Agenda and minutes

Apologies for absence were received from Councillors Mrs K Cook and Mrs R Kaberry-Brown (South Kesteven District Council).

It was noted that Councillor L Wootten (South Kesteven District Council) had replaced Councillor Mrs R Kaberry-Brown (South Kesteven District Council) for this meeting only.

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

RESOLVED

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 23 January 2019 be agreed and signed by the Chairman as a correct record.

Further to the Chairman's announcements circulated with the agenda, the Chairman brought to the Committee's attention the Supplementary Chairman's announcements circulated at the meeting.

The Supplementary Chairman's announcements made reference to:

·         Update from United Lincolnshire Hospitals NHS Trust on Trauma and Orthopaedic Services; and

·         2019 Local Government Elections.

RESOLVED

That the Chairman's Announcements presented as part of the agenda on pages 15 to 18; and the supplementary announcements circulated at the meeting be noted.

(To receive a report from John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP), which invites the Committee to consider the STP's plans for engagement with local communities and partners)

The Chairman welcomed to the meeting John Turner, Senior Responsible Officer, Lincolnshire Sustainability and Transformation Partnership (STP), who reminded the Committee that at the 23 January 2019 meeting, consideration had been given to a summary of the NHS Long Term Plan.  At the said meeting, the Committee had agreed that the next steps for the NHS Long Term Plan included consideration of the engagement by the Lincolnshire Sustainability and Transformation Partnership (STP) on its plan to implement the NHS Local Plan; the Committee also indicated that it would like to consider proposals for the development of urgent treatment centres in Lincolnshire.

It was noted that the Long Term Plan (LTP) promoted that an integrated care system should be developed with NHS partners, public sector and third sector partners.  It was noted that since the publication of the LTP, there had also been further changes to GP Contract arrangements.

It was highlighted that the LTP set out requirements for the next five years and in certain instances for ten years; and that its objectives were consistent with the approach being undertaken in Lincolnshire, which would as a result help to accelerate the process.  It was highlighted further that there was a requirement for a local LTP to be developed by the autumn, which would be the subject of wide and open engagement with partners and the public.

The Committee was advised that the local LTP was in its final stages; and that public engagement would be starting shortly.  Confirmation was given that the engagement would be a comprehensive exercise across the county.  It was highlighted that engagement would involve healthy conversations taking place where there would be sharing of NHS thinking; and the NHS listening to the views of partners and the public.  It was noted that the engagement exercise would continue for the rest of the calendar year; and would cover areas such as: general health issues; self-care; mental health and learning disabilities; integrated care; hospital services including proposed reconfigurations; and urgent care.  It was reported that there would be a number of engagement events across the county and suggestions were welcomed from county council and district council colleagues as to how this could be developed.  The Committee was advised that there would also be material available on the website for people to view. 

It was noted that proposals reflected work that had been done internally with senior clinicians; and that the proposals were a good reflection of the thinking of senior staff locally.

In conclusion, it was emphasised that the next stage was not a formal consultation exercise; it was open engagement; and that feedback from the said engagement would help shape the proposals going forward, prior to the public consultation, which would commence in due course. 

During discussion, the Committee raised the following points:-

·         The need for more emphasis on public health and preventative measures, rather than provision just being responsive.  The Committee was advised that over the last few years, the focus had not been on public  ...  view the full minutes text for item 82.

(To receive a report from Thames Ambulance Service Limited (TASL), which updates the Committee on the Non-Emergency Patient Transport Service.  Representatives from TASL, will be in attendance for this item)

The Chairman welcomed to the meeting Mike Casey, General Manager, Thames Ambulance Service Limited and Andy Hill, Contract Manager, Thames Ambulance Service Limited.

The Chairman invited the Committee to give consideration to the two reports circulated to members of the Committee before the meeting.  It was highlighted that item 6a provided the Committee with an update from Thames Ambulance Service on their current status and service performance; and 6b provided the Committee with the findings of the Care Quality Commission report following its inspection of the Thames Ambulance Service Limited on 23 October 2018.

In an introductory update from the General Manager (TASL), the Committee was advised that TASL had now moved its Head Office to the Old Danwood Building, Lincoln.

Reassurance was given to the Committee that the data issues reported at the December 2018 meeting had now been resolved; and that the report (6a) that had been circulated previously provided the latest position in terms of Service Delivery Performance and organisational changes.  It was noted that there had been significant improvements in all but two areas; these were renal patients and collection of renal patients.

In guiding the Committee through the Care Quality Inspection findings (6b), the Contract Manager made reference to the following points:-

·         Completion of safeguarding/mandatory training.  The Committee was advised that a programme was now in place; and 80% of staff had now received training;

·         Meeting the needs of bariatric patients.  Confirmation was given that 30% of staff had been trained;

·         Cleanliness of ambulance stations/access to equipment.  The Committee was advised that since the CQC inspection a private cleaning company had been contracted to complete the necessary cleaning.  It was also highlighted new arrangements had been made with regard to oxygen bottles; these were now being stored at the hospital; to prevent staff having to carrying them.  It was highlighted further that steps were being taken to make arrangements to have some staff moved;

·         The non-availability of personal digital assistants (PDA).  It was reported that a risk register was now available, which was now complete and up to date;

·         Access to equipment for transporting children.  The Committee was advised that every station now had car seats available to them; and 100% of training for fitting car seats had been completed;

·         Completion of appraisals. The Committee was advised that now station managers were in place, a programme of work based training had been implemented; and there was now adequate resources available to deliver appraisals;

·         Managers and ambulance staff not using performance data.  It was highlighted that as the data was now accurate, staff now had access to view  KPI  data;

·         Leadership not being embedded throughout the service.  The Committee was advised that now the new structure was in place, some signs of empowerment were already being seen; and

·         Complaints – It was noted that the number of complaints had reduced, as a result of there now being corporate ownership.

During discussion, the Committee raised the following issues:-

·         Some concern was expressed relating to the lack of  ...  view the full minutes text for item 83.

(To receive a report from Simon Evans, Health Scrutiny Officer, which invites  the Committee to decide the next steps in relation to the Health Scrutiny Committee for Lincolnshire's January 2018 referral of the Grantham and District Hospital's overnight closure of Accident and Emergency Department to the Secretary of State for Health and Social Care)

Consideration was given to a report from Simon Evans, Health Scrutiny Officer, which provided the Committee with a holding report with regard to the Grantham Accident and Emergency Department – Referral to the Secretary of State for Health and Social Care.

Daniel Steel, Scrutiny Officer introduced the report and invited the Committee to consider what steps it wished to take concerning the January 2018 referral to the Secretary of State for Health and Social Care.

A local member advised the Committee that South Kesteven District Council had sent a letter to the Secretary of State for Health and Social Care concerning the matter.

The Chairman expressed frustration to the fact that no response had yet been received from the Secretary of State for Health and Social Care.

RESOLVED

1.    That the Committees frustration be recorded that some 31 months later, the Grantham A & E still remained closed overnight; and as no response has been received from the letter sent in January 2019 to the Secretary of State for Health and Social Care.

2.    That the Chairman on behalf of the Committee should write directly to the Rt Hon Theresa May, the Prime Minister, with copies of the said letter being sent to the Secretary of State for Health and Social Care, and to all Lincolnshire MP's expressing the Committees concerns and the frustration for the people of Grantham. 

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

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 scrutiny activity was focussed where it could be of greatest benefit.

The Committee gave consideration to the work programme as detailed on pages 28/39 of the report presented.

Items suggested for future meetings included:-

·         Local element of the Long Term Plan;

·         Quality Accounts;

·         Prostate Cancer diagnosis/treatment; and

·         Workforce and Education.

RESOLVED

That the work programme presented be agreed, subject to the inclusion of the suggested changes as detailed above.