Agenda and minutes

RESOLVED

That Councillor C S Macey be elected as Chairman of the Health Scrutiny Committee for Lincolnshire for 2017/18.

COUNCILLOR C S MACEY IN THE CHAIR

RESOLVED

That Councillor C J T H Brewis be elected as Vice-Chairman of the Health Scrutiny Committee for Lincolnshire for 2017/18.

An apology for absence was received from Councillor Mrs R Kaberry-Brown (South Kesteven District Council representative).

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

Councillor M T Fido advised the Committee that his partner was employed by East Midlands Ambulance Service as an Emergency Dispatcher for 999 calls.

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire held on 15 March 2017 be approved and signed by the Chairman as a correct record.

The Chairman extended thanks to the previous Committee and its Chairman for their excellent work in challenging and questioning senior health leaders in the County. 

The Chairman advised that he was looking forward to building on the previous achievements as there would be some significant health proposals and decisions to be scrutinised, in particular the progress of the Lincolnshire Sustainability and Transformation Plan; and the previous Committee's referral about the overnight closure of Grantham Hospital's A & E.

The Committee agreed that a letter of thanks should be sent to the previous Chairman, Councillor Mrs C A Talbot.

(To receive a report by Simon Evans (Health Scrutiny Officer), which describes the key roles of the Health Scrutiny Committee for Lincolnshire)

The Committee gave consideration to a report from Simon Evans (Health Scrutiny Officer), which described the key roles of the Health Scrutiny Committee for Lincolnshire.

The Committee noted that Lincolnshire County Council had delegated all its health scrutiny functions to the Health Scrutiny Committee for Lincolnshire.  It was noted further that the Adults and Community Wellbeing Scrutiny Committee was responsible for the scrutiny of the County Council's public health function; and similarly the Children and Young People Scrutiny Committee would continue to have an overview of children's health services child and adolescent mental health, school nursing and health visiting services.

Some members highlighted that issues affecting more than one scrutiny committee might need to be considered, and one method would be a joint working group of more than one scrutiny committee.  An example of this might be delayed transfers of care and it was agreed that this matter would be discussed further at agenda item 10 'Health Scrutiny Committee for Lincolnshire – Work Programme and Quality Account Arrangements.'

RESOLVED

That the role of the Health Scrutiny Committee for Lincolnshire as explained in the report presented be noted.

To receive a report by Alison Christie (Programme Manager – Health and Wellbeing), which provides the Committee with an update on the Lincolnshire's refreshed Joint Strategic Needs Assessment and the new Joint Health and Wellbeing Strategy.  Chris Weston (Consultant in Public Health) will be in attendance for this item)

Consideration was given to a joint report from Alison Christie (Programme Manager – Health and Wellbeing) and Chris Weston (Consultant – Wider Determinants of Health), which provided the Committee with an update on the Lincolnshire's refreshed Joint Strategic Needs Assessment (JSNA), which had been made publically available on the Lincolnshire Research Observatory from 9 June 2017.

It was highlighted that a report concerning the development of the Joint Health and Wellbeing Strategy (JHWS), including the Engagement Plan had been considered by the Committee at its 15 March meeting.  The Committee noted that the issue raised by the Committee at the above said meeting concerning neurological conditions had been taken on board and was being actively pursued.

In guiding the Committee through the report presented, the Consultant – Wider Determinants of Health advised that Local Authorities and Clinical Commissioning Groups (CCGs) had an equal and joint duty under the Health and Care Act 2012 to prepare a JSNA and JHWS through the Lincolnshire Health and Wellbeing Board (HWB).

In March 2016, the HWB had agreed proposals for a fundamental review of Lincolnshire's JSNA, and that the 35 topics in the 2011 JSNA formed the basis of the review.  As a result of a multi-agency Steering Group made up of representatives from each of the four CCGs, Adult Care, Children's Services, Public Health, Healthwatch Lincolnshire, District Councils and the voluntary sector had been established to oversee the review programme.  The said review had begun in April 2016 and had concluded in April 2017.

It was highlighted that in response to feedback from stakeholders, four topics from the 2011 JSNA had been removed, these were Personalisation; Residential and Nursing Care; Life Expectancy and Youth Work.  The Committee noted that the Childhood & Weight problems topic had been merged the Adult Obesity to form an All Age Obesity topic.  In addition, the Committee was advised that five additional topics had been added and these were Autism; Dementia; Domestic Abuse; Financial Inclusion and Mental Health and Emotional Wellbeing of Children and Young People.

The Committee were provided with a short presentation, which allowed the Committee to view the online web resource which was available on the Lincolnshire Research Observatory.  It was highlighted that a one page summary document ('topic on a page') had been produced for each topic using infographics and graphs to provide key fact and messages in an accessible and user friendly format.

In conclusion, the Committee was reminded that the HWB had a statutory responsibility to produce and publish a JSNA for Lincolnshire and to use the evidence to inform the priority setting for the JHWS.  The Committee was also invited to establish a working group to meet in early July to gather the views of the Committee as part of the prioritisation process for the development of the next JHWS for Lincolnshire which was due to be published in April 2018 and cover the period 2018/2023.

During discussion, the following points were raised:-

·         One member enquired  ...  view the full minutes text for item 8.

(To receive a presentation from Jan Sobieraj (The Trust's Chief Executive), which will provide the Committee with an introduction to United Lincolnshire Hospitals NHS Trust, which is the provider of acute hospital services to most of the residents of Lincolnshire.  The presentation will also outline the Trust's services and hospitals; provide an overview of its budget; and the challenges faced by the Trust in the coming years)

The Committee received a presentation from Jan Sobieraj, Chief Executive, United Lincolnshire Hospitals NHS Trust, which provided an introduction to the United Lincolnshire Hospital Trust.

The presentation provided the Committee with information relating to:-

·         The background behind the Trust;

·         How the Trust was run and funded;

·         How money was spent;

·         Breakdown figures relating to the Trusts deficit;

·         The Trust's successes;

·         The challenges faced by the Trust; and

·         The Trust's vision for the future by 2021 and its five biggest priorities.

During discussion, members of the Committee raised the following issues:-

·         The workings of the sustainability and Transformation Fund.  The Committee noted that the amount drawn down was based on performance.  If all the activity set out was not achieved then a lesser amount would be drawn down;

·         The need to attract more patients to generate the Trust's income and help reduce the deficit.  Reference was made to the 'Choose and Book System' and the impact of it on the amount of work carried out at the Trust.  The Committee noted that the Trust was promoting itself through the 'Choose and Book System' for elective treatment, for example by developing centres of excellence in Lincoln rather than outside the County.  It was highlighted that part of the Five Year Plan would be that services would be provided locally through Neighbourhood Teams whenever possible; and that wherever possible services would be centralised onto fewer sites, which would allow for more elective work;

·         Explanation of the deficit breakdown.  The Committee noted that approximately £30 million of the Trust's deficit related to the duplication of services across several sites.  That reducing reliance on agency staff would help save £13m.  Increasing the amount of elective care from CCGs would support the direction of travel and increase income, which would then reduce the current deficit of £13m; and reducing the ULHT inefficiencies of £13m as part of the five year improvement plan.  It was noted that a national initiative led by Lord Carter of Coles was looking into NHS productivity, cost efficiency and was also providing direction for improvement;

·         The Committee was advised that United Lincolnshire Hospitals NHS Trust would be presenting its response to the CQC report at the next meeting of the Committee on 19 July 2017;

·         Progress of the CT scanner appeal in Louth.  Reference was made to the appeal, which had originally been for a CT scanner in Louth;

·         Funding Formula for Lincolnshire – The Committee was advised that the funding formula was set nationally.  A question was asked as to whether funding that was agreed was weighted demographically and whether those weightings were significant.  It was confirmed that CCGs commissioned services from providers and that they were paid for via contract and tariff arrangements.  Officers advised that there was a formula, which was weighted by population growth, morbidity and rurality.  A suggestion was made for a Lincolnshire voice to promote the needs of Lincolnshire as a rural County;

·         Recruitment – It was reported that recruitment was an issue in Lincolnshire;  ...  view the full minutes text for item 9.

(To receive a report from Simon Evans (Health Scrutiny Officer), which invites the Committee to consider and comment on its work programme; and to confirm arrangements for considering the remaining Quality Accounts from local NHS providers)

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 focussed where it could be of greatest benefit.  Appendix A to the report provided the Committees work programme from 2017 to April 2018.

The Committee was advised that at the 15 March 2017 meeting, arrangements had been agreed for the 2017 Quality Account process.  The Health Scrutiny Officer advised that there were three Quality Accounts requiring statements, which were:-

·         Lincolnshire Community Health Services NHS Trust (joint statement with Healthwatch Lincolnshire)

·         St Barnabas Hospice;

·         United Lincolnshire Hospitals NHS Trust (joint statement with Healthwatch Lincolnshire)

The Committee was advised further that the working group comprising of Councillors C J T H Brewis, J Kirk, P Gleeson and Mrs P A Watson would be meeting on 20 June 2017 to consider the ULHT Quality Account. 

An invitation was extended to members of the Committee to participate in a working group to formulate a response to the Lincoln Walk-in Centre Public Consultation document.  Councillors Mrs K Cook, J Kirk, R A Renshaw, T Boston and C S Macey expressed an interest at the meeting.  The representative from Healthwatch requested a precis of the working group's deliberations.

The Committee agreed that a date for the working group should be arranged which should involve a presentation from the Lincolnshire West CCG to help members of the working group formulate their response to the consultation document.  The response of the working group to then be presented to the next meeting of the Committee scheduled to be held on 19 July 2017.

The Chairman invited members of the Committee to suggest future items for inclusion on the work programme.  The items put forward for inclusion were as follows:-

·         The Lincolnshire Sustainability Transformation Plan (STP) – The Committee agreed that an update report should be included for the October meeting.  The Health Scrutiny Officer agreed to circulate to members of the Committee a copy of an update report being considered by the Health and Wellbeing Board on the 20 June 2017 relating to the STP;

·         Dental Procurement item for a future meeting; and

·         Long Leys Court to a future meeting.

RESOLVED

1.    That the items as detailed above be included as future items for consideration in the work programme.

2.    That the Quality Accounts Working Group meet on 20 June 2017 to consider the draft Quality Accounts of United Lincolnshire Hospitals NHS Trust; and St Barnabas Hospice.

3.    That a working group be established to respond to the Lincoln Walk-in Centre Public Consultation document comprising of the following Councillors Mrs K Cook, J Kirk, R A Renshaw, T Boston and C S Macey.