Agenda and minutes

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Contact: Katrina Cope  Senior Democratic Services Officer

Media

Items
No. Item

1.

Election of Chairman

Minutes:

RESOLVED

 

That Councillor C S Macey be elected as Chairman of the Health Scrutiny Committee for Lincolnshire for 2020/21.

 

COUNCILLOR C S MACEY IN THE CHAIR

2.

Election of Vice-Chairman

Minutes:

RESOLVED

 

That Councillor C J T H Brewis be elected as Vice-Chairman of the Health Scrutiny Committee for Lincolnshire for 2020/21.

3.

INTRODUCTIONS BY THE CHAIRMAN

Minutes:

The Chairman welcomed everyone to the meeting, and advised that in addition to the confirmed members of the Committee, the following people were also present at the meeting:

 

·         Councillor Mike Thompson, (Executive Support Councillor for NHS Liaison and Community Engagement);

·         Jane Marshall, ) Director of Strategy, Lincolnshire Partnership NHS Foundation Trust);

·         Deborah Hussey, (Quality Improvement and Assurance Lead for Specialist Services, Lincolnshire Partnership NHS Foundation Trust);

·         Steve Roberts, (Associate Director of Operations, Older Adult Services, Lincolnshire Partnership NHS Foundation Trust);

·         Yolanda Martin, (Associate Director of communications, Lincolnshire Partnership NHS Foundation Trust);

·         Siu-Ann Pang, (Head of Mental Health, Learning Disability & Autism Specialised Commissioning, NHS England & NHS Improvement Midlands;

·         Liz Ball, (Interim Chief Nursing Officer, Lincolnshire Clinical Commissioning Group);

·         Kakoli Choudhury, (Public Health Consultant); and

·         Simon Evans, (Health Scrutiny Officer).

 

The Committee was advised further that it was expected that Maz Fosh, Chief Executive, Lincolnshire Community Health Services NHS Trust and Tracy Picher, Director of Nursing, Lincolnshire Community Health Services would be joining the meeting later in the proceedings.

 

The Chairman reminded members of the Committee and other participants of meeting etiquette, and the role of the Committee members as constructive scrutineers.

4.

Apologies for Absence/Replacement Members

Minutes:

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

 

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

 

An apology for absence was also received from Councillor S Woolley, (Executive Councillor for NHS Liaison and Community Engagement).

5.

Declaration of Members' Interest

Minutes:

There was no declaration of members' interest made at this stage of the meeting.

6.

Minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 17 June 2020 pdf icon PDF 265 KB

Minutes:

RESOLVED

 

That the minutes of the Health Scrutiny Committee for Lincolnshire meeting held on 17 June 2020 be agreed and signed by the Chairman as a correct record.

7.

Chairman's Announcements pdf icon PDF 199 KB

Additional documents:

Minutes:

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

 

The supplementary announcements provided information on the following four items:

 

·               Fishtoft Road Dialysis Unit, Boston;

·               Review of Renal Services;

·               Powers for Local Authorities During Covid-19; and

·               Parking at Hospitals.

 

The Chairman also advised the Committee that if they were in agreement, he would send a letter to Dr Jason Wong, congratulating him on his recent appointment as Deputy Chief Dental Officer for England.

 

The Committee noted that following a request from presenters, it was the Chairman's intention to reverse items 7 and 8, and therefore item 8 would be then next item on the agenda.

 

RESOLVED

 

1.      That the Supplementary Chairman's announcements and the Chairman's announcements as detailed on pages 15 and 16 of the report pack be noted.

 

2.      That on behalf of the Committee, a letter be sent to Dr Jason Wong, congratulating him on his appointment as Deputy Chief Dental Officer for England.

8.

Lincolnshire Partnership NHS Foundation Trust: Child and Adolescent Mental Health Services (CAMHS) pdf icon PDF 747 KB

(To receive a report from Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, which updates the Committee regarding the impact of the new model of care (interim home treatment team) so far in supporting the needs of Lincolnshire children and young people in the absence of a General Adolescent Unit inpatient facility in the county)

Minutes:

The Committee was advised that Item 8 could be found on pages 25 to 35 of the agenda pack. 

 

It was noted that a decision to close Ash Villa South Rauceby School (attached to the Ash Villa Unit) was due to be made on 31 July 2020 by Councillor Mrs P A Bradwell OBE, (Executive Councillor for Adult Care, Health and Children's Services), as there were no pupils on roll at the school.

 

The Chairman advised that there were three contributors for this item: Jane Marshall, Director of Strategy Lincolnshire Partnership NHS Foundation Trust, Deborah Hussey, Improvement and Assurance Lead for Specialist Services, Lincolnshire Partnership NHS Foundation Trust and Siu-Ann Pang, Head of Mental Health, Learning Disability & Autism Specialised Commissioning, NHS England & NHS Improvement Midlands.

 

The Director of Strategy, Lincolnshire Partnership NHS Foundation Trust highlighted to the Committee that a new model of care had been designed as a potential solution to improve Child and Adolescent Mental Health Service (CAMHS) care in Lincolnshire from March 2020.  However, when the Ash Villa CAMHS Inpatient Unit near Sleaford was suddenly temporarily closed in October 2019, due to a lack of medical cover, the mobilisation of the planned new model of care was brought forward, with the interim intensive home treatment team commencing the service on 4 November 2019, ahead of the planned date of March 2020.

 

The Committee noted that the 13 bedded unit at Ash Villa was commissioned by the NHS England Specialist Commissioning Team.  The young people who had been in receipt of care at Ash Villa were aged between 13 to 18 years of age and had severe and /or complex mental disorders. 

 

It was noted that since the Committee had given consideration to the pilot at its meeting on 22 January 2020, the outcomes of the new model of care were:

 

·               There had been no serious incidents;

·               There had been two out of area patient admissions to General Adolescent Units during the five months of 2019/20, since Ash Villa had been temporarily closed, compared to 22 in the same time period in 2018/19.  It was highlighted this had resulted in one of the patients travelling to Northampton and the other patient having to travel to Bristol;

·               The Service had done everything it could to minimise the number of children and young people travelling out of area.  Confirmation was given that at the time of writing the report, there were no Lincolnshire children and young people out of area;

·               There were approximately 2,100 Lincolnshire children using the service at any one time;

·               There had been a significant reduction in length of stay;

·               The number of occupied bed days were reducing; and

·               That positive feedback from patients and carers had increased.

 

During discussion, the Committee raised the following points:

 

·               Out of hour's provision – The Committee noted that the model of delivery was based on service availability seven days a week from 08:45 to 19:00.  Confirmation was given that out of hours provision was available 24/7;

·               Respite provision -  ...  view the full minutes text for item 8.

9.

Lincolnshire Partnership NHS Foundation Trust: Response to Covid-19 pdf icon PDF 1 MB

(To receive a report from Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, which provides the Committee with some of the response and impact of Covid-19 for patients served by Lincolnshire Partnership NHS Foundation Trust)

Minutes:

The Chairman invited Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust (LPFT) and Deborah Hussey, Quality Improvement and Assurance Lead for Specialist Services, Lincolnshire Partnership NHS Foundation Trust to present the report.  The report was detailed on pages 17 to 23 of the report pack.

 

The Committee was advised that some examples of service changes in respond to the pandemic were shown on pages 18 and 19 of the report pack.  It was highlighted that services had been adapted to ensure that the organisation remained responsive to its patients, whilst respecting the restrictions in place.

 

It was reported that levels of patients being referred to the services had reduced during the lockdown period, but the number of people being seen by LPFT services had remained the same. Details of activity and performance statistics were provided on page 20 of the report pack.  It was highlighted that the number of people being seen by digital and telephone contacts had increased, as the model of delivery changed during the crisis.

 

In conclusion, it was highlighted that the Trust had adapted its service delivery to meet patient needs during lockdown; ensured that key delivery targets were met; established staff well-being support, which included the Black, Asian and Minority Ethnic (BAME) workforce; set up recovery and restoration processes to move to the 'new normal' way of working; and the completion of a questionnaire to gauge staff and patient experiences of working during the Covid-19 pandemic.

 

During discussion, the Committee raised the following points:

 

·               The effect of the pandemic on the service – The Committee was advised that modelling had suggested that the effects of the pandemic on mental health would be seen for up to ten years.  The Committee noted that a recovery plan was being developed for Lincolnshire, which included a universal offer of support relating to emotional wellbeing.  The Committee was advised that plans were in place and work was in progress; and that by working together with other organisations the Trust would through its restoration process be looking at different ways of spotting early signs of need and then providing services earlier.  The Committee was advised that an update on the offer could be considered by the Committee at a future meeting;

·               The effect of social distancing on the service – The Committee was advised that ten acute adult mental health beds had been taken out of wards to ensure compliance with social distancing;

·               It was highlighted that page 19 of the report pack made reference to a 'mothballed inpatient unit', which was currently being explored as a temporary unit.  The Committee was advised that this referred to Ash Villa during Covid-19 being used as a possible temporary accommodation unit; and

·           Support for staff – The Committee was reassured that all steps were being taken to provide support to staff, which included testing; additional psychological support services to provide staff with emotional support; more support for staff experiencing domestic abuse; and a special programme of work, led by the  ...  view the full minutes text for item 9.

10.

Lincolnshire Partnership NHS Foundation Trust: Older Adult Home Treatment Service pdf icon PDF 161 KB

(To receive a report from Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, which provides the Committee with an update on how Lincolnshire Partnership NHS Foundation Trust through its clinical teams is currently testing a new service development to introduce a Home Treatment Team for Older Adults, accessing functional mental health care)

Minutes:

The Chairman highlighted to the Committee that information pertaining to this item could be found on pages 37 to 40 of the report pack.

 

The Chairman advised that there were three contributors for this item: Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, Deborah Hussey, Quality Improvement and Assurance Lead for Specialist Services, Lincolnshire Partnership NHS Foundation Trust and Steve Roberts, Associate Director of Operations, Older Adult Services, Lincolnshire Partnership NHS Foundation Trust.

 

The Associate Director of Operations, Older Adult Services, Lincolnshire Partnership NHS Foundation Trust presented the report and made reference to the Older People Home Treatment Team Outcomes as detailed on pages 38 to 40 of the report pack.  It was highlighted the model had reduced in-patient admissions and the number of patients treated out of area; it had also provided improved treatment efficiency; improved patient wellbeing; reduced clinical incidents; and reduced medication use.

 

The Committee was advised that the Older People Home Treatment Team pilot over the last 18 months had proven to be successful across all performance, financial and quality indicators.  It was highlighted that a process of consultation (or targeted engagement) was now required in order to consider the Home Treatment model as a permanent arrangement taking into account staff, carer, patients and stakeholder views.

 

During discussion, the Committee made the following comments:

 

·               Need for the service – The Committee noted that it was difficult to foresee need going forward, but it was anticipated that need would increase.  It was highlighted that the service was not standalone; and that a continuous care pathway in mental health had been set up, It was noted further that a single point for decision making had been introduced across the pathway, to help decisions to be made in a timely manner;

·               Joint working – The Committee was advised that the service worked with a network of services and providers across the county;

·               Positive effects of Covid-19 -  It was noted that there had been positives from the pandemic, one in particular was that of community engagement; and the need to try to perpetuate some of the enthusiasm going forward,  as part of the universal offer;

·               Older Adult Home Service Treatment Service and the definition of Age for Older. The Committee was advised that the Home Treatment Team dealt with the most acute patients, who did not need to be in hospital; and that contact through the pandemic had continued to be face to face.  It was noted that the other mental health teams, had experienced a reduction in demand; and the service looked at alternative ways to being able to provide the service required.  As mentioned earlier in the item a digital offer was made, as was telephone calling; all patients were monitored and received contact.  Clarification was given that for dementia there was no age limit and that the term older age had traditionally referred to someone 65 and above, but services were largely offered irrespective of age;

·               Ward Provision – Confirmation was given that only  ...  view the full minutes text for item 10.

11.

Integrated Urgent Care in Lincolnshire

(To consider a report from Lincolnshire Community Health Services NHS Trust on the integrated urgent care in Lincolnshire.  Maz Fosh, the Trust's Chief Executive and Tracy Pilcher, Director of Nursing and Deputy Chief Executive, will be in attendance for this item)

Additional documents:

Minutes:

The Chairman advised that the report for this item had been circulated separately by email to all members of the Committee.

 

The Chairman advised further that there were two contributors for this item: Maz Fosh, (Chief Executive, Lincolnshire Community Health Services NHS Trust) and Tracy Pilcher, (Director of Nursing, Lincolnshire Community Health Services NHS Trust).

 

The Committee received an introduction from the Chief Executive, Lincolnshire Community Health Services NHS Trust, which provided an update on the Integrated Urgent Care Services in Lincolnshire, which was in line with the integrated urgent care commissioning standards, which sought to bring urgent care access, treatment and clinical advice into a much closer alignment through a consistent and integrated NHS 111 service model. Details of the Lincolnshire integrated urgent care delivery model was included in paragraph one of the report.

 

In guiding the Committee through the report, the Director of Nursing, Lincolnshire Community Health Services NHS Trust made reference to:

 

·               NHS England's twenty seven standards for Urgent Treatment Centres (UTCs) the Trust had to meet, to ensure that a consistent service was provided to the public.  It was noted that the standards specified that UTCs should be integrated with local urgent care services, usually led by general practitioners and should be ideally located with primary care facilities.  Details of the nationally mandated UTC standards were shown in paragraph 2 of the report;

·               How Lincolnshire Community Health Services were delivering its elements of urgent care; and how this was being achieved.  Paragraph 4 of the report provided the Committee with details relating to the significant amount of transformation that was taking place to move to the integrated model.  It was noted that the Clinical Assessment Service (CAS) was well established and was operating 24/7 365 days a year providing phone based clinical advice and guidance with timely call backs to patients to support care, closer to home. The Committee noted further that e-consultations (video conferencing) had been introduced within CAS for those patients wishing to use it.  The Committee was advised that the Louth and Skegness UTCs had gone live in October 2019; and Lincoln and Boston UTCs had gone live in December 2019.  It was also highlighted that the re-building of Boston UTC had commenced.  Further transformational changes were shown within paragraph 4 of the report;

·               The Committee noted the changes made during Covid-19.  The changes had included an increase in the daily CAS activity of 21%, increasing daily cases to 399; a reduction in attendances at Gainsborough and Spalding Minor Injuries units; a reduction in attendance at Louth and Skegness UTCs; and the designation of Grantham and District Hospital as a temporary UTC (This decision had been taken by the United Lincolnshire Hospitals NHS Trust Board of Directors on 11 June 2020), as part of plans to provide a Covid-19 free 'green' site at Grantham Hospital.

 

During discussion, the Committee raised the following points:

 

·               Some concern was expressed for Grantham & District Hospital to return to having an A&E; and not a temporary  ...  view the full minutes text for item 11.

12.

Correspondence and Other Developments pdf icon PDF 1 MB

(To receive an update from Simon Evans, Health Scrutiny Officer, which provides the Committee with an update on correspondence received and other developments that have happened since the last meeting; and how these issues will be addressed in the Committee's future work programme)

Minutes:

The Chairman advised the Committee that the report for this item could be found on pages 41-57 of the report pack.  The Committee was advised further that to date a response had not been received to the letter sent on behalf of the Committee to the Secretary of State for Health and Social Care

 

The Chairman invited Simon Evans, (Health Scrutiny Officer) to present the report.  The Committee was advised of the action taken by Lincolnshire County Council and South Kesteven District Council relating to the plans for NHS Services in Lincolnshire, in particular the impact of services at Grantham and District Hospital. 

 

Attached at Appendix A to the report was a copy of the letter sent on behalf of the Committee to the Secretary of State for Health and Social Care on 23 June 2020; and at Appendices B and C were copies of letters sent following the Lincolnshire County Council resolution made on 26 June 2020 for the Committee's consideration. 

 

The Committee was advised that once any response was received, a copy would be forwarded on to members of the Committee.

 

RESOLVED

 

1.      That the Committee note that following the Committee's decision on 17 June 2020, a letter had been sent to the Secretary of State for Health and Social Care on 23 June 2020, as shown in Appendix A.

 

2.      That the resolutions passed by Lincolnshire County Council on 26 June 2020 and South Kesteven District Council on 1 July 2020 in relation to NHS Services in Lincolnshire, particularly those services at Grantham and District Hospital be noted.

 

3.      That an update from United Lincolnshire Hospitals NHS Trust on 16 September 2020 on the progress with the restoration plan be noted.

 

4.      That Lincolnshire Clinical Commissioning Group has been requested to report on the Healthy Conversation 2019 engagement exercise and that an update on the Lincolnshire Long Term Plan will be given at the 16 September 2020 meeting, be noted.  

13.

Health Scrutiny Committee for Lincolnshire - Work Programme pdf icon PDF 1 MB

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

Minutes:

The Chairman invited Simon Evans, (Health Scrutiny Officer) to present the report, which was shown on pages 59 to 67 of the report pack.

 

During a short discussion, a suggestion made was for introducing a break in proceedings going forward.  The Chairman agreed to consider this matter at the agenda setting meeting in early September.

 

The Chairman advised the Committee that Liz Ball was retiring from the NHS; and that this would be her last meeting she would be attending.  The Committee was reminded that Liz had been the Committee's special advisor from the NHS, attending each meeting in her role.  On behalf of the Committee the Chairman extended thanks to Liz for her contributions over recent years.

 

RESOLVED

 

          That the work programme presented be received.

 

 
 
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