 30^th September 2014 to maintain momentum.  Councillor Mrs S Woolley (Executive Councillor NHS Liaison, Community Engagement) and Dr Tony Hill (Executive Director of Community Wellbeing and Public Health) will both be in attendance for this item)

A report by Alison Christie (Health and Wellbeing Business Manager) was considered, which provided the Committee with an update on the progress being made to deliver the outcomes defined in the Joint Health and Wellbeing Strategy and detailed the actions which had been agreed by the Lincolnshire Health and Wellbeing Board on 30 September 2014 to maintain momentum.

Councillor Mrs S Woolley (Chairman of the Lincolnshire Health and Wellbeing Board), Dr Tony Hill (Executive Director of Community Wellbeing and Public Health) and Alison Christie (Health and Wellbeing Business Manager) were in attendance and presented the information within the report to the Committee.

Members were reminded that there was a legal duty on the Health and Wellbeing Board to produce a Joint Health and Wellbeing Strategy.  The purpose of the strategy was to set out the strategic commissioning direction to achieve an improvement in the health of the population of Lincolnshire.  The Joint Health and Wellbeing Strategy for Lincolnshire 2013-18 had been developed as a result of the Joint Strategic Needs Assessment and was agreed by the Shadow Lincolnshire Health and Wellbeing Board in September 2012.

The Chairman advised the Committee that she had raised a number of questions on the content of the report and its appendices prior to the meeting.  The Chairman had received the responses to these detailed questions and it was agreed that this document containing these responses to the Chairman's questions would be emailed to Members of the Committee for information.  The Chairman requested that in future the Committee received more detailed reports from the Lincolnshire Health and Wellbeing Board, rather than a summary report, to ensure it could fulfil its scrutiny role.

Members were advised that as part of its role Lincolnshire Health and Wellbeing Board set the strategic commissioning direction to achieve an improvement in the health of the population of Lincolnshire.  It was not the Lincolnshire Health and Wellbeing Board's role to performance manage any NHS organisation delivering any of the services within the Strategy, as this should be undertaken by alternative means.  It was confirmed that the Lincolnshire Health and Wellbeing Board was not allocated a budget, as it was not responsible for the commissioning or delivery of services.

During consideration of the report and appendices, the following comments were noted: -

·        It was reiterated that the role of the Lincolnshire Health and Wellbeing Board was to set the strategic commissioning direction to achieve an improvement in the health of the population of Lincolnshire and it was the role of other bodies to scrutinise performance;

·        The way in which the outcomes were measured would be improved to ensure the information was presented in a clear manner;

·        A number of questions were raised with regards to the priority on 'Improve people's sense of mental wellbeing' and it was agreed that further information would be issued to Members of the Committee via email;

·        Members were reminded that there was not an adequate screening programme in place for the diagnosis of prostate cancer and this  ...  view the full minutes text for item 45.

(To receive a report by Sarah Fletcher (Chief Executive Officer, Healthwatch Lincolnshire), which provides an update on their engagement work, enter and view visits, strategic priorities and an explanation of their new systems in place. The Chief Executive Officer will be in attendance for this item)

Consideration was given to a report and presentation by Sarah Fletcher (Chief Executive Officer) and Dr B Wookey (Board Member and Company Secretary) of Healthwatch Lincolnshire.

Members were reminded that on 19 March 2014, the Committee had received an update from Healthwatch Lincolnshire on its engagement work; enter and view visits; policy and strategic priorities; and an explanation of its new IT systems in place.  Healthwatch Lincolnshire was subsequently invited to return to the Committee to update Members with an outline of what key themes had emerged from patient, service user and carer voices.

The Chief Executive Officer provided the Committee with detailed information, by way of a presentation, which covered the following areas: -

·         Activity – the number of issues raised per month via Healthwatch Lincolnshire;

·         Current research work;

·         GP Did Not Attend;

·         Pharmacy;

·         Young People;

·         Mental Health; and

·         Emerging Issues and Themes.

Members were advised that Healthwatch Lincolnshire was currently undertaking research into the impact of GP Did Not Attends, where it was noted that 38 GP Surgeries had responded to their questionnaire, from an even geographical and demographic spread across Lincolnshire; and 428 patients had responded.  Based on the survey, the average number of missed appointments in Lincolnshire at GP Practices per year was 184,224, and the projected cost for those missed appointments was £6.6m.  The Committee felt that this information should be publicised so that those patients who were missing appointments were aware of the impact on the NHS in Lincolnshire.  The Chief Executive Officer advised that there were also a number of patients who were taking advantage of the online booking appointment system operated by some GP practices, by booking several appointments and then choosing which was more convenient to them, without cancelling those appointments which they were not using.

Healthwatch Lincolnshire was also aware that United Lincolnshire Hospitals NHS Trust had approximately 400 open complaints.  The Trust was working at reducing the number of complaints and had put in place a dedicated complaints team.

The Chairman thanked the Chief Executive Officer for her comprehensive report and presentation.

Members were provided with an opportunity to ask questions, where the following points were noted: -

·         Members were advised of a Healthwatch Lincolnshire Event on 1 December 2014 at the New Life Centre in Sleaford, between 9.00 am and 4.30 pm.  Invitations for this event would be issued to Members in the coming weeks;

·         Healthwatch Lincolnshire had recently produced a factsheet on Men's Health and it was agreed that this would be emailed to the Health Scrutiny Officer for circulation;

·         Members were reminded that Healthwatch Lincolnshire was currently in the process of undertaking follow up enter and view visits at the Accident and Emergency departments at Lincoln County Hospital; Pilgrim Hospital in Boston; and Grantham and District Hospital.  The final follow up enter and view visit would be undertaken at the Accident and Emergency Department at Lincoln County Hospital on 27 October 2014.  It was suggested that the reports following those visits should be sent  ...  view the full minutes text for item 46.

(To receive a report by Chris Weston (Consultant in Public Health), which invites the Committee to make arrangements to provide a response to the consultation being undertaken on the draft Lincolnshire Pharmaceutical Needs Assessment, by setting up a working group, with the Committee’s final response to the draft Pharmaceutical Needs Assessment being considered and approved by the Committee on 19 November 2014)

A report by Simon Evans (Health Scrutiny Officer) was considered, which invited the Committee to make arrangements to provide a response to the consultation being undertaken on the draft Lincolnshire Pharmaceutical Needs Assessment, by setting up a working group, with the Committee's final response to the draft Pharmaceutical Needs Assessment being considered and approved by the Committee on 19 November 2014.

Councillors Mrs C A Talbot (Chairman), C J T H Brewis, R C Kirk and T M Trollope-Bellew volunteered to form part of the Working Group.  It was agreed that this meeting would be held on Monday, 3 November 2014 at 2.15 pm.

RESOLVED

That a Working Group, consisting of Councillors Mrs C A Talbot (Chairman), C J T H Brewis, R C Kirk and T M Trollope-Bellew, be established and held on 3 November 2014 at 2.15 pm to provide a response to the consultation being undertaken on the draft Lincolnshire Pharmaceutical Needs Assessment.

(To receive a report by Simon Evans (Health Scrutiny Officer), which invites the Committee to consider and approve, in principle, the draft protocol with NHS England Leicestershire and Lincolnshire Area Team and the draft 'three way' protocol between Healthwatch Lincolnshire, the Health and Wellbeing Board and the Health Scrutiny Committee for Lincolnshire)

Consideration was given to a report by Simon Evans (Health Scrutiny Officer), which invited the Committee to consider and approve the draft protocol with NHS England Leicestershire and Lincolnshire Area Team and the draft 'three way' protocol between Healthwatch Lincolnshire, the Health and Wellbeing Board and the Health Scrutiny Committee for Lincolnshire.

In relation to the protocol with NHS England Area Team, the Committee was advised that the protocol had been based on the existing protocol that had been agreed with the four Clinical Commissioning Groups in Lincolnshire.  The Committee was supportive of the principles in the protocol, but requested that the provisions relating to the Area Team's responsibilities for commissioning of specialised services be clarified.  The Committee also requested that the paragraph in the protocol relating to the responses to scrutiny reviews include explicit timescales.

The Committee supported the three way protocol with Healthwatch Lincolnshire and the Health and Wellbeing Board, subject to the inclusion of provisions outlining membership of both the Health and Wellbeing Board and the Health Scrutiny Committee, including the role of Healthwatch Lincolnshire representatives in each case. 

RESOLVED

(1)          That the protocol with the NHS England Leicestershire and Lincolnshire Area Team be approved, with the amendments included to reflect the comments of the Committee, prior to its submission to the Area Team.

(2)          That the protocol with Healthwatch Lincolnshire and the Health and Wellbeing Board be approved, subject to the inclusion of additional wording, outlining the membership of both the Health and Wellbeing Board and the Health Scrutiny Committee, including the role of Healthwatch Lincolnshire representatives in each case; and the Chairman, in consultation with the Vice-Chairman, be authorised to approve the protocol, once amended, on behalf of the Committee.

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

The Committee considered its work programme for the Committee's meetings over the coming months.

Members were advised that an informal development workshop on the East Midlands Ambulance Service NHS Trust had been arranged for the afternoon of 14 January 2015.

The Chairman sought volunteers to attend the Healthy Lives, Healthy Futures Joint Event on 17 November 2014 at 1.30 pm in Grimsby.  Councillors C A Talbot (Chairman), C J T H Brewis and C Burke volunteered to attend. 

RESOLVED

That the work programme and changes made therein be approved.