Agenda and minutes

Apologies for absence were received from Councillor Miss E L Ransome.

The Democratic Services Officer reported that, since the last meeting of the Committee, two resignations had been received.  Councillor Mrs L A Rollings had resigned from her position as the representative for West Lindsey District Council and Councillor G Gregory had also resigned his position as the representative for Boston Borough Council.  Substantive replacements remained unconfirmed.

The Chief Executive reported that under the Local Government (Committee and Political Groups) Regulations 1990, he had appointed Councillor Mrs A White to the Committee in place of the current vacancy for West Lindsey District Council.

Councillor Mrs C A Talbot advised the Committee that she remained a patient of Nottingham University Hospitals NHS Trust but was also under the care of a team at United Lincolnshire Hospitals NHS Trust, which would be discussed under Item 6 – Lincolnshire Sustainability and Transformation Plan.

Councillor Mrs P F Watson advised the Committee that she was also a patient of United Lincolnshire Hospitals NHS Trust, which would be discussed under Item 6 – Lincolnshire Sustainability and Transformation Plan.

The Chairman welcomed everyone to the Committee meeting and made the following announcements:-

i)          Councillor Mrs Lesley Rollings and Councillor Gordon Gregory

The Chairman confirmed the two resignations from the Committee by Councillor Mrs Lesley Rollings and Councillor Gordon Gregory.  On behalf of the Committee the Chairman asked that formal thanks be noted for their contribution to the activities of the Committee.  It was also confirmed that, as reported, Councillor Mrs Angela White was in attendance as the representative for West Lindsey District Council.  The Committee looked forward to each council confirming their permanent replacement representatives in due course.

ii)         Dr Peter Holmes

It was reported that Dr Peter Holmes had resigned as the Chairman of the Lincolnshire East Clinical Commissioning Group Governing Body in order to focus on the management of his own Stuart House Surgery in Boston.  The Chairman advised that she had written to Dr Holmes to thank him for his support of the activities of the Health Scrutiny Committee for Lincolnshire.

iii)       Wainfleet GP Surgery Update

At the last meeting the Committee received information on how Lincolnshire East Clinical Commissioning Group had been providing support to Wainfleet Surgery, whose registration had been temporarily suspended by the Care Quality Commission (CQC).

On 7 December 2016, Lincolnshire East Clinical Commissioning Group advised that the two partners at the surgery would not be seeking re-registration with the CQC and, as a result, the CCG was now reviewing the options for GP provision in Wainfleet.  The CCG was also seeking the views of patients, a part of its consideration of all available patients to acess services at another local practice.

iv)       Arboretum GP Surgery Lincoln; Burton Road GP Surgery, Lincoln; Pottergate Surgery, Gainsborough; and Metheringham Surgery

On 28 November 2016, Lincolnshire West Clinical Commissioning Group announced that the Arboretum and Burton Road Surgeries in Lincoln, the Pottergate Surgery in Gainsborough and the Metheringham Surgery would all close on 7 January 2017.  Lincolnshire West CCG had stated that the 11,000 patients across the four surgeries would have an alternative option within 0.2 miles of their existing surgery.

Lincolnshire West Clinical Commissioning Group had sought to secure a long-term provider to take over the management of the four practices but was unable to offer a contract to any of the bidders.  Patients had until 7 January to register with a different GP practice.  If patients did not register by that date, the CCG would automatically allocate those patients to a surgery on their behalf.  If patients were unhappy with their allocated surgery they would still be able to choose an alternative at any time, based on where they lived and the practice boundaries within which they reside.  An update report from Lincolnshire West Clinical Commissioning Group was expected at the Committee on 18 January 2017.

v)        Working Group Meetings

On 20 December 2016, a working group meeting provided initial views on the United Lincolnshire Hospitals NHS Trust Five Year Strategy. The Chairman thanked Councillors S L W Palmer, Mrs S Ransome,  ...  view the full minutes text for item 53.

RESOLVED

          That the minutes of the meeting of the Health Scrutiny Committee for Lincolnshire held on 23 November 2016 be approved and signed by the Chairman as a correct record.

(To receive a report from Simon Evans (Health Scrutiny Officer) providing detail of a public consultation, in relation to decommissioning congenital heart disease surgery from the East Midlands Congenital Heart Centre (formerly known as Glenfield Hospital. Will Huxter (Regional Director of Specialised Commissioning (London), NHS England) and Dr Geraldine Linehan (Regional Director of Specialised Commissioning (Midlands and East), NHS England) will be in attendance for this item)

Consideration was given to a report by Simon Evans (Health Scrutiny Officer) which provided details of a public consultation relating to decommissioning of congenital heart disease surgery from the East Midlands Congenital Heart Centre (formerly known as Glenfield Hospital).

Will Huxter (Regional Director of Specialised Commissioning (London)) and Dr Geraldine Linehan (Regional Clinical Director of Specialised Commissioning (Midlands and East) of NHS England were in attendance for this item.

On 21 July 2016 the Committee unanimously concluded that to decommission Level 1 Paediatric Cardiac and Adult Congenital Heart Disease Services from the East Midlands Congenital Heart Centre would constitute a substantial variation.  It also agreed that the Chairman would write to NHS England to outline the views of the Committee and to seek commitment to a full consultation.

Correspondence between the Chairman and NHS England had established or confirmed the following:-

·       No final decision had been taken in regard to the future of University Hospitals of Leicester NHS Trust or any of the other congenital heart disease services in England;

·       Information regarding consultation about the proposals would be communicated as widely as possible, well in advance of any consultation and NHS England would ensure that the consultation took account of those services which could be impacted by any change to CHD services, including paediatric intensive care and ECMO;

·       NHS England confirmed that they were now in the pre-consultation engagement stage;

·       The national and regional panel assessments of Congenital Heart Disease (CHD) centres against key standards in the new service specification, which came in to effect on 1 April 2016 were completed in June 2016.  Following these assessments, the Committee of NHS England agreed with the recommendation that centres assessed as 'not satisfactory and highly unlikely to meet service standards' should be served notice that NHS England was minded to cease to contract their services.  Providers had been informed of these assessments at the end of June 2016 and advised that any necessary public involvement undertaken before services changes were implemented.

Individual assessment reports for 21 hospital trusts were published by NHS England on 13 September 2016 and were available at the following link:-

          www.england.nhs.uk/commissioning/spec-services/npc-crg/chd/#reports

It was reported that NHS England had met with staff, patients and stakeholders of University Hospitals of Leicester NHS Trust to discuss the assessment of the Trust against the standards.  Additionally, NHS England advised that extensive correspondence and discussions had taken place since that visit.

Blogs by Will Huxter had also been published on the NHS England website, the most recent of which, on 23 November 2016, indicated that consultation would not begin until early in 2017.

The Committee was advised that NHS England had made no final decision, that the proposal did not include closure of all services at University Hospitals of Leicester NHS Trust (UHL) and that some would remain.  Information had been sought from the Trust about the impact of the proposals on all services including any financial implications.

In addition to work being carried out in relation to Congenital Heart Disease Services,  ...  view the full minutes text for item 55.

(To receive a report from Simon Evans (Health Scrutiny Officer) which provides the Public Summary Document of the Lincolnshire Sustainability and Transformation Plan (STP) and invites the Committee to give initial consideration to the content of the STP and to consider a response to the engagement phase of the STP.  Andrew Morgan (Chief Executive, Lincolnshire Community Health Services NHS Trust), Gary James (Accountable Officer, Lincolnshire East Clinical Commissioning Group) and Sarah Furley (Programme Director, Lincolnshire Sustainability and Transformation Plan) will be in attendance for this item)

Consideration was given to a report by the Health Scrutiny Officer which provided the Committee with the Public Summary Document of the Lincolnshire Sustainability and Transformation Plan (STP) and invited initial consideration of the content of the STP with a view to providing a response to the engagement phase of the STP.

Andrew Morgan (Chief Executive, Lincolnshire Community Health Services NHS Trust), Gary James (Accountable Officer, Lincolnshire East CCG) and Sarah Furley (Programme Director, Lincolnshire Sustainability and Transformation Plan) were all in attendance for this item.

It was explained that each local NHS area was required to prepare a Sustainability and Transformation Plan (STP).  The Lincolnshire STP was published on 7 December 2016 together with a public summary document.  It was clarified that the STP was not a consultation document but a strategy document from which formal public consultations would be derived.  These were expected to take place from May 2017 onwards.

On 22 December 2015, Delivering the Forward View:  NHS Planning Guidance 2016/17 – 2020/21 was published by several national NHS organisations, including NHS England and NHS Improvement.  Included in the guidance was a key requirement for each local NHS area to prepare an STP, the aim of which was to find out how health and care organisations could improve the health and wellbeing of their resident population whilst increasing the clinical and financial sustainability of local health and social care services. 

In January 2016, 44 local STP 'footprints' were developed and the Lincolnshire STP covered Lincolnshire East, Lincolnshire West, South Lincolnshire and South West Lincolnshire Clinical Commissioning Group areas.  It was confirmed that North Lincolnshire and North East Lincolnshire Clinical Commissioning Groups were not included.

Draft STPs were submitted in June and September 2016 and an updated plan was submitted on 21 October 2016 for further review by NHS Improvement and NHS England.

Considerable progress had been made in the development of the Lincolnshire STP which had built upon the work already underway in the county to devise a new model for health and care, through the Lincolnshire Health and Care Programme (LHAC).  In addition, there had been discussion and input from Lincolnshire County Council officers, particularly in relation to how health and social care services could be better joined up; and how services in the community, which prevent ill health, could be improved.

A number of key stakeholders, including East Midlands Ambulance Service NHS Trust, Lincolnshire GPs, Lincolnshire pharmacies, key health providers outside Lincolnshire and local organisations from the public, private and voluntary sectors all contributed to the development of the plan.  Healthwatch Lincolnshire also participated on the Stakeholder Board.

Seven health organisations led the work on the development of the STP:-

·       Lincolnshire West Clinical Commissioning Group;

·       Lincolnshire East Clinical Commissioning Group;

·       South West Lincolnshire Clinical Commissioning Group;

·       South Lincolnshire Clinical Commissioning Group;

·       United Lincolnshire Hospitals NHS Trust;

·       Lincolnshire Community Health Services NHS Trust; and

·       Lincolnshire Partnership NHS Foundation Trust.

The Lincolnshire Health and Care (LHAC) programme was launched in 2013 as a result of organisations in  ...  view the full minutes text for item 56.

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

Consideration was given to a report by the Health Scrutiny Officer which gave the Committee the opportunity to consider its work programme for the coming months.

During consideration, the following amendments were proposed:-

1.    Add Congenital Heart Disease (Update) to the work programme for the meeting of the Committee on 18 January 2017;

2.    Cancel the meeting of the Committee scheduled for Wednesday 12 April 2017 due to the Purdah period as a result of the County Council elections in May 2017; and

3.    Add an item to the work programme for a future meeting of the Committee to investigate the delay in patient access to GP appointments.

Previous discussions had resulted in the proposal to form a joint working group, with the Adults Scrutiny Committee, to consider the issues around Delayed Transfers of Care (DTOC).  The Chairman explained that this issue was wider than originally anticipated due to the number of partners involved in this process.  Due to the County Council elections it was proposed to hold one meeting to develop a framework for this work which could be commenced after the election.  The Committee agreed with the proposal, the Health Scrutiny Officer was asked to identify a suitable date for a meeting of the working group.

RESOLVED

1.    That the work programme, with the amendments noted above, be agreed; and

2.    That a meeting be arranged for the Delayed Transfers of Care Working Group, to develop a framework for reviewing Delayed Transfers of Care.

The Chairman thanked the Committee for their tremendous support over the last few months and, in particular, Simon Evans (Health Scrutiny Officer) and Andrea Brown (Democratic Services) for their continued support.