Agenda and minutes

An apology for absence was received from Councillor D P Bond (West Lindsey District Council).

It was agreed that the Democratic Service Officer would contact District Councils highlighting the need to ensure continuity of membership was maintained from District overview and scrutiny representatives.

Councillor S Weller (East Lindsey District Council) joined the meeting at 10.10am as the replacement member for Councillor Mrs P F Watson (East Lindsey District Council).

There were no declarations of Members' Interest made at this stage of the proceedings.

The Chairman thanked everyone for their messages of support during her period of absence.  The Chairman also expressed her thanks to Councillor C J T H Brewis, Vice Chairman of the Health Scrutiny Committee for Lincolnshire for chairing the last meeting.

Further to the announcement above, the Chairman welcomed everyone to the Committee and made the following announcements:-

i)             New Springwells GP Practice

The Committee was advised that the New Springwells GP Practice in Billingborough was the first GP practice in the County to have been given an outstanding rating by the Care Quality Commission, who had published their inspection report on 25 February 2016.  The Committee was advised further that so far in Lincolnshire, 42 GP practices had received ratings under the CQC's revised rating system, introduced in October 2014.  It was reported that the new Springwells GP Practice, situated in the South West Lincolnshire CCG area, provided services for 6,200 patients.  The Chairman extended congratulations to the New Springwells Practice on achieving the outstanding rating and looked forward to other practices in Lincolnshire being awarded this rating.

ii)            Carholme Court, Long Leys Road, Lincoln

It was reported that Lincolnshire Partnership NHS Foundation Trust was looking at options for developing a Psychiatric Intensive Care Unit at Carholme Court, which would be situated at the front of the St George's Hospital site on Long Leys Road, Lincoln.  The Trust was planning to hold a community information event for local residents on 30 March between 5.30pm and 7.30pm.

The Chairman advised that a request would be made for volunteers to attend the event under the Work Programme item later on in the agenda.

It was also highlighted that a Psychiatric Intensive Care Unit (PICU) was a psychiatric inpatient ward, with higher staffing levels than on a normal acute ward.  The PICUs would provide more intensive support to patients with complex needs who could not be managed on open psychiatric wards.

The Committee noted that the planning application was for the Trust to extend the current building, to potentially provide a ten-bed unit on the existing site. 

iii)           Dean Fathers, Chairman of United Lincolnshire Hospitals NHS Trust

The Committee was advised that on 2 March 2016, the United Lincolnshire Hospitals NHS Trust had announced the appointment of Dean Fathers as their new chairman.  Dean Fathers was chairman of Nottinghamshire Healthcare NHS Foundation Trust and would be continuing in his role there. 

It was highlighted that Dean Fathers was replacing Ron Buchanan, who was retiring at the end of February after two years with the Trust.  Dean had started his two year term of office on 5 March 2016, and was looking forward to working with staff, partners, patients and carers to make a positive difference.

The Chairman advised the committee, that she would try and arrange a meeting with the new Chairman, Dean Fathers.

iv)           Sue Noyes, Chief Executive, East Midlands Ambulance Service

The Committee was reminded that at the last meeting, it had been reported that Sue  ...  view the full minutes text for item 92.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire held on 17 February 2016, be approved and signed by the Chairman as correct record.

(To receive a report from Dr Tracey Swaffer (Head of Adult Psychology Psychotherapies Service, Consultant Clinical Psychologist – Lincolnshire Partnership NHS Foundation Trust) which provides information on the Adult Clinical Psychology and Psychotherapies Service for individuals accessing secondary mental health care.  Jane Marshall (Director of Strategy and Performance – Lincolnshire Partnership NHS Foundation Trust) will be in attendance for this item)

The Chairman welcomed to the meeting Jane Marshall, Director of Strategy and Performance, Lincolnshire Partnership NHS Foundation Trust, Rob Harvey, Divisional Manager Adult Community Mental Health, Lincolnshire Partnership NHS Foundation Trust; and Dr Tracey Swaffer, Head of Adult Clinical Psychology and Psychotherapies Service, Consultant Clinical Psychologist.

Before the start of the presentation, the Chairman asked the Director of Strategy and Performance, Lincolnshire Partnership NHS Foundation Trust, to clarify recent media interest with regard to patient waiting times, it had been reported that there were delays of 31 months to access pathways of care after being assessed for Psychology and Psychotherapies Services at Lincoln and Louth.

The Director of Strategy and Performance agreed that the length of time patients were kept waiting was not acceptable, and that it was a concern for the Trust to be in that position.  The Director confirmed that the longest waits were in Louth and Lincoln, with individuals having to wait 31 months to access 18 session individual pathways of care.  Reassurance was given that the service provided was a good quality service, and those patients that had experienced the journey through the service had made positive comments about the service they had received.  It was noted that 94% of patients who accessed the service felt that they would recommend it to family and friends.  Further details relating to waiting times were contained on page 26/27 of the report presented.

It was highlighted that patients that had been assessed, and were waiting further intervention were never actually left without support; they still had access to the service.  It was reported that the eighteen week target on how the service was progressing was not the same as others as the clinicians providing the service were not doctors.  The Committee was advised that for one to one clinical support, there was a longer waiting time, and that all options were being looked into to reduce the waiting time.  Some of those patients were offered group work, and depending on the individual's needs, some had taken up the offer of group work, others had opted to wait for one to one sessions. 

The Committee noted that guidance given was that anyone entering the service could be offered up to eighteen sessions, but quite often patients did not need that number of sessions.

The Committee was advised that Lincolnshire Partnership NHS Foundation Trust (LPFT) delivered its clinical services from four operational divisions.  The Adult Clinical Psychology and Psychotherapies (ACPPS) was commissioned by South West Lincolnshire Clinical Commissioning Group, on behalf of the Lincolnshire CCG's to provide talking therapies to people who presented to services in Lincolnshire that had moderate to severe levels of Psychological need.  It was highlighted that referrals to the service were received in the main from within the Trust such as Outpatient Psychiatry Clinics, Community Mental Health Teams and Improving Access to Psychological Therapies. 

It was reported that in 2007, the Government had released a significant amount of money to provide increased  ...  view the full minutes text for item 94.

(To receive a report from Dr Tony Hill (Director of Public Health – Lincolnshire County Council) which provides an independent statutory report to Lincolnshire County Council on the health of the people of Lincolnshire to raise the issues of importance to the health population of Lincolnshire.  Dr Tony Hill (Director of Public Health – Lincolnshire County Council) will be in attendance for this item.  Please note:  Appendix A to the report has been circulated electronically)

The Committee gave consideration to a report from the Dr Tony Hill, Executive Director of Community Wellbeing and Public Health, which provided the Annual Report on the Health of the People of Lincolnshire for 2015.

It was reported that it was a statutory duty of the Director of Public Health to produce an annual report on the health of the people of the area for which they are responsible.  The report was an independent view of the state of the health of the people of Lincolnshire, with a series of recommendations on the action needed to be taken by a range of organisations and partnerships.  The Committee noted that the previous year's annual report had focused on the major causes of premature mortality, which was when people died under the age of 75 years.  That report had highlighted three major findings, one of which was that the levels of mortality arising from liver disease were deteriorating.  As a result of the increase in preventable liver disease, it was highlighted that the current report concentrated solely on this issue.

The annual report described what liver disease was, what the causes and stages were, and the patterns, facts and figures relating to liver disease.  The Executive Director of Community Wellbeing and Public Health reported that the three main causes of liver disease were obesity, alcohol and hepatitis.  The report highlighted that there was a need for some sustainable investment in liver disease prevention and treatment and the development of effective pathways of care for people with liver disease and its causes.  The Committee were advised that in each chapter there were a series of recommendations on the action needed to be taken by a range of organisations and partnerships.  It was noted that it was hoped that the next year's commissioning plans would address the needs highlighted in the annual report.

During discussion, the following issues were raised:-

·         Budgetary constraints – The Committee noted that the Autumn Statement had reduced the amount of grant relating to public health and that this amount would continue to reduce year on year.  Some preventative services had been de-commissioned, or reduced, however, it was hoped that by working in partnership with other organisations that some of the services would be maintained.  Unfortunately, this information could not be shared with the Committee at this moment in time.  The Committee noted that not all services de-commissioned by the County Council would therefore cease.  The Committee were also advised that the NHS Five Year Forward view emphasised the need for prevention. 

·         The Committee were advised that the smoking cessation contract had been re-commissioned at considerable savings; significant improvement and better value for money.  It was noted further that the weight management contract had been de-commissioned, as its role was for CCGs and NHS England;

·         Page 10 of the Annual report document –Figure 1.1 provided the Committee with data relating to trends in United Kingdom (UK) deaths rate since 1970.  It was noted that during the forty year period, all  ...  view the full minutes text for item 95.

(To receive a report from Simon Evans (Health Scrutiny Officer) which provides information from Councillors Mrs J M Renshaw and Mrs S M Wray following their attendance at a Seminar on Delayed Transfers of care held on 2 March 2016 and hosted by Peterborough and Stamford Hospitals NHS Foundation Trust)

Consideration was given to a report from the Executive Director with responsibility for Democratic Services, which provided an update on the Peterborough and Stamford Hospitals NHS Foundation Trust – Seminar on Delayed Transfers of Care, held on 2 March 2016, to which Councillors Mrs J Renshaw and Mrs S Wray had attended. 

The Health Scrutiny Officer presented the report and advised that there were several issues that had been raised at the seminar, which might merit further exploration.  However the Committee was advised that the Adults Scrutiny Committee was the responsible overview and scrutiny committee for the overall Better Care Fund arrangements, and the reducing delayed transfers of care would be a key element of the Better Care Fund in 2016/17.  The Committee was advised further that it was due to receive a general update report from the Peterborough and Stamford Hospitals NHS Foundation Trust at its meeting planned for 20 July 2016, and it was likely that this update would include information on delayed transfers of care, if this was relevant to the Trust' overall performance. 

It was highlighted that from the report presented, there were still capacity issues around Lincoln and parts of the South of the County.

Reference was also made to the limited capacity for care packages in the community, particularly in cases where people required four visits a day, in these cases people were not being discharged, as a result of their high needs.  Assurance was given that what could be done was being done to get patients out to care in the community.

Other issues highlighted by the Committee included:-

·         Page 33 - Paragraph 2 – reference was made to the suggestion that "step-down" facilities in Lincolnshire could be improved further with a number of available beds in nursing homes to assist patients being moved out of acute beds;

·         The Committee extended their thanks to Councillors Mrs J Renshaw and Mrs S Wray for their report; and

·         The Committee agreed that the Adults Scrutiny Committee be requested to look into delayed transfers of care and report its findings to the Health Scrutiny Committee. 

RESOLVED

1.    That the report presented be noted.

2.    That the Adults Scrutiny Committee, given its role as the lead committee for scrutinising the Better Care Fund, be requested to look into delayed transfers of care and report its findings to the Health Scrutiny Committee.

(To receive a report from Simon Evans (Health Scrutiny Officer) inviting the Committee to make arrangements for the Quality Accounts process for 2016)

Consideration was given to a report from the Executive Director with responsibility for Democratic Services, which invited the Committee to consider which draft Quality Accounts of which local providers of NHS-funded services did the Committee wish to make a statement on.  Also the Committee was asked to consider the joint arrangements with Healthwatch Lincolnshire, who had indicated that they would like to work with the Committee on the Quality Accounts on the three main Lincolnshire based providers, and the Committee were requested to establish a working group for the Quality Account process.  Finally the Committee was asked to comment of the draft priorities for 2016/17 of the East Midlands Ambulance Service NHS Trust, who were seeking initial views in accordance with best practice.

Overall, following a short discussion, members felt that concentration should be made on areas applicable to Lincolnshire; and support was given to the working with Healthwatch with regard to the three areas as detailed in the report presented.

The Chairman asked for volunteers to assist in the Quality Accounts 2015-2016 process.  The Councillors who volunteered were Councillors C J T H Brewis (South Holland District Council), J Kirk (City of Lincoln Council), S L W Palmer, Mrs S M Wray, Mrs J M Renshaw and Mrs C A Talbot.

RESOLVED

1.    That the Health Scrutiny Committee for Lincolnshire make a statement on the draft Quality Accounts of the following local providers of NHS-funded services:-

·         Boston West Hospital;

·         East Midlands Ambulance Service NHS Trust;

·         Lincolnshire Community Health Services NHS Trust;

·         Lincolnshire Partnership NHS Foundation Trust;

·         Peterborough and Stamford Hospitals NHS Foundation Trust;

·         St Barnabas Hospice; and

·         United Lincolnshire Hospitals NHS Trust;

2.    That agreement be given to working jointly with Healthwatch Lincolnshire and prepare a joint statement on the following three draft Quality Accounts:

·         Lincolnshire Community Health Services NHS Trust

·         Lincolnshire Partnership NHS Foundation Trust; and

·         United Lincolnshire Hospitals NHS Trust

3.    That a working group for the Quality Account process be established comprising of Councillors C J T H Brewis, J Kirk, S L W Palmer, Mrs S M Wray, Mrs J M Renshaw and Mrs C A Talbot.

(To receive a report by Simon Evans (Health Scrutiny Officer) which invites the Committee to consider its work programme for the coming months)

The Committee gave consideration to its work programme for its forthcoming meetings.

The Health Scrutiny Officer advised that from the meeting, two items had come forward and they were:-

·         Lincolnshire Community Pharmacies; and

·         The Outcomes of the Committee's report on Reducing Alcohol Harm in Lincolnshire from 2011.

It was also confirmed that training would be planned for the Committee on mental health treatments, approaches and services.  

The Committee were asked for volunteers to attend the Carholme Court, Long Leys Road, information event on 30 March 2016.  Councillors J Kirk and Mrs J M Renshaw volunteered to attend the event and then report back to the Committee.

During a short discussion, the Committee raised the following potential items for inclusion on future agenda.  These were as follows:-

·         Recruitment and retention of GPs in Lincolnshire;

·         Lincolnshire Medical School;

·         Update from Queen Elizabeth's Hospital, King's Lynn. 

RESOLVED

            That the contents of the work programme, with the amendments as             detailed above, be agreed.